856 resultados para geometry features
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We present algorithms for computing the differential geometry properties of intersection Curves of three implicit surfaces in R(4), using the implicit function theorem and generalizing the method of X. Ye and T. Maekawa for 4-dimension. We derive t, n, b(1), b(2) vectors and curvatures (k(1), k(2), k(3)) for transversal intersections of the intersection problem. (C) 2008 Elsevier B.V. All rights reserved.
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Objective: Postoperative agitation in children is a well-documented clinical phenomenon with incidence ranging from 10% to 67%. There is no definitive explanation for this agitation. Possible causes include rapid awakening in unfamiliar settings, pain (wounds, sore throat, bladder distension, etc.), stress during induction, hypoxemia, airway obstruction, noisy environment, anesthesia duration, child's personality, premedication and type of anesthesia. The purpose of this paper is to discuss the possible causes of postoperative agitation in children, providing a foundation for better methods of identifying and preventing this problem.Sources: MEDLINE and PubMed were searched using the following words: emergence, agitation, incidence, etiology, diagnosis, treatment, children, pediatric, anesthesia.Summary of the findings: This study includes a review of potential agitation trigger factors and a proposal for a standardized diagnostic score system, in addition to measures to improve prevention and treatment.Conclusion: No single factor can identified as the cause of postoperative agitation, which should therefore be considered a syndrome made up of biological, pharmacological, psychological and social components, and which anesthesiologists and pediatric intensive care specialists should be prepared to identify, prevent and intervene appropriately as necessary.
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The approach Software Product Line (SPL) has become very promising these days, since it allows the production of customized systems on large scale through product families. For the modeling of these families the Features Model is being widely used, however, it is a model that has low level of detail and not may be sufficient to guide the development team of LPS. Thus, it is recommended add the Features Model to other models representing the system from other perspectives. The goals model PL-AOVgraph can assume this role complementary to the Features Model, since it has a to context oriented language of LPS's, which allows the requirements modeling in detail and identification of crosscutting concerns that may arise as result of variability. In order to insert PL-AOVgraph in development of LPS's, this paper proposes a bi-directional mapping between PL-AOVgraph and Features Model, which will be automated by tool ReqSys-MDD. This tool uses the approach of Model-Driven Development (MDD), which allows the construction of systems from high level models through successive transformations. This enables the integration of ReqSys-MDD with other tools MDD that use their output models as input to other transformations. So it is possible keep consistency among the models involved, avoiding loss of informations on transitions between stages of development
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This thesis deals with the sedimentological/stratigraphic and structural evolution of the sedimentary rocks that occur in the NW continental border of the Potiguar Basin. These rocks are well exposed along coastal cliffs between the localities of Lagoa do Mato and Icapuí, Ceará State (NE Brazil). The sedimentological/stratigraphic study involved, at the outcrop scale, detailed facies descriptions, profile mapping of the vertical succession of different beds, and columnar sections displaying inferred lateral relationships. The approach was complemented by granulometric and petrographic analyses, including the characterization of heavy mineral assemblages. The data set allowed to recognize two kinds of lithological units, a carbonate one of very restricted occurrence at the base of the cliffs, and three younger, distinct siliciclastic units, that predominate along the cliffs, in vertical and lateral extent. The carbonate rocks were correlated to the late Cretaceous Jandaíra Formation, which is covered by the siliciclastic Barreiras Formation. The Barreiras Formation occurs in two distinct structural settings, the usual one with nondeformed, subhorizontal strata, or as tilted beds, affected by strong deformation. Two lithofacies were recognized, vertically arranged or in fault contacts. The lower facies is characterized by silty-argillaceous sandstones with low-angle cross bedding; the upper facies comprises medium to coarse grained sandstones, with conglomeratic layers. The Tibau Formation (medium to coarse-grained sandstones with argillite intercalations) occurs at the NW side of the studied area, laterally interlayered with the Barreiras Formation. Eolic sediments correlated to the Potengi Formation overly the former units, either displaying an angular unconformity, or simply an erosional contact (stratigraphic unconformity). Outstanding structural features, identified in the Barreiras Formation, led to characterize a neocenozoic stress field, which generated faults and folds and/or reactivated older structures in the subjacent late cretaceous (to paleogene, in the offshore basin) section. The structures recognized in the Barreiras Formation comprise two distinct assemblages, namely a main extensional deformation between the localities of Ponta Grossa and Redonda, and a contractional style (succeeded by oblique extensional structures) at Vila Nova. In the first case, the structural assemblage is dominated by N-S (N±20°Az) steep to gently-dipping extensional faults, displaying a domino-style or listric geometry with associated roll-over structures. This deformation pattern is explained by an E-W/WNW extension, contemporaneous with deposition of the upper facies of the Barreiras Formation, during the time interval Miocene to Pleistocene. Strong rotation of blocks and faults generated low-angle distensional faults and, locally, subvertical bedding, allowing to estimate very high strain states, with extension estimates varying between 40% up to 200%. Numerous detachment zones, parallel to bedding, help to acommodate this intense deformation. The detachment surfaces and a large number of faults display mesoscopic features analoguous to the ones of ductile shear zones, with development of S-C fabrics, shear bands, sigmoidal clasts and others, pointing to a hydroplastic deformation regime in these cases. Local occurrences of the Jandaíra limestone are controled by extensional faults that exhume the pre-Barreiras section, including an earlier event with N-S extension. Finally, WNWtrending extensional shear zones and faults are compatible with the Holocene stress field along the present continental margin. In the Vila Nova region, close to Icapuí, gentle normal folds with fold hinges shallowly pluging to SSW affect the lower facies of the Barreiras Formation, displaying an incipient dissolution cleavage associated with an extension lineation at high rake (a S>L fabric). Deposition of the upper facies siliciclastics is controlled by pull-apart graben structures, bordered by N-NE-trending sinistral-normal shear zones and faults, characterizing an structural inversion. Microstructures are compatible with tectonic deformation of the sedimentary pile, burried at shallow depths. The observed features point to high pore fluid pressures during deformation of the sediments, producing hydroplastic structures through mechanisms of granular flow. Such structures are overprinted by microfractures and microfaults (an essentially brittle regime), tracking the change to microfracturing and frictional shear mechanisms accompanying progressive dewatering and sediment lithification. Correlation of the structures observed at the surface with those present at depth was tested through geophysical data (Ground Penetrating Radar, seismics and a magnetic map). EW and NE-trending lineaments are observed in the magnetic map. The seismic sections display several examples of positive flower structures which affect the base of the cretaceous sediments; at higher stratigraphic levels, normal components/slips are compatible with the negative structural inversion characterized at the surface. Such correlations assisted in proposing a structural model compatible with the regional tectonic framework. The strong neogenepleistocene deformation is necessarily propagated in the subsurface, affecting the late cretaceous section (Açu and Jandaíra formations), wich host the hydrocarbon reservoirs in this portion of the Potiguar Basin. The proposed structural model is related to the dextral transcurrent/transform deformation along the Equatorial Margin, associated with transpressive terminations of E-W fault zones, or at their intersections with NE-trending lineaments, such as the Ponta Grossa-Fazenda Belém one (the LPGFB, itself controlled by a Brasiliano-age strike-slip shear zone). In a first step (and possibly during the late Cretaceous to Paleogene), this lineament was activated under a sinistral transpressional regime (antithetic to the main dextral deformation in the E-W zones), giving way to the folds in the lower facies of the Barreiras Formation, as well as the positive flower structures mapped through the seismic sections, at depth. This stage was succeeded (or was penecontemporaneous) by the extensional structures related to a (also sinistral) transtensional movement stage, associated to volcanism (Macau, Messejana) and thermal doming processes during the Neogene-Pleistocene time interval. This structural model has direct implications to hydrocarbon exploration and exploitation activities at this sector of the Potiguar Basin and its offshore continuation. The structure of the reservoirs at depth (Açu Formation sandstones of the post-rift section) may be controlled (or at least, strongly influenced) by the deformation geometry and kinematics characterized at the surface. In addition, the deformation event recognized in the Barreiras Formation has an age close to the one postulated for the oil maturation and migration in the basin, between the Oligocene to the Miocene. In this way, the described structural cenario represents a valid model to understand the conditions of hydrocarbon transport and acummulation through space openings, trap formation and destruction. This model is potentially applicable to the NW region of the Potiguar Basin and other sectors with a similar structural setting, along the brazilian Equatorial Atlantic Margin
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Baixo Vermelho area, situated on the northern portion of Umbuzeiro Graben (onshore Potiguar Basin), represents a typical example of a rift basin, characterized, in subsurface, by the sedimentary rift sequence, correlated to Pendência Formation (Valanginian-Barremian), and by the Carnaubais fault system. In this context, two main goals, the stratigraphic and the structural analysis, had guided the research. For this purpose, it was used the 3D seismic volume and eight wells located in the study area and adjacencies. The stratigraphic analysis of the Valanginian-Barremian interval was carried through in two distinct phases, 1D and 2D, in which the basic concepts of the sequence stratigraphy had been adapted. In these phases, the individual analysis of each well and the correlation between them, allowed to recognize the main lithofacies, to interpret the effective depositional systems and to identify the genetic units and key-surfaces of chronostratigraphic character. The analyzed lithofacies are represented predominantly by conglomerates, sandstones, siltites and shales, with carbonate rocks and marls occurring subordinately. According to these lithofacies associations, it is possible to interpret the following depositional systems: alluvial fan, fluvio-deltaic and lacustrine depositional systems. The alluvial fan system is mainly composed by conglomerates deposits, which had developed, preferentially in the south portion of the area, being directly associated to Carnaubais fault system. The fluvial-deltaic system, in turn, was mainly developed in the northwest portion of the area, at the flexural edge, being characterized by coarse sandstones with shales and siltites intercalated. On the other hand, the lacustrine system, the most dominant one in the study area, is formed mainly by shales that could occur intercalated with thin layers of fine to very fine sandstones, interpreted as turbidite deposits. The recognized sequence stratigraphy units in the wells are represented by parasequence sets, systems tracts and depositional sequences. The parasequence sets, which are progradational or retrogradational, had been grouped and related to the systems tracts. The predominance of the progradation parasequence sets (general trend with coarsening-upward) characterizes the Regressive Systems Tract, while the occurrence, more frequently, of the retrogradation parasequence sets (general trend with finning-upward) represents the Transgressive System Tract. In the seismic stratigraphic analysis, the lithofacies described in the wells had been related to chaotic, progradational and parallel/subparallel seismic facies, which are associated, frequently, to the alluvial fans, fluvial-deltaic and lacustrine depositional systems, respectively. In this analysis, it was possible to recognize fifteen seismic horizons that correspond to sequence boundaries and to maximum flooding surfaces, which separates Transgressive to Regressive systems tracts. The recognition of transgressive-regressive cycles allowed to identify nine, possibly, 3a order deposicional sequences, related to the tectonic-sedimentary cycles. The structural analysis, in turn, was done at Baixo Vermelho seismic volume, which shows, clearly, the structural complexity printed in the area, mainly related to Carnaubais fault system, acting as an important fault system of the rift edge. This fault system is characterized by a main arrangement of normal faults with trend NE-SO, where Carnaubais Fault represents the maximum expression of these lineations. Carnaubais Fault corresponds to a fault with typically listric geometry, with general trend N70°E, dipping to northwest. It is observed, throughout all the seismic volume, with variations in its surface, which had conditioned, in its evolutive stages, the formation of innumerable structural features that normally are identified in Pendencia Formation. In this unit, part of these features is related to the formation of longitudinal foldings (rollover structures and distentional folding associated), originated by the displacement of the main fault plan, propitiating variations in geometry and thickness of the adjacent layers, which had been deposited at the same time. Other structural features are related to the secondary faultings, which could be synthetic or antithetic to Carnaubais Fault. In a general way, these faults have limited lateral continuity, with listric planar format and, apparently, they play the role of the accomodation of the distentional deformation printed in the area. Thus, the interaction between the stratigraphic and structural analysis, based on an excellent quality of the used data, allowed to get one better agreement on the tectonicsedimentary evolution of the Valanginian-Barremian interval (Pendência Formation) in the studied area
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This dissertation describes the igneous suites of the Japi granitoid pluton, intrusive in the Paleoproterozoic gneiss-migmatite complex of the eastern domain of the Seridó Belt, northeastern Brazil. Field relations show that the pluton is affected by strong deformation associated to the Brasiliano orogeny (known as the D3 phase) , with a NW-trending extensionalleft-hand senestral shear zone (the Japi Shear Zone, JSZ) bordering the intrusive body to the west. Four plutonic suites are found in the main pluton and as satellyte intrusions, besides Iate pegmatite and pink leucogranites. An alkaline granitoid suite, dominated by syenogranites bearing sodic augite (and subordinate hornblende), define a main elliptical intrusion. In its northern part, this intrusion is made up by concentric sheets, contrasting with a smaller rounded stock to the south. These granites display a pervasive solid-state S>L fabric developed under high T conditions, characterized by plastic deformation of quartz and feldspar. It is especially, developed along the border of the pluton, with inward dips. A regular magmatic layering is present sometimes, parallel to the tectonic foliation. The syntectonic emplacement as regards to the Brasiliano (D3) event is indicated by the common occurrence of dykes and sheets along transtensional or extensional sites of the major structure. Field relations attest to the early emplacement of the alkaline granites as regards to the other suites. A basic-to-intermediate suite occurs as a western satellyte body and occupying the southern tail of the main alkaline pluton. It comprises a wide variety of compositional terms, including primitive gabbros and gabbro-norites, differentiated to monzonitic intermediate facies containing amphibole and biotite as their main mafic phases. These rocks display transitional high-K calc-alkaline to shoshonitic affinities. Porphyritic monzogranite suítes commonly occur as dykes and minor intrusives, isolated or associated with the basic-tointermediate rocks. In the latter case, magma mingling and mixing features attest that these are contemporaneous igneous suites. These granites show K-feldspar phenocrysts and a hornblende+biotite+titanite assemblage, displaying subalkaline/monzonitic geochemical affinities. Both suites exhibit SL magmatic fabrics overprinting or transitional to solid-state D3 deformation related to the JSI. Chemical data clearly show that they are related to different parental magmas. Finally, a microgranite suite occurs along a few topographic ridges paralell to the JSI. It comprises dominantly granodiorites with a mineralogy similar to the one of the porphyritic granitoids. However, discriminant diagrams show their distinct calc-alkaline affinity. The granodiorites display an essencially magmatic fabric, even though an incipient D3 solid-state structure may be developed along the JSI. Intrusion relationships with the previous suites, as well as regards to the D3 structures, point to their Iate emplacement. All these suites are intrusive in a Paleoproterozoic, high-grade gneiss-migmatite complex affected by two previous deformation phases (D1, D2). The fabrics associated with these earlier events are folded and overprinted by the younger D3 structures along the JSZ. The younger deformation is characterized by NE-dipping foliations and N/NE-plunging stretching lineations. In the JSZ northern termination the foliation acquires an ENE orientation, containing a stretching lineation plunging to the south. Symmetric kinematic cri teria developed at this site confirms the transpressional termination of the JSZ, as also shown by orthorrombic quartz c-axis patterns. E-W-trending d extra I shear zones developed in the central part of the JSZ are interpreted as antithetic structures associated to the transtensional deformation along the JSZ. This is consistent with its extensional-transcurrent kinematics and a flat-and-ramp geometry at depth, as shown by gravimetric data. The lateral displacement of the negative residual Bouguer anomalies, as regards to the main outcropping alkaline pluton, may be modelized by other deeper-seated granite bodies. Based on numerical modelling it was possible to infer two distinct intrusion styles for the alkaline pluton. The calculated model values are consistent with an emplacement by sheeting for the northern body, as already suggested by satellyte imagery and field mapping. On the other hand, the results point to a transition towards a diapir-related style associated to the smaller. southern stock. This difference in intrusion styles may relate to intensity variations and transtensional sites of the shear deformation along the JSZ. Trace element and Sr and Nd isotopes of the alkaline granites are compatible with their derivation trom a more basic crustal source, as compared to the presently outcropping highgrade gneisses, with participation (or alternatively dominated by) of an enriched lithospheric mantle component. Like other igneous suites in the Seridó Belt, the high LlL contents and fractionated REE patterns of the basic rocks also point to an enriched mantle as the source for this kind of magmatism. Geochemical and isotope data are compatible with a lower crustal origin for the porphyritic granites. On the basis of the strong control of the JSZ on the emplacement of lower crustal (porphyritic and alkaline granites) or lithospheric mantle (basic rocks, alkaline granites or a component of them) magmas, one may infer a deep root for this structure, bearing an important role in magma extraction, transport and emplacement in the Japi region, eastern domain of the Seridó Belt
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On the modern Continental Shelf to the north of Rio Grande do Norte state (NE Brazil) is located a paleo-valley, submerged during the last glacial sea-level lowstand, that marks continuation of the most important river of this area (Açu River). Despite the high level of exploration activity of oil industry, there is few information about shallow stratigraphy. Aiming to fill this gap, situated on the Neogene, was worked a marine seismic investigation, the development of a processing flow for high resolution data seismic, and the recognition of the main feature morphology of the study area: the incised valley of the River Açu. The acquisition of shallow seismic data was undertaken in conjunction with the laboratory of Marine Geology/Geophysics and Environmental Monitoring - GGEMMA of Federal University of Rio Grande do Norte UFRN, in SISPLAT project, where the geomorphological structure of the Rio paleovale Açu was the target of the investigation survey. The acquisition of geophysical data has been over the longitudinal and transverse sections, which were subsequently submitted to the processing, hitherto little-used and / or few addressed in the literature, which provided a much higher quality result with the raw data. Once proposed for the flow data was developed and applied to the data of X-Star (acoustic sensor), using available resources of the program ReflexW 4.5 A surface fluvial architecture has been constructed from the bathymetric data and remote sensing image fused and draped over Digital Elevation Models to create three-dimensional (3D) perspective views that are used to analyze the 3D geometry geological features and provide the mapping morphologically defined. The results are expressed in the analysis of seismic sections that extend over the region of the continental shelf and upper slope from mouth of the Açu River to the shelf edge, providing the identification / quantification of geometrical features such as depth, thickness, horizons and units seismic stratigraphyc area, with emphasis has been placed on the palaeoenvironmental interpretation of discordance limit and fill sediment of the incised valley, control by structural elements, and marked by the influence of changes in the sea level. The interpretation of the evolution of this river is worth can bring information to enable more precise descriptions and interpretations, which describes the palaeoenvironmental controls influencing incised valley evolution and preservation to provide a better comprehensive understanding of this reservoir analog system
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The study area is located at the eastern-central portion of the Seridó Belt, on the interface between the Seridó Group Metasediments and the crystalline basement rocks of the Caicó Complex (RN). Petrographic and geochemical data allow us to define aspects related to the genesis and evolution of the Serra Verde Pluton magmas, which composes the goal of this dissertation The Serra Verde Pluton is a stock with outcropping area of about 25 km², which is intrusive into metasedimentary sequence and the basement gneisses. The pluton intrusion is sintectonic to the Brasiliano event, elongated along the NE direction, developing a cornue geometry. The rock is a monzogranite mainly composed by K-feldspar, plagioclase and quartz, which usually compose more than 85% of the modal analisys. The main mafic mineral is the biotite, while amphibole, sphene, epidote, opaque minerals, allanite, zircon and apatite occur as accessory minerals. It features still a latemagmatic paragenesis composed by chlorite, granular epidote, carbonates and muscovite, developed through the percolation of late CO2 and H2O rich fluids. Chemically, the Serra Verde Pluton rocks may be classified as metaluminous, of calc-alkaline affiliation, sometimes showing trondhjemític characteristics, with high Na2O (>4,5%), Sr (>400ppm) and Ba (>800ppm) and low K2O (≤3,0%), MgO (<1,0%), TiO2 (<0,5%), Rb (<90ppm), Y (≤16ppm) and Zr (≤13ppm). Micropetrographic evidences (mineral assembly and microtextures) indicate that the magma evolution occurred in moderated to high fO2 conditions, above the FMQ buffer. Thermo-barometric data obtained by minor elements geochemistry and the CIPW data, suggest a final/minimal pressure crystallization for the Serra Verde Pluton samples of about 3 to 5 kbar, liquidus temperature around 800o C, solidus temperature between 680o and 660o C. This data is compatible with those observed by many authors for the Neoproterozoic granites of the Seridó Belt. The group of analyzed data (Petrographic, microtextural and geochemical), suggests that the dominant process of the generation and evolution of the Serra Verde Granite magma was the fractional crystallization, probably from basement quartz-dioritic and tonalitic orthogneisses source
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The structural framework of the sedimentary basins usually plays an important role in oil prospects and reservoirs. Geometry, interconectivity and density of the brittle features developed during basin evolution could change the permo-porous character of the rocks involved in generation, migration and entrapment of fluid flow. Once the structural characterization of the reservois using only sub-surface data is not an easy task, many studies are focused in analogous outcrops trying to understand the main processes by which brittle tectonic is archieved. In the Santana do Acaraú region (Ceará state, NE Brazil) a pack of conglomeratic sandstone (here named CAC) has its geometry controlled mainly by NE trending faults, interpreted as related to reactivation of a precambrian Sobral Pedro II Lineament (LSP-II). Geological mapping of the CAC showed a major NE-SW trending synform developed before its complete lithification during a dextral transpression. This region was then selected to be studied in details in order of constrain the cretaceous deformation and so help the understanding the deformation of the basins along the brazilian equatorial margin. In order to characterize the brittle deformation in different scales, I study some attributes of the fractures and faults such as orientation, density, kinematic, opening, etc., through scanlines in satellite images, outcrops and thin sections. The study of the satellite images showed three main directions of the macrostructures, N-S, NE-SW and E-W. Two of theses features (N-S and E-W) are in aggreement with previous geophysical data. A bimodal pattern of the lineaments in the CAC´s basement rocks has been evidenciated by the NE and NW sets of structures obtained in the meso and microscale data. Besides the main dextral transpression two others later events, developed when the sediments were complety lithified, were recognized in the area. The interplay among theses events is responsible for the compartimentation of the CAC in several blocks along within some structural elements display diferents orientations. Based on the variation in the S0 orientation, the CAC can be subdivided in several domains. Dispite of the variations in orientations of the fractures/faults in the diferents domains, theses features, in the meso and microscopic scale, are concentrated in two sets (based on their trend) in all domains which show similar orientation of the S0 surface. Thus the S0 orientation was used to group the domains in three major sets: i) The first one is that where S0 is E-W oriented: the fractures are oriented mainly NE with the development of a secondary NW trending; ii) S0 trending NE: the fractures are concentrated mainly along the trend NW with a secondary concentration along the NE trend; iii) The third set, where S0 is NS the main fractures are NE and the secondary concentration is NW. Another analized parameter was the fault/fracture length. This attribute was studied in diferent scales trying to detect the upscale relationship. A terrain digital model (TDM) was built with the brittlel elements supperposed. This model enhanced a 3D visualization of the area as well as the spatial distribution of the fault/fractures. Finally, I believe that a better undertanding of the brittle tectonic affecting both CAC and its nearby basement will help the future interpretations of the tectonic envolved in the development of the sedimentary basins of the brazilian equatorial margin and their oil reservoirs and prospects, as for instance the Xaréu field in the Ceará basin, which subsurface data could be correlated with the surface ones
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This study was undertaken to evaluate the association between the expression of CD31 in the tumor and the histopathologic findings in patients with carcinoma of the cervix. This study included prospectively 30 women, aged 46.6 +/- 10.7 years, with stage IB squamous cell carcinoma of the cervix submitted to radical hysterectomy from November 2001 to September 2002. Samples from the tumor were taken and immunohistochemically evaluated by a monoclonal antibody for CD31. Clinicopathologic characteristics such as stage, tumor size, grade of differentiation, lymphatic vascular space invasion (LVSI), parametrial involvement, and status of pelvic lymph nodes were also recorded. The clinical stage (FIGO) was IB1 in 22 patients (73.3%) and IB2 in 8 patients (26.7%). The expression of CD31 was significantly associated with tumor size and the presence of LVSI, but not with grade of differentiation and vaginal or parametrial involvement (P= 0.03, P= 0.032, P= 0.352, P= 0.208, and P= 0.242, respectively). on univariate analysis, the presence of pelvic lymph node metastasis was influenced by LVSI (P= 0.003) and CD31 expression (P= 0.032). However, on multivariate analysis, the presence of LVSI (P= 0.007) was the only independent predictor of pelvic lymph node metastasis. The CD31 expression in tumor is significantly associated with LVSI and tumor size in patients with early-stage squamous cell carcinoma of the cervix.
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Some patients with obsessive-compulsive disorder (OCD) exhibit an unsatisfactory reduction in symptom severity despite being treated with all the available therapeutic alternatives. The clinical variables associated with treatment-refractoriness in OCD are inconsistently described in the literature.Methods: To investigate factors associated with treatment-reftactoriness of patients with OCD, we conducted a case-control study, comparing 23 patients with treatment-refractory OCD to 26 patients with treatment-responding OCD.Results: the factors associated with refractoriness of OCD were higher severity of symptoms since the onset of OCD (P < 0.001), chronic course (p=0.003), lack of a partner (p=0.037), unemployment (p=0.025), low economic status (p=0.015), presence of obsessive-compulsive symptoms of sexual/religious content (p=0.043), and higher scores on family accommodation (P < 0.001). Only the three latter variables remained significantly associated with treatment-reftactoriness after regression analyses. Limitations: small sample size, the biases and drawbacks inherent to a case-control study, and the inclusion criteria used to define the study groups may have limited the generalisation of the results.Conclusion: A major strength of this study is the systematic and structured evaluation of a vast array of variables related to the clinical expression of OCD, including epigenetic factors and ratings derived from instruments evaluating family accommodation. The presence of sexual/religious symptoms, low economic status and high modification on family function due to OCD were independently associated with, treatment-refractoriness. Future longitudinal studies are warranted to verify if these variables represent predictive factors of treatment non-response. (c) 2006 Elsevier B.V. All rights reserved.
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Background: An impairing preoccupation with a nonexistent or slight defect in appearance is the core symptom of body dysmorphic disorder (ODD), a psychiatric condition common in dermatology settings.Objective: We sought to determine the prevalence of ODD in dermatologic patients, comparing general and cosmetic settings, and describing some demographic and clinical characteristics.Methods: In all, 300 patients were consecutively assessed. Screening and diagnoses were performed with validated instruments plus a best estimate diagnosis procedure. The final sample comprised 150 patients in the cosmetic group, 150 patients in the general dermatology group, and 50 control subjects. Standard statistical analyses were performed (chi(2), nonparametric tests, logistic regression).Results: The current prevalence was higher in the cosmetic group (14.0%) compared with general (6.7%) and control (2.0%) groups. No patient had a previous diagnosis. Frequently the reason for seeking dermatologic treatment was not the main ODD preoccupation. Patients with ODD from the cosmetic group were in general unsatisfied with the results of dermatologic treatments.Limitations: Cross-sectional study conducted in a university hospital is a limitation. It is uncertain if the findings can be generalized. Retrospective data regarding previous treatments are not free from bias.Conclusions: BUD is relatively common in a dermatologic setting, especially among patients seeking cosmetic treatments. These patients have some different features compared with general dermatology patients. Dermatologists should be aware of the clinical characteristics of ODD to identify and refer these patients to mental health professionals. (J Am Acad Dermatol 2010;63:235-43.)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)