Analysis of bone microarchitecture related to anthropometry in climateric women

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Response to Treatment in a Prospective Cohort of Patients with Large Ulcerated Lesions Suspected to Be Buruli Ulcer (Mycobacterium ulcerans Disease)

Background: The World Health Organization (WHO) advises treatment of Mycobacterium ulcerans disease, also called Buruli ulcer'' (BU), with a combination of the antibiotics rifampicin and streptomycin (R+S), whether followed by surgery or not. In endemic areas, a clinical case definition is recommended. We evaluated the effectiveness of this strategy in a series of patients with large ulcers of >= 10 cm in longest diameter in a rural health zone of the Democratic Republic of Congo (DRC).Methods: A cohort of 92 patients with large ulcerated lesions suspected to be BU was enrolled between October 2006 and September 2007 and treated according to WHO recommendations. The following microbiologic data were obtained: Ziehl-Neelsen (ZN) stained smear, culture and PCR. Histopathology was performed on a sub-sample. Directly observed treatment with R+S was administered daily for 12 weeks and surgery was performed after 4 weeks. Patients were followed up for two years after treatment.Findings: Out of 92 treated patients, 61 tested positive for M. ulcerans by PCR. PCR negative patients had better clinical improvement than PCR positive patients after 4 weeks of antibiotics (54.8% versus 14.8%). For PCR positive patients, the outcome after 4 weeks of antibiotic treatment was related to the ZN positivity at the start. Deterioration of the ulcers was observed in 87.8% (36/41) of the ZN positive and in 12.2% (5/41) of the ZN negative patients. Deterioration due to paradoxical reaction seemed unlikely. After surgery and an additional 8 weeks of antibiotics, 98.4% of PCR positive patients and 83.3% of PCR negative patients were considered cured. The overall recurrence rate was very low (1.1%).Interpretation: Positive predictive value of the WHO clinical case definition was low. Low relapse rate confirms the efficacy of antibiotics. However, the need for and the best time for surgery for large Buruli ulcers requires clarification. We recommend confirmation by ZN stain at the rural health centers, since surgical intervention without delay may be necessary on the ZN positive cases to avoid progression of the disease. PCR negative patients were most likely not BU cases. Correct diagnosis and specific management of these non-BU ulcers cases are urgently needed.

Estudo das alterações eletrocorticográficas na insuficiência hepática aguda experimental.

The aim of this study was to test the application and value of electrocorticography (ECG) in the early diagnosis and characterization of electrocorticograms changes on experimental fulminant hepatic failure (FHF). Our material was composed of two groups of guinea pigs: a) ethanolamine group--42 animals with FHF induced by intrabiliary injection of 2.5 ml of monoethanolamine oleate; b) control group--10 animals submitted to intrabiliary injection of 2.5 ml of saline. Electrocorticograms recordings were taken in both groups with the electrodes implanted on the parieto-occipital regions of the skull. The hepatic failure was characterized by clinical manifestations, serum biochemical tests and histopathological findings. In the early hepatic coma the electrocorticograms could not be unequivocally distinguished from normal pattern, and alpha rhythm was recognizable in most animals. With further deterioration of the clinical condition the tracing showed progressive slowness of the normal rhythm, increased voltage and triphasic waves followed by suppression of electrical activity preceding the animal death. The electrocorticography was not suitable for the early diagnosis of hepatic coma, since the ECG alterations became evident only in overt coma. However the method could be useful for the characterization of cerebral disorders and the study of the pathogenesis of fulminant hepatic failure.

The natural history of carpal tunnel syndrome: A study of 20 hands evaluated 4 to 9 years after initial diagnosis

Carpal tunnel syndrome (CTS) is the most frequent entrapment neuropathy. In the last decade several papers have been published on epidemiology, clinical aspects, diagnosis, and treatment, but little is known about its natural history. The objective of this work was to study the natural history of CTS syndrome. From 358 patients with clinical and conduction study diagnosis of CTS, 12 cases were identified that had refused surgical treatment, had not used anti-inflammatory medications, and had not undergone orthopaedic procedures, such as immobilization or anaesthetic infiltration. These 12 patients have 20 compromised hands which have been followed up for between 4 and 9 years. In all cases sensory and motor conduction studies were performed on the median nerve, at the beginning and end of follow-up period. Electrical improvement was marked in 5 hands and slight in 3; there was no significant change in 10, and deterioration in 2. As 8 hands (7 patients) showed improved clinical symptoms and conduction studies over several years, this brings the universally accepted procedure of surgical treatment into doubt.

Independent impact of glycemia ad blood pressure in albuminuria on high-risk subjects for metabolic syndrome

Background: Microalbuminuria may reflect diffuse endothelial damage. Considering that diabetes and hypertension cause vasculopathy, we investigated associations of albumin-to-creatinine ratio (ACR) with plasma glucose and blood pressure levels in high-risk subjects for metabolic syndrome. Methods: A sample of 519 (246 men) Japanese-Brazilians (aged 60 ± 11 years), who participated in a population-based study, had their ACR determined in a morning urine specimen. Backward models of multiple linear regression were created for each gender including log-transformed values of ACR as dependent variable; an interaction term between diabetes and hypertension was included. Results: Macroalbuminuria was found in 18 subjects. ACR mean values for subjects with normal glucose tolerance, impaired fasting glycemia, impaired glucose tolerance and diabetes were 9.9 ± 6.0, 19.0 ± 35.4, 20.7 ± 35.4, and 33.9 ± 55.0 mg/g, respectively. Diabetic subjects showed higher ACR than the others (p < 0.05). An increase in the proportion of albuminuric subjects was observed as glucose metabolism deteriorated (4.9, 17.0, 23.0 and 36.0%). Stratifying into 4 groups according to postchallenge glycemia (< 7.8 mmol/l, n = 9 1; ≥ 7.8 mmol/l, n = 4 10) and hypertension, hypertensive and glucose-intolerant subgroups showed higher ACR values. ACR was associated with gender, waist circumference, blood pressure, plasma glucose and triglyceride (p < 0.05); albuminuric subjects had significantly higher levels of such variables than the normoalbuminuric ones. In the final models of linear regression, systolic blood pressure and 2-hour glycemia were shown to be independent predictors of ACR for both genders (p < 0.05). In men, also waist was independently associated with ACR. No interaction was detected between diabetes and hypertension. Conclusions: These findings suggest that both glucose intolerance and hypertension could have independent but not synergistic effects on endothelial function - reflected by albumin loss in urine. Such hypothesis needs to be confirmed in prospective studies. © 2004 Dustri-Verlag Dr. K. Feistle.

The role of myofibroblasts and interstitial fibrosis in the progression of membranous nephropathy

Renal interstitial fibrosis has been observed in a large number of nephropathies and contributes to the progressive deterioration of renal function. Myofibroblasts have been implicated in the reparative process of tissue injury, including renal scarring secondary to glomerular diseases. We performed a retrospective study on 28 patients with biopsy-proven primary membranous nephropathy, to determine whether interstitial myofibroblasts and tubulointerstitial lesions correlated with renal function at follow-up. Tubulointerstitial pathology was evaluated by morphometric and semiquantitative methods. Interstitial myofibroblasts were counted; 24-hour urinary protein and serum creatinine at the time of diagnosis and at the end of follow-up were available for all the patients. There were 20 males and 8 females, age 2-67 years (mean 42.3±153), most of them with nephrotic syndrome (78.6%). The final renal function had deteriorated in 16 patients (57.1%) and in 5 patients (17.8%) reached end-stage. The renal outcome was correlated with histological changes. We found a positive correlation between the severity of tubulointerstitial damage and the deterioration of the final serum creatinine (r 2=0.185; p=0.016). Myofibroblasts did not predict impaired renal function at the final follow-up. The current data do not support previous suggestions that myofibroblasts are a useful a predictor of end-stage renal disease.

The influence of fluid ingestion on performance of soccer players during a match

The purpose of this study was to verify the effects of a carbohydrate-electrolyte drink on soccer performance. Twenty soccer players volunteered to participate in the study. Players were allocated to two assigned trials according to their positional roles in the team: CHO group (ingesting a 6% carbohydrate-electrolyte solution at regular 15 minutes intervals) and NCHO (ingesting no fluid) during 75 min on-field soccer game. During the trials, body mass loss, heart rate, time spent running, number of sprints and core temperature were measured. There were statistically significant changes (p < 0.05) in body mass loss (CHO: 1.14 ± 0.37 kg vs. NCHO: 1.75 ± 0.47 kg) and number of sprints performed (CHO: 14.70 ± 4.38 vs. NCHO: 10.70 ± 5.80) between groups. The main finding of the present study indicates that supplementation with a carbohydrate-electrolyte drink during a soccer match is beneficial in helping to prevent deterioration in performance. © Journal of Sports Science and Medicine (2004).

Maturidade fisiológica das sementes do ipê amarelo, Tabebuia chrysotricha (Mart. Ex DC.) Standl

Ipê amarelo Tabebuia chrysotricha (Mart. Ex DC.) Standl. is a native forest species that presents heavy and durable wood: it is common to be used for urban arborization. The species is latte secondary and heliophyta. Occurs from Espirito Santo State until Santa Catarina in the Pluvial Atlantic Forest (Mata Atlântica). The seedling production is hard because their seeds have short longevity after dispersion, and so due to the difficulty to harvest winged seeds that are quickly dispersed by the wind. The present study was carried out to evaluate the physiological maturity of Ipê Amarelo seeds, to establish the best moment to harvest them. The study was to accompany the maturation of 100 fruits in just beginning development, from eleven different trees. Morphological characteristic measures were made weekly, with fruits still on trees, starting from the second week development when fruits presented the following averages: 6.3 cm length, 0.71 cm thickness, and 0.82 cm width. From the sixth week of fruit development we harvest them to proceed the germination test, water content rate, and electric conductivity test. The germination has begun by the seventh week development with 28% of germinated seedlings. The highest germination rate happened by the eighth week development, with 74.5% of germinated seedlings and on the ninth week the rate decrease to 65.5%, when the seeds were already in dispersion. Through the electric conductivity test the highest value obtained was 378.06 μS.g -1.cm -1 on the seventh week development and the lowest one was 183.28 μpS.g -1.cm -1 on eighth week. These results support those obtained in the germination test, because as higher is the electric conductivity of seeds, as higher is their deterioration level. Finally, the study allows concluding that the physiological maturation of ipê amarelo seeds has occurred before dispersion close to the eighth week development when fruits presented the following averages: 22.2 cm length, 1.37 cm width, and 1.05 cm thickness; water content rate was 61.8% and electric conductivity was 183.28 μS.g -1.cm -1. In that moment, the fruits presented greened brown coloration and started to show fissures.

Damage detection in a benchmark structure using AR-ARX models and statistical pattern recognition

Structural health monitoring (SHM) is related to the ability of monitoring the state and deciding the level of damage or deterioration within aerospace, civil and mechanical systems. In this sense, this paper deals with the application of a two-step auto-regressive and auto-regressive with exogenous inputs (AR-ARX) model for linear prediction of damage diagnosis in structural systems. This damage detection algorithm is based on the. monitoring of residual error as damage-sensitive indexes, obtained through vibration response measurements. In complex structures there are. many positions under observation and a large amount of data to be handed, making difficult the visualization of the signals. This paper also investigates data compression by using principal component analysis. In order to establish a threshold value, a fuzzy c-means clustering is taken to quantify the damage-sensitive index in an unsupervised learning mode. Tests are made in a benchmark problem, as proposed by IASC-ASCE with different damage patterns. The diagnosis that was obtained showed high correlation with the actual integrity state of the structure. Copyright © 2007 by ABCM.

Early impairment of cognitive functions in Parkinson's disease

Background: Impairment in non-motor functions such as disturbances of some executive functions are also common events in Parkinson's disease patients. Objective: To verify the performance of Parkinson's disease patients in activities requiring visuoconstructive and visuospatial skills. Method: Thirty elderly patients with mild or moderate stages of Parkinson's disease were studied. The assessment of the clinical condition was based on the unified Parkinson's disease rating scale (56.28; SD=33.48), Hoehn and Yahr (2.2; SD=0.83), Schwab and England (78.93%), clock drawing test (7.36; SD=2.51), and mini-mental state examination (26.48; SD=10.11). Pearson's correlation and stepwise multiple regression were used for statistical analyses. Results: The patients presented deterioration in visuospatial and visuoconstructive skills. Conclusion: The clock drawing test proved to be a useful predictive tool for identifying early cognitive impairment in these individuals.

Hindlimb unloading producing effects on bone biomechanical properties in mature male rats

Aging is associated with decline in muscle mass and strength and reduced bone density. Age-related bone loss is a primary factor in osteoporosis and all individuals are potential candidates for osteoporosis because bone loss with aging occurs in men and women, but less studied in men. To examine the appropriateness of hindlimb elevation, by tail suspension as a model for diminished mechanical loading, and to determine the influence of age on bone responsiveness to skeletal unloading, we use dual X ray absorptiometry (DXA) and digital radiographic images to analyze the response of the femur from mature rats to biomechanical loads. Femurs from male Wistar rats (9-mo-old) were scanned using DXA and DIGORA and measures obtained in ephipyseal and diaphyseal regions of interest. The mechanical testing was divided into compression load to fracture the head and a three-point bending load to fracture the femur middiaphysis. In femoral epiphysis from hindlimb unload (HU), animals presented significant differences between mineral bone content and density assessed by DXA. Detailed regions of femoral epiphysis (head, throcanteric fossa, throcanter and metaphysis) presented significant lower values from radiographic density. Only compressive load necessary to fracture the femoral head neck was also significantly diminished in HU animals. Disuse induced, as in elderly patients, deterioration of the trabecular bone architecture with critical effect on bone fragility. Rats with 21 days of hindlimb unloading can simulate disuse, suggesting that certain sub-regions of their aging bones are more susceptible to fracture, while other, i.e. diaphyses, are not.

Treatment of atherosclerotic renovascular disease

Treatment of atherosclerotic renovascular disease is controversial and revascularization is not a beneficial approach to all patients. Conditions as progressive deterioration of renal function, refractory hypertension or accelerated cardiovascular disease, especially recurrent pulmonary edema, could profit from renal angioplasty with stent placement. Surgical revascularization is a good option for patients who will need concomitant surgical corrections of abdominal aortic lesions. Treatment of all other patients must be individualized. Medical therapy is indicated for all patients with atherosclerotic renovascular disease. Observational studies pointed out to the beneficial effect of controlling blood pressure (<130/80 mm Hg), glucose and lipids profile, lifestyle modifications, specific use of platelet antiaggregant therapy, Angiotensin Conversion Enzyme Inhibitors (ACEI) and statins. All others cardiovascular risk factors must be controlled. The evaluation and management of other systemic atherosclerotic vascular lesions is important, especially coronary, carotid and abdominal aortic. This paper presents a review of evidences to rationale the atherosclerotic renovascular disease treatment. © 2008 Bentham Science Publishers Ltd.

Efeito da aplicação de maturadores químicos na cultura da cana de açúcar (Saccharum spp.) variedade SP81-3250

Sugarcane is one of the most important grass crops. This study evaluated the effects of chemical ripeners on the sugarcane variety SP81-3250 in terms of technological quality. The experiment was arranged in randomized blocks with split split-plots. Main treatments were: 1) Control; 2) Aminolon Maduracion, at a rate of 0.7 L of commercial product (c.p.) ha -1; 3) Aminolon Maduracion, at a rate of 1.0 liter of c.p. ha -1; 4) Aminolon Maduracion, at a rate of 1.3 liter of c.p. ha -1; 5) Trinexapac-ethyl (Moddus), at a rate of 0.8 liter of c.p. ha -1. Secondary treatments were the sampling dates: 10 days before application (- 10 d.a.a.); 11; 46; 71; 100 and 117 d.a.a. (days after application). Ripeners differently affected the technological parameters, and trinexapac-ethyl showed the best behavior, followed by Aminolon (0.7 L of c.p. ha -1). The best results were found at the 3rd and 4th sampling dates, 46 and 71 days after application, respectively.

Oxidação lipídica em peixes: mecanismo de ação e prevenção

Aquaculture produces food with high nutritive value, however its environmental conditions and management increase the stress reaction of fishes, prejudicing the quality of their products. The lipid oxidation is one of the main causes of the fishery deterioration, due the high unsaturated value of fatty acid of aquatic organisms. This review describes lipid oxidation mechanisms, their analysis methodology and some preventive ways, emphasizing the antioxidants effects of vitamin E utilization in fish's diet.

Qualidade fisiológica de sementes de Brachiaria e avaliação da produtividade de massa seca em diferentes sistemas de integração lavoura-pecuária sob irrigação

The speed and magnitude of tropical pastures expansion in Brazil are related to the availability of quality seeds. This research aimed to evaluate the physiological quality of seeds of two Brachiaria species submitted to germination and viability tests and also estimate, for both species, the fresh and dry mass yield, under different irrigated crop-livestock integration systems. For field analysis, the experimental design was a randomized complete block, in subplots, with four intercrops in the plot (Brachiaria brizantha cv. Marandu and Brachiaria ruziziensis simultaneously established with corn and nitrogen fertilization coverage), and four forage cutting times, in the winter/spring season, in subplots, with four replications. In the laboratory, the experimental design was completely randomized, with four replications per treatment/test. The germination and viability tests indicated that B. brizantha seeds showed higher physiological quality, when compared with B. ruziziensis, while the tetrazolium test and germinated seedlings characteristics were similar. The B. ruziziensis, simultaneously intercropped with corn, was the less viable intercrop, due to the lower fresh and dry mass yield and litter deposition on the soil surface. In general, the pasture formation for the second season cultivation, intercropped with corn, was an excellent alternative for crop-livestock integration under a no-tillage system.