Vitamin D-Resistant Rickets Type II-A, Basal Ganglia Calcification, and Catatonia: A Casual or Causal Relationship?

Background: Vitamin D-resistant rickets type-IIA (VDRR-IIA) is a rare, congenital, metabolic disorder characterized by hypocalcemia, rickets, and alopecia. There are reports correlating calcium-metabolic disorders with basal ganglia calcification (BGC) and neuropsychiatric symptoms. Objective: The authors document and discuss the relationships of these phenomena. Method: The authors describe a patient born with VDRR-IIA who subsequently developed BGC at age 15, and catatonic symptoms of progressive severity at age 16. Results: There appeared to be a positive correlation between the severity of BGC and neuropsychiatric symptoms. Discussion: This is the first time VDRR-IIA, BGC, and catatonia have been reported in a patient, and the authors discuss the relationship among the conditions. (Psychosomatics 2009; 50: 420-424)

Aves da Estação Ecológica de Itirapina, estado de São Paulo, Brasil

O cerrado é um dos biomas mais ameaçados no mundo, apresentando algumas das maiores taxas de destruição causadas principalmente pela agropecuária. Poucos estudos têm avaliado a diversidade local de aves no cerrado, especialmente em áreas marginais desse bioma. A Estação Ecológica de Itirapina (EEI) contém um dos últimos remanescentes de campos naturais e cerrados do estado de São Paulo. Um levantamento das aves desta unidade de conservação, feito tanto por observações casuais como sistemáticas entre 1998 e 2007, e complementado por revisão de literatura, revelou que 231 espécies apresentaram ocorrência recente na área. Desse total, 38 espécies (16,4%) encontram-se na lista de espécies ameaçadas para o estado de São Paulo e/ou são endêmicas do Cerrado, um alto número quando comparado com outras áreas de cerrados paulistas ou mesmo em relação ao Brasil Central. Tal fato reforça a importância da EEI em relação à conservação da avifauna e demonstra que a mesma está mantendo sua função de conservar a biodiversidade. Adicionalmente, ao longo dos 10 anos de estudo foram detectadas várias ameaças à EEI, e neste sentido são recomendadas aqui algumas sugestões de manejo que consideramos essenciais para essa unidade de conservação manter ou mesmo aumentar sua diversidade de aves.

Idade e uso de preservativo na iniciação sexual de adolescentes brasileiros

OBJETIVO: Analisar a idade e o uso do preservativo na iniciação sexual de adolescentes brasileiros em dois períodos: 1998 e 2005. MÉTODOS: Amostras representativas da população urbana brasileira foram entrevistadas em inquérito domiciliar por duas pesquisas, realizadas em 1998 e 2005. Dentre os entrevistados, 670 jovens (16 a 19 anos) sexualmente ativos foram selecionados para o estudo, 312 de 1998 e 358 de 2005. Para análise dos dados ponderados foram utilizados o teste qui-quadrado de Pearson e o teste exato de Fisher (±<5%). RESULTADOS: Em 2005, 61,6% dos jovens entrevistados tinham iniciado-se sexualmente, cuja idade média foi 14,9 anos, sem diferenças significativas para os jovens entrevistados em 1998. O uso de preservativo na primeira relação sexual aumentou significativamente em relações estáveis (48,5% em 1998 vs. 67,7% em 2005) e casuais (47,2% em 1998 vs. 62,6% em 2005) em quase todos os segmentos. Persistiram as diferenças relacionadas à iniciação sexual e ao uso de preservativos segundo gênero, cor da pele e escolaridade, tal como observado em 1998. A diminuição no uso de preservativo entre os jovens que se iniciaram sexualmente antes dos 14 anos, em todos os contextos de parceria, foi expressiva na região Sudeste e entre os mais escolarizados. CONCLUSÕES: Como em outros países, observou-se tendência à estabilização da idade da iniciação sexual entre jovens de 15 a 19 anos. O adiamento do início da vida sexual, mais freqüente entre os jovens mais escolarizados, deve ser tema discutido no planejamento da educação dos adolescentes para a sexualidade e prevenção das IST. Quanto à diminuição da vulnerabilidade ao HIV, é relevante e significativo o incremento no uso de preservativo na iniciação sexual.

Concentrações de vitamina A no leite humano e características socioeconômicas e nutricionais maternas: resultados de estudos brasileiros

OBJETIVOS: agregar e discutir os resultados de estudos realizados no Brasil que avaliaram a concentração de vitamina A no leite materno. FONTES DOS DADOS: foram pesquisadas as bases LILACS, Banco de Teses da Capes, SciELO (Scientific Electronic Library), e Plataforma Lattes -seção de produção científica. As palavras-chaves utilizadas foram: gestantes, lactante, concentração de vitamina A no leite humano, Brasil. As buscas foram realizadas em 2006 e atualizadas em março de 2008. Foram incluídos todos os estudos localizados. SÍNTESE DOS DADOS: foram localizados 14 estudos, publicados entre 1988 e 2008, heterogêneos quanto ao tamanho da amostra, fase do leite, período do dia da coleta e método de determinação das concentrações de vitamina A. Foram descritas concentrações médias de vitamina A no leite humano entre 0,62 e 4,50 µmol/L. CONCLUSÕES: não houve consenso sobre a relação entre concentração de vitamina A no leite humano e vitamina A dietética, estado nutricional materno, características obstétricas e demográficas e duração da gestação. Sugere-se que estudos futuros utilizem, amostras de leite maduro, coletadas aleatoriamente ao longo dos diferentes períodos do dia, e a utilização do high performance liquid chromatography - HPLC - como método de determinação de vitamina A.

Surrealismo à mineira

Marginal poetry (poesia marginal) has motivated several studies concerning features common to some poets in the literary scene of the nineteen seventies. On the part of contemporary criticism, however, the focus has been on specific details of each writer from that period. The poet Afonso Henriques Neto debuted with the book 0 misterioso ladrao de Tenerife (1972), written in partnership with Eudoro Augusto, and has revealed an influence of surrealist procedures in all his works published since then. The largely casual style and everyday themes are present in several of his texts, where they coexist with prolific imagery and unusual elements which point out the central conflict of his poetry: the oscillation between the affirmation of the intrinsic value of literature, and the perception of its crisis in a peculiar historical moment. In this sense, we consider how the appropriation of the surrealist denial of rationalism and common sense by the Beat Generation and the counterculture ""filtered"" the reception of the avant-garde movement, influencing the poet's work.

Horizontal alliances amongst small retailers in Brazil

Purpose - Application of the horizontal alliance paradigm has particularly relevance to small retailers. It is a powerful mechanism for independents and non-integrated chain retailers to develop competitive advantage, maintaining and improving their performance. The purpose of this article is to analyse the theory of alliance in the context of the retail sector. Design/methodology/approach - Both quantitative and qualitative research was carried out with horizontal retail alliances in Brazil. Findings - Focusing on the alliances among independents and non-integrated chain retailers, our discussion covers specifically the following issues: the reasons for forming a strategic alliance in retail; minimum criteria for the alliance activity amongst retailers; steps that managers must take to create a competitive retail alliance; critical core competencies to be developed on the retail alliance; types of retail alliances; and, finally, forms of strategic retail alliances and stages/steps to develop a retail alliance over time. Research limitations/implications - The study considers horizontal alliances in a Brazilian retail context, which is in some ways unique, however, key principles and findings are very much transferable. Practical implications/implications - The study is of value not only to researchers of retail horizontal alliances, but offers retail practitioners specific experience and guidance. Originality/value - It was identified from the literature that there have been relatively few theoretical and practical studies available that analyse the relationship between the outlined themes concerned with alliances and small retailers. The discussion in our paper provides useful information and new insights to both academics and practitioners.

Home and Ambulatory Blood Pressure to Identify White Coat and Masked Hypertension in the Pediatric Patient

OBJECTIVE To evaluate the effect of the environment and the observer on the measurement of blood pressure (BP) as well as to compare home BP (HBP) and ambulatory BP (ABP) measurements in the diagnosis of white coat hypertension (WCH) and masked hypertension (MH) in children and adolescents with hypertension (HT). METHODS BP of 40 patients with HT (75% of which had secondary HT and were on antihypertensive medication), mean age 12.1 years was evaluated through casual measurements at the clinic and at the HT unit, HBP for 14 days with the OMRON HEM 705 CP monitor (Omron, Tokyo, Japan) and ABP performed with SPACELABS 90207 (Spacelabs, Redmond, WA), for 24 h. RESULTS HT was diagnosed at the doctor`s office by ABP and HBP in 30/40, 27/40, and 31/40 patients, respectively. Based on office BP and ABP, 60% of patients were normotensive, 17.5% HT, 7.5% had WCH, and 15% had MH, whereas based on office BP and HBP 65, 12.5, 10, and 12.5% of patients were classified according to these diagnoses, respectively. There was considerable diagnostic agreement of HT by ABP and HBP (McNemar test, P < 0.01) (kappa = 0.56). CONCLUSION In hypertensive children and adolescents, HBP and ABP present comparable results. HBP appears to be a useful diagnostic test for the detection of MH and WCH in pediatric patients.

Obstructive Sleep Apnea, Masked Hypertension, and Arterial Stiffness in Men

BACKGROUND Obstructive sleep apnea (OSA) is an established cause of hypertension However, it is not clear whether the frequency of masked hypertension in patients with OSA and whether OSA have an independent role on arterial stiffness taking into account ambulatory blood pressure (BP) monitoring (ABPM) METHODS We evaluated 61 male normotensive participants as determined by casual clinic BP level <140/90 mm Hg without clinical evidence of cardiovascular disease and on no medications (43 patients with moderate-to-severe OSA (apnea-hypopnea index (AHI) >= 15 events/hour by polysomnography) and 18 age- and body mass index-matched controls without OSA (AHl <5 events/hour)) Pulse wave velocity (PWV), an index of arterial stiffness, and 24-h ABPM were performed in a blinded fashion Masked hypertension was defined when abnormal daytime ABPM was >= 135 or >= 85 mm Hg RESULTS The AHI and lowest oxygen saturation were 26 +/- 16 and 90 +/- 2 vs 528 +/- 210 events/hour and 75 +/- 10% for controls and OSA patients, respectively, P < 0 001. Compared with controls, patients with OSA had higher office systolic BP (113 +/- 9 vs 118 +/- 10 mm Hg, P=0 05) and a higher unadjusted proportion of masked hypertension (2 controls (11.1%)vs 13 patients (30 2%), P < 005) PWV was 87 +/- 0.7, 9.4 +/- 1.0, and 10.6 +/- 1.1 m/s in the control, OSA without and with masked hypertension groups, respectively (P < 0 01 for each comparison) Multiple regression showed that systolic daytime ABPM and the lowest oxygen saturation were independently related to PWV (adjusted R(2) = 0 34, P < 0 01) CONCLUSIONS Patients with OSA presented a higher unadjusted rate of masked hypertension than matched controls. Lowest oxygen saturation has an independent association with arterial stiffness