Proposal of standardization of Horus® computerized posturography in adults.

PURPOSE: To propose a normalization model of a posturography platform in adults without changes in body balance, through descriptive analysis by age group and sex. METHODS: Cross-sectional observational study. Adults, with no changes in body balance and no vestibular complaints were submitted to 6 sensory conditions on the Horus® posturography platform. The following variables were analyzed: stability limit area and confidence ellipse area, trajectory length and average velocity for each condition tested. The variables were analyzed by age group and sex. The equilibrium score, the sensory integration test and the equilibrium index were calculated on the conditions. RESULTS: Sixty-one subjects (38.3%) and 23 (37.7%) were male, 40 (65.57%) between the ages of 20 and 40 and 21 (34.43). %) between 41 and 59 years. The area of the stability limit and pressure center variables for 6 sensory conditions tested - confidence ellipse area, trajectory length, total mean velocity and confidence ellipse ratio by the area of the stability limit were described. There was a statistically significant difference in the comparison between the area of the stability limit between sexes and between age groups, being a higher value in males and in younger patients. Regarding the analysis of the variables by each condition, there was no difference of results between the sexes and age groups. CONCLUSION: Subjects of different sexes and age groups should be considered separately only in the analysis of the stability limit.

Metastasis to Paranasal Sinuses from Carcinoma of Prostate: Report of a Case and Review of the Literature.

Metastasis from distant primary tumors is extremely rare in the paranasal sinuses with few hundred cases in the literature. Metastatic carcinoma of the prostate is even rarer, despite being one of the most common tumors, with only 24 cases published. In this article, we report a case of a 58-year-old male presenting with epistaxis and nasal obstruction as initial symptoms of a metastatic prostate carcinoma in the ethmoid cells and maxillary sinus.

Termo de consentimento livre e esclarecido: análise do nível de conhecimento dos profissionais médicos do Maranhão / Informed consent: analysis of the level of knowledge of medical professionals from Maranhão

Modelo de Estudo: Estudo observacional, analítico e transversal. Introdução: O Termo de Consentimento Livre e Esclarecido (TCLE) se expressa pelo respeito à dignidade humana exigindo que toda pesquisa ocorra após consentimento livre e esclarecido dos sujeitos, indivíduos ou grupos que, por si e/ou por seus representantes legais, manifestem sua anuência à participação da pesquisa. No entanto, apesar de sua extrema relevância, observa-se que seu uso não é habitual na prática diária da medicina em nosso país, apesar de consistir num direito fundamental do paciente e uma exigência ética para a medicina. Objetivo: Investigar o nível de conhecimento sobre o Termo de Consentimento Livre e Esclarecido dos profissionais médicos ativos no Maranhão. Metodologia: Trata-se de um estudo transversal, analítico, realizado com os médicos em atividade, no período de dezembro de 2012 a outubro de 2013.Foi enviado questionário composto por 18 questões sobre o TCLE para 368 médicos que possuíam emails cadastrados no Conselho Regional de Medicina. Resultados: Foram respondidos 170 questioná-rios (46,2%). O nível de conhecimento sobre o TCLE foi classificado como médio para 83,5% dos avaliados. A maioria dos participantes era especialista (85,7%) e 96,4% reconheceram corretamente que o TCLE é um direito do participante. Quando questionados sobre a principal função do TCLE, 65,9% responderam inadequadamente. Verificou-se também que todos os entrevistados não sabiam como proceder no momento de entregar o TCLE ao paciente...

Design of the Study: Analytical cross-sectional observational study. Introduction: The Informed Consent (IC) is expressed by respect for human dignity requires that all research occurs after informed consent of the subjects, individuals or groups, by themselves and/or their legal representatives express their agreement to participate in the research. However, despite its extreme importance, it is observed that its use is not common in ordinary practice of medicine in our country, because the knowledge about this instrument is still incomplete of many doctors, that consists of a fundamental right of the patient and a ethical requirement for medicine. Objective: Investigate the level of knowledge about the Informed Consent by medical professionals active in Maranhão. Methodology: This is a cross-sectional analytical study with physicians in activity in the period from December 2012 to October 2013. A questionnaire consists of 18 questions about The Informed Consent was sent to 368 doctors who had registered email at the Regional Council of Medicine. Results: 170 (46,2%) questionnaires were answered. The level of knowledge about the IC was rated as average to 83,5% of physicians. Most of participants were specialists (85,7%) and 96,4% correctly recognized that the IC is a right of the patient. When asked about the main function of Informed Consent, 65,9% chose the wrong statement. It was noticed that all interviewees did not know how to proceed when delivering the IC to the patient...

[HLA alleles association and recurrent spontaneous abortion in a São Luis/Maranhão population, in Brazilian Northeastern region]. / Associação de alelos HLA e aborto espontâneo recorrente em uma população de São Luís/Maranhão, na região Nordeste do Brasil.

PURPOSE: To investigate the association of the HLA-A, -B and -DRB1 alleles with the occurrence of Recurrent Spontaneous Abortion. METHODS: A case-control study of 200 women aged 18 to 35 years, consisting of a convenience sample of 100 women who had idiopathic recurrent spontaneous abortion and 100 women without abortion and with two or more children. Peripheral blood genomic DNA was extracted from 500l of Buffy Coat stored at -20°C. HLA typing was performed by the PCR-SSOP method (Polymerase Chain Reaction - Specific Sequence of Oligonucleotides Probes, One Lambda(r), CA, USA). The regions of the amplified DNA were exon 2 and 3 for the A and B loci and only exon 3 for the DRB1 locus. The HLA FUSIONTM program (One Lambda, Canoga Park, CA, USA, version 3.0) was used for HLA-A, HLA-B and HLA-DRB1 genotyping. Absolute frequencies and percentages and calculation of mean and standard deviation were used for standard statistical analysis. The qualitative variables were compared by the χ2 test with Yates correction or by Fisher's exact test. The odds ratio with the 95%CI was used for the comparisons, with the level of significance set at p<0.05. RESULTS: The frequency of the A*34 allele was significantly higher in the case group compared to control (4.0 versus 0.5%; p<0.05). Alleles A*24 (6.0 versus 12.5%; p<0.05) and B*35 (8.0 versus 20.5%; p<0.05) were significantly less frequent in the case group. Among the class II alleles, DRB1*03 showed a slightly higher frequency in the case group (11.0 versus 5.5%, p = 0.056). CONCLUSIONS: It was shown that the HLA-A*34 allele is a risk factor for recurrent spontaneous abortion, while the HLA-A*24 and HLA-B*35 alleles are associated with protection, and no allele of the DRB1 locus was associated with RSA.

Associação de alelos HLA e aborto espontâneo recorrente em uma população de São Luís/Maranhão, na região Nordeste do Brasil / HLA alleles association and recurrent spontaneous abortion in a São Luis/Maranhão population, in Brazilian Northeastern region

Investigar a associação dos alelos HLA-A, -B e -DRB1 com a ocorrência de Aborto Espontâneo Recorrente.