published_or_final_version / Anatomy / Doctoral / Doctor of Philosophy

published_or_final_version / Dentistry / Doctoral / Doctor of Philosophy

Removal of the pineal gland from partially parathyroidectomized rats produces stereotyped violent seizures. Inasmuch as the neurotransmitter norepinephrine (NE) has been implicated in this experimental paradigm, the purpose of this study was to investigate the effect of specific alterations in catecholamine function on convulsions produced by pinealectomy (PinX). Additionally, the role of various pineal substances, sex differences and the caging paradigm in the convulsive response was studied. Male and female rats (grouped five per cage) were found to respond similarly to the convulsive stimulus of parathyroidectomy followed by PinX. Neither implants of melatonin nor ventricular injections of arginine vasotocin in isolated and grouped rats, respectively, produced consistent changes in convulsions from PinX. The method of caging the rats after PinX, however, dramatically influenced seizures. Isolated rats (one per cage) convulsed significantly later after PinX and did so less often than grouped (five per cage) controls. NE neurotransmission appears to play a strong role in influencing PinX-induced seizures. Augmenting NE function with desipramine suppressed seizures. Convulsions were enhanced by the (beta)-receptor antagonist timolol, while neonatal injections of the catecholamine neurotoxin 6-OHDA potentiated seizures so markedly that many rats died from just one convulsion. NE levels were significantly reduced in the telencephalons and increased in the brain stems of sham-pinealectomized rats which had also received neonatal 6-OHDA; telencephalic levels of DA were elevated by 6-OHDA. Both the proconvulsant effects of 6-OHDA and the alterations it produced in central catecholamine levels were prevented, for the most part, by pretreatment with DMI. Altering both NE and DA function with L-dihydroxyphenylalanine, (alpha)-methyl-p-tyrosine, FLA-63 or reserpine did not significantly affect PinX-induced seizures in isolated rats. NE appears to play a strong role in modulating PinX-induced seizures; however, a deficit in NE function per se does not seem to be the fundamental cause of the seizures since sham-pinealectomized rats having lowered NE and/or DA function did not convulse.

Prediction for future coronary artery disease (CAD) from high-density lipoprotein (HDL) and triglyceride (TG) measurements are based off of a single measurement that has been shown to be variable. To better determine risk for CAD based on blood lipids, studies in the postprandial state are warranted. To assess the reproducibility of TG clearance, 10 men underwent three trials of a 70g oral fat loading test with blood samples collected every two hours for eight hours. These trials were all scheduled at least one week apart. Men who had fasting TG concentrations > 250 mg - dL -' were excluded from the study. Each subject presented to the laboratory having abstained from exercise for 24 hours and alcohol 72 hours prior to the upcoming trial. Each subject was also provided with a standardized frozen dinner to eat the night before at a time which allowed the subject to be 12 hours fasted for the next days' trial. To specifically assess postprandial lipemia, TG concentrations were plotted against bi-hourly collection times to form a curve. The area under this curve was then calculated to determine PPL area. Itwas found that there was no significant difference in area under the TG curve (p = 0.25) for any of the three trials (1096 ± 168, 948 ± 105, and 995 ± 127 mg - dL -' - 8 • hr-' respectively for trials one, two, and three). Pearson correlations between trials were 0.79 for trials one and two, 0.82 for trials two and three, and 0.90 for trials one and three. Also, there was no significant difference in peak TG (p = 0.34) on each of the three trial days (167 ± 27, 150 ± 16, and 151 ± 19 mg • dL -1 in peak TG for trials one, two, and three respectively). Time taken to reach peak TG concentrations (p = 0.20) or time to return to baseline TG (p = 0.27) were not significantly different across three trial days. The men in this study reached peak TG concentrations in this study in 3.2 ± 0.5, 4.0 ± 0.4, 4.0 ± 0.3 hours respectively for trials one, two, and three. Time to return to baseline was 6.8 ± 0.6, 7.4 ± 0.4, 7.8 ± 0.4 hours for trials one through three respectively. Correlations between trials and the lack of a difference between trials using repeated measures ANOVA in regards to PPL area gives some preliminary evidence that some postprandial measures such as PPL area and can be reproduced across trials. However, the intra-individual variation was 19 ± 4% which provides no additional support for reproducibility of PPL. Additionally, results from this study, as well as all others pertaining to the study of reproducibility of PPL are specific to the protocol used and the method of interpretation. / School of Physical Education

The purpose of the present study was to compare the scores of the Beck Depression Inventory, State-Trait Anxiety Inventory, and the Coopersmith Inventory of heterosexual men with compulsive sexual behavior (N = 22), homosexual men with compulsive sexual behavior (N = 19), heterosexual men without compulsive sexual behavior (N = 38), and homosexual men without compulsive sexual behavior (N = 8). The Sex Addiction Screening Test was used to determined placement in a group. Findings revealed men who exhibit compulsive sexual behavior are significantly more depressed, experience lower self-esteem and have higher state anxiety (situational) than controls.

M.A. (Psychology) / Please refer to full text to view abstract

RNA-Sequencing (RNA-Seq) has become one of the most widely used techniques to interrogate the transcriptome of an organism since the advent of next generation sequencing technologies [1]. A plethora of tools have been developed to analyze and visualize the transcriptome data from RNA-Seq experiments, solving the problem of mapping reads back to the host organism's genome [2] [3]. This allows for analysis of most reads produced by the experiments, but these tools typically discard reads that do not match well with the reference genome. This additional information could reveal important insight into the experiment and possible contributing factors to the condition under consideration. We introduce PARSES, a pipeline constructed from existing sequence analysis tools, which allows the user to interrogate RNA-Sequencing experiments for possible biological contamination or the presence of exogenous sequences that may shed light on other factors influencing an organism's condition.

This thesis focuses on the possibilities for influencing the motivation of pupils with specific learning disabilities during special pedagogical interventions conducted at schools. The aim of this study is to determine which of the approaches used by specialised pedagogues within the field of specialised pedagogical practice are most effective in increasing the motivation of pupils with learning disabilities and why. One of the sub-goals of this work is to describe the principles for strengthening motivation in special pedagogical interventions. This thesis is divided into two parts: the teoretical and the research part. The theoretical part deals with specific learning disabilities, terminological definitions, etiology and reeducation. It also focuses on motivation, its types, influencing factors and its application. The research part with the use of qualatitive research methods seeks to explore perception of special pedagogues on the role of motivation and support of pupils with specific learning disabilities motivation during the intervention. Key words Learning disabilities, etiology, re -education, motivation, supporting motivation.

Introdução: A epilepsia é um transtorno neurológico que afeta 50 milhões de pessoas no mundo, mais comum em países de baixa renda. No Brasil, estima-se sua prevalência em 2 milhões de indivíduos com epilepsia crônica ativa, dentre os quais, no mínimo, meio milhão teriam crises epilépticas não controladas. Em 2001, Borges et al., estudando epilepsia na população indígena do Mato Grosso, índios Bakairi, encontraram prevalência de 12,4/1000 habitantes (9 pacientes no total). Objetivo: 1-Estudo sobre a epilepsia na população indígena da aldeia Jaguapirú, no município de Dourados, Mato Grosso do Sul, Brasil, com investigação por eletroencefalograma (EEG) e neuroimagem, ou exames laboratoriais, se necessários. 2- Identificação de eventos paroxísticos não-epilépticos e fatores de risco associados ao desenvolvimento de epilepsia nesta amostra populacional. Metodologia: Após aprovações dos órgãos reguladores e consentimento das autoridades da aldeia Jaguapirú, foi realizado estudo transversal com aplicação de questionário de triagem das famílias residentes na aldeia visitadas por agentes de saúde, com o objetivo de identificar história de crises epilépticas e de epilepsia nesta subpopulação. Os pacientes selecionados como positivos foram submetidos a anamnese e exame físico feitos por neurologista, além de EEG e Tomografia (CT) de crânio, solicitados para todos, e/ou RM de crânio. Foi classificada a síndrome epiléptica e os casos de eventos paroxísticos de origem não epiléptica. Em paralelo, foi realizado estudo tipo caso-controle incluindo pacientes com questionário de triagem negativo para epilepsia, submetidos ao mesmo protocolo, para comparação com o grupo de pacientes, quanto a características sociodemográficos e fatores de risco Resultados: Foram entrevistados 2994 indígenas, 1557 (52,0%) do sexo feminino, com idades variando entre 0 e 98 anos e média de 21,3 anos. Em 71 indivíduos, foi encontrada alguma síndrome epiléptica, com confirmação do diagnóstico de epilepsia em 49 (1,6% da amostra populacional) e de uma síndrome epiléptica autolimitada, em 22 (13 casos de convulsão febril e 9 de crises isoladas na vida). Epilepsia focal foi caracterizada em 35 pacientes (71,4% do grupo de 49 epilépticos), generalizada, em 3 (6,1 %) e indeterminada se focal ou generalizada, em 11 (22,4%). Dentre as epilepsias focais, houve 2 casos de síndromes idiopáticas, respectivamente, do lactente e da infância. As demais compreenderam epilepsias focais sintomáticas ou provavelmente sintomáticas, sendo 19 casos de origem temporal (38,7%), 6 frontais (12,2%), 3 multifocais (6,1%), 2 parietais (4,0%) e 3 de origem não definida. As epilepsias generalizadas foram 2 casos idiopáticos com crises tônico-clônicas e 1 de epilepsia mioclônica juvenil (EMJ). A etiologia foi indeterminada em 41 casos (83,6%), sendo o traumatismo craniano, a encefalopatia hipóxico-isquêmica e malformações, vascular e cortical, as demais causas. Nosindígenas não portadores de epilepsia, 82 questionários de triagem foram positivos em decorrência de eventos paroxísticos de origem não epiléptica, predominando entre estes as crises de natureza psicogênica e a síncope. O grupo controle incluiu 84 indivíduos e, na comparação com os grupos de epilépticos e de convulsão febril, foram observadas diferenças significativas quanto ao gênero (predomínio do sexo feminino nos controles), à idades, média e mediana, (maior nos controles) e à classe socioeconômica (C2, predominante nos controles; D e E, nos demais), tendo havido predomínio significativo de retardo no desenvolvimento neuropsicomotor entre os epilépticos (p=0,045). O EEG (231 registros nos 5 anos de estudo / 2 a 4 por paciente portador de epilepsia) contribuiu para a definição do tipo de epilepsia em 24 pacientes (48,9%), 23 epilépticos focais e 1 com EMJ, sendo normal em 22 (44,8%). A ocorrência de \"cluster\" de crises foi identificada em 21 (42,8%) dos pacientes e status epilépticos em 14 (28,5%), tendo havido associação significativa entre o antecedente de \"cluster\" e a ocorrência de status (p<0,001). Apenas 11 pacientes realizaram os exames de neuroimagem solicitados no período. Quarenta e três (87,7%) pacientes se beneficiaram do tratamento com fármaco antiepilépticos (FAE), de primeira geração e em monotropia, tendo remissão ou melhora das crises: remissão completa em 16 (32,6%) e melhora na morbidade ou frequência das crises, em 27 (55,1%). A epilepsia inativa foi considerada em 9 (18,3%), dos 49 pacientes. Conclusão: A prevalência de epilepsia na amostra da população indígena brasileira estudada foi de 1,6%, similar à da população nacional, sendo mais frequente a epilepsia focal e, nesta, a de origem temporal, com apenas 3 casos de epilepsia generalizada idiopática. A prevalência aproximada de convulsão febril foi de 0,4%, taxa inferior à da população geral, o que pode decorrer da natureza transversal do estudo. Observou-se ótima resposta terapêutica aos FAE de primeira geração e em monoterapia. O atraso no desenvolvimento neuropsicomotor foi achado relacionado à epilepsia e a presença de \"cluster\" de crises relacionou-se com presença de status epiléptico no curso da epilepsia. Entre os eventos de natureza não epiléptica, prevaleceu a crise psicogênica, seguida pela síncope. / Introduction: Epilepsy is a neurological disorder that affects 50 million people worldwide, most common in low-income countries. In Brazil, its prevalence is estimated in 2 million individuals with active chronic epilepsy, among which at least half a million would have uncontrolled epileptic seizures. In 2001, Borges et al., Studying epilepsy in the indian population of Mato Grosso, Bakairi Indians, found a prevalence of 12.4 / 1000 inhabitants (9 patients in total). Objective: 1-Study on epilepsy in the indian population of the Jaguapirú village, in the city of Dourados, Mato Grosso do Sul, Brazil, with electroencephalogram (EEG) and neuroimaging, or laboratory tests if necessary. 2- Identification of non-epileptic paroxysmal events and risk factors associated with the development of epilepsy in this population sample. Methodology: After approvals of the regulatory bodies and consent of the Jaguapirú village authorities, a cross-sectional study with a screening questionnaire was applied to families living in the village monitored by health agents, with the objective of identifying the history of seizures and epilepsy in this subpopulation. The patients selected as positive were submitted to anamnesis and physical examination done by a neurologist, in addition to EEG and CT of the skull, requested for all, and / or MRI of the skull. Epileptic syndrome and cases of paroxysmal non-epileptic events were classified. In parallel, a case-control study was conducted, including patients with a negative screening questionnaire for epilepsy, submitted to the same protocol, for comparison with the group of patients, regarding socio-demographic characteristics and risk factors Results: A total of 2994 natives were interviewed, 1557 (52.0%) female, with ages ranging from 0 to 98 years and mean of 21.3 years. In 71 individuals, some epilepsy syndrome was found, with confirmation of the diagnosis of epilepsy in 49 (1.6% of the population sample) and a self-limited epileptic syndrome in 22 (13 cases of febrile convulsion and 9 isolated seizures in the life). Focal epilepsy was characterized in 35 patients (71.4% of 49 epileptics), generalized in 3 (6.1%) and undetermined focal or generalized in 11 (22.4%). Among the focal epilepsies, there were 2 cases of idiopathic syndromes, respectively, of infants and infants. The others included focal or symptomatic focal epilepsies, with 19 cases of temporal origin (38.7%), 6 frontal (12.2%), 3 multifocal (6.1%), 2 parietal (4.0%) and 3 of undefined origin. Generalized epilepsies were 2 idiopathic cases with tonic-clonic seizures and 1 juvenile myoclonic epilepsy (JME). The etiology was undetermined in 41 cases (83.6%), with cranial trauma, hypoxic-ischemic encephalopathy and vascular and cortical malformations, the other causes. In the non-epileptic Indians, 82 screening questionnaires were positive due to paroxysmal events of non-epileptic origin, predominantly psychogenicseizures and syncope. The control group included 84 individuals and, in comparison with the epileptic and febrile seizure groups, significant differences were observed regarding gender (predominance of females in controls), ages, median and median (higher in controls) and (C2, predominant in the controls, D and E, in the others). There was a significant predominance of neuropsychomotor retardation among epileptics (p = 0.045). EEG (231 records in the 5 years of study / 2 to 4 per patient with epilepsy) contributed to the definition of the type of epilepsy in 24 patients (48.9%), 23 focal epileptics and 1 with JME, being normal in 22 (44.8%). The occurrence of cluster of seizures was identified in 21 (42.8%) patients and status epileptics in 14 (28.5%), and there was a significant association between the antecedent cluster and the occurrence of status (p <0.001). Only 11 patients underwent the neuroimaging tests requested in the period. Forty-three (87.7%) patients benefited from antiepileptic drug therapy (SAF), first-generation monotherapy, remission or improvement of seizures: complete remission in 16 (32.6%) and improvement in morbidity or frequency of seizures in 27 (55.1%). Inactive epilepsy was considered in 9 (18.3%) of the 49 patients. Conclusion: The prevalence of epilepsy in the sample of the Brazilian indian population studied was 1.6%, similar to that of the Brazilian population, with focal epilepsy being the most frequent and, in this case, temporal origin, with only 3 cases of generalized idiopathic epilepsy. The approximate prevalence of febrile seizure was 0.4%, a rate lower than that of the general population, which may be due to the transversal nature of the study. An optimal therapeutic response was observed for first generation AEDs and monotherapy. Neuropsychomotor delay was finding related to the group of epileptic patients and the presence of cluster of seizures was significantly related to the occurrency of status epilepticus in epileptic patients. Among the events of non-epileptic origin, there was a predominance of psychogenic seizures followed by syncope.

INTRODUÇÃO: A infecção pelo vírus C é um grande problema de saúde pública e tem se tornado a principal indicação de transplante de fígado. Com uma distribuição universal, é a segunda doença crônica viral mais frequente no mundo. No entanto, a hepatite C crônica é mais que uma doença hepática. Pacientes com infecção crônica pelo HCV podem desenvolver um grande número de manifestações extra-hepáticas independentemente da gravidade da doença hepática. Há muitas doenças reumatológicas associadas à infecção pelo HCV, incluindo artralgia, mialgia e artrite. MÉTODOS: Um estudo transversal desenvolvido entre os pacientes atendidos no Ambulatório de Hepatites da Divisão de Clínica de Moléstias Infeciosas e Parasitárias do HCFMUSP, na cidade de São Paulo, no período de 2004 a 2008, selecionou 243 pacientes que preencheram os critérios de inclusão e assinaram o termo de consentimento após esclarecimentos sobre a pesquisa. Foi realizada uma entrevista com os pacientes, em que foram coletadas informações demográficas, epidemiológicas e clinico-laboratoriais. Foram realizados exames laboratoriais, bioquímicos, hematológicos, imunológicos, PCR, HCV, RNA quantitativo e genotipagem do HCV. A avaliação das características da infecção pelo HCV (epidemiológica, histológica, virológica), associada às manifestações extra-hepáticas clínicas reumatológicas (aquelas com prevalência > 10%) e laboratoriais (com prevalência > 5%), foi realizada utilizando-se as análises univariada e multivariada (regressão logística). Odds ratios (OR) ajustados e intervalos de confiança de 95% (IC 95%) foram derivados do coeficiente do modelo logístico multivariado final. Todas as análises foram realizadas com o pacote estatístico SPSS. RESULTADOS: Dos 243 pacientes estudados, pudemos determinar a provável forma de infecção em 147 (60,49%). Dos 147 pacientes, 93 (38,27%) sofreram transfusão sanguínea prévia, 10 (4,11%) tinham histórico de uso droga injetável há mais de 1 ano, 15 (6,17%) tinham antecedente de uso do droga inalatória há mais de 1 ano, 11 (4,52%) eram profissionais da saúde com histórico de acidente com material perfuro-cortante, 10 (4,11%) realizaram tatuagem e 8 (3,29%) tinham parceiro portador de hepatite C crônica. Nessa análise, 148 (60,9%) dos pacientes com hepatite C crônica apresentaram queixa de artralgia, 145 (59,7%) apresentaram queixa de mialgia, 144 (59,3%), de cansaço. A artrite esteve presente em 50 (20,57%) dos pacientes avaliados nesse estudo. Dentre estes pacientes, o envolvimento foi predominantemente poliarticular em 36 (72%) deles, acometendo grandes e pequenas articulações, simultaneamente, em 29 (58%). Idade maior que 50 anos, dor nas costas e crepitação em articulações mostraram-se fatores associados à artrite. Observou-se que sexo feminino, tabagismo importante e fibrose hepática avançada (F3 e F4) foram fatores associados à artralgia. Sexo feminino e tabagismo importante foram fatores associados à mialgia. CONCLUSÃO: Foi encontrada elevada prevalência de manifestações musculoesqueléticas entre os pacientes portadores de hepatite C crônica deste serviço. Os fatores de risco mais frequentes para a presença das manifestações extra-hepáticas foram sexo feminino e idade maior que 50 anos. Os autoanticorpos, embora freqüentes, não mostraram significância estatística com relação às principais manifestações musculoesqueléticas analisadas. Infiltrado inflamatório hepático e nível de transaminases também não apresentaram significância estatística / INTRODUCTION: C virus infection is a major public health problem and has become the leading indication for liver transplantation. With a worldwide distribution, is the second most common chronic viral worldwide. However, chronic hepatitis C is more than a liver disease. Patients with chronic HCV infection may develop a large number of extra hepatic manifestations regardless of the severity of liver disease. There are many rheumatic diseases associated with HCV infection including arthralgia, myalgia and arthritis. METHODS: A cross-sectional study carried out among patients treated in outpatient Hepatitis Clinical Division of Infectious and Parasitic Diseases of the HC-USP, in São Paulo, in the period from 2004 to 2008, selected 243 patients who met the inclusion criteria and signed the consent form after clarification of the research. An interview was conducted with patients which were collected demographic, epidemiological and clinical-laboratory. Laboratory tests were carried, biochemical, hematological, immunological, quantitative PCR HCV RNA and HCV genotyping. The evaluation of the characteristics of HCV infection (epidemiological, histological, virological) associated with extrahepatic manifestations rheumatology clinics (those with prevalence > 10%) and laboratory (with prevalence > 5%) were performed using univariate and multivariate analysis (regression logistics). Odds ratios (OR) and adjusted confidence intervals of 95% (95% CI) were derived from the ratio of the final multivariate logistic model. All analyzes were performed with the SPSS statistical package. RESULTS: Of the 243 patients studied were able to determine the likely form of infection in 147 (60.49%). Of the 147 patients, 93 (38.27%) had previous blood transfusion, 10 (4.11%) had a history of injection drug use for more than 1 years, 15 (6.17%) had prior use of the drug is inhaled over 1 year, 11 (4.52%) were health professionals with a history of accidents with sharp objects, 10 (4.11%) underwent tattooing and 8 (3.29%) had a partner with hepatitis C chronic. In this analysis, 148 (60.9%) of patients with chronic hepatitis C complained of arthralgia, 145 (59.7%) complained of myalgia, 144 (59.3%) of fatigue. Arthritis was present in 50 (20.57%) of the patients evaluated in this study. Among patients with arthritis of this study, involvement was predominantly polyarticular in 36 (72%) of them, affecting large and small joints simultaneously in 29 (58%). Age greater than 50 years, back pain and crepitus in the joints proved to be factors associated with arthritis. We observed that female smoking important and advanced liver fibrosis (F3 and F4) were associated with arthralgia. Female gender and smoking were important factors associated with myalgia. CONCLUSION: We found a high prevalence of musculoskeletal manifestations among patients with chronic hepatitis C of this service. The most common risk factors for the presence of extra hepatic manifestations were female and older than 50 years. The autoantibodies, although frequently not statistically significant compared with the major musculoskeletal manifestations analyzed. Inflammatory infiltrate and liver transaminase levels did not show statistical significance