915 resultados para Elaine Albright


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OBJETIVOS: Avaliar as características clínicas de mulheres com diagnóstico prévio de miocardiopatia periparto e verificar as características associadas à evolução desfavorável. MÉTODOS: Variáveis clínicas, obstétricas e ecocardiográficas foram estudadas em 12 pacientes com miocardiopatia periparto, avaliadas no momento do diagnóstico e em consulta atual, quando foram divididas em dois grupos: GF (n= 6, sem alterações cardíacas) e GD (n= 6, com cardiomegalia e disfunção ventricular persistentes). As comparações foram feitas com o teste t de Student e exato de Fisher (p<0,05). RESULTADOS: No diagnóstico, a idade média das pacientes (8 brancas e 4 negras/pardas) foi de 24±7,4 anos; todas em classe funcional IV (NYHA) e 8 relataram hipertensão gestacional ou pré-eclâmpsia. A mediana do tempo de seguimento foi de 25 meses. Dez pacientes evoluíram para classe funcional I/II. A comparação entre os grupos mostrou GD com menor fração de ejeção do ventrículo esquerdo (0,30±0,05 vs. 0,58±0,09; p<0,001) e maior diâmetro sistólico do VE (58±5mm vs. 46±3mm; p<0,001), no momento do diagnóstico. A evolução desfavorável foi mais frequente entre as pardas (p=0,01). Na avaliação atual o GD apresentou menor espessura relativa da parede (0,13±0,02 vs. 0,17±0,02; p< 0,05) e maior massa do VE (283±90g vs. 186±41g; p<0,05). CONCLUSÃO: Pacientes com miocardiopatia periparto prévia apresentam evolução desfavorável associada à raça negra e alterações cardíacas iniciais mais acentuadas e a evolução favorável está associada à redução da massa miocárdica e aumento da espessura relativa da parede ventricular.

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There is an urgent need to find consensus on screening, diagnosing and treating all degrees of DYSGLYCEMIA that may occur during pregnancies in Brazil, considering that many cases of DYSGLYCEMIA in pregnant women are currently not diagnosed, leading to maternal and fetal complications. For this reason the Brazilian Diabetes Society (SBD) and the Brazilian Federation of Gynecology and Obstetrics Societies (FEBRASGO), got together to introduce this proposal. We present here a joint consensus regarding the standardization of clinical management for pregnant women with any degree of Dysglycemia, on the basis of current information, to improve medical assistance and to avoid related complications of Dysglycemia in pregnancy to the mother and the fetus. This consensus aims to standardize the diagnosis among general practitioners, endocrinologists and obstetricians allowing the dissemination of information in basic health units, public and private services, that are responsible for screening, diagnosing and treating disglycemic pregnant patients.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Objective: To evaluate maximal respiratory pressures, pulmonary volumes and capacities and exercise functional capacity in pregnant women with preeclampsia. Method: Primigravid women with preeclampsia and healthy primigravid women were evaluated by means of manovacuometry, spirometry and the 6-minute walk test. Results: The group with preeclampsia showed higher minute ventilation and lower forced vital capacity and exercise tolerance. The presence of preeclampsia and forced vital capacity were predictors in the six-minute walk test. Conclusion: Preeclampsia showed significant alterations in the respiratory system and was associated with lower exercise tolerance; however, it did not affect respiratory muscle functions.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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The aim of this study was to perform voice evaluation in teachers with and without vocal symptoms, identifying etiologic factors of dysphonia, voice symptoms, vocal qualities, and laryngeal lesions. Eighty teachers were divided into two groups: GI (without or sporadic symptoms, 40) and GII (with frequent vocal symptoms, 40). They answered a specific questionnaire, and were subject to a perceptual vocal assessment (maximum phonation time, glottal attack, resonance, coordination of breathing and voicing, pitch, and loudness), GIRBAS scale, and to videolaryngoscopy. Females were predominant in both groups, and the age range was from 36 to 50 years. Elementary teachers predominated, working in classes with 31-40 students. Voice symptoms and alterations in the perceptual vocal analysis and in the GIRBAS scale were more frequent in GII In 46 teachers (GI-16; GII-30), videolaryngoscopy exams were abnormal with the vocal nodules being the most frequent lesions. These results indicate that a teacher's voice is compromised, and requires more attention including control of environmental factors and associated diseases, preventive vocal hygiene, periodic laryngeal examinations, and access to adequate specialist treatment.

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Introduction. Vocal symptoms are common among the pediatric population and are often caused by vocal abuse. Laryngoscopy is essential for their diagnosis because it helps differentiate several laryngeal lesions, leading to a decision for suitable treatments considering each case.Objectives. This study aims to present the clinical characteristics, and the laryngoscopic diagnosis of a dysphonic child population.Methods. The parents of 304 children, aged from 4 to 18 years and presenting prolonged hoarseness, answered a questionnaire about their children's voice, and all children were subjected to videolaryngostroboscopy.Results. Male children aged from 7 to 12 years (64%) were predominant. Vocal abuse (n-162) and nasal obstruction symptoms (n-10) were the most frequent associated symptoms. The vocal symptoms had a chronic evolution (over 1 year) and were reported by most parents (n-200). The most commonly diagnosed lesions in the laryngoscopic exams were vocal nodules (n-175) and epidermal cysts (n-47). Furthermore, there was an association of some lesions, especially minor structural alterations.Conclusion. In the present study, dysphonia occurred mainly in children aged from 7 to 12 years, predominantly males. Vocal abuse and nasal obstruction symptoms were frequently reported. Vocal nodules and cysts were the most commonly diagnosed laryngeal lesions in the laryngoscopic exams.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Aim. The purpose of this study was to provide normal values for maximum phonation time (MPT) and the s/z ratio by examining 1660 children aged 4-12 years and without vocal signs or symptoms.Methods. The technique was based on the sustained emission of the /a/ vowel and fricatives /s/ and /z/.Results. The average of the MPT in children of the different age groups was as follows: 6.09 seconds for the age group 4-6 years (males, 5.97; female, 6.21 seconds), 7.94 seconds for the age group 7-9 years (males, 8.07; females, 7.79 seconds), and 8.98 for the age group 10-12 years (males, 9.05; females, 8.92 seconds). The overall average for males was 7.78 and females 7.64 seconds. The s/z ratio was near 1.0 in most children but above 1.2 in 133 children and below 0.8 in 133 children.Conclusion. These values of MPT and s/z ratio can be used as normative in further pediatric studies.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Mucosal bridges are rare laryngeal lesions probably of genetic origin. They may cause dysphonia of varying degrees, especially when associated with other laryngeal lesions such as vocal sulci and cysts. Reports on mucosal bridges are rare, and the better treatment is inconclusive.Aim. To report the authors' experience in 14 cases of mucosal bridge showing details on endoscopic examinations and treatment.Study Design. Retrospective study.Methods. We reviewed the medical records of 14 patients with a diagnosis of mucosal bridge confirmed by video-laryngostroboscopy and direct laryngoscopy who attended the Outpatient Clinic of Voice Disorders of the Discipline of Otorhinolaryngology, Botucatu Medical School, São Paulo State University, São Paulo. Data collected included information on gender, age, symptoms, time of onset, history of intubation, smoking status, alcohol intake, associated laryngeal lesions, treatment, and GRBAS (grade of hoarseness, roughness, breathiness, asthenia, and stress) scale ratings.Results. of 14 patients, 10 were females and four were males. There was a prevalence of adults (n = 12), with only two of the patients being younger than 13 years (10 and 13 years). Mucosal bridges showed no correlations with smoking, alcohol intake, or gastroesophageal and sinonasal symptoms. Voice abuse was reported in 50% of the cases that consisted of patients who had high-voice demand occupations. In seven cases, mucosal bridges were associated with other laryngeal lesions, particularly vocal cysts and sulci. All patients who underwent surgery and phonotherapy showed improved vocal quality.Conclusions. We documented 14 patients with dysphonia caused by mucosal bridge. Promising results were obtained with surgery.

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Since chlorhexidine is effective against microorganisms, it is widely recommended in dentistry. However, studies have provided evidence that chlorhexidine is toxic for a variety of cell types. In order to identify potential genotoxins in different cell types, the purpose of this study was to investigate whether chlorhexidine digluconate is able to cause, in terms of DNA damage, alterations in leukocytes, liver, kidney and urinary bladder by the single cell gel (comet) assay. Ten male Wistar rats were divided into two groups: a negative control and the experimental group treated with 3 ml of 0.12% chlorhexidine digluconate by gavage once a day for 8 days. Statistically significant increases of DNA damage was observed in leukocytes and kidney cells of the chlorhexidine digluconate treated group as depicted by the mean tail moment. Taken together, the data indicate that leukocytes and kidney cells are potential targets for primary DNA damage following oral exposure to chlorhexidine digluconate as detected by single cell gel (comet) assay. (c) 2006 Elsevier GmbH. All rights reserved.

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The Brazilian Agency of Sanitary Vigilance (ANVISA) conducted a study that demonstrated the presence of residues of several pesticides in fresh fruits and vegetables that were available for purchase by the general populace. In order to evaluate potential adverse health effects of low-level exposure to agrochemicals, the reproductive toxicity of the pesticides dicofol, dichlorvos, permethrin, endosulfan, and dieldrin was evaluated in rats dosed with these chemicals individually or as mixtures. Sixty male Lewis rats (6 wk old, 200 x g) were randomly allocated to 8 groups: (1) control group, received basal diet; (2) 5 groups designated a to e received the diet containing each pesticide individually, at the respective effective doses: lowest-observed-adverse-effect level (LOAEL) for dieldrin and endosulfan, lowest-observed-effect level (LOEL) for dicofol, and lowest effect level (LEL) for dichlorvos and permethrin, respectively, depending on the published data; (3) effective dose group, which received a mixture of pesticides added to basal diet at the respective doses reported to produce adverse effects; and (4) low dose group, which received a pesticide mixture added to the basal diet, where each pesticide was at its no-observed-effect level (NOEL). After 8 wk of treatment, reproductive parameters were evaluated. Sperm morphology, daily sperm production (DSP), sperm transit time through the epididymis, hormonal levels, and histopathological evaluation of testis and epididymis did not differ significantly among the groups. However, sperm motility was significantly decreased in animals that received a mixture of dieldrin, endosulfan, dicofol, dichlorvos, and permethrin, as well as in the group receiving dicofol alone. Exposure to the individual pesticides endosulfan, dichlorvos, and permethrin did not markedly affect sperm motility. The impairment of sperm motility in the mixture of pesticides at the NOEL level indicates that reproductive effects not seen with individual pesticides may occur in presence of several pesticides due to an additive effect. However, the pesticide mixtures did not appear to affect DSP or spermatogenesis despite reduced sperm motility.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)