Effects of Green Banana Biomass (Musa spp.) on Laboratory Parameters of Animal Models of Wistar Mice under Hyperlipidic Diet.

AIM: Analyze the effects of green banana biomass (Musa spp.) on the biochemical parameters in Wistar male rats under standard and hyperlipidic diet. METHODS: Ethical approval for this study was obtained from Ethics Committee on the Use of Animals CEUA - PUC-GO and consisted in the division of 32 rats in 4 differentiated groups according to their diet (standard - CT; standard with green banana biomass - CTBM; hyperlipidic - HL and hyperlipidic with green banana biomass - HLBM). Through 8 weeks animals were weighted and their glycemia were measured. After this period, they were euthanized and biological material was collected to evaluate the biochemical parameters, which analysis used the ANOVA test. RESULTS: The weekly evaluation confirmed that the efficacy of the hyperlipidic model since the final weight was bigger in the HL group in comparison with the CT group, from the sixth to the eighth week. It was also possible to observe that the CTBM group had a smaller weight compared to the CT group. Besides, the measurement of glycemia, high-density lipoprotein, triglycerides, alanine aminotransferase, aspartate aminotransferase, serum total bilirubin, direct bilirubin, alkaline phosphatase, urea, serum creatine, uric acid, calcium, phosphor, magnesium and the hematological parameters from the 8 animal of each group were compared by the ANOVA test without any significative difference (p < 0.05) in the comparisons. CONCLUSIONS: This study it did not demonstrate significative changes of the green banana biomass on the observed laboratory parameters during the 8 weeks in comparison to the standard group, indicating an absence of interference of the probiotics in the laboratory parameters on the hyperlipidic model during the analyzed period. Therefore, it is necessary an evaluation of its efficacy in obesity treatment in longer studies with molecular parameters.

A method for evaluating breast cancer screening strategies using screen-preventable loss of life.

The objective of this study is to describe how screen-preventable loss of life (screen-PLL) can be used to analyze the distribution of life savings with mammographic screening. The determination of screen-PLL with mammography is possible using a natural history model of breast cancer that simulates clinical and pathologic events of this disease. This investigation uses a Monte Carlo Markov model with data from the Surveillance, Epidemiology, and End Results Program; American Cancer Society; and National Vital Statistics System. Populations of one million women per screening strategy are simulated over a lifetime with mammographic screening based on current guidelines of the American Cancer Society (ACS), United States Preventive Services Task Force (USPSTF), triennial screening from age 50-70, and no screening. Screen-PLL curves are generated and show guideline performance over a lifetime. The screen-PLL curve with no screening is determined by tumor discovery through clinical awareness and has the highest values of screen-PLL. The ACS and USPSTF strategies demonstrate screen-PLL curves favoring the elderly. The curve for triennial screening is more uniform than the ACS or USPSTF curves but could be improved by adding screen(s) at either end of the 50-70 age range. This study introduces the use of screen-PLL as a tool to improve the understanding of screening guidelines and allowing a more balanced allocation of life savings across an aging population. The method presented shows how screen-PLL can be used to analyze and potentially improve breast cancer screening guidelines.

Avaliação dos parâmetros hematológicos em ratos Wistar descendentes de mães obesas / Evaluation of hematological parameters in Wistar rats descending from obese mothers

O modelo de obesidade em ratos por meio de uma dieta hiperlipídica têm se consolidado, sendo relevante compreender os componentes da hereditariedade nesta enfermidade. Por meio do hemograma é possível avaliar os elementos sanguíneos e as células responsáveis pela defesa do organismo, incluindo sua morfologia, bem como interpretando-as. Compreender esses fatores em ratos descendentes de mães obesas poderia contribuir na compreensão dos mecanismos imuno-hematológicos envolvidos na obesidade e na hereditariedade. Com isso, o objetivo deste estudo é avaliar os parâmetros hematológicos e leucocitários de ratos alimentados com dieta hiperlipídica descendentes de mães obesas. Foram utilizadas 20 ratas Wistar (peso inicial 200g) alimentadas com dieta padrão (CT) ou com dieta hiperlipídica (HL). Posteriormente, alocou-se 3 fêmeas com 1 macho por 4 dias, certificando o cruzamento. Após 23 dias do nascimento da ninhada, foi feita a separação da prole em 4 grupos com 5 animais cada, e submetidos à dieta HL ou CT. Ficando então os grupos CT, CT+ HL, HL, HL + CT. Após 20 semanas de dieta, os animais foram anestesiados e tiveram peritônio exposto para coleta de sangue, que serviu para a realização e análise do hemograma, por diferenciação celular. Todos os procedimentos foram realizados de acordo com as diretrizes da utilização de animais para fins científicos (Lei 11.794/08), e protocolada no CEUA sob o n° 9062310117. As ratas HL tiveram um ganho de peso significativamente maior a partir da 10ª semana, comparando as ratas CT. Já em relação à prole, após 13 semanas, o grupo HL obteve um ganho de peso maior em relação aos demais grupos: CT: 144,8 ± 12,15 g; CT+HL (ratos descendentes de mães CT alimentados com ração HL): 138,6 ± 5,34 g; HL+CT (ratos descendentes de mães HL alimentados com ração CT): 152,2 ± 5,23 g; HL 161 ± 10,75 g. Nos parâmetros hematológicos da prole, foi observada diferença entre o grupo CT e experimental, os monócitos apresentaram uma redução significativa de 1,6± 0,89, hemoglobina 13,8 ± 1,07, hematócrito 37,9 ± 5,51 nos grupos que receberam dieta CT comparado à CT+HL, VCM apresentou aumento de 50,4 ± 0,55 no grupo CT e 53,5 ± 0,58 na dieta HL. Dentro das condições experimentais deste trabalho e com base nos resultados obtidos, conclui-se que a dieta hiperlipídica é capaz de induzir a obesidade, com capacidade de influenciar a proliferação e a diferenciação hematopoiética, porém a prole alimentada com ração padrão (CT) consegue adaptar a dieta independente do fator hereditário em relação à obesidade.

The obesity model in rats maintained by a hyper-lipidic diet is well known, and thus, there is a need to understand the components of heredity in this disease. Using HEM, it is possible to study the blood elements and cells involved in the defense of the organism, including cell morphology and its interpretation. Understanding these factors in rats descending from obese mothers may contribute to the comprehension of the immunity and hematologic mechanisms involved in both obesity and heredity. The purpose of this study is to evaluate the hematologic and leukocyte parameters of rats fed with a hyper-lipidic diet descending from obese mothers. A total of twenty Wistar female rats (initial weight 200g) fed standard diet (SD) or hyperlipidic diet (HD) were used. Subsequently, 3 females were housed with a male for 4 days in order to get inseminated. Twenty-three days after born, the animals were separated into 4 groups, with 5 animals in each group. The groups were organized as follows: SD, SD+HD, HD, SD+HD. The animals were kept on a diet for 20 weeks. In the end of that period, animals were anesthetized and had their peritoneum exposed for the collection of blood, which was used for performing the erythrogram and leukogram analysis via cellular differentiation. All procedures were performed according the animal welfare guidelines (Law No. 11.794/08) and approved by CEUA (number 9062310117). After 10 weeks, HL mothers presented an increased body weight when compared with SD mothers. In relation to the offspring, after 13 weeks, the HD group presented greater weight gain when compared to the other groups, as follows: SD: 144.8 ± 12.15 g; SD+HD (rats from SD mothers fed with HD feed): 138.6 ± 5.34 g; HD + SD (offspring from HL mothers fed with SD feed): 152.2 ± 5.23 g; HD 161 ± 10.75 g. The offspring hematological parameters presented differences between the SD and the experimental group, where the monocytes presented a significant reduction (1.6 ± 0.89), hemoglobin (13.8 ± 1.07), hematocrit (37.9 ± 5.51) in the groups that received a SD diet compared with the SD + HD; the MCV presented an increase of 50.4 ± 0.55 in the SD group and 53.5 ± 0.58 in the group on HD diet. Conclusion: Based on the results, it can be concluded that a hyper-lipidic diet is capable of inducing obesity and may also influence hematopoietic proliferation and differentiation. However, the offspring fed with standard diet (SD) is able to adapt the diet regardless of the hereditary factor in relation to obesity.

Prevalência de sífilis em pacientes atendidos no Laboratório de Análises Clínicas da Pontifícia Universidade Católica de Goiás em 2018 / Prevalence of syphilis in patients attended at the Laboratory of Clinical Analysis of the Pontifical Catholic University of Goiás in 2018

Objetivo: Apesar de o tratamento ser de fácil acesso e também eficaz, a sífilis permanece em nosso meio e por isso foi realizado um levantamento de dados sobre os casos de sífilis em pacientes do Sistema Único de Saúde (SUS) atendidos no Laboratório de Análises Clínicas da PUC-GO (LAC) no período de janeiro a dezembro de 2018. Métodos: Trata-se de um estudo quantitativo e retrospectivo. Resultados: Foi constatado um aumento de 3,6% do número total de casos em relação ao ano de 2014 e um maior índice de prevalência no sexo masculino (16,6%). Além disso, verificou-se que 51,1% dos casos de VDRL reagente do LAC- PUC em 2018 eram de pacientes em idade fértil com faixa etária entre 21 e 40 anos. Conclusão: Isso demonstra a necessidade de uma mudança mais profunda, não somente nas políticas de Saúde Pública, mas também na conscientização social sobre os riscos da mesma.

Abstract Objective: Although the treatment is easy to access and also effective, syphilis remains in our country, so a data collection was carried out on syphilis cases in patients from the Unified Health System (SUS) attended at the Laboratory of Clinical Analysis of PUC-GO (LAC) from January to December 2018. Methods: This is a quantitative and retrospective study. Results: There was a 3.6% increase in the number of cases in relation to 2014 and a higher prevalence rate in males (16.6%). In addition, it was found that 51.1% of the cases of reactive VLDL of the LAC-PUC in 2018 are of patients of fertile age, with age between 21 and 40 years. Conclusion: This demonstrates the need for a more profound change, not only in Public Health policies, but also in social awareness about the risks of the same.

Sources of Error in Office Blood Pressure Measurement.

PURPOSES: To evaluate 2 commonly overlooked sources of error in measuring blood pressure (BP) in the office, improper patient positioning and frequency of terminal digit bias (TDB) using manual and automated (BP) devices. METHODS: BPs recorded by 3 nurses using manual and automated devices were analyzed for TDB. In the next part of the study, 294 patients were recruited and tested with each patient's BP measured twice in the table position and compared with BP measured in the chair position. To eliminate concern for position sequence, a randomized controlled trial was initially conducted. RESULTS: Significant TDB for the digit zero was identified in BPs measured by all nurses using a manual device. No such bias was identified for any nurse when measuring BP with an automated device. For the positional study, the randomized controlled study showed no significant sequencing effect therefore the sequence of table then chair BP measurements was adopted. Significant BP lowering was observed in 128 patients (42.7%) in the chair compared with the table position. Misclassification of prehypertension and hypertension would have occurred in 15.3% and 16% of patients, respectively, when BP was recorded in the table instead of the chair position. CONCLUSIONS: Significant TDB was identified for all nurses when using a manual but not an automated device. Patient positioning on the examination table resulted in elevations of systolic and diastolic BPs.

Prevalência de anemia microcítica hipocrômica em pacientes atendidos no Posto de Saúde da Vila Mutirão e assistidos pelo laboratório da PUC ­ Goiás, no período de agosto a outubro de 2018 / Hypochromic microcytic anemia prevalence in patients attended at Vila Mutirão Health station and assisted by the PUC - Goiás laboratory from August to December, 2018

Objetivo: Avaliar a prevalência de anemia microcítica hipocrômica de pacientes atendidos no Posto da Vila Mutirão do laboratório clínico da PUC-GO no período de agosto a dezembro de 2018. Métodos: O delineamento do estudo foi do tipo transversal, com base em um levantamento de dados a partir de indivíduos atendidos no Posto da Vila Mutirão, localizado na região noroeste de Goiânia-GO, no período de agosto de 2018 a outubro de 2018. Resultados: Foram coletadas 1.399 amostras de pacientes atendidos no Posto da Vila Mutirão de Goiânia ­ GO de ambos os sexos e de diversas idades. Os valores de VCM e HCM foram mensurados para todos os pacientes coletados. Os resultados obtidos foram divididos em quatro faixas etárias (1 a 10 anos; 11 a 20; 21 a 60 anos; 61 a 98 anos). A média geral do VCM dos pacientes com idade de 1 a 10 anos de ambos os sexos foi de 77,0 fL e HCM de 26,7 pg. Nos pacientes com idade de 11 a 20 anos, o VCM foi de 83,8 fL e HCM de 28,7 pg. Pacientes com idade de 21 a 60 o VCM foi de 85,4 fL e HCM foi 29,1 pg. E, por fim, os pacientes com idade de 61 a 98 anos, o VCM foi de 86,9 fL e HCM foi de 29,4 pg. Conclusão: Foi observada uma prevalência elevada de anemia microcítica hipocrômica em crianças de 1 a 10 anos de idade.

Objective: To evaluate the prevalence of hypochromic microcytic anemia in patients attending the Vila Mutirão clinic in the PUC-GO clinical laboratory from August to December, 2018. Methods: The study design was of a cross-sectional type based on a survey of data from individuals attended at the Vila Mutirão Post, located in the northwest region of Goiânia-GO, from August 2018 to October 2018. Results: A total of 1,399 patient samples were collected from the Vila Mutirão Post Office Goiânia-GO of both sexes and of different ages. The values of VCM and HCM were measured for all patients collected. The results were divided into four age groups (1 to 10 years, 11 to 20, 21 to 60 years, 61 to 98 years). The overall mean MCV of patients aged 1 to 10 years of both sexes was 77.0 fL and HCM of 26.7 pg. In patients aged 11 to 20 years, VCM was 83.8 fL and HCM was 28.7 pg. Patients aged 21 to 60 VCM was 85.4 fL and HCM was 29.1 pg. And finally, patients aged 61-98 years, the VCM was 86.9 fL and HCM was 29.4pg. Conclusion: A high prevalence of hypochromic microcytic anemia has been observed in children 1 to 10 years of age

Getting the hypertension Dx right: Patient positioning matters.

Taking blood pressure with the patient seated on the edge of an exam table led to misclassification of prehypertension or hypertension in 13.2% of patients.

Insights Into Breast Cancer Screening: A Computer Simulation of Two Contemporary Screening Strategies.

OBJECTIVE: The debate over the value of screening mammography is rekindled with each new published study or guideline. Central to the discussion are the uncertainties about screening benefits and harms and the criteria used to assess them. Today, the magnitude of benefits for a population is less certain, and the evolving concept of harm has come to encompass false-positives (FPs), unnecessary biopsies, overdiagnosis, and overtreatment. This study uses a Monte Carlo computer simulation to study the balance of benefits and harms of mammographic breast cancer screening for average-risk women. MATERIALS AND METHODS: This investigation compares the American Cancer Society's 2015 mixed annual-biennial guideline with the U.S. Preventive Services Task Force's 2016 fixed biennial guideline. Screening strategies are compared using cost-effectiveness acceptability curves, an economic analysis describing uncertainty in evaluating costs and health outcomes. Strategy preference is examined under changing assumptions of willingness to pay for a quality-adjusted life-year. Additionally, comparative effectiveness analysis is performed using FP screens and unnecessary biopsies per life-year gained. Alternative scenarios are compared assuming a reduced mortality benefit of screening. RESULTS: In general, results using both cost-effectiveness and clinical measures indicate that American Cancer Society's 2015 mixed annual-biennial guideline is preferred. Assuming decreases in the mortality benefit of mammography, no screening may be reasonable. CONCLUSION: The use of a mixed annual-biennial strategy for population screening takes advantage of the nonuniformity of occurrence of mammography benefits and harms over the duration of screening. This approach represents a step toward improving guidelines by exploiting age dependencies at which benefits and harms accrue.

African American and European American veterans' perspectives on receiving mental health treatment.

Little is known about client attitudes, especially veterans', toward the types of structured interventions that are increasingly being offered in public sector and U.S. Department of Veterans Affairs mental health clinics, nor is the possible impact these attitudes may have on treatment engagement well understood. Previous work indicates that attitudes of African Americans and European Americans toward treatment may differ in important ways. Attitudes toward treatment have been a proposed explanation for lower treatment engagement and higher dropout rates among African Americans compared with European Americans. Yet to date, the relationship between race and attitudes toward treatment and treatment outcomes has been understudied and the findings inconclusive. The purpose of this study was to explore African American and European American veteran attitudes toward mental health care, especially as they relate to structured treatments. Separate focus groups were conducted with 24 African American and 37 European American military veterans. In general, both groups reported similar reasons for seeking 0treatment and similar thoughts regarding the purpose of therapy. Differences emerged primarily regarding therapist preferences. In both groups, some participants expressed favorable opinions of structured treatments and others expressed negative views; treatment preferences did not appear to be influenced by race.

Military unit support, postdeployment social support, and PTSD symptoms among active duty and National Guard soldiers deployed to Iraq.

Research suggests that military unit support and community postdeployment social support are associated with fewer PTSD symptoms following military deployment. This study extended prior research by examining the associations among predeployment unit support and PTSD symptoms before Iraq deployment as well as unit support, PTSD symptoms, and postdeployment social support after deployment among 835 U.S. Army and 173 National Guard soldiers. Multiple regression analyses indicated that predeployment unit support was not significantly associated with postdeployment PTSD severity in either group of soldiers, whereas higher unit support during deployment was significantly associated with lower postdeployment PTSD severity among active duty soldiers only. Among both groups, higher levels of postdeployment social support were associated with lower levels of postdeployment PTSD symptom severity. These findings suggest that postdeployment social support is a particularly strong buffer against postdeployment PTSD symptoms among both groups of soldiers whereas the effects of unit support may be limited.

Clinicians' perspectives on cognitive therapy in community mental health settings: implications for training and implementation.

Policymakers are investing significant resources in large-scale training and implementation programs for evidence-based psychological treatments (EBPTs) in public mental health systems. However, relatively little research has been conducted to understand factors that may influence the success of efforts to implement EBPTs for adult consumers of mental health services. In a formative investigation during the development of a program to implement cognitive therapy (CT) in a community mental health system, we surveyed and interviewed clinicians and clinical administrators to identify potential influences on CT implementation within their agencies. Four primary themes were identified. Two related to attitudes towards CT: (1) ability to address client needs and issues that are perceived as most central to their presenting problems, and (2) reluctance to fully implement CT. Two themes were relevant to context: (1) agency-level barriers, specifically workload and productivity concerns and reactions to change, and (2) agency-level facilitators, specifically, treatment planning requirements and openness to training. These findings provide information that can be used to develop strategies to facilitate the implementation of CT interventions for clients being treated in public-sector settings.

The sustainability of new programs and innovations: a review of the empirical literature and recommendations for future research.

BACKGROUND: The introduction of evidence-based programs and practices into healthcare settings has been the subject of an increasing amount of research in recent years. While a number of studies have examined initial implementation efforts, less research has been conducted to determine what happens beyond that point. There is increasing recognition that the extent to which new programs are sustained is influenced by many different factors and that more needs to be known about just what these factors are and how they interact. To understand the current state of the research literature on sustainability, our team took stock of what is currently known in this area and identified areas in which further research would be particularly helpful. This paper reviews the methods that have been used, the types of outcomes that have been measured and reported, findings from studies that reported long-term implementation outcomes, and factors that have been identified as potential influences on the sustained use of new practices, programs, or interventions. We conclude with recommendations and considerations for future research. METHODS: Two coders identified 125 studies on sustainability that met eligibility criteria. An initial coding scheme was developed based on constructs identified in previous literature on implementation. Additional codes were generated deductively. Related constructs among factors were identified by consensus and collapsed under the general categories. Studies that described the extent to which programs or innovations were sustained were also categorized and summarized. RESULTS: Although "sustainability" was the term most commonly used in the literature to refer to what happened after initial implementation, not all the studies that were reviewed actually presented working definitions of the term. Most study designs were retrospective and naturalistic. Approximately half of the studies relied on self-reports to assess sustainability or elements that influence sustainability. Approximately half employed quantitative methodologies, and the remainder employed qualitative or mixed methodologies. Few studies that investigated sustainability outcomes employed rigorous methods of evaluation (e.g., objective evaluation, judgement of implementation quality or fidelity). Among those that did, a small number reported full sustainment or high fidelity. Very little research has examined the extent, nature, or impact of adaptations to the interventions or programs once implemented. Influences on sustainability included organizational context, capacity, processes, and factors related to the new program or practice themselves. CONCLUSIONS: Clearer definitions and research that is guided by the conceptual literature on sustainability are critical to the development of the research in the area. Further efforts to characterize the phenomenon and the factors that influence it will enhance the quality of future research. Careful consideration must also be given to interactions among influences at multiple levels, as well as issues such as fidelity, modification, and changes in implementation over time. While prospective and experimental designs are needed, there is also an important role for qualitative research in efforts to understand the phenomenon, refine hypotheses, and develop strategies to promote sustainment.

Comparative analysis of cervical spine management in a subset of severe traumatic brain injury cases using computer simulation.

BACKGROUND: No randomized control trial to date has studied the use of cervical spine management strategies in cases of severe traumatic brain injury (TBI) at risk for cervical spine instability solely due to damaged ligaments. A computer algorithm is used to decide between four cervical spine management strategies. A model assumption is that the emergency room evaluation shows no spinal deficit and a computerized tomogram of the cervical spine excludes the possibility of fracture of cervical vertebrae. The study's goal is to determine cervical spine management strategies that maximize brain injury functional survival while minimizing quadriplegia. METHODS/FINDINGS: The severity of TBI is categorized as unstable, high risk and stable based on intracranial hypertension, hypoxemia, hypotension, early ventilator associated pneumonia, admission Glasgow Coma Scale (GCS) and age. Complications resulting from cervical spine management are simulated using three decision trees. Each case starts with an amount of primary and secondary brain injury and ends as a functional survivor, severely brain injured, quadriplegic or dead. Cervical spine instability is studied with one-way and two-way sensitivity analyses providing rankings of cervical spine management strategies for probabilities of management complications based on QALYs. Early collar removal received more QALYs than the alternative strategies in most arrangements of these comparisons. A limitation of the model is the absence of testing against an independent data set. CONCLUSIONS: When clinical logic and components of cervical spine management are systematically altered, changes that improve health outcomes are identified. In the absence of controlled clinical studies, the results of this comparative computer assessment show that early collar removal is preferred over a wide range of realistic inputs for this subset of traumatic brain injury. Future research is needed on identifying factors in projecting awakening from coma and the role of delirium in these cases.

Impact of cervical spine management brain injury on functional survival outcomes in comatose, blunt trauma patients with extremity movement and negative cervical spine CT: application of the Monte Carlo simulation.

Cervical spine (CS) magnetic resonance imaging (MRI) and collar use may prevent quadriplegia, yet create brain injury. We developed a computer model to assess the effect of CS management strategies on outcomes in comatose, blunt trauma patients with extremity movement and a negative CS CT scan. Strategies include early collar removal (ECR), ECR & MRI, late collar removal (LCR), and LCR & MRI. MRI risks include hypoxia, hypotension, increased intracranial pressure (↑ICP), and ventilator-associated pneumonia (VAP). LCR risks include ↑ICP, VAP, and delirium. Model elements include Quadriplegia and Primary, Secondary, LCR, and MRI Brain Injury. The Monte Carlo simulation determines health outcomes (Functional Survival versus Quadriplegia, Severe Brain Disability, or Dead). Utility values are Functional Survival 0.90, Quadriplegia 0.20, Severe Brain Disability 0.10, and Dead 0.00. Years of life expectancy are Functional Survival 39.5, Quadriplegia 20.0, Severe Brain Disability 20.0, and Dead 0.0. Unstable CS rate 2.5%: Functional Survival/1,000: Unstable Patients: ECR 384, LCR 350, LCR & MRI 332, ECR & MRI 331; High-Risk Patients: ECR 161, LCR 151, LCR & MRI 140, ECR & MRI 153; Stable Patients: ECR 596, LCR 587, LCR & MRI 573, ECR & MRI 595. Quality-Adjusted Life Months for Unstable, High-Risk, and Stable Patients are greater with ECR; Stable Patient ECR and ECR & MRI are similar. Unstable CS rate 0.5%: Functional Survival/1000: Unstable Patients: ECR 394, LCR 352, LCR & MRI 332, ECR & MRI 332; High-Risk Patients: ECR 164, LCR 151, LCR & MRI 140, ECR & MRI 152; Stable Patients: ECR 611, LCR 592, LCR & MRI 576, ECR & MRI 598. Quality-Adjusted Life Months for Unstable, High-Risk, and Stable Patients are greater with ECR. LCR and MRI brain injury results in losses of functional survivorship that exceed those from quadriplegia. Model results suggest that early collar removal without cervical spine MRI is a reasonable, and likely the preferable, cervical spine management strategy for comatose, blunt trauma patients with extremity movement and a negative cervical spine CT scan.

The moderating effects of stimulus valence and arousal on memory suppression.

This study examined the separate and combined effects of stimulus valence and arousal on retrieval inhibition. Participants performed Anderson and Green's (2001) memory suppression task with stimuli varying across dimensions of valence and arousal. Memory was tested through free and cued recall as well as speeded recognition. Results showed that both stimulus valence and arousal influenced the extent to which participants successfully inhibited retrieval, but not in the ways anticipated. Specifically, the strongest inhibition effects were for highly arousing, pleasant words. In addition, unpleasant stimuli that were suppressed were better recalled during both cued and free-recall tasks than pleasant stimuli that were suppressed. Across all tests of memory performance, there were no significant differences between the experimental conditions for highly arousing, unpleasant words. The implications of these findings are discussed.

Prevalência de talassemias e hemoglobinas variantes em pacientes portadores de lúpus eritematoso sistêmico / Prevalence of thalassemias and variant hemoglobins in patients with systemic lupus erythematosus

O lúpus eritematoso sistêmico (LES) é uma doença tipicamente multigênica e multifatorial, com grande complexidade clínica e fisiopatológica. As causas do LES não são totalmente conhecidas, mas sabe-se que fatores ambientais e genéticos estão envolvidos. Dentre as várias manifestações clínicas observadas em pacientes com LES, as anemias chamam a atenção principalmente quando se observa nesse estudo uma prevalência de 52,5 por cento dos pacientes com índices hematimétricos sugestivos de anemias. Embora a anemia geralmente já seja observada em pacientes com LES, estudos sobre a prevalência de anemias hereditárias, especialmente as hemoglobinopatias na população com LES, não têm sido conduzidos. O objetivo desse trabalho foi o de avaliar a prevalência das hemoglobinopatias e talassemia em pacientes portadores de LES. Para isso, foram estudadas 80 amostras de sangue de pacientes portadores de lúpus atendidos no ambulatório do Hospital das Clínicas de Goiânia. Foram utilizados testes laboratoriais não moleculares para a detecção das hemoglobinopatias. A freqüência das alterações da hemoglobina foi de 10,0 por cento, encontradas em oito pacientes. Dessas alterações, a mais prevalente foi a talassemia alfa, encontrada em quatro pacientes, correspondendo a uma freqüência de 5,0 por cento da população estudada. Depois, foi o heterozigoto para a hemoglobina S, encontrada em dois pacientes, correspondendo a 2,5 por cento da população, e também outro heterozigoto para a hemoglobina C, encontrada em um paciente, correspondendo a 1,25 por cento, e um paciente com beta talassemia menor, correspondendo a 1,25 por cento. Nenhum caso de homozigose foi encontrado no presente estudo. Este trabalho demonstrou que não houve diferença na prevalência dos distúrbios da hemoglobina entre a população em geral e os portadores de LES.

Systemic lupus erythematosus (SLE) is a typically multigenic and multifatorial disease with remarkable clinical and pathogenic complexities. The causes of SLE are not totally known, but It is known that environmental and genetic factors are involved. Among various clinical manifestations observed in lupus patients, anemia calls the attention because of a prevalence of 52.5 percent of the patients with RBC indices suggestive of anemia identified in this study. Although anemia is usually seen in patients with SLE, studies of the prevalence of hereditary anemias, particularly hemoglobinopathies, have not been carried out in populations. The objective of this work was to evaluate the prevalence of hemoglobinophaties in patients with SLE. We studied 80 blood samples of patients with SLE in Hospital das Clínicas in Goiania, Brazil. The frequency of alterations of the hemoglobin was 10.0 percent (8 patients). Among these alterations, the most prevalent was alpha thalassemia in 4 patients (5.0 percent of the studied population). The heterozygosity for hemoglobin S was seen in 2 patients (2.5 percent), hemoglobin C in one patient (1.25 percent) and one patient was identified with beta thalassemia minor. No homozygous cases were found in the present study. According to this work no difference in the prevalence of hemoglobin disorders was observed between general population and patients with SLE.

Correlação entre eosinofilia e protoparasitose por Giardia lamblia em crianças / Correlation between eosinophilia and parasitic infections for Giardia lamblia in children

A relação entre eosinofilia e protozoários é pouco descrita na literatura científica. É importante assinalar que nem todos os parasitos intestinais são capazes de induzir eosinofilia, principalmente aqueles que estão na luz do intestino, sendo mais pronunciada quando há invasão tecidual. Dentre as protoparasitoses mais comuns, notadamente em crianças, destaca-se a giardíase, provocada pelaGiardia lamblia, parasito do intestino delgado, que causa diarréia e má-absorção. O objetivo deste trabalho foi identificar a existência de correlação entre eosinofilia e protoparasitose por Giardia lamblia, utilizando 1598 amostras de pacientes infectados, com idades variando entre zero e dez anos, oriundos da população de Goiânia que procuram o serviço do Laboratório Escola do Departamento deBiomedicina da Universidade Católica de Goiás. Desta amostragem 949 apresentavam eosinofilia (59,4 %). Essa proporção é significativamentediferente da esperada se não houvesse relação entre giardíase e eosinofilia (1:1) (c2 = 28.16; P < 0,01). Portanto, a eosinofilia é um parâmetro hematológico que deve ser considerado na abordagem e na avaliação do paciente que a apresenta, pois pode sugerir a existência de protoparasitose intestinal por Giardia lamblia, e ser um indicativo, com valor preditivo para a incorporação no tratamento conjunto com as doenças causadas por protozoários intestinais, entre outras parasitoses, bem como processos alérgicos

A importância do diagnóstico precoce na prevenção das anemias hereditárias / The importance of early diagnosis in the prevention of hereditary anemias

As anemias hereditárias, que englobam as hemoglobinopatias e talassemias são doenças determinadas geneticamente. Na maioria dos casos os heterozigotos são assintomáticos e desconhecem o defeito genético do qual são portadores. De uma forma geral existe uma deficiência no diagnóstico clínico e laboratorial para a investigação destas doenças que acometem uma parcela significativa da população brasileira. A comunicação deste caso à comunidade científica tem como objetivo destacar a importância de um diagnóstico clínico-laboratorial realizado o mais precocemente. Entretanto, este diagnóstico só é possível se for realizado por um profissional capacitado através de metodologias específicas para a elucidação das mais diferentes interações genéticas. Faz parte também deste diagnóstico o estudo familiar que é estritamente necessário no caso de um possível aconselhamento genético com o intuito de evitar a transmissão genética e conseqüentemente a geração de indivíduos doentes ou com uma sobrevida pequena.

Hereditary anaemias, which include hemoglobinopathies and thalassaemias, are genetically determined diseases. In most cases patients are asymptomatic and do not know about their genetic defect. In general, there is a deficit in the clinical and laboratorial investigations of these diseases that affect a significant number of Brazilians. The reporting of this case aims at highlighting the importance of precocious clinical-laboratorial diagnosis. This diagnosis is only possible if it is performed, by a qualified professional, using specific methodologies to elucidate the varying genetic interactions. A study of the affected families is an essential part of the diagnoses; many cases require genetic counseling to avoid transmission of these anomalies resulting in sick individuals who occasionally have short life expectancies.