Molecular diagnosis of Huntington disease in Brazilian patients

Huntington disease (HD) is a progressive neurodegenerative disorder with autosomal dominant inheritance, characterized by choreiform movements and cognitive impairment. Onset of symptoms is around 40 years of age and progression to death occurs in approximately 10 to 15 years from the time of disease onset. HD is associated with an unstable CAG repeat expansion at the 5' and of the IT15 gene. We have genotyped the CAG repeat in the IT15 gene in 44 Brazilian individuals (42 patients and 2 unaffected family members) belonging to 34 unrelated families thought to segregate HD. We found one expanded CAG allele in 32 individuals (76%) belonging to 25 unrelated families. In these HD patients, expanded alleles varied from 43 to 73 CAG units and normal alleles varied from 18 to 26 CAGs. A significant negative correlation between age at onset of symptoms and size of the expanded CAG allele was found (r=0.6; p=0.0001); however, the size of the expanded CAG repeat could explain only about 40% of the variability in age at onset (r2=0.4). In addition, we genotyped 25 unrelated control individuals (total of 50 alleles) and found normal CAG repeats varying from 16 to 33 units. The percentage of heterozigocity of the normal allele in the control population was 88%. In conclusion, our results showed that not all patients with the HD phenotype carried the expansion at the IT15 gene. Furthermore, molecular diagnosis was possible in all individuals, since no alleles of intermediate size were found. Therefore, molecular confirmation of the clinical diagnosis in HD should be sought in all suspected patients, making it possible for adequate genetic counseling.

Fatores associados à maior mortalidade e tempo de internação prolongado em uma unidade de terapia intensiva de adultos

OBJECTIVE: The intensive care unit is synonymous of high severity, and its mortality rates are between 5.4 and 33%. With the development of new technologies, a patient can be maintained for long time in the unit, causing high costs, psychological and moral for all involved. This study aimed to evaluate the risk factors for mortality and prolonged length of stay in an adult intensive care unit. METHODS: The study included all patients consecutively admitted to the adult medical/surgical intensive care unit of Hospital das Clínicas da Universidade Estadual de Campinas, for six months. We collected data such as sex, age, diagnosis, personal history, APACHE II score, days of invasive mechanical ventilation orotracheal reintubation, tracheostomy, days of hospitalization in the intensive care unit and discharge or death in the intensive care unit. RESULTS: Were included in the study 401 patients; 59.6% men and 40.4% women, age 53.8±18.0. The mean intensive care unit stay was 8.2±10.8 days, with a mortality rate of 13.5%. Significant data for mortality and prolonged length of stay in intensive care unit (p <0.0001), were: APACHE II>11, OT-Re and tracheostomy. CONCLUSION: The mortality and prolonged length of stay in intensive care unit intensive care unit as risk factors were: APACHE>11, orotracheal reintubation and tracheostomy.

Cumulative doses of radioiodine in the treatment of differentiated thyroid carcinoma: knowing when to stop

OBJECTIVE: Evaluate the efficacy of cumulative doses (CDs) of 131I-iodide therapy (RIT) in differentiated thyroid cancer (DTC). SUBJECTS AND METHODS: The probability of progressive disease according to CDs was evaluated in patients < 45 years old and > 45 years old and correlated to tumor-node-metastasis (TNM), thyroglobulin values, histological types and variants, age, and zduration of the disease. RESULTS: At the end of a follow-up period of 69 ± 56 months, 85 out of 150 DTC patients submitted to fixed doses RIT had no evidence of disease, 47 had stable disease and 18 had progressive disease. Higher CDs were used in the more aggressive variants (p < 0.0001), higher TNM stages (p < 0.0001), and follicular carcinomas (p = 0.0034). Probability of disease progression was higher with CDs > 600 mCi in patients > 45 years old and with CDs > 800 mCi in patients < 45 years. CONCLUSION: Although some patients may still respond to high CDs, the impact of further RIT should be carefully evaluated and other treatment strategies may be warranted.

Desempenho da força explosiva durante uma temporada em futebolistas púberes

Universidade Estadual de Campinas . Faculdade de Educação Física

Monitoramento de parâmetros imunológicos em atletas adolescentes de basquetebol durante e após a temporada esportiva= : Monitoring of immunological parameters in adolescent basketball athletes during and after a sports season

Universidade Estadual de Campinas . Faculdade de Educação Física

Respostas agudas da variabilidade da frequência cardíaca após sesão de exercício de força com restrição de fluxo sanguíneo = : Acute responses of heart rate variabiblity afer blood flow restriction resistance exercise

Universidade Estadual de Campinas . Faculdade de Educação Física

Periodontal treatment during pregnancy decreases the rate of adverse pregnancy outcome: a controlled clinical trial

OBJECTIVES: The aim of this study was to evaluate the effects of non-surgical treatment of periodontal disease during the second trimester of gestation on adverse pregnancy outcomes. MATERIAL AND METHODS: Pregnant patients during the 1st and 2nd trimesters at antenatal care in a Public Health Center were divided into 2 groups: NIG - "no intervention" (n=17) or IG- "intervention" (n=16). IG patients were submitted to a non-surgical periodontal treatment performed by a single periodontist consisting of scaling and root planning (SRP), professional prophylaxis (PROPH) and oral hygiene instruction (OHI). NIG received PROPH and OHI during pregnancy and were referred for treatment after delivery. Periodontal evaluation was performed by a single trained examiner, blinded to periodontal treatment, according to probing depth (PD), clinical attachment level (CAL), plaque index (PI) and sulcular bleeding index (SBI) at baseline and 35 gestational weeks-28 days post-partum. Primary adverse pregnancy outcomes were preterm birth (<37 weeks), low birth weight (<2.5 kg), late abortion (14-24 weeks) or abortion (<14 weeks). The results obtained were statistically evaluated according to OR, unpaired t test and paired t test at 5% signifcance level. RESULTS: No signifcant differences were observed between groups at baseline examination. Periodontal treatment resulted in stabilization of CAL and PI (p>0.05) at IG and worsening of all periodontal parameters at NIG (p<0.0001), except for PI. Signifcant differences in periodontal conditions of IG and NIG were observed at 2nd examination (p<0.001). The rate of adverse pregnancy outcomes was 47.05% in NIG and 6.25% in IG. Periodontal treatment during pregnancy was associated to a decreased risk of developing adverse pregnancy outcomes [OR=13.50; CI: 1.47-123.45; p=0.02]. CONCLUSIONS: Periodontal treatment during the second trimester of gestation contributes to decrease adverse pregnancy outcomes.

Antibacterial activity of root canal filling materials for primary teeth: zinc oxide and eugenol cement, Calen paste thickened with zinc oxide, Sealapex and EndoREZ

This study evaluated in vitro the antibacterial activity of 4 root canal filling materials for primary teeth - zinc oxide and eugenol cement (ZOE), Calen paste thickened with zinc oxide (Calen/ZO), Sealapex sealer and EndoREZ sealer - against 5 bacterial strains commonly found in endodontic infections (Kocuria rhizophila, Enterococcus faecalis, Streptococcus mutans, Escherichia coli and Staphylococcus aureus) using the agar diffusion test (agar-well technique). Calen paste, 1% chlorhexidine digluconate (CHX) and distilled water served as controls. Seven wells per dish were made at equidistant points and immediately filled with the test and control materials. After incubation of the plates at 37oC for 24 h, the diameter of the zones of bacterial growth inhibition produced around the wells was measured (in mm) with a digital caliper under reflected light. Data were analyzed statistically by analysis of variance and Tukey's post-hoc test (?=0.05). There were statistically significant differences (p<0.0001) among the zones of bacterial growth inhibition produced by the different materials against all target microorganisms. K. rhizophila was inhibited more effectively (p<0.05) by ZOE, while Calen/ZO had its highest antibacterial activity against E. faecalis (p<0.05). S. mutans was inhibited by Calen/ZO, Sealapex and ZOE in the same intensity (p>0.05). E. coli was inhibited more effectively (p<0.05) by ZOE, followed by Calen/ZO and Sealapex. Calen/ZO and ZOE were equally effective (p>0.05) against S. aureus, while Sealapex had the lowest antibacterial efficacy (p<0.05) against this microorganism. EndoREZ presented antibacterial activity only against K. rhizophila and S. aureus. The Calen paste and Calen/ZO produced larger zones of inhibition than 1% CHX when the marker microorganism was E faecalis. In conclusion, the in vitro antibacterial activity of the 4 root canal filling materials for primary teeth against bacterial strains commonly found in endodontic infections can be presented in a decreasing order of efficacy as follows: ZOE>Calen/ZO>Sealapex>EndoREZ.

Correlação entre métodos de aleitamento, hábitos de sucção e comportamentos orofaciais

TEMA: o desenvolvimento do controle motor oral depende em parte das experiências sensoriais e motoras. OBJETIVO: analisar a relação entre a duração do aleitamento natural, artificial e da sucção e destas com o desempenho motor orofacial. MÉTODO: cento e setenta e seis crianças, de 6 a 12 anos de idade, passaram por avaliação miofuncional orofacial, empregando o protocolo com escores, e os responsáveis foram entrevistados a respeito do aleitamento e hábitos de sucção de suas crianças. As correlações foram calculadas pelo teste de Spearman. RESULTADOS: na amostra estudada, a média de duração do aleitamento natural foi de 10,30 meses (variando de zero a 60 meses), do aleitamento artificial 44,12 (zero a 122 meses) e dos hábitos de sucção de 39,32 meses (zero a 144 meses). Houve correlação negativa da duração do aleitamento natural com a duração do aleitamento artificial e a duração dos hábitos de sucção (p < 0,001). A maior duração do aleitamento artificial correspondeu à maior duração dos hábitos de sucção, apresentando, assim, correlação positiva (p < 0,001). A duração do aleitamento natural foi correlacionada positivamente com a mobilidade orofacial (p = 0,05). Houve correlação negativa da duração do aleitamento artificial e da duração dos hábitos de sucção com, respectivamente, o desempenho na mastigação e na deglutição, bem como da duração de ambos os tipos de sucção com a prova de diadococinesia (p = 0,05). CONCLUSÃO: a duração do aleitamento natural mostrou efeito positivo sobre a mobilidade das estruturas orofaciais. Os efeitos deletérios da duração dos hábitos de sucção no controle motor orofacial foram confirmados.

Effect of different polishing systems on the surface roughness of microhybrid composites

The use of composite resins in dentistry is well accepted for restoring anterior and posterior teeth. Many polishing protocols have been evaluated for their effect on the surface roughness of restorative materials. This study compared the effect of different polishing systems on the surface roughness of microhybrid composites. Thirty-six specimens were prepared for each composite $#91;Charisma® (Heraeus Kulzer), Fill Magic® (Vigodent), TPH Spectrum® (Dentsply), Z100® (3M/ESPE) and Z250® (3M/ESPE)] and submitted to surface treatment with Enhance® and PoGo® (Dentsply) points, sequential Sof-Lex XT® aluminum oxide disks (3M/ESPE), and felt disks (TDV) combined with Excel® diamond polishing paste (TDV). Average surface roughness (Ra) was measured with a mechanical roughness tester. The data were analyzed by two-way ANOVA with repetition of the factorial design and the Tukey-Kramer test (p<0.01). The F-test result for treatments and resins was high (p<0.0001 for both), indicating that the effect of the treatment applied to the specimen surface and the effect of the type of resin on surface roughness was highly significant. Regarding the interaction between polishing system and type of resin used, a p value of 0.0002 was obtained, indicating a statistically significant difference. A Ra of 1.3663 was obtained for the Sof-Lex/TPH Spectrum interaction. In contrast, the Ra for the felt disk+paste/Z250 interactions was 0.1846. In conclusion, Sof-Lex polishing system produced a higher surface roughness on TPH Spectrum resin when compared to the other interactions.

Estressores em Unidade de Terapia Intensiva: versão brasileira do The Environmental Stressor Questionnaire

Este estudo teve como objetivo realizar a adaptação cultural do The Environmental Stressor Questionnaire - (ESQ) para a língua portuguesa do Brasil e verificar sua confiabilidade e validade. Foram empregadas as etapas metodológicas recomendadas pela literatura para adaptação cultural. A versão brasileira do ESQ foi aplicada a 106 pacientes de Unidade de Terapia Intensiva (UTI) de dois hospitais, público e privado, do interior do Estado de São Paulo. A confiabilidade foi avaliada quanto à consistência interna e estabilidade (teste e reteste); a validade convergente foi verificada por meio da correlação entre o ESQ e questão genérica sobre estresse em UTI. A confiabilidade foi satisfatória com Alfa de Crombach=0,94 e Coeficiente de Correlação Intraclasse=0,861 (IC95% 0,723; 0,933). Constatou-se correlação entre o escore total do ESQ e a questão genérica sobre estresse (r=0,70), confirmando a validade convergente. A versão brasileira do ESQ mostrou-se uma ferramenta confiável e válida para avaliação de estressores em UTI.

Relationship among malocclusion, number of occlusal pairs and mastication

This study evaluated the relationship among malocclusion, number of occlusal pairs, masticatory performance, masticatory time and masticatory ability in completely dentate subjects. Eighty healthy subjects (mean age = 19.40 ± 4.14 years) were grouped according to malocclusion diagnosis (n = 16): Class I, Class Class II-2, Class III and Normocclusion (control). Number of occlusal pairs was determined clinically. Masticatory performance was evaluated by the sieving method, and the time used for the comminute test food was registered as the masticatory time. Masticatory ability was measured by a dichotomic self-perception questionnaire. Statistical analysis was done by one-way ANOVA, ANOVA on ranks, Chi-Square and Spearman tests. Class II-1 and III malocclusion groups presented a smaller number of occlusal pairs than Normocclusion (p < 0.0001), Class I (p < 0.001) and II-2 (p < 0.0001) malocclusion groups. Class I, and III malocclusion groups showed lower masticatory performance values compared to Normocclusion (p < 0.05) and Class II-2 (p < 0.05) malocclusion groups. There were no differences in masticatory time (p = 0.156) and ability (χ2 = 3.58/p= 0.465) among groups. Occlusal pairs were associated with malocclusion (rho = 0.444/p < 0.0001) and masticatory performance (rho = 0.393/p < 0.0001), but malocclusion was not correlated with masticatory performance (rho = 0.116/p= 0.306). In conclusion, masticatory performance and ability were not related to malocclusion, and subjects with Class I, II-1 and III malocclusions presented lower masticatory performance because of their smaller number of occlusal pairs.

Níveis de concentrado e sais de cálcio de ácidos graxos para novilhos terminados em confinamento

Objetivou-se avaliar o efeito do nível de concentrado e dos sais de cálcio de ácidos graxos (SCAG) sobre o desempenho e qualidade da carne de novilhos terminados em confinamento. Sessenta novilhos Nelore e cruza Nelore foram divididos em quatro grupos e confinados por um período de 85 dias com as seguintes dietas: (BC) 46,7% de concentrado; (BC-SCAG) dieta BC acrescida de 3% de SCAG; (AC) dieta contendo 76,6% de concentrado e (AC-SCAG) dieta AC com 3% de SCAG. O nível de concentrado não influenciou o ganho médio diário, a espessura de gordura subcutânea e a área de olho de lombo, mas as dietas AC aumentaram o peso (P=0,0011) e o rendimento (P<0,0001) de carcaça, além da força de cisalhamento (P=0,0438). Animais alimentados com as dietas AC apresentaram maior peso (P=0,0011) e rendimento (P<0,0001) de carcaça em relação aos animais do tratamento BC. Os SCAG aumentaram o ganho de peso em dietas de AC (P=0,0311), mas sem efeito nas dietas BC. Animais tratados com as dietas contendo SCAG apresentaram maior peso (P=0,0133) e rendimento de carcaça (P=0,0160), mas sem diferenças na espessura de gordura subcutânea, área de olho de lombo e força de cisalhamento. Dietas de alto concentrado e os SCAG melhoraram as características quantitativas (peso e rendimento) das carcaças de bovinos na fase de terminação e podem ser utilizadas pelos produtores como alternativa para melhorar a eficiência do sistema de produção.

Evaluation of DNA extraction protocols for Brucella abortus pcr detection in aborted fetuses or calves born from cows experimentally infected with strain 2308

The objective of the present study was to improve the detection of B. abortus by PCR in organs of aborted fetuses from infected cows, an important mechanism to find infected herds on the eradication phase of the program. So, different DNA extraction protocols were compared, focusing the PCR detection of B. abortus in clinical samples collected from aborted fetuses or calves born from cows challenged with the 2308 B. abortus strain. Therefore, two gold standard groups were built based on classical bacteriology, formed from: 32 lungs (17 positives), 26 spleens (11 positives), 23 livers (8 positives) and 22 bronchial lymph nodes (7 positives). All samples were submitted to three DNA extraction protocols, followed by the same amplification process with the primers B4 and B5. From the accumulated results for organ, the proportion of positives for the lungs was higher than the livers (p=0.04) or bronchial lymph nodes (p=0.004) and equal to the spleens (p=0.18). From the accumulated results for DNA extraction protocol, the proportion of positives for the Boom protocol was bigger than the PK (p<0.0001) and GT (p=0.0004). There was no difference between the PK and GT protocols (p=0.5). Some positive samples from the classical bacteriology were negative to the PCR and viceversa. Therefore, the best strategy for B. abortus detection in the organs of aborted fetuses or calves born from infected cows is the use, in parallel, of isolation by classical bacteriology and the PCR, with the DNA extraction performed by the Boom protocol.

Oxigenoterapia domiciliar prolongada em crianças e adolescentes: uma análise do uso clínico e de custos de um programa assistencial

OBJETIVOS: Descrever as características clínicas e laboratoriais dos pacientes em oxigenoterapia domiciliar prolongada acompanhados pelo programa de atendimento domiciliar do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, durante um período de 8 anos, e comparar os grupos com e sem hipertensão pulmonar secundária. Estimar o custo do programa utilizando concentradores versus cilindros de oxigênio arcados pela instituição. MÉTODOS: Estudo descritivo retrospectivo e de coorte dos pacientes em oxigenoterapia domiciliar prolongada, em seguimento no período de 2002 a 2009, na Unidade de Pneumologia do Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. RESULTADOS: Foram estudados 165 pacientes, 53% do sexo masculino, com as medianas: idade de início da oxigenoterapia - 3,6 anos; tempo de oxigenoterapia - 7 anos; e tempo de sobrevida após início da oxigenoterapia - 3,4 anos. Os principais diagnósticos foram: fibrose cística (22%), displasia broncopulmonar (19%) e bronquiolite obliterante (15%). Dos 33 pacientes que realizaram espirometria, 70% apresentavam distúrbio ventilatório obstrutivo grave. O exame ecocardiográfico foi executado em 134 pacientes; 51% deles tinham hipertensão pulmonar secundária. Houve associação estatisticamente significante entre: presença de hipertensão pulmonar e necessidade de maiores fluxos de oxigênio (qui-quadrado, p = 0,011); e presença de hipertensão pulmonar e maior tempo de oxigenoterapia (Logrank, p = 0,0001). Não houve diferença estatisticamente significante entre tempo de sobrevida após início da oxigenoterapia e presença de hipertensão pulmonar. Os custos médios mensais do programa foram: US$ 7.392,93 para os concentradores e US$ 16.630,92 para cilindros. CONCLUSÕES: A oxigenoterapia domiciliar prolongada foi empregada em distintas doenças crônicas, predominantemente em lactentes e pré-escolares. Houve alta frequência de hipertensão pulmonar associada a maiores períodos de uso e fluxos de oxigênio, sem associação à sobrevida. A substituição dos cilindros por concentradores poderá reduzir custos significativamente.