Consenso brasileiro para a abordagem clínica e tratamento do hipotireoidismo subclínico em adultos: recomendações do Departamento de Tireoide da Sociedade Brasileira de Endocrinologia e Metabologia

INTRODUÇÃO: O hipotireoidismo subclínico (HSC), definido por concentrações elevadas do TSH em face de níveis normais dos hormônios tireoidianos, tem elevada prevalência no Brasil, particularmente entre mulheres e idosos. Embora um número crescente de estudos venha associando o HSC com maior risco de doença arterial coronariana e de mortalidade, não há ensaio clínico randomizado sobre o benefício do tratamento com levotiroxina na redução dos riscos e o tratamento permanece controverso. OBJETIVO: Este consenso, patrocinado pelo Departamento de Tireoide da Sociedade Brasileira de Endocrinologia e Metabologia e desenvolvido por especialistas brasileiros com vasta experiência clínica em tireoide, apresenta recomendações baseadas em evidências para uma abordagem clínica do paciente com HSC no Brasil. MATERIAIS E MÉTODOS: Após estruturação das questões clínicas, a busca das evidências disponíveis na literatura foi realizada inicialmente na base de dados do MedLine-PubMed e posteriormente nas bases Embase e SciELO - Lilacs. A força da evidência, avaliada pelo sistema de classificação de Oxford, foi estabelecida a partir do desenho de estudo utilizado, considerando-se a melhor evidência disponível para cada questão e a experiência brasileira. RESULTADOS: Os temas abordados foram definição e diagnóstico, história natural, significado clínico, tratamento e gestação, que resultaram em 29 recomendações para a abordagem clínica do paciente adulto com HSC. CONCLUSÃO: O tratamento com levotiroxina foi recomendado para todos os pacientes com HSC persistente com níveis séricos do TSH > 10 mU/L e para alguns subgrupos especiais de pacientes.

Laryngeal electromyography: Technical features

Laryngeal Electromyography (LEMG) is an auxiliary diagnostic method used for the comprehension and diagnosis of different neurological diseases that compromise laryngeal function. The most common LEMG technique is the percutaneous insertion of needle electrodes guided by surface anatomical references. We describe techniques for inserting needle electrodes into the tireoaritenoideus (TA), cricotireoideus (CT), cricoaritenoideus lateralis (CAL) and cricoaritenoideus posterioris (CAP) muscles; these are used at UNICAMP laryngology ambulatory; we discuss difficulties found and their proposed solutions. All patients were submitted to otorhinolaryngological, phonoaudiological and laryngeal endoscopy before LEMG. The CAP approach, by digital rotation of the thyroid cartilage was found to be the most difficult, followed by the CAL approach. TA and CT approaches gave no major problems, except with some older and obese patients. A significant complication of the TA approach via thyroid cartilage was a hematoma in one patient which partially obstructed the laryngeal lumen.

Using serial bluetooth converters as a sensor link in networked control systems

Networked control systems (NCS) are distributed control system in which sensors, actuators and controllers are physically separated and connected through communication networks. NCS represent the evolution of networked control architectures providing greater modularity and control decentralization, ease maintenance and diagnosis and lower cost of implementation. A recent trend in this research topic is the development of NCS using wireless networks which enable interoperability between existing wired and wireless systems. This paper presents the feasibility analysis of using a serial RS-232 to Bluetooth converter as a wireless sensor link in NCS. In order to support this investigation, relevant performance metrics for wireless control applications such as jitter, time delay and messages lost are highlighted and calculated to evaluate the converter capabilities. In addition the control performance of an implemented motor control system using the converter is analyzed. Experimental results led to the conclusion that serial RS-232 Bluetooth converters can be used to implement wireless networked control systems (WNCS) providing transmission rates and closed control loop times which are acceptable for NCS applications. © 2011 IEEE.

Evaluating serial ZigBee devices for application in wireless networked control systems

Networked control systems (NCS) are distributed control system where the sensors, actuators and controllers are physically separated and connected through communication networks. NCS represent the evolution of networked control architectures providing greater modularity and control decentralization, ease maintenance and diagnosis and lower cost of implementation. A recent trend in this research topic is the development of NCS using wireless networks (WNCS) enabling interoperability between existing wired and wireless systems. This paper evaluates a serial RS-232 ZigBee device as a wireless sensor link in NCS. In order to support this investigation, relevant performance metrics for wireless control applications such as jitter, time delay and messages lost are highlighted and calculated to evaluate the device capabilities. In addition the control performance of an implemented motor control system using the device is analyzed. Experimental results led to the conclusion that serial RS-232 ZigBee devices can be used to implement WNCS and the use of this device delay information in the PID controller discretization can improve the control performance of the system. © 2012 IEEE.

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.

Avaliação de sintomas neuropsiquiátricos na demência: Para melhorar a precisão

The issue of this article concerned the discussion about tools frequently used tools for assessing neuropsychiatric symptoms of patients with dementia, particularly Alzheimer's disease. The aims were to discuss the main tools for evaluating behavioral disturbances, and particularly the accuracy of the Neuropsychiatric Inventory - Clinician Rating Scale (NPI-C). The clinical approach to and diagnosis of neuropsychiatric syndromes in dementia require suitable accuracy. Advances in the recognition and early accurate diagnosis of psychopathological symptoms help guide appropriate pharmacological and non-pharmacological interventions. In addition, recommended standardized and validated measurements contribute to both scientific research and clinical practice. Emotional distress, caregiver burden, and cognitive impairment often experienced by elderly caregivers, may affect the quality of caregiver reports. The clinician rating approach helps attenuate these misinterpretations. In this scenario, the NPI-C is a promising and versatile tool for assessing neuropsychiatric syndromes in dementia, offering good accuracy and high reliability, mainly based on the diagnostic impression of the clinician. This tool can provide both strategies: a comprehensive assessment of neuropsychiatric symptoms in dementia or the investigation of specific psychopathological syndromes such as agitation, depression, anxiety, apathy, sleep disorders, and aberrant motor disorders, among others.

Discriminação entre pacientes normais e hemiplégicos utilizando plataforma de força e redes neurais

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeitos das distorções harmônicas (tensões e correntes) e desequilíbrios (tensões) em medidores eletrônicos trifásicos de energia elétrica ativa

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise experimental de erros de medição de energia elétrica ativa em medidores eletromagnéticos tipo indução, sujeitos a distorções harmônicas de correntes e tensões, em sistemas equilibrados e desequilibrados

Pós-graduação em Engenharia Elétrica - FEIS

Caracterização fisionômica de fragmentos vegetacionais do distrito de Rubião Júnior, minicípio de Botucatu, São Paulo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Detecção parasitológica, molecular e sorológica de Erlichia canis e babesia canis em cães da região Centro-Oriental da Colômbia

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Ocorrência de inibidores de fator de coagulação em pacientes hemofílicos atendidos no hemocentro regional de Maringá-PR

Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

Procedimentos de coletas de óleo para análise preditiva de turbinas à gás

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo de arboviroses em pacientes positivos para malária da região Amazônica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Erliquiose monocítica canina subclínica, naturalmente adquirida: diagnóstico, aspectos clínico-laboratoriais, envolvimento renal e evolução com o tratamento

Pós-graduação em Medicina Veterinária - FCAV