RESUMO
BACKGROUND: Evidence on the diagnostic performance of palpatory methods and possible confounding factors is scarce. OBJECTIVES: To examine the sensitivity of palpatory methods for location of lumbopelvic landmarks and to assess its association with personal characteristics. METHODS: Eighty-three participants (41 men, 55.6 (16.5) years, 25.9 (4.8) kg/m2 [mean (SD)]) were enrolled in this single-blinded study. Fourteen body and softy-tissue landmarks were sequentially palpated from the spinous process of L4 to the ischial tuberosity. CT-scan images were used to assess what landmark was located. RESULTS: Sensitivity for location was in range 22-86% for soft-tissues and 26-69% for bony landmarks. Reduction in sensitivity was observed from the quadratus lumborum to the inferior and lateral angle of the sacrum (86-26% and 75-33%, left and right sides, respectively). Palpations of L4 and L5 spinous processes were systematically more cephalic than other landmarks. Gender was weakly correlated to almost all landmarks (rpâ¢b= 0.333 or weaker). Body mass index was weakly correlated to the accurate location of ILAS and quadratus lumborum, great trochanter, PSIS, and piriformis (rpâ¢b=-0.307 or weaker). CONCLUSIONS: Systematic and propagation errors were present using sequential palpatory methods. Palpation in men was more sensitive and higher BMI was associated with lower sensitivity for lumbopelvic landmarks.
Assuntos
Pontos de Referência Anatômicos , Região Lombossacral , Palpação/métodos , Adulto , Idoso , Estatura , Índice de Massa Corporal , Peso Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Palpação/estatística & dados numéricos , Sacro , Método Simples-Cego , Tomografia Computadorizada por Raios XRESUMO
About 25% of children with sickle cell disease (SCD) have statural deficit and retarded skeletal maturation and pubertal development. These disorders have been attributed to low serum concentrations of zinc. We report the study of serum zinc in 34 patients with SCD, of whom 17 had statural deficit (SCS group) and 17 without growth deficiency (SCN group). They were compared with 20 normal children (N group). GH secretion and thyroid function were investigated in the group with short stature (SCS) in order to rule out GH deficiency and hypothyroidism. The mean serum zinc concentration was 108.45+/-22.888 microg/100 ml in the N group, 87.529+/-30.069 microg/100 ml in the SCN group and 82.765+/-34.766 microg/100 ml in the SCS group. There was a statistically significant difference between the mean of the N group and the mean of the SCN group (p<0.05) but no difference was found between the two groups of patients (N>SCN=SCS). Although there is a well-established zinc deficiency in patients with SCD, the statural retardation found in the SCS group could not be attributed only to zinc deficiency. Many other severe metabolic disturbances are also involved.
Assuntos
Anemia Falciforme/sangue , Hormônio do Crescimento Humano/sangue , Zinco/sangue , Anemia Falciforme/patologia , Estatura , Criança , Feminino , Humanos , Masculino , Concentração Osmolar , Valores de ReferênciaRESUMO
A importancia do estudo das relacoes entre o cerebro e o sistema endocrino e o seu impacto sobre o comportamento e um dos objetivos principais da nova disciplina chamada psiconeuroendocrinologia. Dentre os varios hormonios estudados, aqueles provenientes do eixo tireoidiano tem recebido uma atencao especial. Os autores apresentam uma revisao da literatura referente aos aspectos psiquiatricos dos transtornos tireoidianos e apresentam cinco casos de hipertireoidismo (Doenca de Basedow-Graves) que cursaram com transtorno mental organico. Dois destes casos apresentaram-se como 'delirium'e os outros tres foram diagnosticados como sindrome organico do humor (maniaco). A evolucao e a conduta terapeutica dos casos sao discutidas de acordo com literatura revista.
Assuntos
Transtornos Mentais , Hipertireoidismo , Psicofarmacologia , Revisão , Transtornos Mentais , Hipotireoidismo , PsicofarmacologiaRESUMO
A importância do estudo das relaçöes entre o cérebro e o sistema endócrino e o seu impacto sobre o comportamento é um dos objetivos principais da nova disciplina chamada psiconeuroendocrinologia. Dentre os vários hormônios estudados, aqueles provenientes do eixo tireoidiano têm recebido uma atençäo especial. Os autores apresentam uma revisäo da literatura referente aos aspectos psiquiátricos dos transtornos tireoidianos e apresentam cinco casos de hipertireoidismo (Doença de Basedow-Graves) que cursaram com transtorno mental orgânico. Dois destes casos apresentaram-se como "delirium" e os outros três foram diagnosticados como síndrome orgânica do humor (maníaco). A evoluçäo e a conduta terapêutica dos casos säo discutidas de acordo com literatura revista.