Densidade mineral óssea, vitamina D e terapia anticonvulsivante

The aim of this study was to assess bone mineral density and vitamin D metabolism in patients on chronic anticonvulsant therapy. METHODS: Sixty-nine men, outpatients on chronic anticonvulsant therapy, who had been treated for at least 5 years, were studied, comparing them to thirty healthy controls. Bone mineral density was measured as well as serum levels of calcium, ionized calcium, alkaline phosphatase, PTH, 25-hydroxycholecalciferol and 1,25-dihydroxycholecalciferol. RESULTS: No differences in bone mineral density, serum levels of vitamin D and intact-PTH were observed between patients and controls. Bone mineral density was not associated with chronic anticonvulsant therapy. CONCLUSION: Those adult patients who were on chronic anticonvulsant therapy and who lived in low latitude regions had normal bone mineral density as well as vitamin D serum levels.O objetivo deste estudo foi avaliar a densidade mineral óssea e o metabolismo da vitamina D em usuários crônicos de anticonvulsivantes. MÉTODOS: Foram estudados 69 pacientes ambulatoriais, masculinos, usuários crônicos de anticonvulsivantes por período mínimo de 5 anos e comparados a 30 controles normais. Foram efetuadas as medidas da densidade mineral óssea e dos níveis plasmáticos do cálcio, cálcio iônico, fosfatase alcalina, paratormônio, 25-hidroxi-colecalciferol e 1,25-di-hidroxi-colecalciferol. RESULTADOS: Nenhuma diferença na densidade mineral óssea e nos níveis plasmáticos da vitamina D e paratormônio foram observadas entre os pacientes e os controles. A densidade mineral óssea não se mostrou associada ao uso crônico de anticonvulsivantes. CONCLUSÕES: Pacientes adultos, do sexo masculino, usuários crônicos de anticonvulsivantes, residentes em regiões ensolaradas, têm densidade mineral óssea e níveis plasmáticos de vitamina D normais61662

Densidade mamária em mulheres com falência ovariana prematura ou na pós-menopausa e em uso de terapia hormonal: estudo transversal analítico

CONTEXT AND OBJECTIVE: Studies on postmenopausal women have reported increased risk of breast cancer relating to the type and duration of hormone therapy (HT) used. Women with premature ovarian failure (POF) represent a challenge, since they require prolonged HT. Little is known about the impact of prolonged HT use on these women's breasts. This study aimed to evaluate the effects of one type of HT on the breast density of women with POF, compared with postmenopausal women. DESIGN AND SETTING: Cross-sectional study at the Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (Unicamp). METHODS: 31 women with POF and 31 postmenopausal women, all using HT consisting of conjugated equine estrogen combined with medroxyprogesterone acetate, and matched according to HT duration, were studied. Mammography was performed on all subjects and was analyzed by means of digitization or Wolfe's classification, stratified into two categories: non-dense (N1 and P1 patterns) and dense (P2 and Dy). RESULTS: No significant difference in breast density was found between the two groups through digitization or Wolfe's classification. From digitization, the mean breast density was 24.1% ± 14.6 and 18.1% ± 17.2 in the POF and postmenopausal groups, respectively (P = 0.15). Wolfe's classification identified dense breasts in 51.6% and 29.0%, respectively (P = 0.171). CONCLUSION: There was no difference in breast density between the women with POF and postmenopausal women, who had used HT for the same length of time. These results may help towards compliance with HT use among women with POF.CONTEXTO E OBJETIVO: Estudos com mulheres na pós-menopausa relatam aumento no risco de câncer de mama relacionado ao tipo e duração da terapia hormonal (TH) utilizada. Mulheres com falência ovariana prematura (FOP) representam desafio por necessitarem de TH prolongada. Pouco se conhece sobre ação da TH nas mamas dessas mulheres. Este estudo objetivou avaliar os efeitos de um tipo de TH sobre a densidade mamária de mulheres com FOP comparativamente à de mulheres pós-menopausa. TIPO DE ESTUDO E LOCAL: Estudo de corte transversal no Departamento de Tocoginecologia, Universidade Estadual de Campinas (Unicamp). MÉTODOS: Estudaram-se 31 mulheres com FOP e 31 mulheres na pós-menopausa, todas usando TH com estrogênio conjugado equino mais acetato de medroxiprogesterona, pareadas pelo tempo de utilização da TH. Todas realizaram mamografia, analisada por digitalização e por classificação de Wolfe, estratificada em duas categorias: não densa (padrão N1 e P1) e densa (P2 e Dy). RESULTADOS: Não houve diferença significativa entre a densidade mamária dos grupos analisadas por digitalização ou classificação de Wolfe. Pela digitalização, calculou-se densidade mamária média em 24.1% ± 14.6 e 18.1% ± 17.2 nas com FOP e pós-menopausa, respectivamente (P = 0,15); pela classificação de Wolfe identificou-se mamas densas em 51,6% e 29,0%, respectivamente (P = 0,171). CONCLUSÃO: Não se observou diferença na densidade mamária de mulheres com FOP comparativamente à de mulheres na pós-menopausa utilizando TH pelo mesmo período de tempo. Estes resultados podem auxiliar na aderência à TH de pacientes com FOP.21121

Reassessment Of Diagnostic Criteria In Cutaneous Lymphocytic Infiltrates.

Non-specific lymphocytic infiltrates of the skin pose difficulties in daily practice in pathology. There is still a lack of pathognomonic signs for the differential diagnosis between benign and malignant lymphocytic infiltrates. To evaluate the morphological and immunohistochemical profile of lymphocytic infiltrations of the skin according to clinical outcome. Retrospective; histopathological and immunohistochemical analysis. Referral center, university hospital. 28 cases of lymphocytic infiltrates of difficult differential diagnosis selected from the records. Eighteen histological variables and the immunophenotypic profile were assessed using the CD4, CD8, CD3, CD20 and CD30 lymphoid markers and compared to subsequent follow-up. The most common diagnoses were: initial mycosis fungoides (eight cases) and drug reactions (five cases). Single morphological variables did not discriminate between benign and malignant infiltrates except for the presence of Pautrier-Darier's microabscesses, which were found only in mycosis fungoides (p = 0.015). Patterns of superficial and deep infiltration (p = 0.037) and also the presence of eosinophils (p = 0.0207) were more frequently found in benign lymphocytic infiltrates. Immunohistochemical profile of T-cell subsets showed overlap between benign and malignant infiltrates with a predominance of CD4-positive (helper) lymphocytes in the majority of cases. A combination of clinical and histological features remains the most reliable approach for establishing a definite diagnosis in cases of lymphoid skin infiltrates.122161-

The use of vancomycin-loaded poly-l-lactic acid and poly-ethylene oxide microspheres for bone repair: an in vivo study

OBJECTIVE: The aim of this study was to investigate bone repair after the implantation of vancomycin-loaded poly-L-lactic acid/poly-ethylene oxide microspheres compared with vancomycin-unloaded poly-L-lactic acid/poly-ethylene oxide microspheres. METHODS: Poly-L-lactic acid/poly-ethylene oxide microspheres were implanted in rat tibiae and evaluated for periods of 2, 4, 8, and 12 days and 4, 8, 16, and 32 weeks. The groups implanted with vancomycin-loaded and vancomycin-unloaded microspheres were compared. Histopathologic (semi-quantitative) and histomorphometric analyses were performed to evaluate the bone formation process. RESULTS: During the first period (second day), fibrin and hemorrhaging areas were observed to be replaced by granulation tissue around the microspheres. Woven bone formation with progressive maturation was observed. All of the histopathological findings, evaluated by a semi-quantitative assay and a quantitative analysis (percentage of bone formation), were similar between the two groups. CONCLUSION: Vancomycin-loaded poly-L-lactic acid/poly-ethylene oxide microspheres are a good bone substitute candidate for bone repair. Local antibiotic therapy using vancomycin-loaded poly-L-lactic acid/poly-ethylene oxide microspheres should be considered after the microbiological evaluation of its efficacy

Imagem corporal e comportamento alimentar em estudantes universitárias

Este estudo avaliou a imagem corporal e as atitudes alimentares de uma amostra de estudantes universitárias de uma faculdade do Mato Grosso do Sul, Brasil. Método: quantitativo, exploratório, descritivo e de corte transversal. Participaram da pesquisa 106 alunas. Foram aplicados três instrumentos, sendo um questionário sócio-demográfico; para avaliar a insatisfação com a imagem corporal foi utilizado o Questionário de Imagem Corporal (Body Shape Questionnaire-BSQ) e para a identificação da presença de distúrbios de atitudes alimentares foi utilizado o Teste de Atitudes Alimentares (Eating Attitude Test-EAT-26). Resultados indicaram, pelo EAT26, que 15,2% das alunas tinham escore sugestivo de distúrbio alimentar (acima de 21) e 84,8% escore igual ou inferior a 21, portanto indicativo de ausência de distúrbio alimentar. Tanto a idade quanto o IMC e a frequência semanal de atividade física são semelhantes nos grupos identificados pelo EAT26 como sem distúrbio ou com provável distúrbio alimentar. As médias para a idade em cada grupo foram 24,86 e 25,44 anos; IMC médio de 21,78 e 22,77; e média de 3,83 e 3,33 de vezes/semana de prática de atividade física. Em relação ao BSQ, seu resultado foi conclusivo para 95 alunas, as quais se distribuíram em 74,7% sem transtorno, 11,6% com transtorno leve, 8,4% com transtorno moderado e 5,3% com transtorno grave.

Respiratory function in obese patients submitted to Fobi-Capella operation

BACKGROUND: The objective this study was to measure quantitatively those breathing alterations until 30 days postoperative. METHOD: Breathing evaluations were accomplished before and after bariatric surgery, in morbid obese with IMC greater than 39 kg/m², through arterial gasometry, spirometry function, manovacuometry, to motivate breathing and circumferences. They were breathing physiotherapeutic accomplished, orientations and treatment in the postoperative, with comparative data among evaluations in the 1st, 14th ·e 30th postoperative day. RESULTS: Until the 30th postoperative day, those individuals didn't achieve significant differences in the evaluated parameters, and showed no breathing complications for physiotherapeutic treatment. CONCLUSION: There were no alterations in the analyzed parameters, nor breathing complications in this study with intervention physiotherapy before and after bariatric surgery. Studies should be accomplished, for a longer postoperative period, including specific exercises to achieve different results.INTRODUÇÃO: O objetivo deste trabalho foi mensurar quantitativamente essas alterações respiratórias desses pacientes comparando-os até 30 dias de pós-operatório. MÉTODO: Foram realizadas avaliações respiratórias nos períodos pré e pós-operatório de cirurgia bariátrica em obesos mórbidos com IMC superior a 39kg/m², através de gasometria arterial, prova de função respiratória, manovacuômetria, incentivador da respiração e cirtometrias. Foram realizadas também orientações fisioterápicas respiratórias e tratamento no pós-operatório, com dados comparativos entre as avaliações feitas no préoperatório, no 1º, 14º·e 30º dia pós-operatórios. RESULTADOS: Até o 30º dia de pós-operatório, esses indivíduos não obtiveram diferença significativa nos parâmetros estudados, não havendo, em decorrência do tratamento fisioterápico, complicações respiratórias. CONCLUSÃO: Não houve alterações dos parâmetros analisados, nem complicações respiratórias neste estudo com intervenção fisioterápica pré e pós-operatório de cirurgia bariátrica. Estudos devem ser realizados, para mensuração de um tempo maior de pós-operatório e de exercícios específicos, podendo, assim apresentar resultados diferentes.31432

Avaliação da escrita através da fotogrametria – estudo da preensão trípode dinâmica

INTRODUCTION: Different grasp patterns can be used for handwriting and the dynamic tripod is the most prevalent among adults. Although it is considered an ideal grasp pattern, there are few studies that analyses the range of motion of hand joints during this activity. OBJECTIVE: To obtain the variations of range of motion in distal upper limb articulations during a handwriting task among healthy adults. METHODS: 50 young adults, right-handed and without impairment in the upper limb had their hands photographed during a handwriting task and analyzed with Postural Assessment Software (SAPO). RESULTS: A common pattern of forearm pronation, abduction of the fi rst interdigital space, fl exion of metecarpophalangeal and proximal interphalangeal joints of the index fi nger was observed among subjects, matching previous studies and descriptions for this grasppattern. CONCLUSION: It was possible to establish a standardpostural pattern for handwriting through photogrammetric analysis, demonstrating the applicability of this method for the upper limb.INTRODUÇÃO: Dentre as preensões utilizadas para a escrita a trípode dinâmica apresenta a maior prevalência entre a população. Apesar de considerada padrão para a escrita manual, são escassos estudos que envolvam a análise da amplitude articular das mãos durante esta atividade. OBJETIVO: Obter as variações das amplitudes de movimento das articulações distais do membro superior durante a atividade de escrita manual em adultos. METODOLOGIA: 50 adultos jovens, destros e sem comprometimento no membro superior tiveram suas mãos fotografadas durante a escrita e posteriormente analisadas através do Software de Avaliação Postural (SAPO). RESULTADOS: Foi observado um padrão comum de pronaçãode antebraço, abdução entre I e II metacarpianos e fl exão de metacarpofalangeana e interfalangeana proximal do II dedo, similar às descrições encontradas na literatura. CONCLUSÃO: Foi possível estabelecer um padrão postural por meio da análise fotogramétrica, demonstrando a aplicabilidade deste método para a análise da motora do membro superior durante a atividade de escrita manual

Breast density in women with premature ovarian failure or postmenopausal women using hormone therapy: analytical cross-sectional study

CONTEXT AND OBJECTIVE: Studies on postmenopausal women have reported increased risk of breast cancer relating to the type and duration of hormone therapy (HT) used. Women with premature ovarian failure (POF) represent a challenge, since they require prolonged HT. Little is known about the impact of prolonged HT use on these women's breasts. This study aimed to evaluate the effects of one type of HT on the breast density of women with POF, compared with postmenopausal women. DESIGN AND SETTING: Cross-sectional study at the Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (Unicamp). METHODS: 31 women with POF and 31 postmenopausal women, all using HT consisting of conjugated equine estrogen combined with medroxyprogesterone acetate, and matched according to HT duration, were studied. Mammography was performed on all subjects and was analyzed by means of digitization or Wolfe's classification, stratified into two categories: non-dense (N1 and P1 patterns) and dense (P2 and Dy). RESULTS: No significant difference in breast density was found between the two groups through digitization or Wolfe's classification. From digitization, the mean breast density was 24.1% ± 14.6 and 18.1% ± 17.2 in the POF and postmenopausal groups, respectively (P = 0.15). Wolfe's classification identified dense breasts in 51.6% and 29.0%, respectively (P = 0.171). CONCLUSION: There was no difference in breast density between the women with POF and postmenopausal women, who had used HT for the same length of time. These results may help towards compliance with HT use among women with POF