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PREDICT is a tool designed to estimate the benefits of adjuvant therapy and the overall survival of women with early breast cancer. The model uses clinical, histological, and immunohistochemical variables. This study aimed to evaluate the model's performance in a Brazilian population. We assessed the discrimination and calibration of the PREDICT model to estimate overall survival (OS) in five and ten years of follow-up in a cohort of 873 women with early breast cancer diagnosed from January 2001 to December 2016. A total of 743 patients had estrogen receptor (ER)-positive and 130 had ER-negative tumors. The area under the receiver operating characteristic (ROC) curve (AUC) for discrimination was 0.72 (95%CI: 0.66-0.78) at five years and 0.67 (95%CI: 0.61-0.72) at ten years for women with ER-positive tumors. The AUC was 0.72 (95%CI: 0.62-0.81) at five years and 0.67 (95%CI: 0.54-0.77) at ten years for women with ER-negative tumors. The predicted survival in ER-positive tumors was 91.0% (95%CI: 90.2-91.6%) at five years and 79.3% (95%CI: 77.7-81.0%) at ten years, and the observed survival 90.7% (95%CI: 88.6-92.9%) and 77.2% (95%CI: 73.4-81.4%), respectively. The predicted survival in ER-negative tumors was 84.5% (95%CI: 82.5-86.6%) at five years and 75.0% (95%CI: 71.6-78.5%) at ten years, and the observed survival 76.3% (95%CI: 69.1-84.3%) and 67.9% (95%CI: 58.6-78.6%), respectively. In conclusion, PREDICT was accurate to estimate OS in women with ER-positive tumors and overestimated the OS in women with ER-negative tumors.
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The objective of this study was to evaluate the immunohistochemical expression of Dicer, Drosha, and Exportin-5 in the eutopic and ectopic endometrium of women with adenomyosis. Twenty-two paired ectopic and eutopic endometrium from women with adenomyosis and 10 eutopic endometrium samples from control women undergoing hysterectomy were included in the study. Paraffin-embedded tissue blocks were cut and stained for immunohistochemistry. The percentage of epithelial cells positively marked was identified digitally after an automated slide scanning process. Mann-Whitney test or Wilcoxon signed-rank test was performed for independent and paired groups, respectively. A lower expression of Drosha was observed in the eutopic endometrium of women with adenomyosis than in the eutopic endometrium of women without the disease (69.9±3.4% vs 85.2±2.9%, respectively) (P=0.016; 95%CI: 3.4 to 27.4%). We also detected lower Drosha expression in the ectopic endometrium of women with adenomyosis than in the eutopic endometrium of the same women (59.6±3.2% vs 69.9±3.4%, respectively) (P=0.004; 95%CI: 2.3 to 16.7%). Additionally, we observed a correlation between Drosha expression in the ectopic and paired eutopic endometrium (P=0.034, rho=0.454). No significant difference in Dicer or Exportin expression was observed. Predominant pattern of cytoplasmic staining for the anti-Drosha antibody and both a nuclear and cytoplasmic pattern for the anti-Exportin antibody were observed. Drosha expression was significantly lower in the endometrium of women with adenomyosis compared to the eutopic endometrium of asymptomatic women without the disease. Furthermore, its expression was lower in the ectopic endometrium but correlated to the paired eutopic endometrium.
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Obesity has been associated with an increased risk of breast cancer recurrence and death. Some readily available biomarkers associated with systemic inflammation have been receiving attention as potential prognostic indicators in cancer, including neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). This study aimed to explore the correlation between body mass index (BMI) and invasive breast cancer and the association of NLR, PLR, and BMI with breast cancer outcomes. We undertook a retrospective study to evaluate patients treated for breast cancer over 14 years. Clinicopathological data was obtained before receiving any treatment. Of the 1664 patients included with stage I-III, 567 (34%) were obese (BMI≥30 kg/m2). Obese patients had larger tumors compared to non-obese patients. Higher BMI was associated with recurrence and worse survival only in patients with stage I disease. NLR and PLR were classified into high and low level groups. The NLRhigh (NLR>4) was found to be an independent prognostic factor for recurrence and mortality, while the PLRhigh (PLR>150) group had no impact on survival. A subgroup of patients with NLRhigh and BMIhigh had the worst disease-free survival (P=0.046), breast cancer-specific survival (P<0.001), and overall survival (P=0.006), compared to the other groups. Patients with early-stage breast cancer bearing NLRhigh and BMIhigh had worse outcomes, and this might be explained by the dysfunctional milieu of obesity in adipose tissue and its effects on the immune system. This study highlights the importance of lifestyle measures and the immune system interference with clinical outcomes in the early breast cancer setting.
Assuntos
Humanos , Feminino , Neoplasias da Mama , Neutrófilos , Prognóstico , Linfócitos , Estudos Retrospectivos , Recidiva Local de Neoplasia , Obesidade/complicaçõesRESUMO
The objective of this prospective study was to determine the plasma levels of nitric oxide (NO) in women with chronic pelvic pain secondary to endometriosis (n=24) and abdominal myofascial pain syndrome (n=16). NO levels were measured in plasma collected before and 1 month after treatment. Pretreatment NO levels (μM) were lower in healthy volunteers (47.0±12.7) than in women with myofascial pain (64.2±5.0, P=0.01) or endometriosis (99.5±12.9, P<0.0001). After treatment, plasma NO levels were reduced only in the endometriosis group (99.5±12.9 vs 61.6±5.9, P=0.002). A correlation between reduction of pain intensity and reduction of NO level was observed in the endometriosis group [correlation = 0.67 (95%CI = 0.35 to 0.85), P<0.0001]. Reduction of NO levels was associated with an increase of pain threshold in this group [correlation = -0.53 (-0.78 to -0.14), P<0.0001]. NO levels appeared elevated in women with chronic pelvic pain diagnosed as secondary to endometriosis, and were directly associated with reduction in pain intensity and increase in pain threshold after treatment. Further studies are needed to investigate the role of NO in the pathophysiology of pain in women with endometriosis and its eventual association with central sensitization.
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Adulto , Feminino , Humanos , Adulto Jovem , Dor Crônica/etiologia , Endometriose/complicações , Óxido Nítrico/sangue , Limiar da Dor/efeitos dos fármacos , Dor Pélvica/etiologia , Dor Crônica/sangue , Endometriose/cirurgia , Laparoscopia , Síndromes da Dor Miofascial/complicações , Medição da Dor , Estudos Prospectivos , Dor Pélvica/sangue , Inquéritos e QuestionáriosRESUMO
Neste trabalho foi avaliado o efeito do óleo essencial do fruto de Schinus terebinthifolius sobre o crescimento micelial do fungo Colletotrichum gloeosporioides in vitro, e no desenvolvimento da antracnose no período de pós-colheita em mamões. As diferentes concentrações de óleo foram diluídas em Tween 80 a 8%. No experimento in vitro foram preparados meios de cultura BDA nas concentrações de 0,05; 0,10; 0,25 e 0,50% do óleo essencial. O controle negativo foi realizado apenas com meio BDA e o controle solvente com meio BDA e Tween 80 a 8%. A inibição do crescimento do fungo foi diretamente proporcional à quantidade do óleo e a maior inibição encontrada foi de 79,07% na concentração de óleo de 0,50%. No experimento in vivo os frutos do mamoeiro foram inoculados com o fungo em quatro tratamentos: com biofilme; com biofilme mais 0,50% do óleo; com fungicida Prochloraz e frutos controle. Embora o tratamento com óleo tenha sido eficiente contra o fungo, não foi indicado comercialmente, pois apresentou valores elevados de perda de massa fresca, de firmeza, e também sintomas de fitotoxidade. O óleo tem propriedade antifúngica contra C. gloeosporioides in vitro e in vivo, contudo, não é recomendado para o mamão em função da fitotoxidez.
This study evaluated the effect of essential oil from Schinus terebinthifolius fruit on the mycelial growth of the fungus Colletotrichum gloeosporioides in vitro and on the anthracnose development during the postharvest period of papaya fruits. The different oil concentrations were diluted in 8% Tween 80. For the in vitro experiment, PDA culture media were prepared at the concentrations of 0.05, 0.10, 0.25 and 0.50% essential oil. Negative control was prepared with PDA medium alone, while solvent control was prepared with PDA medium and 8% Tween 80. Fungal growth inhibition was directly proportional to the oil amount and the greatest inhibition was 79.07% at 0.50% oil concentration. For the in vivo experiment, papaya fruits were inoculated with the fungus in four treatments: with biofilm, with biofilm plus 0.50% oil, with the fungicide Prochloraz and control fruits. Although treatment with oil was efficient against the fungus, it was not commercially recommended since it presented high values of loss of fresh mass and firmness, as well as phytotoxicity symptoms. The oil has antifungal property against C. gloeosporioides both in vitro and in vivo; however, it is not recommended for papaya fruits due to its phytotoxicity.
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Óleos Voláteis/análise , Anacardiaceae/fisiologia , Colletotrichum/isolamento & purificação , Carica/efeitos dos fármacosRESUMO
The objective of this study was to determine the inter- and intra-examiner reliability of pain pressure threshold algometry at various points of the abdominal wall of healthy women. Twenty-one healthy women in menacme with a mean age of 28 ± 5.4 years (range: 19-39 years) were included. All volunteers had regular menstrual cycles (27-33 days) and were right-handed and, to the best of our knowledge, none were taking medications at the time of testing. Women with a diagnosis of depression, anxiety or other mood disturbances were excluded. Women with previous abdominal surgery, any pain condition or any evidence of inflammation, hypertension, smoking, alcoholism, or inflammatory disease were also excluded. Pain perception thresholds were assessed with a pressure algometer with digital traction and compression and a measuring capacity for 5 kg. All points were localized by palpation and marked with a felt-tipped pen and each individual was evaluated over a period of 2 days in two consecutive sessions, each session consisting of a set of 14 point measurements repeated twice by two examiners in random sequence. There was no statistically significant difference in the mean pain threshold obtained by the two examiners on 2 diferent days (examiner A: P = 1.00; examiner B: P = 0.75; Wilcoxon matched pairs test). There was excellent/good agreement between examiners for all days and all points. Our results have established baseline values to which future researchers will be able to refer. They show that pressure algometry is a reliable measure for pain perception in the abdominal wall of healthy women.
Assuntos
Adulto , Feminino , Humanos , Parede Abdominal , Dor Abdominal/etiologia , Medição da Dor/métodos , Percepção da Dor/fisiologia , Limiar da Dor/fisiologia , Variações Dependentes do Observador , Pressão , Valores de Referência , Reprodutibilidade dos TestesRESUMO
Objetivo: evaluar la calidad nutritional de la cena consumida por 105 turistas de la tercera edad hospedados en un hotel. Método: para la estandarización previa del peso medio de los alimentos consumidos fueron pesadas tres porciones de cada una de las opciones ofrecidas. El consumo alimentario fue verificado por la observación directa de las porciones servidas en el plato, convertidas posteriormente en gramos. En la evaluación de la composición nutritional de la comida, se consideraron los datos sobre valor energético, macronutrientes, grasa saturada, colesterol, sodio y fibra. Resultados: la mayoría de los turistas era de Argentina (88 por ciento), del sexo femenino (70 por ciento), con edades entre 60 y 84 años (85 por ciento). Se notó un alto consumo de energía (175 por ciento), grasas totales (235 por ciento), grasas saturadas (207 por ciento), colesterol (151 por ciento), proteína (170 por ciento) y sodio (133 por ciento). Se observó un consumo mayor de grasa saturada entre el sexo masculino. La ingestión fue adecuada para carbohidratos (102 por ciento) y fibras (98 por ciento).
Objective: To evaluate the nutritional quality of the meals consumed by 105 elderly tourists in a hotel. Method: To ensure the accuracy of the data, three portions of each option were collected and weighed. The three weights were then averaged to create a standard measure. The number of portions that each tourist took for their meal were recorded and later converted to grams using the standard measure. When evaluating the nutritional composition of the selected foods, calories, macronutrients, saturated fat, cholesterol, sodium and fiber content were all taken into consideration. Results: Most of the tourists were females (70 percent) from Argentina (88 percent) between the ages of 60 and 85 (85 percent). It was noted that the males consumed foods with a higher caloric content (175 percent of recommended amounts), total fat (235 percent), and saturated fat, cholesterol (151 percent), proteins (170 percent) and sodium (133 percent). The quantities of carbohydrates (102 percent) and fiber (98 percent) were appropriate to meet dietary needs.
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Dieta , Ingestão de Energia , Ingestão de Alimentos , Necessidades Nutricionais , Brasil , Qualidade dos Alimentos , Nível de Saúde , Estado Nutricional , Fatores Socioeconômicos , ViagemRESUMO
CONTEXTUALIZAÇÃO: As lesões nervosas periféricas podem comprometer atividades diárias de um indivíduo e resultam em perda da sensibilidade e motricidade do território inervado. OBJETIVO: Com o intuito de acelerar os processos regenerativos, objetivou-se analisar a influência da aplicação do laser de arsenieto de gálio e alumínio (AsGaAl, 660Nm) sobre a recuperação funcional do nervo ciático de ratos. MATERIAIS E MÉTODOS: O nervo ciático de 12 ratos Wistar foi submetido à lesão por neurotmese e anastomose epineural e divididos em dois grupos: controle e laserterapia. Após a lesão, utilizou-se o laser de GaAlAs, 660Nm, 4J/cm², 26,3mW, feixe de 0,63cm², em três pontos eqüidistantes sobre a lesão, por 20 dias. As impressões das pegadas dos animais foram obtidas antes e após (sete, 14 e 21 dias pós-operatórios) o procedimento cirúrgico e calculou-se o índice funcional do ciático (IFC). RESULTADOS: A comparação do IFC não resultou em diferença significante (p>0,05) entre os grupos. CONCLUSÕES: Conclui-se que os parâmetros e métodos empregados na laserterapia demonstram resultados nulos sobre o IFC no período avaliado.
CONTEXT: Peripheral nerve injuries result in sensory and motor losses in the innervated area and can hinder individuals' daily activities. Objective: The objective was to analyze the influence of applying gallium-aluminum-arsenide (GaAlAs) laser (660Nm) on the functional recovery of the sciatic nerve in rats. METHODS: The sciatic nerve of 12 Wistar rats was subjected to injury consisting of neurotmesis and epineural anastomosis. The rats were divided into two groups: control and laser therapy. After the injury, a GaAlAs laser was used (660Nm, 4J/cm², 26.3mW and 0.63cm² beam) at three equidistant points on the injury, for 20 days. Footprint impressions were obtained from the animals before and seven, 14 and 21 days after the surgical procedure and the sciatic functional index (SFI) was calculated. RESULTS: Comparison of the SFI did not show any significant difference (p>0.05) between the two groups. CONCLUSIONS: The parameters and methods used for the laser therapy did not produce any effect on the SFI over the period evaluated.
Assuntos
Ratos , Animais , Terapia com Luz de Baixa Intensidade , Regeneração Nervosa , Nervo Isquiático , Modalidades de Fisioterapia , Ratos WistarRESUMO
Cystic fibrosis (CF) is the most common autosomal recessive disease of the Caucasian population. Among the various CF mutations, p.F508del is the most frequent, accounting for two-thirds of the global CF chromosomes, although showing great variability among populations. We have studied 115 unrelated CF patients from a mixed population of Minas Gerais (Brazil). To evaluate part of the DNA sequence of the cystic fibrosis transmembrane conductance regulator (CFTR) gene, blood DNA was obtained and PCR was performed using two pairs of primers that anneal to exons 10 and 24 of the CFTR gene. The PCR product was then submitted to automatic sequencing using the ABI PRISM 310 Genetic Analyzer. The p.F508del mutation was found in 50 (21.7 percent) of 230 unrelated CF alleles. Fifteen (13.0 percent) patients were homozygous for this mutation, while 20 (17.4 percent) were heterozygous; the remaining 80 (69.6 percent) patients did not carry the p.F508del mutation. Exon 24 sequence had no change in 75 (65.2 percent) patients, 21 (18.3 percent) had the sequence variation 4521G/A, 11 (9.6 percent) had a not yet described sequence variation 4407T/A and 8 (7.0 percent) patients had both sequence variations (4521G/A and 4407T/A). The polymorphism 4407T/A results in an amino acid modification from aspartic acid to glutamic acid, which will probably have no function effect in CFTR. This low p.F508del prevalence can be due to the variable ethnic origin of this population from Minas Gerais, which may have a high diversity of CF rare mutations.
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Feminino , Humanos , Masculino , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Fibrose Cística/genética , Mutação/genética , Brasil/etnologia , Fibrose Cística/sangue , Frequência do Gene , Reação em Cadeia da Polimerase , Análise de Sequência de DNA/métodosRESUMO
A proposta deste estudo foi verificar a diferença entre o ângulo quadricipital em indivíduos sintomáticos e assintomáticos, em duas diferentes situações de exame, com o quadríceps relaxado e em contração isométrica voluntária máxima (CIVM) através da mensuração radiográfica para contribuir na avaliação e tratamento de pacientes com disfunção femoropatelar (DFP). Foram avaliadas 20 mulheres (40 joelhos), com idade média de 21 anos, através de método radiológico padronizado. Os indivíduos foram posicionados em decúbito dorsal com um estabilizador podálico em "U", com os membros inferiores relaxados, com a utilização de película de chumbo sobre a tuberosidade anterior da tíbia. Para a análise estatística foram utilizadas as médias dos grupos assintomático e sintomático, em estado de relaxamento e em CIVM, e o teste t de Student, com nível de significância de p < 0,05. Os valores médios do ângulo Q para os assintomáticos foram de 17,15º em relaxamento e de 14,5º em CIVM, enquanto os sintomáticos apresentaram 21,45º e 15,8º, respectivamente. Nos resultados para a análise da igualdade entre os grupos sintomáticos e assintomáticos no estado de relaxamento obteve-se p = 0,004, e para o estado de contração isométrica voluntária máxima, p = 0,29. Considerando os dados obtidos no presente estudo, pode-se verificar que em estado de relaxamento há diferença entre o valor do ângulo Q entre indivíduos sintomáticos e assintomáticos, sendo este maior nos portadores da DFP, enquanto que em estado de contração isométrica máxima do músculo quadricipital não houve diferença estatística, ocorrendo redução do ângulo em ambos os grupos.
The purpose of this study was to analyze the difference between the angle of the quadriceps in symptomatic and asymptomatic individuals in two different examination situations, having the quadriceps relaxed and in a maximal voluntary isometric contraction (MVIC) through radiographic measurement, aiming to contribute to the assessment and treatment of patients with patelofemoral disorder (PFD). Through the standard radiological method twenty 21 years old mean women (40 knees) were assessed. All individuals were positioned supine using a U-podalic stabilizer, having their lower limbs relaxed, using a plumb film on the anterior tuberosity of the tibia. For the statistical analysis, the averages for the asymptomatic and symptomatic groups in a relaxed and MVIC status, as well as the Student's t-test with p < 0.05 significance level were used. The mean values to the Q angle compared to the asymptomatic group were 17.15º on relaxation, and 14.5º on MVIC, while the asymptomatic group presented 21.45º, and 15.8º, respectively. The results in the equality analysis between the symptomatic and asymptomatic groups on the relaxed status attained a p = 0.004, and to the maximal voluntary isometric contraction, p = 0.29. Considering the data attained in the present study, it can be verified that in a relaxing status, there is a difference between the value of the Q angle among symptomatic and asymptomatic individuals, being found a higher value in the FPD bearers, while in a maximal isometric contraction of the quadriceps muscle no statistical difference was found in the present study, with a reduction in the angle in both groups.
La propuesta de este estudio era verificar la diferencia entre el ángulo cuadricipital en los individuos sintomáticos y asintomáticos, en dos situaciones diferentes del examen físico; con el cuadriceps relajado y en el máximo de la reducción isométrico voluntario (CIVM) a través de la medida radiográfica para contribuir en la evaluación y el tratamiento de pacientes con trastorno fémoro-patelar (DFP). Se estimaron 20 mujeres (40 rodillas), con la edad media de 21 años, a través de método radiológico estandardizado. Los individuos se pusieron en decúbito con un estabilizador podálico en "U", con los miembros inferiores relajados, con el uso de película de plomo en la tuberosidad anterior de la espinilla. Para el análisis estadístico se usaron las medias del grupo asintomático y sintomático, en estado de relajación y en CIVM, y la prueba del test t, con un nivel de significancia de p < 0,05. Los valores medios del ángulo Q para los asintomáticos fueron de 17,15º en la relajación y de 14,5º en CIVM, mientras los sintomáticos presentaron 21,45º y 15,8º, respectivamente. En los resultados para el análisis de la igualdad entre los grupos sintomático y asintomático en el estado de relajación se obtuvo p = 0,004, y para el estado de reducción isométrica voluntaria máximo, p = 0,29. Considerando los datos obtenidos en el estudio presente, puede verificarse que en el estado de relajación hay diferencia entre el valor del ángulo Q entre los individuos sintomáticos y asintomáticos, siendo este más grande en los portadores de DFP, mientras en el estado de contracción isométrica máxima del músculo cuadriceps no presentó diferencia estadística, habiendo reducción del ángulo en ambos los grupos.
Assuntos
Humanos , Feminino , Adulto , Análise de Variância , Antropometria , Contração Isométrica/fisiologia , Fêmur/anatomia & histologia , Joelho/anatomia & histologia , Músculos/anatomia & histologia , Patela/anatomia & histologia , PelvimetriaRESUMO
The present study evaluated whether the luteal phase elevation of body temperature would be offset during exercise by increased sweating, when women are normally hydrated. Eleven women performed 60 min of cycling exercise at 60 percent of their maximal work load at 32°C and 80 percent relative air humidity. Each subject participated in two identical experimental sessions: one during the follicular phase (between days 5 and 8) and the other during the luteal phase (between days 22 and 25). Women with serum progesterone >3 ng/mL, in the luteal phase were classified as group 1 (N = 4), whereas the others were classified as group 2 (N = 7). Post-exercise urine volume (213 ± 80 vs 309 ± 113 mL) and specific urine gravity (1.008 ± 0.003 vs 1.006 ± 0.002) changed (P < 0.05) during the luteal phase compared to the follicular phase in group 1. No menstrual cycle dependence was observed for these parameters in group 2. Sweat rate was higher (P < 0.05) in the luteal (3.10 ± 0.81 g m-2 min-1) than in the follicular phase (2.80 ± 0.64 g m-2 min-1) only in group 1. During exercise, no differences related to menstrual cycle phases were seen in rectal temperature, heart rate, rate of perceived exertion, mean skin temperature, and pre- and post-exercise body weight. Women exercising in a warm and humid environment with water intake seem to be able to adapt to the luteal phase increase of basal body temperature through reduced urinary volume and increased sweating rate.
Assuntos
Humanos , Feminino , Adulto , Exercício Físico/fisiologia , Fase Folicular/fisiologia , Fase Luteal/fisiologia , Progesterona/sangue , Sudorese/fisiologia , Temperatura Corporal , Fase Folicular/sangue , Fase Luteal/sangueRESUMO
We investigated the effects of hippocampal lesions with ibotenic acid (IBO) on the memory of the sound-context-shock association during reexposure to the conditioning context. Twenty-nine adult pigeons were assigned to a non-lesioned control group (CG, N = 7), a sham-lesioned group (SG, N = 7), a hippocampus-lesioned experimental group (EG, N = 7), and to an unpaired nonlesioned group (tone-alone exposure) (NG, N = 8). All pigeons were submitted to a 20-min session in the conditioning chamber with three associations of sound (1000 Hz, 85 dB, 1 s) and shock (10 mA, 1 s). Experimental and sham lesions were performed 24 h later (EG and SG) when EG birds received three bilateral injections (anteroposterior (A), 4.5, 5.25 and 7.0) of IBO (1 µl and 1 µg/µl) and SG received one bilateral injection (A, 5.25) of PBS. The animals were reexposed to the training context 5 days after the lesion. Behavior was videotaped for 20 min and analyzed at 30-s intervals. A significantly higher percent rating of immobility was observed for CG (median, 95.1; range, 79.2 to 100.0) and SG (median, 90.0; range, 69.6 to 95.0) compared to EG (median, 11.62; range, 3.83 to 50.1) and NG (median, 7.33; range, 6.2 to 28.1) (P<0.001) in the training context. These results suggest impairment of contextual fear in birds who received lesions one day after conditioning and a role for the hippocampus in the modulation of emotional aversive memories in pigeons
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Animais , Condicionamento Clássico/fisiologia , Agonistas de Aminoácidos Excitatórios/farmacologia , Medo/fisiologia , Hipocampo/lesões , Hipocampo/fisiologia , Ácido Ibotênico/farmacologia , Aprendizagem/fisiologia , Memória/fisiologia , Encéfalo/citologia , Columbidae , Sinais (Psicologia) , Hipocampo/citologia , Hipocampo/efeitos dos fármacosRESUMO
The objective of the present study was to determine the possible prognostic factors which may explain the difference in the survival of patients with cystic fibrosis (CF) with and without meconium ileus. Over a period of 20 years, 127 patients with CF, whose diagnosis was confirmed by typical clinical characteristics and altered sweat chloride levels, were studied retrospectively. The patients were divided into two groups: group 1 consisted of patients who presented CF and meconium ileus (N = 9), and group 2 consisted of patients with CF without meconium ileus (N = 118). The characteristics studied were based on data obtained upon admission of the patients using a specific protocol. Demographic, clinical, nutritional and laboratory data were obtained. The genotype was determined in 106 patients by PCR. Survival was analyzed using the Kaplan-Meier method. The median follow-up period was 44 months. A statistically significant difference was observed between the groups studied regarding the following variables: age at diagnosis and weight and height z scores. The presence of meconium ileus was associated with an earlier diagnosis; these patients had greater deficits in height and weight at the time of diagnosis and at the end of the study. The estimated probability of survival for patients with CF without meconium ileus was 62 ± 14 percent and for those with meconium ileus 32 ± 18 percent. Patients with CF and meconium ileus presented a poor nutritional status at diagnosis and a lower survival rate compared to the general CF population
Assuntos
Humanos , Feminino , Masculino , Recém-Nascido , Lactente , Fibrose Cística/complicações , Mecônio , Obstrução Intestinal/etiologia , Distribuição de Qui-Quadrado , Fibrose Cística/genética , Fibrose Cística/mortalidade , Seguimentos , Prognóstico , Estudos RetrospectivosRESUMO
The present study was designed to assess the effects of bromocriptine, a dopamine agonist, on pituitary wet weight, number of immunoreactive prolactin cells and serum prolactin concentrations in estradioltreated rats. Ovariectomized Wistar rats were injected subcutaneously with sunflower oil vehicle or estradiol valerate (50 or 300 mug rat-1 week-l) for 2, 4 or 10 weeks. Bromocriptine (0.2 or 0.6 mg rat-1 day-l) was injected daily during the last 5 or 12 days of estrogen treatment. Data were compared with those obtained for intact control rats. Administration of both doses of estrogen increased serum prolactin levels. No difference in the number of prolactin cells in rats treated with 50 mug estradiol valerate was observed compared to intact adult animals. In contrast, rats treated with 300 mug estradiol valerate showed a significant increase in the number of prolactin cells (P<0.05). Therefore, the increase in serum prolactin levels observed in rats treated with 50 mug estradiol valerate, in the absence of morphological changes in the pituitary cells, suggests a "functional" estrogen-induced hyperprolactinemia. Bromocriptine decreased prolactin levels in all estrogen-treated rats. The administration of this drug to rats previously treated with 300 mug estradiol valerate also resulted in a significant decrease in pituitary weight and number of prolactin cells when compared to the group treated with estradiol alone. The general antiprolactinemic and antiproliferative pituitary effects of bromocriptine treatment reported here validate the experimental model of estrogen-induced hyperprolactinemic rats.
Assuntos
Ratos , Animais , Feminino , Bromocriptina/farmacologia , Estradiol/uso terapêutico , Hiperprolactinemia/induzido quimicamente , Ovariectomia , Hipófise/efeitos dos fármacos , Hipófise/fisiologia , Prolactina/sangue , Prolactina/efeitos dos fármacos , Ratos WistarRESUMO
OBJETIVOS: A fibrose cística (FC) é a doença genética letal, de herança autossômica recessiva, mais comum entre pacientes de cor branca. O presente estudo foi realizado com o objetivo de identificar o quadro clínico e nutricional à admissäo dos pacientes no Centro de Tratamento de FC do HC-UFMG e avaliar a sobrevida a longo prazo. PACIENTES E MÉTODOS: Em um período de 20 anos, 127 pacientes portadores de FC foram acompanhados longitudinalmente e submetidos a protocolo previamente estabelecido, após confirmaçäo do diagnóstico pelo teste do suo...
Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Masculino , Feminino , Adolescente , Criança , Estado Nutricional , Fibrose Cística/mortalidade , Suor/química , Brasil/epidemiologia , Análise de Sobrevida , Cloro/análise , Seguimentos , Estudos Longitudinais , Idade de Início , Fibrose Cística/diagnóstico , Fibrose Cística/genética , Genótipo , Distúrbios Nutricionais/epidemiologiaRESUMO
OBJETIVO - Detectar diferenças nas prevalências das dislipidemias em adultos da demanda laboratorial de três diferentes prestadores de assistência médica, em Salvador, 1995. MÉTODOS - Estudo seccional, clínico epidemiológico, baseado em resultados das dosagens de lípides séricos de uma amostra probabilística de 25 'por cento' dos 104 laboratórios que usavam o mesmo método de dosagem e o mesmo padräo para controle de qualidade. O critério de dislipidemias foi o do II Consenso Brasileiro de Dislipidemias para adultos. Os resultados foram agrupados conforme procedência: Sistema Unico de Saúde (SUS), convênios (C) e seguros privados + particulares (SP). Análise: prevalência com intervalos de confiança (IC) a 95 'por cento', e teste do X². RESULTADOS - Dos 5.464 adultos com mensäo da procedência, 14,8 'por cento' do SUS, 31,6 'por cento' dos C e 53,6 'por cento' S + P. As mais elevadas prevalências de hipercolesterolemia - 28,0 'por cento' (IC 24,0; 32,0) e de LDL-c elevado - 30,4 'por cento' (IC 27,6; 33,2) foram detectados no grupo C. No grupo S + P concentram-se as maiores prevalências de HDL-c anormal - 12,3 'por cento' (IC 10,0; 13,8) e hipertrigliceridemia - 17,8 'por cento' (IC 16,3; 19,3). Quase todas as diferenças entre as prevalências foram estatisticamente significantes, favoráveis às taxas mais baixas do SUS. CONCLUSÄO - O melhor perfil lipídico do grupo SUS sugere diferenças sociais nas prevalências das dislipidemias. Para os três prestadores de assistência, a prevalência do HDL-c menor que 35mg/dL foi baixa quando comparada às das demais dislipidemias. Os resultados podem ser inferidos para a prática médica dos respectivos prestadores de assistência e indicam a necessidade de informaçäo e de orientaçäo dos usuários para a reduçäo das dislipidemias e melhoria do estilo de vida.
Assuntos
Humanos , Adulto , Hiperlipidemias , Hiperlipidemias/diagnóstico , Atenção à Saúde/estatística & dados numéricos , Brasil , Estudos de Coortes , Prevalência , Sistema Único de Saúde/organização & administraçãoRESUMO
OBJETTIVO - Determinar a prevalência das dislipidemias em adultos da demanda laboratorial não-hospitalar da cidade de Salvador (BA). MÉTODOS - Casuística procedente de amostra probalística de 25 'por cento' dos laboratórios não-hospitalares da cidade que usavam o método enzimático para dosagem dos lípides séricos e controle de qualidade da Sociedade Brasileira de Patologia Clínica (93 'por cento'); LDL estimado pela fórmula de Friedewald. Sorteados os meses ímpares de 1995 para o estudo. Critérios para dislipidemias, em mg/dl: colesterol 'maior ou igual' 240; LDL 'maior ou igual' 160; HDL 'menor' 35 e triglicérides 'maior ou igual' 200. Análise: prevalências. seus intervalos de confiaça (IC) a 95 'por cento' e qui-quadrado (X²). RESULTADOS - Excluídos uma recusa e um laboratório que arquivava laudos só por 3 meses, foram analisados dados de 24 dos 26 laboratórios amostrados. Dos 7392 adultos, 65,5 'por cento' eram mulheres. Prevalências estimadas e valores ... "Fórmulas"... Todas as prevalências diferiram significantemente inter-gênero (p,0,05 a p<0,001). Também foram mais freqüentes nas mulheres os níveis indesejáveis do colesterol e LDL. CONCLUSÄO - As dislipidemias são importante fator de risco para aterosclerose na demanda laboratorial de Salvador em ambos os gêneros. Os resultados subsidiam os médicos para incentivar mudanças no estilo de vida que conduzam seua pacientes a níveis lipídicos desejáveis
Assuntos
Humanos , Masculino , Feminino , Criança , Adulto , HDL-Colesterol , LDL-Colesterol , Hiperlipidemias , Fatores de Risco , Fatores de Tempo , Triglicerídeos/sangueRESUMO
Foram estudados 392 recem-nascidos que tomaram a vacina BCG injetavel (cepa Moureau-Rio), entre 0 e 30 dias de vida, que completaram o teste tuberculinico PPD RT 23 - 2 UT, cinco a seis meses apos a vacinacao e que nao apresentavam, nesta epoca, nenhum fator de negativacao do teste.Entre 279/392 lactentes que tomaram a vacina preparada ha menos de quatro horas, 12,5% eram nao reatores ao teste e 3l,9% eram reatores fortes (somente 1,8% com papula acima de 15 mm). Entre os 113/392 que tomaram a vacina preparada ha 24 + 4 horas, 36,3% eram nao reatores e somente 16,8% reatores fortes. Em 160 lactentes do primeiro grupo, o diametro medio das papulas tuberculinicas foi de 8,34 +/- 3,38mm, comparado com o das cicatrizes vacinais de 4,80 +/- l,l5mm. O autor discute a validade do teste para o diagnostico futuro da tuberculose em criancas vacinadas com o BCG quando recem-nascidos e as complicacoes da vacina aplicada na dose de 0,l ml, nesta idade
Assuntos
Recém-Nascido , Humanos , Vacina BCG , Hipersensibilidade , Teste TuberculínicoRESUMO
Os autores apresentam experiencia pessoal com a realizacao do teste de agua, para pesquisa radiologica do refluxo gastroesofagiano. Em 80 pacientes portadores de queixas do trato digestivo alto, encontraram positividade de 30%. Comparam com outro grupo de caracteristicas semelhantes, estudado anteriormente, em que, pelo metodo rotineiro, somente conseguiram comprovar refluxo em 12,5%. Testando a confiabilidade do teste, foi executado em 10 individuos assintomaticos e nos quais a pesquisa de hernia hiatal, pelo metodo do coxim compressivo, foi negativa e todos eles tiveram o mesmo negativo. Ainda, em 34 casos de hernia hiatal, do grupo citado de inicio, a positividade do teste foi de 47,l%. Dos estudos aqui referidos, concluem: a) no grupo de 80 pacientes relatados, o refluxo gastroesofagico, levando a esofagite de refluxo, foi positivo em 30% de portadores de queixas digestivas altas e em 47,l% de portadores de hernia hiatal; b) o teste e confiavel, de facil execucao, sem qualquer reacao ou efeito desagradavel, nao interfere com a rotina radiologica e nao deve trazer novos gastos, se incorporado a rotina do exame radiologico do trato digestivo alto
Assuntos
Adolescente , Adulto , Humanos , Masculino , Feminino , ÁguaRESUMO
The effect of morphine on the onset of puberty was studied in female Wistar rats bearing pituitary grafts implanted at 21 days of age, or sham operated (SO). Morphine was given sc, daily, from day 22 until the occurrence of vaginal opening (VO), taken as an index of puberty. Two doses of morphine (2 or 8 mg kg-1 day-1) were used and control animals received saline of the same volume. Morphine (both doses) induced delayed puberty in SO rats, as indicated by age at VO: mean ñ SEM, 36.90 ñ 0.75 and 36.33 ñ 1.08 days vs 33.06 ñ 0.69 days for 2 and 8 mg vs control group. Pituitary graft induced precocious puberty and this effect was reversed by the highest dose of morphine (29.47 ñ 0.84 vs 32.80 ñ 0.59 days for saline vs 8 mg morphine, grafted rats). These data show that chronic administration of morphine during the prepuberal period delayed the onset of puberty and reversed the precocious puberty induced by pituitary graft in the female rat