O uso das pregas cutâneas e da circunferência muscular do braço no diagnóstico de desnutrição energético-protéica em pacientes adultos: estudo crítico.

The use of anthropometric measurements of triceps (TSF) and subscapular skinfolds (SSF) and mid-upper arm muscle circumference (MAMC) was examined as far as the diagnosis of energy-protein malnutrition (EPM) is concerned. The study was undertaken in five groups of patients (n = 231): arterial hypertension (AH, n = 63), chronic obstructive pulmonary disease (COPD, n = 17), hemodialyzed chronic renal failure (CRF, n = 19), critically ill patients with an acute event (CA, n = 42) and critically ill patients with chronic diseases (CCD, n = 90). The results were compared to those obtained in a group of healthy individuals (control group, n = 102). The control group and the group of patients were allocated in subgroups according to sex and age (less than 50 and more than 50 years). It was expected that significant differences would be found for the anthropometric values between the control subgroups and the COPD, the CRF and the CCD subgroups of patients. For the skinfold thicknesses (TSF and SSF), significant differences were found between CRF, CCD subgroups and the control subgroups under fifty years of age; however, the differences were not significant when the subgroups over fifty were analyzed. Concerning the MAMC, significant differences were found: 1 degree) between the CRF subgroups (males and females) and the control subgroups under fifty years of age; 2 degrees) between the CCD male subgroups (younger and older subgroups) and the respective control subgroups and 3 degrees) between the COPD and the control subgroups.(ABSTRACT TRUNCATED AT 250 WORDS)

Obstrução nasolacrimal congênita - Diagnóstico e tratamento

Patients with congenital nasolacrimal obstruction (CNLO) were evaluated at the Lacrimal Apparatus Service of Botucatu Faculty of Medicine - UNESP from 1990 to 1993. 45 children were seen at this period with CNLO. The diagnosis was confirmed by dacryocystography (DCG). Obstruction was unilateral in 77,7% of the patients; 68,1% at Arlt Sinus and 43,6% had lacrimal sac grade 1. Probing was made in children older than 6 months, under general anaesthesia, after DCG was performed. Cure was greater in children age 6 to 12 months with obstruction at Hasner's Valve and without dilation of lacrimal sac.

Diagnóstico da deficiência de fósforo em bovinos pelos exames histológicos e microrradiográficos de costelas

The objective of the present study was to show the efficiency of histologic and microradiographic techniques performed on rib bone samples as a mean of diagnosing the phosphorus status of cattle raised on phosphorus deficient pastures and receiving different mineral supplements. The rib samples were obtained from cattle of different ages which died from disease that was clinically and epidemiologically diagnosed as botulism. Ten out of 24 juvenile and adult animals studied exibited alterations of osteomalacia, while the others without those alterations served as controls. It is suggested that the method could be useful to improve the diagnosis of phosphorus deficiency of cattle in Brazil.

Diagnóstico laboratorial de hemoglobinopatias em populações diferenciadas

The inherited haemoglobinopathies are a heterogeneous group of recessive disorders that include the thalassaemias and sickle cell disease. Nearly a thousand mutant alleles have now been characterized. The mutations are regionally specific and in most cases the geographical and ethnic distribution shave been determined providing the foundation for a program of control through screening, genetic counseling and prenatal diagnosis. The diagnosis of hemoglobinopathies requires care for the methodologies applied and the population group which will be evaluated. The information about the abnormal hemoglobin, the medical and psychological aspects and genetic counseling of the carriers and their families are goals of great importance for the success of preventive programs in this area. Aiming to evaluate the laboratory methods for hemoglobinopathy screening and their use in clinical laboratories, we have compared abnormal hemoglobins incidence in the different population groups: blood donors, anemia carriers, newborn and students. The laboratory methods applied involved eletrophoretic proceedings, cytological and biochemical analysis. Within the period from September 1999 through January 2000, we analyzed 524 individuals with varied types of abnormal hemoglobins. Among blood donors, we diagnosed two sickle cell carriers, which suggest the necessity for better care in the process of selection of blood donor candidates. The current interest in the medical and social aspects of sickle cell anemia has resulted in a great increase in methodology research leading to the development of sickle cell screening techniques.

Expressão dos filamentos intermediários no diagnóstico dos tumores mamários de cadelas

Immunohistochemical evaluation was performed to study the histogenesis of canine mammary tumors and to contribute to a better understanding of their classification. Monoclonal antibodies specific for different types of intermediate filaments (cytokeratins, vimentin, α-actin) were used. Epithelial cells stained positively for cytokeratins and their expression was lost as the malignant transformation occurs. Myoepithelial cells stained positively for vimentin and α-actin. In contrast to vimentin, α-actin lost the expression as the cartilaginous or osseous metaplasia occurs. Immunohistochemical evaluation with monoclonal antibodies proved to be efficient for identification of tumor histogenesis.

Evolução no diagnóstico citológico do câncer de colo uterino - Novas tecnologias para o rastreamento citológico cervical

The cancer of the uterine cervix remains a serious public health problem in developing countries with low social-economic conditions. Papanicolaou smear has been used to screen women for cervical cancer since 1940, and it is widely recognized as an effective method for preventing cervical cancer. In Brazil, conventional Papanicolaou is the most common method used in diagnosis cytopathological routine, involving the morphological cell analysis by microscopic examination of cervical samples smeared on glass slides. On the other hand, the liquid cytology is an advantageous method whose specimen collected is put into a fluid alcohol based to guarantee the potential use of residual cellular material in cytobrush. Moreover, this method permits additional diagnostic studies, preserving the morphological cell features as the conventional one does. The aim of the present study was report the historical evolution of different cervical cytologic tests, emphasizing the advantages and disadvantages between conventional Papanicolaou method and new technologies in liquid based cytology.

Diagnóstico diferencial da fobia social: Uma revisâo

Social phobia is a common mental disorder that can cause considerable distress and impairment in functioning and quality of life but it is still an underdiagnosed and undertreated disorder. The differential diagnosis is not always simple. because its clinical features overlap with many other mental and non-mental disorders characterized by social avoidance. The aim of this study was to review the literature and discuss the differential diagnosis of social phobia with the following conditions. normal social anxiety (shyness), depressive disorders, alcoholism, body dysmorphic disorder, panic disorder and agoraphobia, simple phobias, generalized anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, delusional disorders and avoidant and schizoid personality disorders. A Medline and Lilacs search was conducted between 1990 and 2002, using the key words social phobia, social anxiety disorder, diagnosis and defferential diagnosis. The accurate diagnosis is very important for the appropriate treatment approach.

Avaliação da eficiência dos métodos Direto, COPROTEST e Rugai no diagnóstico da estrongiloidíase

Strongyloidiasis, a relatively common parasitism in tropical and sub-tropical areas, is the result of the infection by the smaller nematode, the Strongyloides stercoralis. Humans can be infected by this parasite, which has in its vital cycle free-life forms of male and female individuals able to live in the ground, and with another step necessary parasitism in the intestinal wall. The diagnostic of the infection is routinely done by the microscopic observation of the larva in stool samples and the high sensibility of urn method over another one allows an trustable and efficient diagnostic. The efficiency of three methods (Direct, COPROTEST and Rugai) used in the Parasitology Sector of the NAC-LACAL in Araraquara (SP) to diagnosis the strongiloidiasis were evaluated. A number of 2346 samples of stool of patients from NAC-LACAL and Nestor Goulart Reis Hospital were analyzed in the period between August and December of 2002. The Rugai Method with an positivity index of 65 % was elected as the most efficient of thee ones.

Obstrução nasolacrimal congênita - Diagnóstico e tratamento

This article assembled the congenital lacrimal obstruction according embryology, clinical presentation, propedeutic exams and other differential anomalies.

Comparação entre técnicas coproparasitológicas no diagnóstico de ovos de helmintos e oocistos de protozoários em cães.

In this study we evaluated the frequency of enteroparasites in pet dogs and their association with age, sex and breed, as well as the efficiency of the Willis-Mollay, Faust, Sedimentation and Direct exam methods. By these methods we processed 401 fecal samples. The samples were positive in the following percentages: Ancylostoma spp. (53.1%), Toxocara canis (20.7%), Cystoisospora ohioensis (15.7%), Trichuris vulpis (3.7%), Dipylidium caninum (2.5%) and Taenia spp. (1.0%). Toxocara canis (67.3%) and C. ohioensis (47.3%) showed higher positivity in the puppies. The Willis-Mollay technique was more efficient in the diagnosis of Ancylostoma spp. and T. canis eggs. The Direct method was the least efficient. It was found that the majority of the cases of D. caninum were diagnosed by the Sedimentation method (8=2.0%), while for T. vulpis Willis-Mollay (12=3.0%) and Sedimentation (13=3.2%) were more efficient. In view of these results, we can recommend the association of Willis-Mollay and Sedimentation methods for the diagnosis of gastrointestinal helminths. Due to the elevated occurrence of Ancylostoma spp. and T. canis, which are involved in zoonotic diseases, it becomes necessary to apply more efficient prophylaxis of canine intestinal parasitosis at the City of Araçatuba, state of São Paulo.

Diagnóstico de uma área compactada por atividade minerária, na floresta amazônica, empregando métodos geoestatísticos à variável resistência mecânica à penetração do solo

A quite common problem in the recovery of degraded areas in the mineral exploration understands the compaction of the soil due to the intense traffic of machines and earth movement. The most common problem of the compaction of a degraded surface is: increase of the mechanical resistance to the penetration of the rooats, reduction of the aeration, alteration of the water flow and heat. Thus the present work had the basic objective of diagnosing the compaction of a degraded area by mining in a space way, through the mechanical resistance the way penetration to guide a future subsoiling in the place seeking recovery. Through the studies it was concluded that the kriging method in agreement with the space variation allows the division of the area studies in sub areas facilitating a future work to reduce cost and unnecessary interference to the atmosphere. The method was shown quite appropriate and it can be used in diagnosis of the compaction in a degraded area by mining, foreseeing subsoiling need.

Avaliação de diferentes métodos no diagnóstico laboratorial de Giardia lamblia

The protozoan parasite Giardia lamblia is responsible for a common intestinal infection in all regions of the world. In this study, four laboratory tests were evaluated for diagnostic reproducibility in the detection of this infection: Coprotest®, Direct modified method, Faust method and iron-hematoxylin staining. Positive diagnoses were tested for association with factors such as the age group and gender of the subject and the month when the sample was taken. Feces of 200 children in the Araraquara region (SP, Brazil) were examined by all four methods and the results compared. G. lamblia was found to be the most frequent parasite and 8.0% of the children showed giardiasis. There was no apparent correlation with gender, but most of the parasites were found in three- to five-year-olds. The highest frequency of infection occurred in January. The most reliable diagnostic results for G. lamblia were achieved by combining at least two methods of good reproducibility, i.e. Coprotest-Faust, Direct-Faust or Coprotest-Direct (A > 0.81).

Avaliação do kit TF-Test para o diagnóstico das infecções por parasitas gastrintestinais em ovinos

This study was performed to standardize parasite egg counting in feces of sheep by TF-Test, in addition to compare this test to the Gordon & Whitlock technique (G&W). Twenty-four lambs were artificially infected with Haemonchus contortus throughout 12 weeks. At the end of this time, faecal samples were taken and animals were slaughtered for worm identification and counting. G&W and TF-Test methods were carried out on each fecal sample. Both tests showed Haemonchus eggs in 95.8% of the samples (P>0.05). The correlation coefficients (r) between fecal egg counts (FEC) using G&W × Total Worm Count (TWC) were r=0.52 (not transformed data) and r=0.85 (transformed data); between FEC by TF-Test × TWC were r=0.51 (not transformed data) and r=0.87 (transformed data). Other 100 fecal samples were taken from naturally infected sheep. In these animals, the G&W and TF-Test methods showed 85% and 86% of fecal samples positive for Strongylidea eggs, respectively (P>0.05). Also in those animals, Eimeria oocysts were found in 33% of fecal samples by TF-Test, whereas in the G&W only 12% were positive (P<0.001). For Strongyloides spp., TF-Test showed 15% of positive fecal samples, whereas G&W showed 5% (P<0.05). In conclusion, both methods were efficient to diagnose gastrointestinal nematodes and TF-Test was superior to diagnose oocysts of Eimeria spp. and eggs of Strongyloides spp; conversely, Strongylidea eggs counting using TF-Test was underestimated.

Síndrome das pernas inquietas: Diagnóstico e tratamento. Opinião de especialistas Brasileiros

This article contains the conclusions of the November 17-18, 2006 meeting of the Brazilian Study Group of Restless Legs Syndrome (GBE-SPI) about diagnosis and management of restless legs syndrome (RLS). RLS is characterized by abnormal sensations mostly but not exclusively in the legs which worsen in the evening and are improved by motion of the affected body part. Its diagnosis is solely based on clinical findings. Therapeutic agents with efficacy supported by Class I studies are dopamine agonists, levodopa and gabapentine. Class II studies support the use of slow release valproic acid, clonazepan and oxycodone. The GBE-SPI recommendations for management of SPI are sleep hygiene, withdrawal of medications capable of worsening the condition, treatment of comorbidities and pharmacological agents. The first choice agents are dopaminergic drugs, second choice are gabapentine or oxycodone, and the third choice are clonazepan or slow release valproic acid.