Pre-analytical parameters associated with unsuccessful karyotyping in myeloid neoplasm: a study of 421 samples

Cytogenetics is essential in myeloid neoplasms (MN) and pre-analytical variables are important for karyotyping. We assessed the relationship between pre-analytical variables (time from collection to sample processing, material type, sample cellularity, and diagnosis) and failures of karyotyping. Bone marrow (BM, n=352) and peripheral blood (PB, n=69) samples were analyzed from acute myeloid leukemia (n=113), myelodysplastic syndromes (n=73), myelodysplastic syndromes/myeloproliferative neoplasms (n=17), myeloproliferative neoplasms (n=137), and other with conclusive diagnosis (n=6), and reactive disorders/no conclusive diagnosis (n=75). The rate of unsuccessful karyotyping was 18.5% and was associated with the use of PB and a low number of nucleated cells (≤7×103/µL) in the sample. High and low cellularity in BM and high and low cellularity in PB samples showed no metaphases in 3.9, 39.7, 41.9, and 84.6% of cases, respectively. Collecting a good BM sample is the key for the success of karyotyping in MN and avoids the use of expensive molecular techniques.

Brief daily postpartum separations from the litter alter dam response to psychostimulants and to stress

Neonatal handling induces several behavioral and neurochemical alterations in pups, including decreased responses to stress and reduced fear in new environments. However, there are few reports in the literature concerning the behavioral effects of this neonatal intervention on the dams during the postpartum period. Therefore, the aim of the current study was to determine if brief postpartum separation from pups has a persistent impact on the dam's stress response and behavior. Litters were divided into two neonatal groups: 1) non-handled and 2) handled [10 min/day, from postnatal day (PND) 1 to 10]. Weaning occurred at PND 21 when behavioral tasks started to be applied to the dams, including sweet food ingestion (PND 21), forced swimming test (PND 28), and locomotor response to a psychostimulant (PND 28). On postpartum day 40, plasma was collected at baseline for leptin assays and after 1 h of restraint for corticosterone assay. Regarding sweet food consumption, behavior during the forced swimming test or plasma leptin levels did not differ between dams briefly separated and non-separated from their pups during the postpartum period. On the other hand, both increased locomotion in response to diethylpropion and increased corticosterone secretion in response to acute stress were detected in dams briefly separated from their pups during the first 10 postnatal days. Taken together, these findings suggest that brief, repeated separations from the pups during the neonatal period persistently impact the behavior and induce signs of dopaminergic sensitization in the dam.

Do intrauterine growth restriction and overweight at primary school age increase the risk of elevated body mass index in young adults?

Obesity is one of the rising public health problems characterized as a risk factor for many chronic diseases in adulthood. Early life events such as intrauterine growth restriction, as well as life style, are associated with an increased prevalence of this disease. The present study was performed to determine if intrauterine growth restriction interacts with overweight at primary school age to affect body mass index (BMI) in young adults. From June 1, 1978 to May 31, 1979, 6827 singleton liveborns from Ribeirão Preto, São Paulo State, Brazil, corresponding to 98 percent of all births at the 8 maternity hospitals, were examined and their mothers were interviewed. Samples from the initial cohort were examined again at primary school age (8 to 11 years of age) and at the time of military service (18 years of age). There were 519 male individuals with complete measurements taken in the three surveys. Intrauterine growth-restricted individuals had a BMI 0.68 kg/m² lower than that of individuals who were not restricted (95 percentCI = -1.34 to -0.03) and overweight at primary school age showed a positive and strong effect on BMI at 18 years of age (coefficient 5.03, 95 percentCI = 4.27 to 5.79). However, the increase in BMI was much higher - 6.90 kg/m² - when the conscript had been born with intrauterine growth restriction and presented overweight at primary school age (95 percentCI = 4.55 to 9.26). These findings indicate that the effect of intrauterine growth restrictionon BMI at 18 years of age is modified by later weight gain during school age.

Fuzzy expert system in the prediction of neonatal resuscitation

In view of the importance of anticipating the occurrence of critical situations in medicine, we propose the use of a fuzzy expert system to predict the need for advanced neonatal resuscitation efforts in the delivery room. This system relates the maternal medical, obstetric and neonatal characteristics to the clinical conditions of the newborn, providing a risk measurement of need of advanced neonatal resuscitation measures. It is structured as a fuzzy composition developed on the basis of the subjective perception of danger of nine neonatologists facing 61 antenatal and intrapartum clinical situations which provide a degree of association with the risk of occurrence of perinatal asphyxia. The resulting relational matrix describes the association between clinical factors and risk of perinatal asphyxia. Analyzing the inputs of the presence or absence of all 61 clinical factors, the system returns the rate of risk of perinatal asphyxia as output. A prospectively collected series of 304 cases of perinatal care was analyzed to ascertain system performance. The fuzzy expert system presented a sensitivity of 76.5 percent and specificity of 94.8 percent in the identification of the need for advanced neonatal resuscitation measures, considering a cut-off value of 5 on a scale ranging from 0 to 10. The area under the receiver operating characteristic curve was 0.93. The identification of risk situations plays an important role in the planning of health care. These preliminary results encourage us to develop further studies and to refine this model, which is intended to implement an auxiliary system able to help health care staff to make decisions in perinatal care.

Lipid peroxidation and total radical-trapping potential of the lungs of rats submitted to chronic and sub-chronic stress

Exposure to stress induces a cluster of physiological and behavioral changes in an effort to maintain the homeostasis of the organism. Long-term exposure to stress, however, has detrimental effects on several cell functions such as the impairment of antioxidant defenses leading to oxidative damage. Oxidative stress is a central feature of many diseases. The lungs are particularly susceptible to lesions by free radicals and pulmonary antioxidant defenses are extensively distributed and include both enzymatic and non-enzymatic systems. The aim of the present study was to determine lipid peroxidation and total radical-trapping potential (TRAP) changes in lungs of rats submitted to different models of chronic stress. Adult male Wistar rats weighing 180-230 g were submitted to different stressors (variable stress, N = 7) or repeated restraint stress for 15 (N = 10) or 40 days (N = 6) and compared to control groups (N = 10 each). Lipid peroxidation levels were assessed by thiobarbituric acid reactive substances (TBARS), and TRAP was measured by the decrease in luminescence using the 2-2'-azo-bis(2-amidinopropane)-luminol system. Chronic variable stress induced a 51 percent increase in oxidative stress in lungs (control group: 0.037 ± 0.002; variable stress: 0.056 ± 0.007, P < 0.01). No difference in TBARS was observed after chronic restraint stress, but a significant 57 percent increase in TRAP was presented by the group repeatedly restrained for 15 days (control group: 2.48 ± 0.42; stressed: 3.65 ± 0.16, P < 0.05). We conclude that different stressors induce different effects on the oxidative status of the organism.

Interaction between repeated restraint stress and concomitant midazolam administration on sweet food ingestion in rats

Emotional changes can influence feeding behavior. Previous studies have shown that chronically stressed animals present increased ingestion of sweet food, an effect reversed by a single dose of diazepam administered before testing the animals. The aim of the present study was to evaluate the response of animals chronically treated with midazolam and/or submitted to repeated restraint stress upon the ingestion of sweet food. Male adult Wistar rats were divided into two groups: controls and exposed to restraint 1 h/day, 5 days/week for 40 days. Both groups were subdivided into two other groups treated or not with midazolam (0.06 mg/ml in their drinking water during the 40-day treatment). The animals were placed in a lighted area in the presence of 10 pellets of sweet food (Froot loops(r)). The number of ingested pellets was measured during a period of 3 min, in the presence or absence of fasting. The group chronically treated with midazolam alone presented increased ingestion when compared to control animals (control group: 2.0 +/- 0.44 pellets and midazolam group: 3.60 +/- 0.57 pellets). The group submitted to restraint stress presented an increased ingestion compared to controls (control group: 2.0 +/- 0.44 pellets and stressed group: 4.18 +/- 0.58 pellets). Chronically administered midazolam reduced the ingestion in stressed animals (stressed/water group: 4.18 +/- 0.58 pellets; stressed/midazolam group: 3.2 +/- 0.49 pellets). Thus, repeated stress increases appetite for sweet food independently of hunger and chronic administration of midazolam can decrease this behavioral effect

Estudo da qualidade de informação sobre morbidade através da ficha de atendimento ambulatorial em unidade públicas de municípios selecionados no Rio Grande do Sul / Study of the quality of the information regarding morbidity through the use of the out patients files in the cities selected in RS

Este trabalho trata do estudo da ficha de atendimento ambulatorial (FAA) que é o documento oficial de coleta de dados da rede prestadora de serviços do Sistema Únicos de Saúde (SUS) no Rio Grande do Sul. Verificar a eficácia deste documento como instrumento de informação de morbidade ambulatoial através da análise do preenchimento de seus campos, seu fluxo, produção e retorno das informações.

Olho seco em pessoas com idade superior a 40 anos selecionadas em 3 cidades brasileiras / Frequency of dry eyes in 3 different Brazilian cities

Foram estudados 300 pacientes (100 em Brasília, 100 em Säo Paulo e 100 em Teresina), de 40 a 89 anos, 50 por cento das mulheres, nos meses de junho a agosto de 1993, com o objetivo de determinar a frequência de olho seco e avaliar a influência de fatores ambientais: temperatura e umidade relativa do ar. Foram coletados dados de identificaçäo, fatores ambientais, sintomatologia e realizada avaliaçäo biomicroscópica, testes de Schrimer I, Rosa Bengala e break up time (BUT). Dos 200 olhos examinados em cada cidade, foram encontrados 38 olhos em Brasília, 37 em Säo Paulo e 2 em Teresina com teste de Schirmer I positivo; 2 olhos em Brasília, 37 em Säo Paulo e 10 em Teresina com BUT positivo. A temperatura média em Brasília foi de 21oC, variando de 14oC a 29oC; em Säo Paulo foi de 17,5 por cento, variando de 28oC a 32oC. A umidade relativa do ar média em Brasília foi de 49,5, variando de 12 por cento a 87 por cento; a média em Säo Paulo foi de 70,5 por cento, variando de 43 por cento a 98 por cento; a média em Teresina foi de 58 por cento, variando de 46 a 70 por cento. Foram determinados como olhos secos em Brasília, 42 em Säo Paulo e 5 em Teresina. Os resultados näo mostram a influência da temperatura e umidade relativa do ar na síndrome do olho seco. Os casos positivos foram mais frequentes em mulheres, em média de 60 por cento. Pacientes mais jovens em Säo Paulo apresentaram uma incidência maior de olhos secos, fato atribuído talvez a fatores do meio ambiente näo avaliados, possivelmente a poluiçäo do ar. O número de pacientes com sintomas visuais foi maior em Brasília, fato atribuído à baixa umidade relativa do ar

Complicaçöes vasculares em dependentes de drogas injetáveis / Vascular complications in infectable drug abusers

Foram revistos os prontuários de 20 pacientes atendidos pelo Serviço de Cirurgia Vascular do Hosptial Universitário da Universidade Federal de Santa Catarina, entre janeiro de 1986 e setembro de 1990, com complicaçöes relacionadas à dependência de drogas injetáveis. Dezesseis pacientes eram do sexo masculino, com idade entre 20 e 35 anos. O propoxifeno foi a droga mais utilizada, seguido da cocaína. os sinaos e sintomas mais encontrados foram edema, úlceras e dor nos membros inferiores. Seis pacientes tiveram diagnóstico de trombose venosa em membros inferiores, quatro de linfangite aguda de membros inferiores e seis, de síndrome pós-trombótica; cinco pacientes apresentaram oclusöes arteriais e dois deles síndrome de compartimento; um apresentou aneurisma micótico de artéria femoral comum e outro falso aneurisma de artéria femoral superficial. As complicaçöes venosas e linfáticas foram tratadas clinicamente, com antibióticos, heparinizaçäo e cuidados locais. Foram realizadas duas aneurismectomias, uma delas com revascularizaçäo, duas amputaçöes, uma fasciotomia de antebraço e uma drenagem de abascesso. Tratamento clínico foi feito em 14 pacientes. Em outros seis fez-se tratamento cirúrgico. Em dois pacientes foi feita aneureismectomia, sendo em um com restauraçäo arterial e em outro só com ligadura arterial. Um paciente foi submetido a amputaçäo de coxa e outro a amputaçäo do dedo da mäo. Em um paciente com síndrome compartimental de antebraço por isquemia aguda fez-se a faciotomia descompressiva. Drenagem de abscesso de antebraço foi feita em mais de um paciente

Imunidade passiva e potencial de sobrevivência no suíno recém-nascido / Passive immunity and potential of survival in new-born swine

A importância dos primeiros dias de vida para a sobrevivência dos leitöes é destacada no presente trabalho. Na espécie suína, em particular, o recém-nascido depende do leite natural ou artificial para sobreviver no início do período pós-natal. O colostro da porca é muito rico em gamaglobulina e seus anticorpos associados, de forma que o leitäo recém-nascido é suprido com uma imunidade passiva imediata se lhe for possível mamar

Efeito de pedilúvio com soluçäo de formalina associado a desgastamento do piso, sobre o quadro clínico de porcas com afecçöes podais / The effect of formalin solution in footbath associated with floor abrasiveness reduction on clinical aspects of lameness in sows

Com o objetivo de verificar o efeito do tratamento dos cascos com uma soluçäo de formalina a 10 por cento em pedilúvio associado a diminuiçäo da abrasividade do piso, sobre a melhoria do quadro clínico de porcas com claudicaçöes, foi desenvolvido um experimento envolvendo 102 fêmeas alojadas em 14 baias, com piso parcialmente ripado. As baias, abrigando em média sete animais, foram distribuídas ao acaso em grupo testemunha (T1) e tratado (T2). Os animais do T2 foram submetidos a uma série de 12 passagens por pedilúvio, contendo uma soluçäo de formol a 10 por cento, distribuídos ao longo de cinco semanas. O piso foi classificado visual e manualmente como muito abrasivo. Através do uso de uma lixadeira elétrica procedeu-se à diminuiçäo da abrasividade do piso de todas as baias (T1 e T2) sendo após classificado como levemente abrasivo. O tratamento com a soluçäo de formalina foi iniciado após correçäo do piso. Para determinar a frequência e gravidade das claudicaçöes examinaram-se clinicamente os animais antes do início do tratamento e no final do período experimental. A eficácia dos tratamentos foi medida através do teste do qui-quadrado. Conclui-se que, diminuindo o poder abrasivo do piso, näo ocorreu melhora nem agravamento no quadro clínico das claudicaçöes, mas o tratamento com soluçäo de formalina a 10 por cento promove uma melhora significativa no quadro clínico de claudicaçöes

Avaliacao e tendencias economico-profissionais do medico: um estudo sobre o futuro da profissao medica. / Evaluation and economic-profissional trend of physicians: a study on the future of the medical profession

Um estudo amplo e pioneiro no Brasil e feito sobre o futuro do exercicio profissional da Medicina a partir das aspiracoes de medicos e pacientes. Sao analisados fatores determinantes desse futuro, mostrando quanto ganha o medico, qual sua renda familiar, como exerce sua profissao, qual a rentabilidade e o futuro do consultorio medico - extincao ou florescimento - e como e feito esse tipo de atendimento entre nos