Association between phase angle, anthropometric measurements, and lipid profile in HCV-infected patients

OBJECTIVE: The objective of this study was to investigate the associations between phase angle, anthropometric measurements, and lipid profile in patients chronically infected with the hepatitis C virus. METHODS: A total of 160 consecutive patients chronically infected with the hepatitis C virus and who received treatment at the hepatitis C outpatient unit of our hospital from April 2010 to May 2011 were prospectively evaluated. Bioelectrical impedance analysis, anthropometric measurements, and serum lipid profile analysis were performed. RESULTS: Twenty-five patients were excluded. A total of 135 patients with a mean age of 49.8±11.4 years were studied. Among these patients, 60% were male. The phase angle and BMI means were 6.5±0.8° and 26.5±4.8 kg/m2, respectively. Regarding anthropometric variables, mid-arm circumference, mid-arm muscle circumference, and arm muscle area had a positive correlation with phase angle. In contrast, when analyzing the lipid profile, only HDL was inversely correlated with phase angle. However, in multiple regression models adjusted for age and gender, only mid-arm circumference (p = 0.005), mid-arm muscle circumference (p = 0.003), and arm muscle circumference (p = 0.001) were associated with phase angle in hepatitis C virus-infected patients. CONCLUSIONS: In conclusion, phase angle is positively correlated with anthropometric measures in our study. However, there is no association between phase angle and lipid profile in these patients. Our results suggest that phase angle is related to lean body mass in patients chronically infected with hepatitis C virus.

Risk factors for blindness in patients with open-angle glaucoma followed-up for at least 15 years

Purpose: To determine the proportion of blindness and investigate the relationships between risk factors based on clinical characteristics and development of blindness in patients with primary open-angle glaucoma (POAG) treated for at least 15 years. Methods: A retrospective observational chart review was performed with 403 patients referred to a tertiary level hospital, each with a diagnosis of primary open-angle glaucoma, treated for at least 15 years. Blindness attributable to glaucoma was defined based on visual acuity and/or visual field tests. Variables considered to be possible risk factors for blindness were evaluated using odds ratio (OR), confidence interval (95% CI), and univariate and multivariate analyses. Results: Thirty-one patients became blind [13/53 (24.5%) - unilaterally and 18/53 (34%) - bilaterally] during the follow-up period of treatment (19.5 +/- 4.6 years, range 15-31 years). Multivariate statistics with regression analysis revealed that persistency on initial therapy <= 6 months was significantly associated with blindness, both unilateral (OR: 8.4; 95% CI: 1.3-56.4) and bilateral (OR: 7.2; 95% CI: 1.3-39.6). Other potential factors such as race, age, gender or number of medications were not associated with blindness. Conclusion: Blindness from primary open-angle glaucoma was not uncommon in this population of treated patients after the long follow-up period proposed. Persistence rates with the first therapy, as measured by a medical decision to change, were low. Persistence <= 6 months was statistically associated with the development of unilateral and bilateral blindness from glaucoma.

Angle class II correction with MARA appliance

Objective: To assess the effects produced by the MARA appliance in the treatment of Angle’s Class II, division 1 malocclusion. Methods: The sample consisted of 44 young patients divided into two groups: The MARA Group, with initial mean age of 11.99 years, treated with the MARA appliance for an average period of 1.11 years, and the Control Group, with initial mean age of 11.63 years, monitored for a mean period of 1.18 years with no treatment. Lateral cephalograms were used to compare the groups using cephalometric variables in the initial and final phases. For these comparisons, Student’s t test was employed. Results: MARA appliance produced the following effects: Maxillary growth restriction, no change in mandibular development, improvement in maxillomandibular relationship, increased lower anterior facial height and counterclockwise rotation of the functional occlusal plane. In the upper arch, the incisors moved lingually and retruded, while the molars moved distally and tipped distally. In the lower arch, the incisors proclined and protruded, whereas the molars mesialized and tipped mesially. Finally, there was a significant reduction in overbite and overjet, with an obvious improvement in molar relationship. Conclusions: It was concluded that the MARA appliance proved effective in correcting Angle’s Class II, division 1 malocclusion while inducing skeletal changes and particularly dental changes.

Age, trauma and the critical shoulder angle accurately predict supraspinatus tendon tears.

BACKGROUND The pathogenesis of full-thickness tears of the rotator cuff remains unclear. Apart from age and trauma, distinct scapular morphologies have been found to be associated with rotator cuff disease. The purpose of the present study was to evaluate whether a score formed using these established risk factors was able to predict the presence of a rotator cuff tear reliably. METHODS We retrospectively assessed a consecutive series of patients with a minimal age of 40 years old, who had true antero-posterior (AP) radiographs of their shoulders, as well as a magnetic resonance (MR) gadolinium-arthrography, between January and December 2011. In all of these patients, the critical shoulder angle (CSA) was determined, and MR images were assessed for the presence of rotator cuff tears. Additionally, the patients' charts were reviewed to obtain details of symptom onset. Based on these factors, the so-called rotator cuff tear (RCT) score was calculated. RESULTS Patients with full-thickness RCTs were significantly older and had significantly larger CSAs than patients with intact rotator cuffs. Multiple logistic regression, using trauma, age and CSA as independent variables, revealed areas under the curve (AUCs) for trauma of 0.55, for age of 0.65 and for CSA of 0.86. The combination of all three factors was the most powerful predictor, with an AUC of 0.92. CONCLUSION Age, trauma and the CSA can accurately predict the presence of a posterosuperior RCT. LEVEL OF EVIDENCE Level IV. Case series with no comparison groups.

Aplicaciones de interés forestal de las imágenes obtenidas con el sensor Multi-angle Imaging SpectroRadiometer (MISR)

Las aplicaciones de la teledetección al seguimiento de lo que ocurre en la superficie terrestre se han ido multiplicando y afinando con el lanzamiento de nuevos sensores por parte de las diferentes agencias espaciales. La necesidad de tener información actualizada cada poco tiempo y espacialmente homogénea, ha provocado el desarrollo de nuevos programas como el Earth Observing System (EOS) de la National Aeronautics and Space Administration (NASA). Uno de los sensores que incorpora el buque insignia de ese programa, el satélite TERRA, es el Multi-angle Imaging SpectroRadiometer (MISR), diseñado para capturar información multiangular de la superficie terrestre. Ya desde los años 1970, se conocía que la reflectancia de las diversas ocupaciones y usos del suelo variaba en función del ángulo de observación y de iluminación, es decir, que eran anisotrópicas. Tal variación estaba además relacionada con la estructura tridimensional de tales ocupaciones, por lo que se podía aprovechar tal relación para obtener información de esa estructura, más allá de la que pudiera proporcionar la información meramente espectral. El sensor MISR incorpora 9 cámaras a diferentes ángulos para capturar 9 imágenes casi simultáneas del mismo punto, lo que permite estimar con relativa fiabilidad la respuesta anisotrópica de la superficie terrestre. Varios trabajos han demostrado que se pueden estimar variables relacionadas con la estructura de la vegetación con la información que proporciona MISR. En esta Tesis se ha realizado una primera aplicación a la Península Ibérica, para comprobar su utilidad a la hora de estimar variables de interés forestal. En un primer paso se ha analizado la variabilidad temporal que se produce en los datos, debido a los cambios en la geometría de captación, es decir, debido a la posición relativa de sensores y fuente de iluminación, que en este caso es el Sol. Se ha comprobado cómo la anisotropía es mayor desde finales de otoño hasta principios de primavera debido a que la posición del Sol es más cercana al plano de los sensores. También se ha comprobado que los valores máximo y mínimo se van desplazando temporalmente entre el centro y el extremo angular. En la caracterización multiangular de ocupaciones del suelo de CORINE Land Cover que se ha realizado, se puede observar cómo la forma predominante en las imágenes con el Sol más alto es convexa con un máximo en la cámara más cercana a la fuente de iluminación. Sin embargo, cuando el Sol se encuentra mucho más bajo, ese máximo es muy externo. Por otra parte, los datos obtenidos en verano son mucho más variables para cada ocupación que los de noviembre, posiblemente debido al aumento proporcional de las zonas en sombra. Para comprobar si la información multiangular tiene algún efecto en la obtención de imágenes clasificadas según ocupación y usos del suelo, se han realizado una serie de clasificaciones variando la información utilizada, desde sólo multiespectral, a multiangular y multiespectral. Los resultados muestran que, mientras para las clasificaciones más genéricas la información multiangular proporciona los peores resultados, a medida que se amplían el número de clases a obtener tal información mejora a lo obtenido únicamente con información multiespectral. Por otra parte, se ha realizado una estimación de variables cuantitativas como la fracción de cabida cubierta (Fcc) y la altura de la vegetación a partir de información proporcionada por MISR a diferentes resoluciones. En el valle de Alcudia (Ciudad Real) se ha estimado la fracción de cabida cubierta del arbolado para un píxel de 275 m utilizando redes neuronales. Los resultados muestran que utilizar información multiespectral y multiangular puede mejorar casi un 20% las estimaciones realizadas sólo con datos multiespectrales. Además, las relaciones obtenidas llegan al 0,7 de R con errores inferiores a un 10% en Fcc, siendo éstos mucho mejores que los obtenidos con el producto elaborado a partir de datos multiespectrales del sensor Moderate Resolution Imaging Spectroradiometer (MODIS), también a bordo de Terra, para la misma variable. Por último, se ha estimado la fracción de cabida cubierta y la altura efectiva de la vegetación para 700.000 ha de la provincia de Murcia, con una resolución de 1.100 m. Los resultados muestran la relación existente entre los datos espectrales y los multiangulares, obteniéndose coeficientes de Spearman del orden de 0,8 en el caso de la fracción de cabida cubierta de la vegetación, y de 0,4 en el caso de la altura efectiva. Las estimaciones de ambas variables con redes neuronales y diversas combinaciones de datos, arrojan resultados con R superiores a 0,85 para el caso del grado de cubierta vegetal, y 0,6 para la altura efectiva. Los parámetros multiangulares proporcionados en los productos elaborados con MISR a 1.100 m, no obtienen buenos resultados por sí mismos pero producen cierta mejora al incorporarlos a la información espectral. Los errores cuadráticos medios obtenidos son inferiores a 0,016 para la Fcc de la vegetación en tanto por uno, y 0,7 m para la altura efectiva de la misma. Regresiones geográficamente ponderadas muestran además que localmente se pueden obtener mejores resultados aún mejores, especialmente cuando hay una mayor variabilidad espacial de las variables estimadas. En resumen, la utilización de los datos proporcionados por MISR ofrece una prometedora vía de mejora de resultados en la media-baja resolución, tanto para la clasificación de imágenes como para la obtención de variables cuantitativas de la estructura de la vegetación. ABSTRACT Applications of remote sensing for monitoring what is happening on the land surface have been multiplied and refined with the launch of new sensors by different Space Agencies. The need of having up to date and spatially homogeneous data, has led to the development of new programs such as the Earth Observing System (EOS) of the National Aeronautics and Space Administration (NASA). One of the sensors incorporating the flagship of that program, the TERRA satellite, is Multi-angle Imaging Spectroradiometer (MISR), designed to capture the multi-angle information of the Earth's surface. Since the 1970s, it was known that the reflectance of various land covers and land uses varied depending on the viewing and ilumination angles, so they are anisotropic. Such variation was also related to the three dimensional structure of such covers, so that one could take advantage of such a relationship to obtain information from that structure, beyond which spectral information could provide. The MISR sensor incorporates 9 cameras at different angles to capture 9 almost simultaneous images of the same point, allowing relatively reliable estimates of the anisotropic response of the Earth's surface. Several studies have shown that we can estimate variables related to the vegetation structure with the information provided by this sensor, so this thesis has made an initial application to the Iberian Peninsula, to check their usefulness in estimating forest variables of interest. In a first step we analyzed the temporal variability that occurs in the data, due to the changes in the acquisition geometry, i.e. the relative position of sensor and light source, which in this case is the Sun. It has been found that the anisotropy is greater from late fall through early spring due to the Sun's position closer to the plane of the sensors. It was also found that the maximum and minimum values are displaced temporarily between the center and the ends. In characterizing CORINE Land Covers that has been done, one could see how the predominant form in the images with the highest sun is convex with a maximum in the camera closer to the light source. However, when the sun is much lower, the maximum is external. Moreover, the data obtained for each land cover are much more variable in summer that in November, possibly due to the proportional increase in shadow areas. To check whether the information has any effect on multi-angle imaging classification of land cover and land use, a series of classifications have been produced changing the data used, from only multispectrally, to multi-angle and multispectral. The results show that while for the most generic classifications multi-angle information is the worst, as there are extended the number of classes to obtain such information it improves the results. On the other hand, an estimate was made of quantitative variables such as canopy cover and vegetation height using information provided by MISR at different resolutions. In the valley of Alcudia (Ciudad Real), we estimated the canopy cover of trees for a pixel of 275 m by using neural networks. The results showed that using multispectral and multiangle information can improve by almost 20% the estimates that only used multispectral data. Furthermore, the relationships obtained reached an R coefficient of 0.7 with errors below 10% in canopy cover, which is much better result than the one obtained using data from the Moderate Resolution Imaging Spectroradiometer (MODIS), also onboard Terra, for the same variable. Finally we estimated the canopy cover and the effective height of the vegetation for 700,000 hectares in the province of Murcia, with a spatial resolution of 1,100 m. The results show a relationship between the spectral and the multi-angle data, and provide estimates of the canopy cover with a Spearman’s coefficient of 0.8 in the case of the vegetation canopy cover, and 0.4 in the case of the effective height. The estimates of both variables using neural networks and various combinations of data, yield results with an R coefficient greater than 0.85 for the case of the canopy cover, and 0.6 for the effective height. Multi-angle parameters provided in the products made from MISR at 1,100 m pixel size, did not produce good results from themselves but improved the results when included to the spectral information. The mean square errors were less than 0.016 for the canopy cover, and 0.7 m for the effective height. Geographically weighted regressions also showed that locally we can have even better results, especially when there is high spatial variability of estimated variables. In summary, the use of the data provided by MISR offers a promising way of improving remote sensing performance in the low-medium spatial resolution, both for image classification and for the estimation of quantitative variables of the vegetation structure.

Characterization of a Right Angle Transfer Point in a Fruit Packing Line

Characteristics of the impacts su!ered by the fruit on a transfer point of an experimental fruit packing line were analysed. The transfer is made up by two transporting belts at di!erent heights forming an angle of 903. These transfer points are very common in fruit packing lines, in which fruits receive two impacts: the "rst onto the belt base and the second into the lateral plate. Diferent tests were carried out to study the e!ect of transfer height, velocity, belt structure and padding on the acceleration values recorded by an instrumental sphere (IS 100). Results showed that transfer height and belt structure a!ect mainly impact values on the belt base, and padding a!ects mainly impact values registered for lateral contact. The elect of belt velocity in both impacts is less important when compared to the rest of the variables. Additionally, two powered transfer decelerators were tested at the same point with the aim of decreasing impacts su!ered by the fruit. Comparing impacts registered using these decelerators to those analysed in the first part of the study without decelerators, a high reduction of the impact values was observed.

AVALIAÇÃO CEFALOMÉTRICA DO ESPAÇO AÉREO NASO E BUCOFARÍNGEO E SUA IMPORTÂNCIA SOBRE O PADRÃO DE CRESCIMENTO E FUNÇÃO RESPIRATÓRIA EM INDIVÍDUOS COM MÁ OCLUSÃO CLASSE II, DIVISÃO 1 DE ANGLE

O objetivo deste estudo foi avaliar o tamanho do espaço aéreo naso e bucofaríngeo em indivíduos com má oclusão Classe II, divisão 1 de Angle. A metodologia constou da mensuração do espaço aéreo naso e bucofaríngeo em 122 telerradiografias laterais de indivíduos na faixa etária dos 12 aos 21 anos, brasileiros leucodermas. Desses indivíduos, 62 apresentavam respiração nasal e 60 respiração bucal, não sendo submetidos a tratamento ortodôntico prévio. Os resultados demonstraram a ausência de dimorfimo sexual; os indivíduos respiradores nasais apresentaram maiores dimensões dos limites superior e inferior e da menor secção transversal do espaço aéreo quando comparado aos respiradores bucais. O tamanho médio da adenóide foi maior nos pacientes respiradores bucais. Quando comparamos as variáveis estudadas com os padrões faciais não foram observadas diferenças entre os mesmos, porém quando associamos padrão facial com o tipo de respiração foi encontrada maior proporção de indivíduos respiradores bucais nos padrões dolicofacial e mesofacial em relação ao padrão braquifacial.

AVALIAÇÃO DAS ALTERAÇÕES DENTOESQUELÉTICAS DE PACIENTES COM MÁ OCLUSÃO DE CLASSE II DE ANGLE, TRATADOS COM O APARELHO REGULADOR DE FUNÇÃO DE FRÄNKEL (RF-2).

Esta pesquisa objetivou estudar retrospectivamente por meio de radiografias em norma frontal e modelos de gesso as alterações dentoesqueléticas de pacientes com má oclusão de Classe II, 1ª divisão, divididos em dois grupos: Grupo Tratado, constituído de 28 pacientes, sendo 13 pacientes do sexo masculino e 15 do sexo feminino, tratados com aparelho regulador de função de Fränkel - 2 (RF-2), por um período ativo de 1,5 anos; Grupo Controle: constituído de 28 pacientes, sendo 12 do sexo masculino e 16 do sexo feminino, sem nenhum tipo de tratamento durante o acompanhamento longitudinal de 1,5 anos. A amostra deste estudo consistiu de 112 telerradiografias em norma frontal e 112 pares de modelos de gesso, 56 obtidos ao início (T1) e 56 ao final da observação (T2). Após a análise estatística das mensurações obtidas, concluiu- se que houve como resultado alterações estatisticamente significantes em todas as medidas analisadas e o aparelho RF-2 teve atuação direta nas variáveis: distância intermolares superio res e inferiores (radiografias e modelos),profundidade palatina, largura maxilar e altura facial ântero-inferior.

Percepção dos Ortodontistas quanto à época ideal para o tratamento ortodôntico da má oclusão de Classe II de Angle.

O objetivo deste estudo foi verificar, por meio de questionário, a percepção dos ortodontistas quanto a época ideal para o tratamento ortodôntico da má oclusão de Classe II de Angle, avaliar a eficiência deste tipo de tratamento em uma ou duas fases e identificar os diversos métodos de tratamento utilizados. A amostra constituiu de 163 ortodontistas brasileiros que responderam ao questionário via e-mail. O questionário continha perguntas do tipo aberta, semi aberta e fechada, e, para sua validação, foi realizado um teste piloto entre 15 ortodontistas, participantes ou ex-alunos do Programa de Pós-graduação em Odontologia da Universidade Metodista de São Paulo, que não foram inclusos neste trabalho. Os dados foram tabulados com a utilização de frequência absoluta (n) e frequência relativa (%). Para verificar a correlação entre as variáveis ordinais foi utilizado o Coeficiente de Correlação de Spearman. Para verificar a associação entre variáveis qualitativas nominais foi utilizado o teste do qui-quadrado. Em todos os testes foi adotado nível de significância de 5% (p<0,05). Todos os procedimentos estatísticos foram executados no programa Statistica v.5.1 (StatSoft Inc., Tulsa, USA). Observou-se que os ortodontistas brasileiros preferem tratar os pacientes portadores da má oclusão de Classe II durante a fase da dentadura mista tardia, onde a procura por tratamentos nos consultórios e/ou clínicas tem maior ocorrência entre 10 a 13 anos e no sexo feminino. Dentre as modalidades de tratamento, verificou-se que 25 a 50% dos profissionais tratam seus pacientes em duas fases, seja na utilização do Aparelho Extra Bucal (49,1%), Bionator (33,1%) ou propulsores mandibulares, como APM (17,8%), e, Elásticos Classe II (8,6%).

Structure and function in primary open angle glaucoma

The study utilised a Normal group, an Ocular Hypertensive (OHT) group and a Primary Open Angle Glaucoma (POAG) group to investigate two aspects. Firstly, the within- and between-visit variability for stereometric measurements of the optic nerve head (ONH) using the Heidelberg Retina Tomograph (HRT); retinal nerve fibre layer (RNFL) thickness using the HRT and using optical coherence tomography with the Optical Coherence Tomography Scanner (OCT); the visual field using white-on-white (W-W), short-wavelength (SWAP) and Frequency Doubling perimetry (FDT); and retinal haemodynamics using the Heidelberg Retinal Flowmeter (HRF). Secondly, the association demonstrated between some of the derived variables. The within- and between-visit variability for stereometric measurements of the entire ONH and the between-visit variability for sectoral measurements were similar for Normals and OHTs but greater for POAGs. The within-visit variability of the visual field pointwise parameters for SWAP were greater than for W-W and FDT particularly with increase in eccentricity and for the OHT group. The between-visit variability increased with increase in defect depth for the POAG group, across all types of perimetry. The MS was greater, the MD and PSD smaller and the examination duration shorter in FDT compared to W-W and SWAP across all groups. The within-visit variability was less than the between-visit variability for the OCT circumferential and sector RNFL thickness using the 1.5R, 2.0R and the fixed 1.73mm circular scan radii, across the three groups. The variability increased with decrease in the RNFL thickness, and was least for the 2.0R scan radius.

Solid Lipid Nanoparticles For Hydrophilic Biotech Drugs: Optimization And Cell Viability Studies (caco-2 & Hepg-2 Cell Lines).

Insulin was used as model protein to developed innovative Solid Lipid Nanoparticles (SLNs) for the delivery of hydrophilic biotech drugs, with potential use in medicinal chemistry. SLNs were prepared by double emulsion with the purpose of promoting stability and enhancing the protein bioavailability. Softisan(®)100 was selected as solid lipid matrix. The surfactants (Tween(®)80, Span(®)80 and Lipoid(®)S75) and insulin were chosen applying a 2(2) factorial design with triplicate of central point, evaluating the influence of dependents variables as polydispersity index (PI), mean particle size (z-AVE), zeta potential (ZP) and encapsulation efficiency (EE) by factorial design using the ANOVA test. Therefore, thermodynamic stability, polymorphism and matrix crystallinity were checked by Differential Scanning Calorimetry (DSC) and Wide Angle X-ray Diffraction (WAXD), whereas the effect of toxicity of SLNs was check in HepG2 and Caco-2 cells. Results showed a mean particle size (z-AVE) width between 294.6 nm and 627.0 nm, a PI in the range of 0.425-0.750, ZP about -3 mV, and the EE between 38.39% and 81.20%. After tempering the bulk lipid (mimicking the end process of production), the lipid showed amorphous characteristics, with a melting point of ca. 30 °C. The toxicity of SLNs was evaluated in two distinct cell lines (HEPG-2 and Caco-2), showing to be dependent on the concentration of particles in HEPG-2 cells, while no toxicity in was reported in Caco-2 cells. SLNs were stable for 24 h in in vitro human serum albumin (HSA) solution. The resulting SLNs fabricated by double emulsion may provide a promising approach for administration of protein therapeutics and antigens.

[impact Variables On The Decline In Infant Mortality In The State Of São Paulo, Brazil: 1998-2008].

This is an ecological, analytical and retrospective study comprising the 645 municipalities in the State of São Paulo, the scope of which was to determine the relationship between socioeconomic, demographic variables and the model of care in relation to infant mortality rates in the period from 1998 to 2008. The ratio of average annual change for each indicator per stratum coverage was calculated. Infant mortality was analyzed according to the model for repeated measures over time, adjusted for the following correction variables: the city's population, proportion of Family Health Programs (PSFs) deployed, proportion of Growth Acceleration Programs (PACs) deployed, per capita GDP and SPSRI (São Paulo social responsibility index). The analysis was performed by generalized linear models, considering the gamma distribution. Multiple comparisons were performed with the likelihood ratio with chi-square approximate distribution, considering a significance level of 5%. There was a decrease in infant mortality over the years (p < 0.05), with no significant difference from 2004 to 2008 (p > 0.05). The proportion of PSFs deployed (p < 0.0001) and per capita GDP (p < 0.0001) were significant in the model. The decline of infant mortality in this period was influenced by the growth of per capita GDP and PSFs.

Variables Associated With The Performance Of Centers For Dental Specialties In Brazil.

The aim of this study was to evaluate the performance of the Centers for Dental Specialties (CDS) in the country and associations with sociodemographic indicators of the municipalities, structural variables of services and primary health care organization in the years 2004-2009. The study used secondary data from procedures performed in the CDS to the specialties of periodontics, endodontics, surgery and primary care. Bivariate analysis by χ2 test was used to test the association between the dependent variable (performance of the CDS) with the independents. Then, Poisson regression analysis was performed. With regard to the overall achievement of targets, it was observed that the majority of CDS (69.25%) performance was considered poor/regular. The independent factors associated with poor/regular performance of CDS were: municipalities belonging to the Northeast, South and Southeast regions, with lower Human Development Index (HDI), lower population density, and reduced time to deployment. HDI and population density are important for the performance of the CDS in Brazil. Similarly, the peculiarities related to less populated areas as well as regional location and time of service implementation CDS should be taken into account in the planning of these services.

Sexual dysfunction in epilepsy: identifying the psychological variables

In order to evaluate the psychological variables that affect sexual dysfunction (SD) in epilepsy, where compared 60 epileptics (Group 1) with 60 healthy individuals (Group 2), through the State-Trait Anxiety Inventory (Spielberger et al., 1970), Beck Depression Inventory (Beck, 1974) and Sexual Behavior Interview (Souza, 1995). Sexual dysfunction (SD), anxiety and depression were found more frequently in Group 1 than in Group 2 and were not related to sex. Variables such as the onset duration and frequency of seizures as well as the use to medication were not associated with SD. Temporal lobe epilepsy was related to SD (p = 0.035) but not to anxiety or depression. Anxiety and depression were related to SD in both groups. Perception in controlling the seizures was closely related to anxiety (p = 0) and depression (p = 0.009). We conclude that psychological factors play an important role in the alteration of sexual behavior in epileptics and that suitable attention must be given to the control of these variables.

Identification of family variables in parents' groups of children with epilepsy

OBJECTIVE: To verify the effectiveness of the support group in the identification of family variables linked to epilepsy. METHOD: Pre-test were applied to parents of 21 children with benign epilepsy of childhood recently diagnosed, from 5 to 15 years, who participated in the groups at HC/Unicamp. There was a presentation of an educational video, discussion and application of the post-test 1. After six months, the post-test 2 was applied. RESULTS: The beliefs were: fear of swallowing the tongue during the seizures (76.19%) and of a future mental disease (66.67%). Facing the epilepsy, fear and sadness appeared. 76.19% of the parents presented overprotection and 90.48%, expected a new seizure. In the post-test 1, the parents affirmed that the information offered had modified the beliefs. In the post-test 2, 80.95% didn't report great doubts about epilepsy and 90.48% considered their relationship with their children better. CONCLUSIONS: The demystification of beliefs supplied from the groups influenced the family positively, prevented behavior alterations and guaranteed effective care in the attendance to the child with epilepsy.