Manifestações sistêmicas na doença pulmonar obstrutiva crônica

Chronic obstructive pulmonary disease is progressive and is characterized by abnormal inflammation of the lungs in response to inhalation of noxious particles or toxic gases, especially cigarette smoke. Although this infirmity primarily affects the lungs, diverse extrapulmonary manifestations have been described. The likely mechanisms involved in the local and systemic inflammation seen in this disease include an increase in the number of inflammatory cells (resulting in abnormal production of inflammatory cytokines) and an imbalance between the formation of reactive oxygen species and antioxidant capacity (leading to oxidative stress). Weakened physical condition secondary to airflow limitation can also lead to the development of altered muscle function. Chronic obstructive pulmonary disease presents diverse systemic effects including nutritional depletion and musculoskeletal dysfunction (causing a reduction in exercise tolerance), as well as other effects related to the comorbidities generally observed in these patients. These manifestations have been correlated with survival and overall health status in chronic obstructive pulmonary disease patients. In view of these facts, the aim of this review was to discuss findings in the literature related to the systemic manifestations of chronic obstructive pulmonary disease, emphasizing the role played by systemic inflammation and evaluating various therapeutic strategies.

Espectro de agentes etiológicos associados a surtos de doenças transmitidas por alimentos em núcleos receptores turísticos de três regiões geográficas do Estado de São Paulo

Foodborne and waterborne diseases are spread by the consumption of food or water contaminated with bacteria and/or their toxins, viruses, parasites or chemicals. The aim of the research reported here was to establish the spectrum of etiologic agents of foodborne outbreaks at 15 tourist resorts in three geographic regions of the State of Sao Paulo (Brazil). The study was based on the cases reported to the Epidemic Surveillance Center (CVE) of the Public Health Authority of the State of São Paulo (SES), from 2002 to 2005. The tourist centers were chosen at random in three regions of the state (Capital, Interior and Coast) and offered the following attractions: events, agribusiness, cultural history, shopping, town center, gastronomy, health and leisure, sun and sea. Among the bacteria, the results showed that Salmonella spp. were most frequently associated with outbreaks, followed by Shigella spp., enterotoxigenic Escherichia coli, Staphylococcus aureus, Clostridium perfringens, Bacillus cereus and Campylobacter spp. Viruses (Rotavirus and Hepatitis A) played a part in many of the cases, while the frequency of parasites and worm infestations was low in the foodborne disease outbreaks at these resorts. The mixed foods (rice, beans, liver, potatoes, barbecue, juice), fish and poultry were the three commonest vehicles implicated in the outbreaks.

Fatores de risco para doenças cardiovasculares em idosos com diabetes mellitus tipo 2

The aim of this study was to analyze the risk factors related to the cardiovascular diseases (CVRF) in elderly type 2 diabetics. A cross-sectional observational study was carried out on 100 elderly patients attending the Rehabilitation Center of Araraquara (CRRA), São Paulo State, Brazil, from March to December, 2004. The majority were married, female, white, with a low income and low educational level. Regarding habits and style of life, the subjects had an adequate diet, were sedentary, non-smoking and non-drinking. In the population of 100, 42% were overweight, 42% obese, 71% had above-normal waist measurements and 84% high waist-to-hip ratios. Concerning the CVRF, it was observed that more than half had hypertension, hypercholesterolaemia and hypertriglyceridaemia. 84% had high values of LDL-cholesterol and 59% HDL-cholesterol levels below the reference values, 78% high levels of fasting glycemia, 76% glycohemoglobin and 57% fibrinogen and thus subject to cardiovascular risk. The results showed a high frequency of cardiovascular risk factors, differing according to sex and the age.

Susceptibilidade in vitro a antimicrobianos da Mannheimia haemolytica e da Pasteurella multocida isoladas de ovinos sadios e com doenças respiratórias

Pasteurella multocida and Mannheimia haemolytica (P. haemolytica) are associated with ovine respiratory diseases. With the purpose of observe the susceptibility in vitro of these organisms against antimicrobials, were collected samples of nasopharingeal (n=180) and oropharingeal (n=82) from ovines healthy and with respiratory disease. Among the antimicrobials tested, the sensibility was greater for enrofloxacin (100%) and florfenicol (100%), for both bacteria. The greater resistance indices for M. haemolytica and P. multocida were observed with tetracyclin (15.64% and 17.65% respectively) and penicillin (1.82% and 4.2%).

Doenças respiratórios em aves atendidas no Laboratório de Ornitopatologia da FMVZ-UNESP/Botucatu-SP, Brasil, nos anos de 2005 a 2006

The respiratory tract of birds shows anatomical and physiological characteristics that facilitates the occurrence of disease, mainly those of microbiological origin. This article analyzes the frequency of respiratory diseases in domestic and wild birds treated during the years 2005-2006 at the Ornitopathology Laboratory of the Veterinary Hospital, Faculty of Veterinary Medicine and Zootecnics, São Paulo State University (FMVZ-UNESP). Diagnoses were obtained through clinical and radiographic exams as well as haemogram, microbiological culture, parasitological tests and necropsy, being septicemic processes, aspergillosis and mycoplasmosis the most diagnosed diseases. No zoonotic threats were identified, so the entities were described as of low-impact on public health. However, the above mentioned agents can provoke death of birds and difficult for treating and eradication as well.

Uso de expressões orais durante a implementação do recurso de comunicação suplementar e alternativa

The literature has discussed the importance of early implementation of augmentative and alternative systems with people with various disabilities. This discussion is related to concerns about language acquisition and development within the various expressive possibilities. Researchers advise that starting intervention early through resources and procedures using augmentative and alternative communication does not impede speech acquisition and development. This paper aimed to describe oral expressive abilities during the implementation of augmentative and alternative communication with a student with cerebral palsy. An 11-year-old student with cerebral palsy participated in the augmentative and alternative communication program for two years. Twelve sessions were selected during the first year of the intervention. The sessions were filmed and the augmentative and alternative communication resource procedures were transcribed. The categories of analysis were defined as verbal expression; nonverbal expression and verbal and nonverbal expression associated. The results of this study identified that augmentative and alternative communication resources supported the use of verbal expression such as vocalizations, words and unintelligible oral expressions.

Efeitos terapêuticos da suplementação de L-arginina nas doenças cardiovasculares e endócrino-metabólicas

Nitric oxide is synthesized from L-arginine and plays an important role in blood pressure regulation, platelets aggregation and atherosclerosis development. Most of the studies have shown that the beneficial effects of the L-arginine supplementation are related to an increasing of nitric oxide bioavailability to the cells, improving the endothelial dysfunction, decreasing oxidative stress, ameliorating lipid profile and insulin resistance. However some studies show conflicting results. Considering the role of the endothelium on the pathogenesis of the cardiovascular diseases as well as on the endocrine-metabolic diseases, this review will update studies involving the role of nitric oxide and its signaling pathways in the regulation of vascular function. Furthermore, this review will focus on the main results of the clinical trials using oral L-arginine supplementation, with or without physical exercise, in an attempt to obtain beneficial effects on the cardiovascular and endocrine-metabolic systems in patients and healthy subjects.

Associação entre doenças crônicas em adultos e redução dos níveis de atividade física

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise das prevalências de doenças detectadas pelo programa nacional de triagem neonatal no município de Araraquara no ano de 2009

The National Neonatal Screening Program (NNSP) set up in all Brazil, aims, through planned phases of local implementation, to detect diseases such as phenylketonuria, congenital hypothyroidism, hemoglobinopathies and cystic fibrosis. The aim of this study was to assess, through a cross-sectional observational study, the prevalence of the diseases detected by the NNSP in the city of Araraquara, in records issued by the São Paulo APAE laboratory in the period between April and December 2009.The results show that Araraquara had a prevalence of phenylketonuria and congenital hypothyroidism 0.06% above the national averages of 0.01% and 0.03% respectively. With respect to hemoglobinopathies, the prevalence of sickle cell trait was 2.15% below the national average of 2.6%. The prevalence of Hb C in the city was 0.57%, similar to national values reported in the literature. Confirmed Hb Bart's had a prevalence of 0.13% in Araraquara, below the average of 0.38% for the surrounding region. The neonatal screening by heel-prick test and counseling for caregivers are important factors in reducing morbidity related to the evolution of these diseases.

Aparecimento de psoríase durante o tratamento das doenças inflamatórias intestinais com infliximabe: A terapia biológica deve ser suspensa?

Context - Several paradoxical cases of infliximab-induced or-exacerbated psoriatic lesions have been described in the recent years. There is disagreement regarding the need to discontinue infliximab in order to achieve the resolution of these adverse cutaneous reactions specifically in inflammatory bowel disease (IBD) patients. Objective - To systematically review the literature to collect information on IBD patients that showed this adverse cutaneous reaction, focusing mainly on the therapeutic approach. Methods - A systematic literature review was performed utilizing Medline, Embase, SciELO and Lilacs databases. Published studies were identified, reviewed and the data were extracted. Results - Thirty-four studies (69 IBD patients) met inclusion criteria for review. There was inconsistency in reporting of some clinical and therapeutic aspects. Most patients included had Crohn's disease (89.86%), was female (47.83%), had an average age of 27.11 years, and no reported history of psoriasis (84.05%). The patients developed primarily plaque-type psoriasis (40.58%). There was complete remission of psoriatic lesions in 86.96% of IBD patients, existing differences in the therapeutic approaches; cessation of infliximab therapy led to resolution in 47.83% of cases and 43.48% of patients were able to continue infliximab therapy. Conclusion - As increasing numbers of IBD patients with psoriasis induced or exacerbated by infliximab, physicians should be aware of its clinical manifestations so that appropriate diagnosis and treatment are properly established. The decision whether to continue or discontinue infliximab should be individualized.

Manifestações clínicas, bioquímicas, ultrassonográficas e metabólicas da síndrome dos ovários policísticos em adolescentes

PURPOSE: To evaluate the clinical, ultrasonographic, biochemical and metabolic alterations of adolescents with polycystic ovary syndrome (PCOS). METHODS: Retrospective observational study conducted on 44 adolescents aged 12 to 19 years, diagnosed with PCOS according to the Rotterdam Consensus. Metabolic changes were assessed according to the recommendations of the International Diabetes Federation, considering: waist circumference (WC) ≥90th percentile (10-15 years of age) or >80 cm (age >16 years), fasting glucose >100 mg/dL, triglycerides >150 mg/dL, HDL <40 mg/dL, and blood pressure ≥Hg 130/85 mm. RESULTS: Mean age was 16.7±2.2 years and age at menarche was 11.8±1.4 years. The menstrual irregularity most frequently observed was amenorrhea (72.7%) followed by oligomenorrhea (27.3%); hirsutism was observed in 86.4% and acne in 56.8%. Polycystic ovaries were observed by ultrasound only in 27.3%. Mean BMI was 30.3±6.6 kg/m2. According to BMI, 52.3% of adolescents were obese, 13.6% were overweight and 6.8% had a healthy weight. Increased waist circumference (63.6%, 28/44) and the reduction of HDL-C (34.1%, 15/44) were the metabolic changes most frequently observed. Increased triglycerides were observed in 27.3% (12/44) and increased blood pressure and impaired fasting glucose were found in 9.1% (4/44) and 4.5% (2/44) of cases, respectively. Acanthosis nigricans was observed in 52.3% and insulin resistance in 62.8% of the adolescents with PCOS. Metabolic syndrome was identified in six children (13.6%), all of them obese or overweight. CONCLUSION: In the adolescents with PCOS studied here, menstrual irregularity and hirsutism were the most common clinical manifestations, while the sonographic findings consistent with polycystic ovaries were less prevalent. Obesity associated with insulin resistance predisposes these adolescents to a higher frequency of metabolic disorders.

Dermatologia ambiental: Manifestações dermatológicas de acidentes por animais aquáticos (invertebrados)

Contact between humans and coastal areas has increased in recent decades, which has led to an increase in injuries from aquatic animals. The majority of these present dermatological manifestations, and some of them show typical lesions. The highest percentages of injuries that occur in marine environments are associated with invertebrates such as sea urchins, jellyfish and Portuguese men-of-war (echinoderms and cnidarians). In this review, we discuss the clinical, therapeutic and preventive aspects of injuries caused by marine and freshwater invertebrates, focusing on first aid measures and diagnosis for dermatologists and professionals in coastal areas. © 2013 by Anais Brasileiros de Dermatologia.

A leitura e a produção de textos: desempenhos de alunos do ensino fundamental e as manifestações de seus professores

Pós-graduação em Educação - IBRC

Os palhaços nas manifestações populares brasileiras: Bumba-meu-boi, Cavalo-marinho, Folia de Reis e Pastoril Profano

Pós-graduação em Artes - IA

Efeitos da exposição a queima de biomassa na função pulmonar e transportabilidade mucociliar e investigação de doenças ocupacionais dos trabalhadores rurais do setor canavieiro

Pós-graduação em Fisioterapia - FCT