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1.
Sleep Breath ; 26(2): 941-948, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-34365593

RESUMO

BACKGROUND: Temporomandibular disorders (TMD) is a collective term that refers to complaints of temporomandibular joint (TMJ) pain, fatigue and/or pain of the craniocervical muscles, limitation of movement of the mandible, and TMJ noises. Sleep bruxism (SB) is a disorder involving rhythmic (phasic) or non-rhythmic (tonic) masticatory muscle activity during sleep and is not a movement disorder or a sleep disorder in otherwise healthy individuals. The present study aimed to support or reject the null hypothesis that there is no association between SB and TMD. METHODS: The study population was recruited from patients who visited the Artmedica Clinic, Mossoro city, Rio Grande do Norte, Brazil. Patients who underwent polysomnography received information about the research and were invited to participate following the inclusion and exclusion criteria. The study sample consisted of 40 individuals with age ranging from 19 to 76 years. The subjects were administered the questionnaire of the European Academy of Craniomandibular Disorders (AEDC). Those who answered affirmatively to at least one question of the questionnaire were recommended to visit the primary researcher's dental clinic for examination; those who met the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were evaluated, and their condition was classified into one or more subtypes of TMD. The subjects were divided into 4 groups according to the polysomnographic findings and the responses to the AEDC questionnaire. Of the 40 individuals who answered the AEDC questionnaire and underwent polysomnography, 28 presented with TMD symptoms. The data were expressed as simple frequency and percentage values using statistical software. Values of p < 0.05 were considered to be significant. RESULTS: The results showed that the frequency of TMD in individuals diagnosed to have SB was 46.4%. According to the DC/TMD of the 28 individuals, the most prevalent TMD subtype was local myalgia (85.7%). Of the total subjects, 32.5% had TMD and SB, 36.4% were males, and in the age range of 31 to 40 years (40%). CONCLUSION: In this study sample, there was no association between SB as currently defined and TMD, thus confirming previous findings on this topic.


Assuntos
Bruxismo do Sono , Transtornos da Articulação Temporomandibular , Adulto , Idoso , Estudos de Casos e Controles , Dor Facial , Feminino , Humanos , Masculino , Músculos da Mastigação , Pessoa de Meia-Idade , Bruxismo do Sono/diagnóstico , Transtornos da Articulação Temporomandibular/diagnóstico , Transtornos da Articulação Temporomandibular/epidemiologia , Adulto Jovem
2.
EClinicalMedicine ; 35: 1-13, 2021. ilus
Artigo em Português | LILACS, Coleciona SUS, Sec. Est. Saúde SP, CONASS, SESSP-IALPROD, Sec. Est. Saúde SP | ID: biblio-1222994

RESUMO

Background: COVID-19 in children is usually mild or asymptomatic, but severe and fatal paediatric cases have been described. The pathology of COVID-19 in children is not known; the proposed pathogenesis for severe cases includes immune-mediated mechanisms or the direct effect of SARS-CoV-2 on tissues. We describe the autopsy findings in five cases of paediatric COVID-19 and provide mechanistic insight into the mechanisms involved in the pathogenesis of the disease. Methods: Children and adolescents who died with COVID-19 between March 18 and August 15, 2020 were autopsied with a minimally invasive method. Tissue samples from all vital organs were analysed by histology, electron microscopy (EM), reverse-transcription polymerase chain reaction (RT-PCR) and immunohistochemistry (IHC). Findings: Five patients were included, one male and four female, aged 7 months to 15 years. Two patients had severe diseases before SARS-CoV-2 infection: adrenal carcinoma and Edwards syndrome. Three patients were previously healthy and had multisystem inflammatory syndrome in children (MIS-C) with distinct clinical presentations: myocarditis, colitis, and acute encephalopathy with status epilepticus. Autopsy findings varied amongst patients and included mild to severe COVID-19 pneumonia, pulmonary microthrombosis, cerebral oedema with reactive gliosis, myocarditis, intestinal inflammation, and haemophagocytosis. SARSCoV- 2 was detected in all patients in lungs, heart and kidneys by at least one method (RT-PCR, IHC or EM), and in endothelial cells from heart and brain in two patients with MIS-C (IHC). In addition, we show for the first time the presence of SARS-CoV-2 in the brain tissue of a child with MIS-C with acute encephalopathy, and in the intestinal tissue of a child with acute colitis. Interpretation: SARS-CoV-2 can infect several cell and tissue types in paediatric patients, and the target organ for the...(AU)


Assuntos
Fenótipo , Autopsia
3.
Mil Med Res ; 5(1): 23, 2018 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-30049289

RESUMO

BACKGROUND: The activities carried out by soldiers in the army involve great physical demands and require intense trainings to perform combat-specific tasks. Musculoskeletal injury is a potential threat to the health and physical integrity of the soldier. This study aimed to evaluate the prevalence of lower limb musculoskeletal injuries among soldiers and to propose a training protocol to prevent the most frequent injuries. METHODS: This observational (cross-sectional) study recruited a sample of 103 soldiers who required medical attention, from a total 202 new battalion soldiers. The medical records (paper and online) had a form of running text. All data collected were recorded by the registered physicians of the battalion medical post. The records were analyzed by the following variables: medical diagnosis, injury site, mechanism, type of treatment, time loss, existence of previous injury, and recurring injury. RESULTS: A total of 112 musculoskeletal injuries were diagnosed in 71 soldiers, and other types of diseases/injuries were diagnosed in the other soldiers. Joint pain accounted for 55.4% of the diagnoses. The knee was the most affected site, while trauma and overload were the most common mechanisms of injury. Drug treatment was used most frequently, accounting for 58% of the cases. The majority of the sample obtained a temporary leave of absence for 1 to 6 days or not at all. Previous injuries and recurrence were not presented as risk factors for injury. With the data received, a protocol for the prevention of injuries to the lower limbs was proposed. CONCLUSION: This study indicated that the most frequent site of injury is the knee, and joint pain is the most common diagnosis. These results may support the necessity to develop a neuromuscular training protocol to prevent lower limb injuries, which we suggest to be applied in future studies.


Assuntos
Extremidade Inferior/lesões , Militares , Sistema Musculoesquelético/lesões , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/prevenção & controle , Adolescente , Brasil , Estudos Transversais , Humanos , Masculino , Medicina Militar , Dor/epidemiologia , Prevenção Primária , Fatores de Risco , Corrida , Adulto Jovem
4.
Arq Bras Oftalmol ; 70(1): 19-21, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17505713

RESUMO

PURPOSE: To describe morphological features of the macula in patients with retinopathy of prematurity. METHODS: Twelve premature babies with retinopathy of prematurity grades I, II and III underwent dilated fundus examination and optical coherence tomography evaluation. RESULTS: In all thirteen eyes of the twelve premature patients optical coherence tomography revealed a condensed retinal pigmented epithelial layer in the macular-foveal area shown by increased reflectivity. In these eyes the retinal layers were not well differentiated. Foveal depression was clearly evident in 23%. CONCLUSIONS: In premature patients with retinopathy of prematurity, optical coherence tomography revealed poorly differentiated layers in the macular region with increased reflectivity in retinal pigmented epithelial-choriocapillaris zone.


Assuntos
Macula Lutea/patologia , Retinopatia da Prematuridade/diagnóstico , Tomografia de Coerência Óptica , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Retinopatia da Prematuridade/patologia , Estudos Retrospectivos , Índice de Gravidade de Doença
5.
BMC Public Health ; 7: 50, 2007 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-17408470

RESUMO

BACKGROUND: Chronic hemodialysis patients are at higher risk for acquiring hepatitis C virus (HCV). The prevalence varies among different countries and hemodialysis centers. Although guidelines for a comprehensive infection control program exist, the nosocomial transmission still accounts for the new cases of infection. The aim of this study was analyze the follow up of newly acquired acute hepatitis C cases, during the period from January 2002 to May 2005, in the Hemodialysis Center, located in the Southwest region of Parana State, Brazil and to analyze the effectiveness of the measures to restrain the appearance of new cases of acute hepatitis C. METHODS: Patients were analyzed monthly with anti-HCV tests and ALT measurements. Patients with ALT elevations were monitored for possible acute hepatitis C. RESULTS: During this period, 32 new cases were identified with acute hepatitis C virus infection. Blood screening showed variable ALT levels preceding the anti-HCV seroconversion. HCV RNA viremia by PCR analysis was intermittently and even negative in some cases. Ten out of 32 patients received 1 mcg/kg dose of pegylated interferon alfa-2b treatment for 24 weeks. All dialysis personnel were re-trained to strictly follow the regulations and recommendations regarding infection control, proper methods to clean and disinfect equipment were reviewed and HCV-positive patients were isolated. CONCLUSION: Laboratory tests results showed variable ALT preceding anti-HCV seroconversion and intermittent viremia. The applied recommendations contributed importantly to restrain the appearance of new cases of acute hepatitis C in this center and the last case was diagnosed in May 2004.


Assuntos
Surtos de Doenças , Transmissão de Doença Infecciosa/prevenção & controle , Hepatite C/sangue , Hepatite C/prevenção & controle , Diálise Renal/efeitos adversos , Doença Aguda , Brasil/epidemiologia , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/virologia , Unidades Hospitalares de Hemodiálise/estatística & dados numéricos , Hepacivirus/genética , Hepacivirus/imunologia , Hepatite C/epidemiologia , Hepatite C/genética , Humanos , Incidência , Isolamento de Pacientes/métodos , Testes Sorológicos , Precauções Universais , Viremia/genética
6.
Arq. bras. oftalmol ; 70(1): 19-21, jan.-fev. 2007. tab, ilus
Artigo em Português | LILACS | ID: lil-453123

RESUMO

PURPOSE: To describe morphological features of the macula in patients with retinopathy of prematurity. METHODS: Twelve premature babies with retinopathy of prematurity grades I, II and III underwent dilated fundus examination and optical coherence tomography evaluation. RESULTS: In all thirteen eyes of the twelve premature patients optical coherence tomography revealed a condensed retinal pigmented epithelial layer in the macular-foveal area shown by increased reflectivity. In these eyes the retinal layers were not well differentiated. Foveal depression was clearly evident in 23 percent. CONCLUSIONS: In premature patients with retinopathy of prematurity, optical coherence tomography revealed poorly differentiated layers in the macular region with increased reflectivity in retinal pigmented epithelial-choriocapillaris zone.


OBJETIVO: Descrever os aspectos morfológicos da mácula em pacientes com retinopatia da prematuridade (ROP). MÉTODOS: Doze pacientes com retinopatia da prematuridade graus I, II and III foram submetidos a mapeamento de retina e avaliação por tomografia de coerência óptica. RESULTADOS: Em todos os treze olhos de 12 pacientes a tomografia de coerência óptica mostrou a camada do epitélio pigmentar hiperrefletiva, sendo a área macular com maior intensidade. Nesses olhos as camadas da retina não estavam totalmente diferenciadas. A depressão foveal ficou claramente evidente pela tomografia de coerência óptica em 23 por cento. CONCLUSÃO: Nos pacientes prematuros com retinopatia da prematuridade, a tomografia de coerência óptica mostrou as camadas da retina pouco diferenciadas com aumento da refletividade na área macular do complexo epitélio retiniano pigmentar-coriocapilar.


Assuntos
Humanos , Recém-Nascido , Macula Lutea/patologia , Retinopatia da Prematuridade/diagnóstico , Tomografia de Coerência Óptica , Idade Gestacional , Recém-Nascido de muito Baixo Peso , Estudos Retrospectivos , Retinopatia da Prematuridade/patologia , Índice de Gravidade de Doença
7.
Liver Int ; 26(6): 636-42, 2006 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16842318

RESUMO

UNLABELLED: Hepatitis B virus (HBV) can be classified into at least eight genotypes, A-H. We evaluated the distribution HBV genotypes among patients with chronic infection. METHODS: We consecutively evaluated adult patients with chronic HBV infection from Salvador, Brazil. Patients were classified according to HBV infection chronic phases based on HBV-DNA levels and presence of serum HBV markers. HBV-DNA was qualitatively and quantitatively detected in serum by polymerised chain reaction (PCR). Isolates were genotyped by comparison of amino acid mutations and phylogenetic analysis. RESULTS: One-hundred and fourteen patients were evaluated. HBV-DNA was positive in 96 samples. HBV genotype was done in 76. Mean age was 36 +/- 11.3. In 61 of 76 cases subjects were classified as inactive HBsAg carriers. Their mean HBV serum level was 1760 copies/ml and 53 of 61 were infected with HBV genotype A, seven with HBV genotype F and one with genotype B. Twelve of the 76 patients had detectable hepatitis B e-antigen (HBeAg) in serum. Ten were infected with HBV genotype A and two with genotype F; most had increased alanine aminotransferase and high HBV-DNA levels. Three patients were in the immunotolerant phase, two were infected with HBV genotype A and one with genotype F. HBV subtyping showed subtypes adw2 and adw4. CONCLUSIONS: HBV genotype A adw2 and genotype F adw4 were the most prevalent isolates found. We could not find differences in genotype distribution according to HBV clinical phases and DNA levels. We did not detect HBV genotype D in contrast to a previous study in our center with acute hepatitis B. All inactive HBsAg carriers had low HBV-DNA levels.


Assuntos
Vírus da Hepatite B/genética , Hepatite B Crônica/virologia , Adolescente , Adulto , Idoso , Sequência de Aminoácidos , Sequência de Bases , Brasil , DNA Viral/sangue , DNA Viral/genética , Feminino , Genes Virais , Genótipo , Vírus da Hepatite B/classificação , Vírus da Hepatite B/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Filogenia , Homologia de Sequência de Aminoácidos , Proteínas Virais/genética
9.
São Paulo; s.n; 2005. 130 p. ilus, map, tab.
Tese em Português | LILACS, Coleciona SUS, Sec. Est. Saúde SP, SESSP-CTDPROD, Sec. Est. Saúde SP, SESSP-ACVSES, SESSP-TESESESSP, Sec. Est. Saúde SP | ID: biblio-933111

RESUMO

A infecção pelo Vírus da Hepatite B (HBV) está relacionada a diversas formas de evolução clínica, porém os fatores determinantes do curso clínico da infecção ainda não estão claramente definidos. Diversos estudos têm evidenciado que a variabilidade genética do HBV pode estar associada com diferentes taxas de transmissão, evolução clínica da doença, resposta ao tratamento ou progressão para carcinoma hepatocelular. A prevalência da infecção pelo HBV no Brasil é considerada intermediária, porém algumas regiões apresentam uma elevada endemicidade, apesar disso ainda há poucas informações disponíveis sobre a variabilidade genética das cepas circulantes. O objetivo deste trabalho foi padronizar reações de PCR e seqüenciamento para a caracterização de genomas completos do HBV de diferentes genótipos que circulam no Brasil. Uma amostra previamente determinada como genótipo D foi utilizada para a padronização, posteriormente 30 amostras pertencentes aos diferentes genótipos já caracterizados no Brasil com base na seqüência parcial do gene S foram então caracterizadas. O DNA extraído foi amplificado utilizando-se os “primers” P1 e P2 (Günther et al., 1995) e a mistura de enzimas ELONGASE, sendo que para amplificar algumas amostras houve a necessidade de realização de reações de “nested” PCR. Os produtos amplificados foram purificados e seqüenciados utilizando-se o seqüenciador automático ABI model 377. Com esta metodologia, foram caracterizados 19 genomas completos do HBV (4 genótipo A, 1 genótipo B, 5 genótipo C, 3 genótipo D, 5 genótipo F e 1 genótipo H). A análise filogenética demonstrou que os dois subgruposdo genótipo A (A1 e A2) circulam no Brasil, assim como dois subgrupos (Ib e II) do genótipo F. No gene pré-core foi observada a mutação G1896A, principalmente entre as amostras pertencentes ao genótipo C e D; no genepré-S foram identificadas deleções em duas amostras genótipo F; no gene S de algumas amostras foram identificadas mutações relacionadas ao escape ...


Assuntos
Genoma Viral , Genótipo , Vírus da Hepatite B/genética , Epidemiologia Molecular , Mutação , Reação em Cadeia da Polimerase/métodos , Brasil , Saúde Pública
10.
São Paulo; s.n; 2005. 130 p. ilus, mapas, tab.
Tese em Português | LILACS, Sec. Est. Saúde SP, SESSP-TESESESSP, Sec. Est. Saúde SP | ID: lil-440846

RESUMO

A infecção pelo Vírus da Hepatite B (HBV) está relacionada a diversas formas de evolução clínica, porém os fatores determinantes do curso clínico da infecção ainda não estão claramente definidos. Diversos estudos têm evidenciado que a variabilidade genética do HBV pode estar associada com diferentes taxas de transmissão, evolução clínica da doença, resposta ao tratamento ou progressão para carcinoma hepatocelular. A prevalência da infecção pelo HBV no Brasil é considerada intermediária, porém algumas regiões apresentam uma elevada endemicidade, apesar disso ainda há poucas informações disponíveis sobre a variabilidade genética das cepas circulantes. O objetivo deste trabalho foi padronizar reações de PCR e seqüenciamento para a caracterização de genomas completos do HBV de diferentes genótipos que circulam no Brasil. Uma amostra previamente determinada como genótipo D foi utilizada para a padronização, posteriormente 30 amostras pertencentes aos diferentes genótipos já caracterizados no Brasil com base na seqüência parcial do gene S foram então caracterizadas. O DNA extraído foi amplificado utilizando-se os “primers” P1 e P2 (Günther et al., 1995) e a mistura de enzimas ELONGASE, sendo que para amplificar algumas amostras houve a necessidade de realização de reações de “nested” PCR. Os produtos amplificados foram purificados e seqüenciados utilizando-se o seqüenciador automático ABI model 377. Com esta metodologia, foram caracterizados 19 genomas completos do HBV (4 genótipo A, 1 genótipo B, 5 genótipo C, 3 genótipo D, 5 genótipo F e 1 genótipo H). A análise filogenética demonstrou que os dois subgruposdo genótipo A (A1 e A2) circulam no Brasil, assim como dois subgrupos (Ib e II) do genótipo F. No gene pré-core foi observada a mutação G1896A, principalmente entre as amostras pertencentes ao genótipo C e D; no genepré-S foram identificadas deleções em duas amostras genótipo F; no gene S de algumas amostras foram identificadas mutações relacionadas ao escape d


Assuntos
Epidemiologia Molecular , Genoma Viral , Genótipo , Mutação , Reação em Cadeia da Polimerase/métodos , Vírus da Hepatite B/genética , Brasil , Saúde Pública
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