Avaliação do estado nutricional de indivíduos adultos sadios de classe média: ingestão energética e protéica, antropometria, exames bioquímicos do sangue e testes de imunocompetência

Foram estudados parâmetros relacionados ao estado nutricional de 151 adultos sadios, pertencentes à classe média e residindo em Botucatu, SP, Brasil. Valores antropométricos foram maiores nos homens, com exceção da prega tricipital e da área adiposa do braço. O aumento da idade associou-se a aumento dos valores da massa muscular (homens e mulheres) e do peso do corpo, da prega tricipital e da área adiposa do braço (mulheres). Os resultados antropométricos aproximaram-se dos valores referenciais internacionais, mas não foram inteiramente concordantes com eles, sendo inferiores para o peso corpóreo e circunferência e área musculares do braço. Nos indivíduos de menos de 50 anos, os valores da ingestão energética foram ligeiramente inferiores aos níveis recomendados. A ingestão protéica foi adequada. Os valores médios das proteínas e lípides do soro foram similares aos valores de referência. Testes de hipersensibilidade cutânea são apresentados como uma prova funcional para avaliação do estado nutricional.

Triple bothropic envenomation in horses caused by a single snake

In the present study, snakebites caused by a single Bothrops pauloensis simultaneously affecting three male adult horses are described. Whereas the first two affected horses were six years old, the third was 16 years old; they weighed respectively 555, 550 and 500 kg. All horses presented swollen muzzles. The first animal received an initial antivenom dose of 19 vials and adjuvant medication, it was also subjected to tracheostomy due to the progression of acute respiratory failure. The second and third horses respectively received 15 vials of antivenom each, in addition to adjuvant medication. Due to continuous changes in blood coagulation observed during hospitalization, the first and the second horses received five more vials of antivenom, respectively, in the second and third days of treatment. The first animal was discharged on 15(th) day and the other on the 8(th) day of hospitalization. Several factors including the main actions of Bothrops venom (coagulation, proteolytic and vasculotoxic activities), the importance of early diagnosis based on clinical history and clinical examination suggesting the diagnosis of Bothrops snakebite, the adequate doses of antivenom, and finally the immediate tracheostomy are herein discussed. The tracheostomy, required to save the life of the first horse, should only occur after the administration of antivenom and control measures for changes in blood coagulation.

Titanium surface topography after brushing with fluoride and fluoride-free toothpaste simulating 10 years of use

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Blood lactate response and critical speed in swimmers aged 10-12 years of different standards

It has previously been shown that measurement of the critical speed is a non-invasive method of estimating the blood lactate response during exercise. However, its validity in children has yet to be demonstrated. The aims of this study were: (1) to verify if the critical speed determined in accordance with the protocol of Wakayoshi et al. is a non-invasive means of estimating the swimming speed equivalent to a blood lactate concentration of 4 mmol . l(-1) in children aged 10-12 years; and (2) to establish whether standard of performance has an effect on its determination. Sixteen swimmers were divided into two groups: beginners and trained. They initially completed a protocol for determination of speed equivalent to a blood lactate concentration of 4 mmol . l(-1). Later, during training sessions, maximum efforts were swum over distances of 50, 100 and 200 m for the calculation of the critical speed. The speeds equivalent to a blood lactate concentration of 4 mmol . l(-1) (beginners = 0.82 +/- 0.09 m . s(-1), trained = 1.19 +/- 0.11 m . s(-1); mean +/- s) were significantly faster than the critical speeds (beginners = 0.78 +/- 0.25 m . s(-1), trained = 1.08 +/- 0.04 m . s(-1)) in both groups. There was a high correlation between speed at a blood lactate concentration of 4 mmol . l(-1) and the critical speed for the beginners (r = 0.96, P < 0.001), but not for the trained group (r = 0.60, P > 0.05). The blood lactate concentration corresponding to the critical speed was 2.7 +/- 1.1 and 3.1 +/- 0.4 mmol . l(-1) for the beginners and trained group respectively. The percent difference between speed at a blood lactate concentration of 4 mmol . l(-1) and the critical speed was not significantly different between the two groups. At all distances studied, swimming performance was significantly faster in the trained group. Our results suggest that the critical speed underestimates swimming intensity corresponding to a blood lactate concentration of 4 mmol . l(-1) in children aged 10-12 years and that standard of performance does not affect the determination of the critical speed.

Translocation (11;19)(q23;p13.3) associated with a novel t(5;16) (ql3;q22) in a patient with acute myelocytic leukemia

A novel association of t(11;19)(q23;p13) and t(5;16)(q13;q22) was detected by G-banding and spectral karyotyping studies in an 18-year-old patient. While balanced t(11; 19) has been often described in acute myelocytic leukemia (AML) French-American-British Cooperative Group subtypes M4 and M5, this patient was diagnosed with the variant AML-M4 with eosinophilia (AML-M4Eo), which is associated with abnormalities in 16q22 and has good prognosis. However, the patient relapsed after allogeneic transplant and died within 2 years of diagnosis, which suggests that the association of these two translocations correlates with a poor prognosis. This report expands the molecular basis of the variability in clinical outcomes and adds the novel t(5;16)(q13;q22) to the spectrum of chromosome 16q22 abnormalities in AML. (C) 2003 Elsevier B.V. All rights reserved.

The malarial impact on the nutritional status of Amazonian adult subjects

A avaliação antropométrica (pêso, altura, circunferência branquial, prega cutânea tricipital, prega cutânea subescapular, índice de Quetelet e circunferência muscular do braço) e bioquímica (proteínas e lipides) foi realizado em 120 indivíduos (93 masculinos e 27 do sexo feminino), de 17 a 72 anos de idade, moradores de área endêmica de malária (Humaitá -AM). de acordo com a história da doença (malária) eles foram divididos em 4 grupos: G1 - controle (n = 30), sem história de malária; G2 - controle (n = 40), com história de malária, mas sem manifestação de doença atual; G3 - doentes com Plasmodium vivax (n = 19) e G4 - doentes com Plasmodium faleiparum (n = 31). O diagnóstico de malária foi estabelecido por manifestações clínicas e confirmado laboratorialmente (gota espessa e esfregaço). No global as medidas antropométricas e bioquímicas discriminaram os grupos diferentemente. As medidas antropométricas do pêso, altura, reservas calóricas e estoque proteicos somáticos, apresentaram pouca sensibilidade, discriminado apenas os grupos extremos (Gl > G4). As medidas bioquímicas, no geral diferenciaram dois grandes grupos, os sadios e os doentes (G1+G2) e (G3+G4). Os doentes com Plasmodium falciparum (G4) foram os que se apresentaram em pior estado nutricional para a maioria das variáveis, sem entretanto, nenhuma variável individual que os discriminasse significativamente do G3. Estes dados permitem concluir que a malária resulta em desnutrição do hospedeiro, cuja gravidade está relacionada ao tipo e estágio da doença.

Effect of maternal obesity on diabetes development in adult rat offspring

This study aimed to evaluate whether maternal obesity leads to the onset of diabetes in adult Wistar rats offspring. MSG solution neonatally administration induced obesity in rats (F(1)MSG group, n = 30); and saline solution was also administrated to control rats (F1CON group, n = 13). In 3rd month of age, both control and MS G groups were mated for offspring (generation FA named as F2CON, n = 28 and F(2)MSG groups, n = 15; and so both generations were studied until 7th month of life. Lee Index was measured for experimental obesity validation from 5th to 7th month. Glycemia was weekly determined during pregnancy and monthly from 3rd to 7th month. In the end of experimental period all rats were submitted to oral glucose tolerance test (OGTT), with estimation of total area under the curve (AUC); and insulin tolerance test (ITT). Rats were then anesthetized and killed. Data were statistically analyzed with significance level of p < 0.05. Lee Index has confirmed obesity in all MSG rats. Glycemic levels comparisons between generations showed significant maternal interference in control and MSG groups. OGTT analysis showed higher glycemia in obese rats (F(1)MSG) and their offspring (F(2)MSG) as compared to their respective controls; and MSG groups increased AUC from OGTT. As regards ITT, F(2)MSG showed higher glycemia at 30 and 120 min, suggesting a delay of insulin action decreasing. Although glucose intolerance and insulin resistance clinical conditions represent as a factors for type 2 Diabetes mellitus development, this experimental model proposal was not efficient to induce type 2 Diabetes mellitus, but for obesity developing, glucose intolerance and insulin resistance in successive generations of rats. (c) 2007 Elsevier B.V. All rights reserved.

Cauda equina syndrome after spinal tetracaine: Electromyographic evaluation-20 years follow-up

CAUDA equina syndrome (CES) has long been recognized as a rare complication of spinal anesthesia.(1) CES has been described after administration of spinal anesthetics with lidocaine(2) and bupivacaine.(3) In 1991,(4) CES was reported after continuous spinal anesthesia with 1% tetracaine. In 1980, at our university hospital, six adult female patients underwent perineal gynecologic surgery using a spinal anesthetic of 2 ml tetracaine, 1.2%, in 10% glucose. The concentration of the injected tetracaine was unknown by the anesthetists. In all cases, lumbar puncture was performed at the L3-L4 interspace with a disposable spinal needle while the patients were in the sitting position. CES was first diagnosed 72 h or later postoperatively; previous diagnosis was not possible because patients had an indwelling urethral catheter. The diagnosis of CES was confirmed in all patients. During the past year, after institutional approval and informed consent, clinical, magnetic resonance imaging, electromyographic examinations, and conduction studies were performed in three of the above patients. Examinations were not possible on the other three patients because one had recently died, another could not be located, and the third refused to participate. T1 and T2 magnetic resonance image readings were obtained with Gadolinium contrast from a 0.5 Tesla General Electric apparatus (General Electric, Tokyo, Japan). Bilateral sensory and motor conduction studies of the sciatic nerve branches were obtained using a two-channel Nihon-Kohden Neuropack 2 (Nihom-Kohden Corporation, Tokyo, Japan). Electromyography was performed in accordance with conventional techniques.(5,6)

Histology and morphometry of the testes of adult domestic cats (Felis catus)

Testicles of 30 mongrel cats were analyzed histologically and morphometrically, divided into three groups: G1 (1-2 years old), G2 (over 2 and up to 4 years old) and G3 (over 4 and up to 6 years old). After orchiectomy and histopathology, the morphometric parameters studied were: thickness of the tunica albuginea (72 mu m) and seminiferous epithelium (77.19 mu m), perimeter (53.81; 90.57 mu m), (54.80; 101.07 mu m); area (174.23; 494.55 mu m(2)), (176.68; 629.70 mu m(2)); maximum diameter (14.94; 28.02 mu m), (14.76; 31.66 mu m); minimum diameter (13.25; 21.92 mu m), (13.30; 24.52 mu m); and shape factor (index for regularity of the format) (1.36; 1.36), (1.39; 1.35) of the nucleus and cytoplasm of spermatogonia and Leydig cells, respectively. The results can be used for comparative studies and contribute knowledge concerning the height of the seminiferous epithelium, thickness of the tunica albuginea and size of spermatogonia and Leydig cells.

Paracoccidioidomicose: estudo radiológico e pulmonar de 58 casos

Spirometric and haemogasimetric tests were performed in 52 patients with unifocal and multifocal progressive Paracoccidioidomycosis pulmonary diseases, in 5 patients with juvenile and 1 female internal genital forms. The age ranged from 20 to 74 years old and the duration of disease from 3 to 25 years. Dyspnea, cough, tegumentary and lymphatic manifestations were the most predominant signs observed. Fourteen of them was developed Cor pulmonale. Impaired renal function was recorded in 19 patients, cardiac symptoms were described in 7 and hyporeactor adrenal activity was showed in 13 patients. Radiological studies demonstrated mild in 16, moderate in 24 and severe pulmonary lesions types in 18 patients. The pulmonary function revealed: normal spyrographic findings in 17, pure obstructive type in 32 and mixed form in 9 of them. Hyperventilation was described in 54 individuals and all of them showed an increasing of the alveolo-arterial difference. PaO2 less than 80 mm/Hg observed in 36 of them. Statistical analysis demonstrated significative association between clinical evolution and radiological interpretation. Similar data were obtained in radiology evaluations, clinical evolutive studies and pulmonary functions described in these patients. The granulomatous reaction due to Paracoccidioidomycosis, in heavy smokers patients, gave origin to the alterations in small airways predisposing the interalveolar dissemination an impaired alveolo-arterial diffusion.

Epidemiology of neurocysticercosis in Brazil

A revision of literature was done with the objective of tracing an epidemiologic profile of neurocysticercosis (NCC) in Brazil. The prevalence was 0.12-9% in autopsies. The frequency was 0.03-7.5% in clinical series and 0.68-5.2% in seroepidemiological studies. The disease corresponds to 0.08-2.5% of admissions to general hospitals. Patient origin was rural in 30 63% of cases. The most involved age range (64-100%) was 11 to 60 years, with a predominance (22-67%) between 21 and 40 years. The male sex was the most affected (51-80%). In the severe forms there was a predominance of urban origin (53-62%) and of the female sex (53-75%). The period of hospitalization ranges from 1 to 254 days and 33 to 50% of patients suffer 1.7 ± 1.4 admissions. The clinical picture was variable, with a predominance of epileptic syndrome (22-92%) and intracranial hypertension (19-89%). Psychiatric manifestations were associated in 9-23% of patients. Lethality was 0.29% in terms of all diseases in general and 4.8-25.9% in terms of neurologic diseases. The asymptomatic form was detected in 6% of patients in clinical serie and in 48.5% of case from autopsies The racemose form and ventricular localization also was observed as asymptomatic form. Among the patients with cutaneous cysticercosis 65% of them showed neurologic manifestations.

Cytogenetic evaluation of 20 primary breast carcinomas

Chromosome analysis was performed on samples from 20 Brazilian patients with breast cancer. All the samples were from untreated patients who presented the clinical symptoms for months or years before surgical intervention. Six cases showed axillary lymph node metastases. Clonal chromosome abnormalities were detected in all cases. The numerical alterations most frequently observed involved the loss of chromosomes X, 19, 20, and 22 followed by gain of chromosomes 9 and 8. Among the structural anomalies observed, there was preferential involvement of chromosomes 11, 6, 1, 7, 3, and 12, supporting previous reports that these chromosomes may harbour genes of importance in the development of breast tumors. Two cases with a family history of breast cancer had in common total or partial trisomy 1.

Comparacao da recuperacao de anestesia venosa com propofol e anestesia inalatoria com sevoflurano para laparoscopia ginecologica

Backgrounds and Objectives: Both continuous venous anesthesia with propofol and inhalational anesthesia with sevoflurane propitiate fast arousal with few side effects. The aim of this study was to compare the arousal and post anesthestic recovery times in patients submitted to these two agents. Methods: Forty three patient aged 18 to 50 years, physical status I or II, submitted to gynecological laparoscopy were distributed in two groups: G1 - propofol in continuous infusion of 115 μg.kg -1.min -1 and G2 sevoflurane. All the patients were pre-medicated with 7.5 mg midazolam, sufentanil 0.5 μg.kg -1, propofol 2 mg.kg -1, atracurium 0.5 mg.kg -1, N 2O in 50% of oxygen in a no-rebreathing system. The depth of the anesthesia and arousal time were assessed by the Bispectral index (BIS). The time between end of anesthesia and eye opening, time for command response and time for orientation were also evaluated. Results: The times recorded in minutes were: G1 - eye opening 8.2 ± 2.9, command response 8.6 ± 3.1, orientation 9.8 ± 3.4, recovery 31.6 ± 3.8; G2 - eye opening 4.5 ± 3, command response 4.9 ± 3.4, orientation 6.2 ± 3.4, recovery 66 ± 8. Except the recovery time, all the values were larger in G1. Conclusions: Both intravenous propofol or inhalational sevoflurane were considered excellent anesthetic techniques as to recovery time and recovery room discharge. Sevoflurane provided an earlier arousal with a longer recovery room stay as compared to propofol.

Hodgkin disease in adult and juvenile groups from two different geographic regions in Brazil: Characterization of clinicopathologic aspects and relationship with Epstein-Barr virus infection

We analyzed clinicopathologic data, immunophenotype, and Epstein-Barr virus (EBV) status in 96 cases of Hodgkin disease (HD) in juveniles (younger than 20 years) and adults (20 years or older) from 2 distinctive states in Brazil. We studied 34 juvenile (group 1) and 16 adult (group 2) cases from Ceara and 31 juvenile (group 3) and 15 adult (group 4) cases from São Paulo. Ceara has a socioeconomic profile similar to a developing country; São Paulo is in better economic condition. Mixed cellularity (MC) was the major histologic subtype among groups 1 (22 [65%]), 3 (21 [68%]), and 4 (7 [47%]); nodular sclerosis (NS) was more frequent in group 2 (8 [50%]). EBV infection was observed in 61 cases (64%), including the following (among others): group 1, MC, 22 (65%) and NS, 4 (12%); group 2, NS, 3 (19%) and MC, 2 (12%); group 3, MC, 16 (52%) and NS, 1 (3%); and group 4, MC, 7 (47%). There was predominance of EBV+ HD cases in group 1 compared with group 3. HD in Brazilian patients is highly associated with EBV infection, but geographic differences reflect histologic subtypes and age distribution.

The natural history of carpal tunnel syndrome: A study of 20 hands evaluated 4 to 9 years after initial diagnosis

Carpal tunnel syndrome (CTS) is the most frequent entrapment neuropathy. In the last decade several papers have been published on epidemiology, clinical aspects, diagnosis, and treatment, but little is known about its natural history. The objective of this work was to study the natural history of CTS syndrome. From 358 patients with clinical and conduction study diagnosis of CTS, 12 cases were identified that had refused surgical treatment, had not used anti-inflammatory medications, and had not undergone orthopaedic procedures, such as immobilization or anaesthetic infiltration. These 12 patients have 20 compromised hands which have been followed up for between 4 and 9 years. In all cases sensory and motor conduction studies were performed on the median nerve, at the beginning and end of follow-up period. Electrical improvement was marked in 5 hands and slight in 3; there was no significant change in 10, and deterioration in 2. As 8 hands (7 patients) showed improved clinical symptoms and conduction studies over several years, this brings the universally accepted procedure of surgical treatment into doubt.