Estudo clínico e níveis de ansiedade em uma série de casos de líquen plano oral

Oral Lichen Planus (OLP) is a relatively common, cronic inflammatory disease. Its etiopathogenesis is no completely understood and several factors have proposed in attempt to explain the appearance, variety of clinical manifestations and periods of exacerbation and remission of the symptons of the lesions. The objective of the present study was to assess the presence of local factors, systemic diseases and levels of anxiety in patients with OLP, investigating their association with the clinical characteristics of the lesions. The sample consisted of 37 patients with histopathologically confirmed OLP that were submitted to a clinical exam to evaluate the presence of smoking habits, consumption of alcoholic beverages, diabetes mellitus, hypertension and hepatitis C virus (HCV) infection. The existence of skin lesions, as well as the time course, clinical form, symptomatology, number and location of the oral lesions were also registered. The trait anxiety was measured by Spielberger s Stai-Trait Anxiety Inventory (STAI), and to associate the variables we used the chi-square or Fisher s exact test. It was observed that females were the most affected (75%) and the mean age of the patients was 53,3 years. Most cases were non-smoker (97,3%) and none was drinker. Diabetes mellitus and hypertension were present in 10,8% e 16,2% of the sample, respectively and only one patient was HCV-seropositive (2,7%). Moderate levels of anxiety were seen in most cases (78,4%) and 21,6% had elevated levels. The oral lesions persisted in 95% of the cases for a period of 6 months to 13 years. The erosive form was the most prevalent (57,1%) and symptons were reported by 45,7% of the patients. Multiple lesions were frequent (60%), affecting mainly the buccal mucosa, followed by gums e tongue. There was no significant association of the presence of diabetes mellitus, hypertension and levels of anxiety with the clinical form or symptomatology of the oral lesions (p>0,005), despite a trend in patients with hypertension to have erosive lesions. It was concluded that, in the sample studied, moderate levels of anxiety were commonly observed, and the HCV infection apparently is not related to the onset of the OLP. In this study, the presence of diabetes mellitus, hypertension and levels of anxiety seem not to be associated with the clinical characteristics of the lesions of OLP

Administração repetida de baixas doses de reserpina: um possível modelo para o estudo de déficits cognitivos e motores associados à Doença de Parkinson

Parkinson's disease (PD) is one of the most common neurodegenerative brain disorders and is characterized primarily by a progressive degeneration of dopaminergic neurons nigroestriatais. The main symptoms of this disease are motor alterations (bradykinesia, rigidity, tremor at rest), which can be highly disabling in advanced stages of the condition. However, there are symptomatic manifestations other than motor impairment, such as changes in cognition, mood and sensory systems. Animal models that attempt to mimic clinical features of PD have been used to understand the behavioral and neural mechanisms underlying neurophysiological disturbance of this disease. However, most models promote an intense and immediate motor impairment, consistent with advanced stages of the disease, invalidating these studies for the evaluation of its progressive nature. The administration of reserpine (a monoamine depletor) in rodents has been considered an animal model for studying PD. Recently we found that reserpine (in doses lower than those usually employed to produce the motor symptoms) promotes a memory deficit in an aversive discrimination task, without changing the motor activity. It was suggested that the administration of this drug in low doses can be useful for the study of memory deficits found in PD. Corroborating this data, in another study, acute subcutaneous administration of reserpine, while preserving motor function, led to changes in emotional context-related (but not neutral) memory tasks. The goal of this research was to study the cognitive and motor deficits in rats repeatedly treated with low doses of reserpine, as a possible model that simulates the progressive nature of the PD. For this purpose, 5-month-old male Wistar rats were submitted to a repeated treatment with vehicle or different doses of reserpine on alternate days. Cognitive and motor parameters and possible changes in neuronal function were evaluated during treatment. The main findings were: repeated administration of 0.1 mg / kg of reserpine in rats is able to induce the gradual appearance of motor signs compatible with progressive features found in patients with PD; an increase in striatal levels of oxidative stress and changes in the concentrations of glutamate in the striatum were observed five days after the end of treatment; in animals repeatedly-treated with 0. 1 mg/kg, cognitive deficits were observed only after the onset of motor symptoms, but not prior to the onset of these symptoms; 0.2 mg / kg reserpine repeated treatment has jeopardized the cognitive assessment due to the presence of severe motor deficits. Thus, we suggest that the protocol of treatment with reserpine used in this work is a viable alternative for studies of the progressive appearance of parkinsonian signs in rats, especially concerning motor symptoms. As for the cognitive symptoms, we suggest that more studies are needed, possibly using other behavioral models, and / or changing the treatment regimen

Os núcleos dopaminérgicos do mesencéfalo do mocó (kerodon rupestris): caracterização citoarquitetônica e por imunoistoquímica para tirosina-hidroxilase

The 3-hydroxytyramine/dopamine (DA) is a monoamine of catecholamineric group and consists in the progenitor substantia of synthesis of noradrenaline and adrenaline, having the enzyme tyrosine hydroxylase as a regulator of this process. Nuclei of midbrain expressing DA are the retrorubral field (RRF, A8 group), the substantia nigra pars compacta (SNc, A9 group) and the ventral tegmental area (VTA, A10 group). These nuclei are involved in three complex circuitry called mesostriatal, mesocortical and mesolimbic, which are related directly with various behavioral manifestations such as motor control, reward signaling in behavioural learning, motivation and pathological manifestations of Parkinson s disease and schizophrenia. The aim of this study was describe the morphology of midbrain dopaminergic neurons (A8, A9 and A10) of the rock cavy (Kerodon rupestris), a rodent belonging to the family Caviidae typical of the Brazilian Northeast, which is being adopted as a model for neuroanatomical studies in laboratory of neuroanatomy of the Federal University of Rio Grande do Norte. Coronal sections of brains of the rock cavies were submitted to staining by Nissl s method and immunohistochemistry against tyrosine hydroxylase. The nuclear organization of the midbrain dopaminergic nuclei of the rock cavy is very similar to that found in other animals of the order Rodentia, except by the presence of the tail of substantia nigra, which was found only in the studied species. We concluded that the midbrain dopaminergic nuclei are phylogenetically stable among species, but we think to be it necessary to expand the studies about the particularity found the rock cavy, investigating its occurrence in other species of rodents or investigating its functional relevance

Avaliação das características de afetividade em crianças e jovens com síndrome de down

This work presents the processes and the results of a research concerning the affectivity in children suffering from the Down´s Syndrome (DS). The relevance of the study is justified due to the need of the development of researches, in the area of psychological evaluation of people who suffers from Down´s Syndrome (DS), that are backed by the use of appropriate instruments for such purpose. The thematic discussed focuses the characteristics of the affectivity of children suffering from Down´s Syndrome. Affectivity, conceptually, is considered a wide phenomenon, including several aspects such as emotions, passions, anxiety, anguish, sadness, happiness and even the pleasure sensations and pain. The general objective of the study consisted of investigating the manifestation of the affectivity in children and young with Down´s Syndrome and the parents´ and educators´ perception concerning the expression of the affectivity in the behavior and in the social activities. The specific objectives were: to identify the parents' perceptions about the several manifestations of indicative behaviors of affectivity; to verify in the social atmosphere, outside home, through the teachers' perception, the several forms and intensities of the expression of the affectivity; and, to make possible the use of the technique of Zulliger (Z-test) in people with Down´s Syndrome. 70 (seventy) children and young with Down´s Syndrome participated in the research, in the age group from 04 to 26 years old, which are attended by Institutions of Paraíba and of Rio Grande do Norte. The instruments used were two questionnaires, applied with the parents and teachers, and the projective technique, Z-test, applied, individually, with the children and young with Down´s Syndrome. For analysis of the data of the questionnaires, the program Trideux-Mots was used, with the intention of selecting the main outstanding words for the parents and teachers concerning the expression of the children's affectivity and young with Down´s Syndrome. For so much, it was organized a database that was processed by that program and, soon after, interpreted through the Factorial Analysis by Correspondence (AFC), looking for to clear the modalities of presented answers in an organized way, through a graph. The data of the Z-test were analyzed, taking in consideration the need to characterize the aspects of the affectivity and the elaboration of specific norms for this sample type, through normalized scores. In agreement with the data presented by Tri-deux-Mots, it was observed that in the affective behavior and in the relationship with the other, home and in the school, the children and young with Down´s Syndrome they express your affectivity through positive and negative characteristics, in the same way that any other child that doesn't have to syndrome. The Z-test made possible initial elements to work with that population, however it is necessary that grow other researches with the intention of investigating the reason of the answers they present not the specific categories that you/they are related to the affectivity, since it was well-known the diversity of affective characteristics presented by the researched group

A infância no âmbito do discurso dos parâmetros curriculares nacionais

The educational institution, committed to the production and transmission of knowledge, has increasingly revealed a specific dimension of that commitment, which is to form people und to produce certain kinds of subjectivity. The child is involved in a context of subjectivity production becoming the object of expectations; expectations arising from the demands of a globalized world, and based upon a discourse of specialized fields of scientific knowledge relative to childhood. The purpose of the present work is to analyse the discourse found in the Parâmetros Curriculares Nacionais - PCNs (National Curriculum Guidelines) as concerns the first four years of Elementary education, trying to disclose its ideas and conceptions about the subject-child. Conceiving this discourse as an ideological phenomenon in which the word becomes the central stage where contradictory values are confronted, according to Bakhtin thinking, the analysis constitutes an effort to point out the voices which supply its basis, in what it reveals about the child. Assertions such as "preparing children for the working market", or for "exercising their citizenship", among others which can be found in the institutionalized pedagogical discourse, are stated in a universalized and normative sense, and have become the object of doubt and criticism. The investigation on the implicit and explicit conceptions about childhood as revealed in the PCNs, whose spokesperson has been the school, serves as the starting point for a series of other studies and reflections intended to pave the way for the implementation of educational processes which allow for singular manifestations of the subject-child

Percepção de estigma e qualidade de vida em crianças com neoplasia

The increase in survival time and cure requires more extensive care about the quality of life of cancer patients, which begins soon after diagnosis. Thus, it seems reasonable to the emphasis on development of studies covering the psychosocial variables, such as stigma, treatment of childhood cancer aiming thereby to the attention of the overall needs of the child. Thus, this research aims to investigate the perception of stigma and quality of life in children with cancer. This is a cross-sectional research and understanding of the descriptive type, the type specimen being adopted for convenience. This consisted of thirty children with cancer and thirty children without chronic disease. The instruments used were the Quality of Life Questionnaire, the Perceived Stigma Scale and Technical Drawing Story with a Theme. The results indicate that the chronic condition, no interfered significantly in satisfaction with the quality of life in children with cancer and identified that the quality of life is not related to the stigma. Comparison with children with no chronic disease with infants with cancer, no significant differences were observed. However, the group mean contrast was lower, suggesting a greater impairment in quality of life of children with cancer compared to those without chronic disease. It is worth noting that the psychosocial effects and the limitations imposed by disease and treatment are presented as important factors in the design mode of subjective manifestations of children with cancer. Therefore, it is expected that knowledge elucidated by this study will assist, greatly to the promotion of improved emotional, biological and social development itself and the involvement of children with cancer treatment

Violência nas escolas: Um novo olhar ante as relações sociais

The most varied ways of manifestation of the violence phenomenon in the contemporary society are each time more found in the media spaces and among society discussions. It makes think about procedures to be taken before the growth and new outbreaks of such phenomenon. The violences manifestations in schools reveal themselves as a reflection of what happens in the scope of social violence. Its dynamics originates in society and reflects itself in scholl, that is, the violences in schools combine internal and external elements to school enviroment of many fields and spheres of which the individuals participate. To reflect about the violences in the schools requires, over all, to make a bridge with the categories: youth and violence. Violences in schools: A new look to the social relations, is a Ms. Sc. Dissertation that has as main objective: to analyze the main existing forms of violence in the school space. For its achievement, it was made a bibliographical survey, questionnaires application (annexed) and observation. Thus, this research articulated the two approaches: qualitative and quantitative. The questionnaires application happened in a state school of the Natal city and amongst yhe criteria for this choice there was the fact of the school had more than 500 pupils, to be located on a strategical place of the city, providing a subjects heterogeneity to be researched, deyond the limitations of available resources financial and material and the available time for the research accomplishment. The scool congregates objective conditions, specifically in what concerns the criteria previously defined: age range, socioenomical level and number of pupils. Amongst the main results obtained, it can be detached that the violence is a phenomenon seen, for the great majority of the research subjects, as a phenomenon connected to the most visible violence forms: the agressions. And a question always present in the public education institutions: infrastructures precariousness, high scool evasion índex and vulnerability among the pupils that makes possible to the pupil to see school as an home extension. Such dissertation concludes that the phenomenon of the violence in scools demands and requires of the most varied subjects involved in the processes na understanding of its determinants so that thus, one can intervene in such phenomenon that does not restrains itself to the physical acts of aggression, but that it is, over all, on a non respecting the different

Adolescência e violência: um estudo da medida socioeducativa de prestação de serviço a comunidade no município do Natal

This Project was built to reflect about juvenile violence and the socio-educational´s range of community services provision. It is known that the juvenile violence is a phenomenon inserted on the capitalism system, backed on neo liberal project. Though, it is essential a historical analysis, showing the economical, political, social and cultural mechanisms which determine the juvenile violence personality. On this way, it is seek understand the elements that leads on work world changes, on the State and public politics sphere, that deepens social dissimilarities. On this propose, it is known that there is a relation among the violence, while one of many manifestations of social question on society and the macroestructuals´determinant that lead the teenager to a social rick situation. This research focused on a inquiry quail-quantitative, using the theoric-metodological procedures of observation, interview and documental quest techniques. The universe had been defined by the intentional sample of 22 interviewed on total, during August and October 2008, covering adolescents and their relatives, technical and the coordinator, which subsidized the Socio educational program of community services provision from Natal analysis of limits and their range. The results of this investigation indicate the necessity of development, with the teenagers authors of infringement acts, a care system that is grounded on a professional formation, respect on human rights and citizenship conquest, regarding that children and teenagers are designed as people on development, that have theirs rights and integral protection, being the State, society and family responsibility assure the integral development of them

Síndrome de Silver-Russell: relato de caso

OBJETIVO: descrever o fenótipo da síndrome de Silver-Russell (SSR) e apresentar um caso diagnosticado com esta afecção genética, abordando aspectos genéticos, psicológicos e fonoaudiológicos. MÉTODOS: trata-se de relato de caso de uma criança do gênero feminino, sete anos e onze meses, portadora da síndrome de Silver-Russel. Foram realizadas avaliação genética médica e molecular, avaliação psicológica, avaliação fonoaudiológica e aplicação de testes complementares. RESULTADOS: a análise molecular da região 7p11 excluiu a dissomia uniparental para este caso. No exame físico foram constatados os principais sinais clínicos da SSR que incluiu retardo no crescimento de origem pré-natal, fácies típica, assimetrias ósseas e clinodactilia do 5º dedo. A avaliação cognitiva e fonoaudiológica mostraram deficiência mental, distúrbio de linguagem oral e comprometimento das funções orais. CONCLUSÃO: o estudo deste caso possibilitou a divulgação do fenótipo da SSR com suas manifestações físicas, cognitivas e fonoaudiológicas. Embora o teste molecular não tenha confirmado um dos possíveis mecanismos etiológicos da síndrome, a avaliação genética médica constatou a presença dos principais sinais clínicos que foram correlacionados à literatura. A avaliação psicológica e fonoaudiológica apontaram para comprometimento cognitivo e de comunicação, funções orais , sugerindo que importantes alterações fonoaudiológicas podem fazer parte do fenótipo desta síndrome, ainda pouco difundida para fonoaudiólogos.

Treinamento de habilidades fonológicas e correspondência grafema-fonema em crianças de risco para dislexia

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Neurofibromatose: relato de caso

Os autores apresentam um caso de neurofibromatose em paciente que apresentava uma tumoração lombossacral volumosa, alertando-se para o diagnóstico, as variantes clínicas da moléstia e a preocupação quanto a degeneração malígna de tal afecção.

Management of tracheobronchial foreign body in children

To study cases of foreign bodies (FB) in the tracheobronchial tree investigating the clinical and radiological FB characteristics, complications and endoscopic and surgical intervention. Medical and radiological records review of all FB aspiration cases treated at S (a) over tilde uo Paulo State University Hospital over the last 30 years. One hundred and sixty-four FB cases were analyzed; 57% were male, 84% of these were under 16 years old. The most common clinical manifestations were coughing (68.3%) and choking (54.9%). The most common FBs were seeds (peanut, bean, maize) and also small metal or plastic objects. Radiography was normal in 21.3%, atelectasis was present in 40.9%, hyperinsufflation in 17.1% and the FB was radio-opaque in 20.7%. FB time in the bronchial tree varied from hours to years. The most serious complications, as fibroatelectasis and difficult resolution pneumonia, were caused by the long time that the FB remained in the bronchial tree. FB extraction was by endoscopy in 89% of cases, while 6% required surgical extraction or resection of destroyed part of lung, and 5% spontaneously eliminated the FB. There was no mortality in this series. Coughing and choking were the commonest clinical findings. Most FBs were dried seeds. Complications were due to delays in diagnosis, and most would not have existed if the doctor had given credence to the history. Radiography can be normal as most FBs are radiotransparent. FB extraction was by endoscopy, but a few cases required surgery and others were spontaneously eliminated.

Meningeal tumor: A rare extrahepatic association in patients with polycystic liver disease enrolled for liver transplantation

In the present study, we described a rare association of polycystic liver disease (PCLD) with intracranial meningiomas in patients included on a liver transplant list, focusing on the diagnosis, treatment and possible association with any genetic alterations. Two female patients, aged 39 and 49 years were included on a liver transplant list due to extensive PCLD, with symptoms related to an abdominal compartmental syndrome. Screening for extrahepatic manifestation revealed a right frontal meningioma in the first patient, and a parietal posterior calcified meningioma in the second patient, measuring 1 and 7x3x2 cm in diameter, respectively. Following tumor removal, the histological pattern was compatible with fibrous and transitional meningioma, respectively. Cytogenetic studies conducted following surgery did not reveal any changes in metaphase chromosomes. The postoperative follow-up for the two patients was uneventful, without complications, with the patients remaining on a liver transplant waiting list. We conclude that screening for extrahepatic manifestations of PCLD is mandatory, as certain lesions require treatment prior to liver transplantation. The lack of a genetic or familial association between these two cases show they are likely to have occurred by chance, rather than representing a previously unrecognized association between polycystic liver disease and cranial meningioma.

Trombose venosa profunda de membros superiores: estudo coorte retrospectivo de 52 casos

OBJETIVO: Rever os fatores predisponentes e a evolução em série de casos de trombose venosa profunda dos membros superiores de nossa instituição. MÉTODOS: Cinqüenta e dois pacientes consecutivos, com trombose venosa profunda dos membros superiores (29 homens e 23 mulheres), idade média de 52,3 anos, documentados por mapeamento dúplex (71,1%), flebografia (11,1%) ou clinicamente (15,6%), foram incluídos no presente estudo. RESULTADOS: As manifestações clínicas foram: dor no antebraço (24 casos - 46,1%), dor no braço (27 casos - 51,9%), edema do membro superior (45 casos - 86,5%), dor à compressão do membro superior (36 casos - 70,2%) e dor à movimentação do mesmo (32 casos - 61,7%). Os principais fatores de risco foram: punção ou acesso venoso (20 casos - 39,1%) e câncer (16 casos - 32,6%). As veias envolvidas foram: umeral (n = 18), axilar (n = 27), subclávia (n = 15) e jugular (n = 11). A embolia pulmonar estava inicialmente presente em quatro casos (7,6%). O tratamento inicial foi feito com heparina não-fracionada intravenosa (64,3%), subcutânea (16,7%), ou heparina de baixo peso molecular (17,1%), seguido de varfarina. Doze pacientes morreram antes da alta, em função de causas não relacionadas à embolia pulmonar. Foram acompanhados os 40 pacientes restantes por período de 3 meses a 10 anos, sendo que dois morreram de causas não relacionadas à embolia pulmonar, um paciente desenvolveu seqüelas pós-trombóticas, como edema residual e limitações aos movimentos, e seis ficaram com discretos sintomas residuais (edema e dor). CONCLUSÕES: A trombose venosa profunda dos membros superiores foi mais freqüente em pacientes submetidos a acessos venosos e com neoplasia em atividade. Comparando com dados da literatura, a evolução dos pacientes sob tratamento exclusivo com anticoagulantes foi, no mínimo, similar a outros tratamentos propostos.

Piomiosite tropical: apresentações atípicas

A piomiosite tropical é uma infecção primária dos músculos, que ocorre principalmente em países tropicais. Inicialmente, suas manifestações são leves e inespecíficas, o que dificulta o diagnóstico. A história natural dessa doença costuma ser benigna, com raras complicações. Essa apresentação descreve quatro casos de piomiosite, com manifestações e complicações peculiares.