Critical analysis of the international classification of headache disorders diagnostic criteria (ICHD I-1988) and (ICHD II-2004), for migraine in children and adolescents

The present study analyzed the (ICHD I-1988) and ( ICHD II-2004) diagnostic criteria in children and adolescents. Our population consisted of 496 patients of the Headache Outpatient Ward for Children and Adolescents retrospectively studied from 1992 to 2002. Individuals were classified according to three diagnostic groups: Intuitive Clinical Diagnosis ( Gold Standard), ICHD I-1988 and ICHD II-2004. They were statistically compared using the variables: Sensitivity ( S), Specificity (Sp), Positive Predictive Value (PPV), Negative Predictive Value (NPV). When ICHD I-1988 was used, the sensitivity of migraine without and with aura was 21% and 27%, respectively, whereas in ICHD II-2004 it changed to 53% and 71% without affecting specificity. As a conclusion, the current classification criteria ( ICHD II-2004) showed greater sensitivity and high specificity for migraine than ICHD I-1988, although it improved migraine diagnosis in children and adolescents, the sensitivity remains poor.

EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part I: Overall methodology and clinical characterisation

Objectives To report methodology and overall clinical, laboratory and radiographic characteristics for Henoch-Schonlein purpura (HSP), childhood polyarteritis nodosa (c-PAN), c-Wegener granulomatosis (c-WG) and c-Takayasu arteritis (c-TA) classification criteria.Methods The preliminary Vienna 2005 consensus conference, which proposed preliminary criteria for paediatric vasculitides, was followed by a EULAR/PRINTO/PRES-supported validation project divided into three main steps. Step 1: retrospective/prospective web-data collection for HSP, c-PAN, c-WG and c-TA, with age at diagnosis <= 18 years. Step 2: blinded classification by consensus panel of a subgroup of 280 cases (128 difficult cases, 152 randomly selected) enabling expert diagnostic verification. Step 3: Ankara 2008 Consensus Conference and statistical evaluation (sensitivity, specificity, area under the curve, kappa-agreement) using as 'gold standard' the final consensus classification or original treating physician diagnosis.Results A total of 1183/1398 (85%) samples collected were available for analysis: 827 HSP, 150 c-PAN, 60 c-WG, 87 c-TA and 59 c-other. Prevalence, signs/symptoms, laboratory, biopsy and imaging reports were consistent with the clinical picture of the four c-vasculitides. A representative subgroup of 280 patients was blinded to the treating physician diagnosis and classified by a consensus panel, with kappa-agreement of 0.96 for HSP (95% CI 0.84 to 1), 0.88 for c-WG (95% CI 0.76 to 0.99), 0.84 for c-TA (95% CI 0.73 to 0.96) and 0.73 for c-PAN (95% CI 0.62 to 0.84), with an overall. of 0.79 (95% CI 0.73 to 0.84).Conclusion EULAR/PRINTO/PRES propose validated classification criteria for HSP, c-PAN, c-WG and c-TA, with substantial/almost perfect agreement with the final consensus classification or original treating physician diagnosis.

Associação entre classe econômica e estresse na ocorrência da disfunção temporomandibular

Objetivou-se neste estudo verificar a associação da classe econômica e do estresse com a ocorrência de disfunção temporomandibular (DTM). A população deste estudo constituiu-se de uma amostra estatisticamente significativa de 354 indivíduos de ambos os sexos, pertencentes a diferentes classes econômicas da zona urbana do município de Piacatu, São Paulo, Brasil. Para isso, utilizou-se o Critério de Classificação Econômica Brasil (CCEB) para a estratificação econômica da população. Retirou-se uma amostra de cada estrato, na qual aplicou-se o Questionário de Fonseca para verificar o grau de DTM, e a Escala de Reajustamento Social (SRRS) para verificar o grau de estresse. Os dados coletados foram tabulados por meio do programa Epi Info 2000, versão 3.2, e analisados estatisticamente por meio do Teste Qui-Quadrado, com nível de significância de 5%. Os chefes das famílias foram assim distribuídos: 4 famílias pertencentes à Classe A2, 14 à Classe B1, 25 à Classe B2, 112 à Classe C, 174 à Classe D e 25 à Classe E. Após a análise estatística não foi observada associação significativa entre classe econômica e disfunção temporomandibular (DTM); entretanto, a mesma ocorreu entre estresse e DTM (p<0,01). A classe econômica não influencia na ocorrência de DTM, mas existe associação direta entre estresse e disfunção temporomandibular.

Geochemical Study of the Itabirite Iron Ores of the Alegria Mine - Quadrilátero Ferrífero, Minas Gerais, Brazil

The iron ores of Alegria mine are composed of itabirites enclosing minor bodies of high-grade ores. The itabirites are classified according to mineralogical composition in five types: martite-rich, goethite-rich, specularite-rich, magnetite-rich and anphibolite-rich ores. The hematites are martite-rich, magnetite-rich, specularite-rich and more rarely, amphibolite-rich. Other classification criteria of the ores are based on the physical properties and the degree of compaction. As such, the itabirites and hematites can be classified as hard, friable and soft types. The mineralogical/textural evolution of the ores is linked to the pressure and temperature conditions that accompanied the tectonic processes in anphibolite facies and the different degrees of subsequent surficial weathering processes. Petrographic and microstructural studies indicate that the magnetite and amphibole bearing itabirites represent the parent rocks that created the other itabirites and that the specularite itabirites and the hard martite types are related to silica dissolution and redeposition in zones of high and low strain. Most of itabirites ores correspond to chert oxide facies banded iron formation, except the goethite and amphibole bearing itabirite that resemble a silicate or oxide-silicate facies with minor carbonate impurities. The great mass and pods of soft martite itabirites are probably shaley oxide facies BIFs with little volcanic contribution. Trace element contents of the Alegria's itabirites show strong dissimilarities with BIFs associated with volcanism (Algoma type), but closely ressemble to the Lake Superior type, with high content in Cr, Co and low V, Ni, Cu and Zn. Although the absolute contents of REE present in the Alegria's itabirites are, in general very low, the pattern when normalised by NASC is similar to the great majority of the Archean and Paleoproterozoic BIFs elsewhere in the world, and characterised by positive Eu anomaly.

Juvenile localized scleroderma: Clinical and epidemiological features in 750 children. An international study

Objective. Juvenile localized scleroderma (JLS) includes a number of conditions often grouped together. With the long-term goal of developing uniform classification criteria, we studied the epidemiological, clinical and immunological features of children with JLS followed by paediatric rheumatology and dermatology centres. Methods. A large, multicentre, multinational study was conducted by collecting information on the demographics, family history, triggering environmental factors, clinical and laboratory features, and treatment of patients with JLS. Results. Seven hundred and fifty patients with JLS from 70 centres were enrolled into the study. The disease duration at diagnosis was 18 months. Linear scleroderma (LS) was the most frequent subtype (65%), followed by plaque morphea (PM) (26%), generalized morphea (GM) (7%) and deep morphea (DM) (2%). As many as 15% of patients had a mixed subtype. Ninety-one patients (12%) had a positive family history for rheumatic or autoimmune diseases; 100 (13.3%) reported environmental events as possible trigger. ANA was positive in 42.3% of the patients, with a higher prevalence in the LS-DM subtype than in the PM-GM subtype. Scl70 was detected in the sera of 3% of the patients, anticentromere antibody in 2%, anti-double-stranded DNA in 4%, anti-cardiolipin antibody in 13% and rheumatoid factor in 16%. Methotrexate was the drug most frequently used, especially during the last 5 yr. Conclusion. This study represents the largest collection of patients with JLS ever reported. The insidious onset of the disease, the delay in diagnosis, the recognition of mixed subtype and the better definition of the other subtypes should influence our efforts in educating trainees and practitioners and help in developing a comprehensive classification system for this syndrome. © 2006 Oxford University Press.

Assessment of health-related quality of life in children with functional defecation disorders

Objective: To evaluate the health-related quality of life in children with functional defecation disorders. Methods: One hundred children seen consecutively were enrolled and subdivided into three subsets according to the Roma II classification criteria: functional constipation (n = 57), functional fecal retention (n = 29) and nonretentive functional soiling (n = 14). The generic instrument Child Health Questionnaire - Parent Form 50 (CHQ-PF50®), was used to measure quality of life and to assess the impact of these disorders from the point of view of parents. The instrument measures physical and psychosocial wellbeing in 15 health domains, each of which is graded on a scale from 0 to 100, with higher values indicating better health and greater wellbeing. Ten of these are then used to obtain two aggregated and summary scores: the physical and psychosocial scores. Results: No statistically significant differences were detected between subsets in terms of demographic or anthropometric characteristics. In 14 domains, children with defecation disorders scored lower than healthy children. When subsets were compared, statistically significant differences were detected between children with nonretentive functional soiling (lower scores) and those with functional constipation. Physical and psychosocial scores for the entire sample were lower than those for the group of healthy children used as controls. Conclusions: The CHQ-PF50® was considered adequate for demonstrating compromised quality of life in children with functional defecation disorders, as has been reported for other diseases, being a useful tool for making treatment decisions and for patient follow-up. Copyright © 2006 by Sociedade Brasileira de Pediatria.

Distribuição, tamanho populacional, hábitat e conservação do bicudinho-do-brejo Stymphalornis acutirostris Bornschein, Reinert e Teixeira, 1995 (Thamnophilidae)

The Marsh Antwren (Stymphalornis acutirostris) is restricted to the lowlands between Antonina Bay, in the coastal plain of the state of Paraná, and Itapocu river, in the northern coastal plain of the state of Santa Catarina (from 0 to c. 5 m a.s.l.). It doesn't occur continuously in this region, being found in eight populations that span over an total area of about 6,060 ha (= area of occupancy; 4,856.67 in Paraná and c. 1,200 in Santa Catarina). Nine habitat types used by the Marsh Antwren were defined, based on vegetation physiognomy, localization, dominancy of botanical species, dominant life-form and history of the region. Five of these are herbaceous (marshes), while four have an upper arboreal stratum and an herbaceous lower stratum with marsh plants. According to the classification criteria of the Brazilian vegetation proposed by the Radambrasil Project, they were classified as Pioneering Formation of Fluvial Influence, Pioneering Formation of Fluvial-marine Influence, and/or Pioneering Formation of Lacustrine Influence. They occur as patches or narrow strips ranging from 0.001 to 203.0 ha in the state of Paraná. They are found mainly in the interior of bays, in the lower courses of rivers that drain into bays, in alluvial plains, and between sand dunes in the coastal plain. Characteristic herbaceous species are cattail (Typha domingensis), bulrush (Scirpus californicus), Crinum salsum, Panicum sp. cf. P. mertensii, saw grass (Cladium mariscus) and Fuirena spp. Hibiscus pernambucensis is the characteristic bush species, and Calophyllum brasiliense, Tabebuia cassinoides, Annona glabra and Laguncularia racemosa are the characteristic arboreal species. The Marsh Antwren lives in herbaceous vegetation, but also uses bushes and branches of small tress. It has low flight capacity and a single flight of more than 25 m was never recorded. Territories of 0.25 ha were estimated in one kind of habitat (tidal marsh) (= 8 individuals per hectare) and of 3.2 ha in another one (saw grass marsh) (= 0.62 individual per hectare). The global population estimate is of about 17,700 mature individuals (13,700 in Paraná and 4,000 in Santa Catarina). The species is really under threat of extinction, mainly because of it's restricted geographical distribution and habitat loss by human activities and biological contamination caused by invasion of exotic grasses (Urochloa arrecta and Brachiaria mutica).

Dimensões do corredor bucal em diferentes faixas etárias e sua proporção com a distância inter pré-molar e inter comissura

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Potencial hidromineral das águas hipertermais do sistema aquífero Guarani no Estado de São Paulo

Pós-graduação em Geociências e Meio Ambiente - IGCE

O estatuto lexical das preposições sob e sobre

This paper describes the prepositions sob and sobre in the Functional Discourse Grammar framework (HENGEVELD; MACKENZIE, 2008) aiming at checking their lexical or grammatical status on the basis of classification criteria postulated by Keizer (2007). The following aspects point to their lexical status : (i) they consist of an Ascription Subact; (ii) they contain a specific content on the vertical axis signaling inferiority and superiority position in relation to a limit; (iii) they are not required by any predicate, but they are predicates by themselves, which require complementation by an argument playing Reference semantic function; (iv) they may be combined with de, em, para and por; which are genuine grammatical prepositions; and, finally, (v) they are not subjected to any phonological process of reduction and fusion.

Análise dos atendimentos obstétricos realizados pelo SAMU de Botucatu, SP

Pós-graduação em Enfermagem (mestrado profissional) - FMB

A classification of Pepper yellow mosaic virus isolates into pathotypes

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

Mapping the knowledge covered by library classification systems

This study explores, in 3 steps, how the 3 main library classification systems, the Library of Congress Classification, the Dewey Decimal Classification, and the Universal Decimal Classification, cover human knowledge. First, we mapped the knowledge covered by the 3 systems. We used the 10 Pillars of Knowledge: Map of Human Knowledge, which comprises 10 pillars, as an evaluative model. We mapped all the subject-based classes and subclasses that are part of the first 2 levels of the 3 hierarchical structures. Then, we zoomed into each of the 10 pillars and analyzed how the three systems cover the 10 knowledge domains. Finally, we focused on the 3 library systems. Based on the way each one of them covers the 10 knowledge domains, it is evident that they failed to adequately and systematically present contemporary human knowledge. They are unsystematic and biased, and, at the top 2 levels of the hierarchical structures, they are incomplete.

Postoperative renal function evaluation, through RIFLE criteria, of elderly patients who underwent femur fracture surgery under spinal anesthesia

Introduction. The postoperative acute renal failure (ARF) incidence in different kinds of surgery has rarely been studied. Age, cardiac dysfunction, previous renal dysfunction, intraoperative hypoperfusion, and use of nephrotoxic medications are mentioned as risk factors for ARF at the postoperative period. The postoperative ARF definition was based on the creatinine increase by the RIFLE classification (R = risk, I = injury, F = failure, L = loss, E = end stage), which corresponds to a 1.5 creatinine increase, two to three times, respectively, above the basal value. This study aimed to evaluate the postoperative ARF incidence in elderly patients who underwent femur fracture surgery under subarachnoid anesthesia and stratify it by the RIFLE criteria. Methods. Ninety patients older than 65 years under spinal anesthesia with fixed dosage of 15 mg of 0.5% isobaric bupivacaine associated with morphine 50 g were studied. Immediate postoperative creatinine was considered basal and compared with maximal creatinine evaluated at 24, 48, and 72 postoperative hours. Results. The mean age of the patients was 80.27 years. ARF incidence was 24.44% and stratified this way: R = 21.11% and I = 3.33%. Conclusions. In conclusion, the postoperative ARF incidence after femur fracture surgery in patients over 65 years was 24.44%. By analyzing the stratification based on the RIFLE classification, the incidence was categorized as Risk (R) = 21.11% and Injury (I) = 3.33%.