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Sample records for contralateral em lactentes

  1. Botulismo Infantil em Portugal – um lactente com hipotonia

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    Malveiro, D; C. Henriques; Flores, P.; Barata, D; Vieira, JP; Cabral, P.

    2013-01-01

    O Botulismo Infantil (BI) constitui uma síndrome neuroparalítica rara, potencialmente fatal, causada pela neurotoxina do Clostridium botulinum. Descreve-se o primeiro caso reportado desde o início da notificação obrigatória em Portugal (1999). Lactente de dois meses, internado por prostração, dificuldade alimentar e obstipação. Constatou-se envolvimento inicial dos pares cranianos associado a fraqueza muscular progressiva, descendente e simétrica. Constituíam factores de risco o consumo...

  2. Sibilância recorrente em lactentes: mudanças epidemiológicas

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    Herberto José Chong Neto

    2011-12-01

    Full Text Available OBJETIVO: Verificar mudanças na epidemiologia da sibilância recorrente em lactentes de Curitiba (PR. MÉTODOS: Estudo transversal com aplicação do questionário Estudio Internacional de Sibilancias en Lactantes (EISL. Pais de lactentes entre 12 e 15 meses de vida preencheram o instrumento entre agosto de 2005 e dezembro de 2006 (fase I, e de setembro de 2009 a setembro de 2010 (fase III. RESULTADOS: Pais de 3.003 lactentes participaram da fase I, e 22,6% dos lactentes apresentaram sibilância recorrente (> 3 episódios. Após 5 anos, 1.003 pais preencheram o mesmo questionário na fase III, e 19,8% dos lactentes apresentaram sibilância recorrente (p = 0,1. Houve redução na gravidade dos sintomas (p = 0,001 e nas visitas a prontos-socorros (p < 0,001, mas não houve redução nas internações (p = 0,12. Ter o diagnóstico médico de asma foi mais frequente na fase III (p = 0,03. CONCLUSÕES: Não houve mudança na prevalência de sibilância recorrente em lactentes, mas ocorreu redução na gravidade, embora sem afetar o nível de internações e com aumento do diagnóstico de asma pelos clínicos.

  3. Status de Vitamina D em Lactentes Com Alergia à Proteína do Leite de Vaca

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    Silva, Cristiane Marroscos

    2015-01-01

    A deficiência de vitamina D pode estar relacionada a distúrbios do sistema imunológico. A avaliação dessa deficiência em crianças com alergia à proteína do leite de vaca (APLV) residentes em locais ensolarados ainda é escassa, e restrita à forma IgE mediada. Esta pesquisa teve como objetivo verificar se lactentes com APLV possuem menores níveis de vitamina D, quando comparados aos lactentes saudáveis. A amostra foi composta por lactentes atendidos nos ambulatórios de Gastroenterologia Pediátr...

  4. Deficiência de ferro em lactentes brasileiros com doença falciforme

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    Priscila C. Rodrigues

    2011-10-01

    Full Text Available OBJETIVO: Avaliar a deficiência ou sobrecarga de ferro em lactentes com doença falciforme, a fim de embasar a decisão de recomendar (ou não a suplementação profilática de ferro nessa população. MÉTODOS: Estudo retrospectivo transversal envolvendo 135 lactentes menores de 2 anos (66 meninos e 69 meninas, com genótipos SS e SC (77/58, nascidos entre 2005 e 2006 em Minas Gerais. Os indicadores de uma possível deficiência de ferro foram: volume corpuscular médio (VCM, hemoglobina corpuscular média (HCM, saturação da transferrina (ST e ferritina. Dezessete lactentes [12,6%, intervalo de confiança de 95% (IC95% 7,0-18,2%] haviam recebido hemotransfusão antes da coleta dos exames. RESULTADOS: ST e ferritina estavam significativamente mais baixas nos lactentes com hemoglobina SC (p < 0,001. Quando dois indicadores foram utilizados para definir a deficiência de ferro (VCM ou HCM baixos mais ST ou ferritina baixas, 17,8% das crianças (IC95% 11,3-24,3% tinham deficiência de ferro, predominando naquelas com perfil SC (p = 0,003. Análise das crianças que não haviam sido transfundidas (n = 118 mostrou prevalência de ferropenia em 19,5%. Constatou-se aumento de ferritina em 15 lactentes (11,3%; IC95% 5,9-16,7%; a maioria havia sido transfundida. CONCLUSÕES: A maior parte dos lactentes com doença falciforme não desenvolve deficiência de ferro, mas alguns têm déficit significativo. Este estudo indica que lactentes com doença falciforme, principalmente aqueles com hemoglobinopatia SC, talvez possam receber ferro profilático; no entanto, a suplementação deve ser suspensa após a primeira hemotransfusão.

  5. Hipertensão pulmonar em lactente associada a pulmão em ferradura: relato de caso

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    Juliana Rodrigues Neves

    2011-06-01

    Full Text Available Relatamos caso de lactente jovem com desconforto respiratório precoce e hipertensão pulmonar, diagnosticado como variante de pulmão em ferradura, e revisamos literatura a cerca desta rara malformação pulmonar e suas repercussões cardíacas e hemodinâmicas.

  6. Fatores associados à anemia em lactentes nascidos a termo e sem baixo peso

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    Netto,Michele Pereira; Rocha,Daniela da Silva; Sylvia do Carmo Castro FRANCESCHINI; Lamounier, Joel Alves

    2011-01-01

    OBJETIVO: Investigar os fatores envolvidos na gênese da anemia ferropriva em lactentes. MÉTODOS: Trata-se de um estudo transversal, no qual foram avaliadas 104 crianças no segundo ano de vida, que nasceram a termo e sem baixo peso, no município de Viçosa, Minas Gerais. Foi aplicada entrevista aos pais, realizado recordatório 24 horas e avaliação antropométrica. Os exames laboratoriais foram eritrograma, ferritina e retinol sérico. O estudo foi aprovado pelos Comitês de Ética com seres humanos...

  7. Meningencefalite por Pasteurella multocida: estudo clínico-laboratorial de um caso em lactente

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    C. E. Levy

    1989-12-01

    Full Text Available Os autores apresentam descrição clínico-laboratorial e evolutiva do caso de lactente com o diagnóstico de meningencefalite por Pasteurella multocida que apresentou na evolução atraso neuromotor, manifestações epilépticas, surdez neurossensorial e paresia crural à esquerda. Fazem também breve revisão do papel deste agente etiológico na patologia humana. Ressaltam a importância da P. multocida em casos de meningites bacterianas, fazendo-se o diagnóstico laboratorial diferencial com o Haemophilus influenzae e Neisseria meningitidis em processos infecciosos conseqüentes a arranhadura ou mordida de animais e nas bacteremias ou septicemias em pacientes com hepatopatias crônicas ou em estados de imunodepressão.

  8. Cistinúria como causa de litíase renal bilateral em lactente

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    Cardoso, Rita; Moura, Márcio; Tapadinhas, Fernando; Simão, Carla; Mendes,Patrícia

    2014-01-01

    A litíase renal é pouco frequente em idade pediátrica e a sua manifestação clínica é variável. No entanto, é possível identificar em grande número destas crianças os factores precipitantes para formação de litíase, entre eles, causas metabólicas.Descreve-se o caso de um lactente de 5 meses, sexo masculino, que manifestou quadro de vómitos, recusa alimentar e presença de sangue na fralda. O exame citoquímico de urina revelou hematúria e o exame cultural foi negativo. A ecografia revelou litías...

  9. Doença da arranhadura do gato por Bartonella quintana em lactente: uma apresentação incomum

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    Azevedo Zina Maria Almeida de

    2000-01-01

    Full Text Available Relato de caso de doença da arranhadura do gato (DAG, em um paciente lactente, com história epidemiológica negativa, descrevendo o rastreamento diagnóstico, a imagem ao ultra-som, a evolução clínica e o prognóstico. B. quintana foi identificada em aspirado de secreção ganglionar pelo método de PCR. B. henselae, embora seja o agente causal habitualmente responsável pela DAG, não foi isolada. Os autores concluem que a pesquisa de B. quintana e B. henselae deve ser incluída na investigação de adenites, principalmente quando a evolução é subaguda, mesmo em lactentes e, ainda que a história epidemiológica seja negativa.

  10. Hiperoxalúria primária com insuficiência renal crônica terminal em lactente

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    Macedo Célia S.; Yoshida Eneida M.; Viero Rosa Marlene; Riyuzo Márcia C.; Bastos Herculano D.

    2002-01-01

    Objetivo: descrever caso clínico de um lactente com insuficiência renal crônica terminal, causada por hiperoxalúria primária.Método: após revisão da literatura, verifica-se a raridade da doença; na França, a prevalência é de 1,05/milhão, com taxa de incidência de 0,12/milhão/ano. Pesquisa abordando centros especializados mundiais detectou, em 1999, 78 casos em lactentes; destes, em 14% o quadro inicial foi de uremia. A gravidade e a raridade da doença sugerem o relato deste caso.Resultados: c...

  11. Anemia em lactentes de baixa renda em aleitamento materno exclusivo Anemia in low-income exclusively breastfed infants

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    Marco Antonio A. Torres

    2006-08-01

    Full Text Available OBJETIVO:Verificar o comportamento dos valores da hemoglobina e a prevalência de anemia entre lactentes de termo de 3 a 6 meses de idade em aleitamento materno exclusivo. MÉTODOS: Estudo transversal em 242 lactentes de 3 a 6 meses de idade com peso de nascimento superior a 2.500 g, em aleitamento materno exclusivo e em acompanhamento no Programa de Promoção do Crescimento e Desenvolvimento do Lactente do Programa Einstein na Comunidade de Paraisópolis. A dosagem de hemoglobina foi realizada por meio de punção digital entre o terceiro e o sexto meses de vida. Adotaram-se os valores de Hb OBJECTIVE: To verify the behavior of hemoglobin levels and anemia prevalence in full term infants, aged 3 to 6 months and on exclusive breastfeeding. METHODS: A cross-sectional study of 242 infants aged 3 to 6 months with birth weights of more than 2,500 g, on exclusive breastfeeding and monitored by the Program for the Promotion of Infant Growth and Development, part of the Paraisópolis Einstein Community Program. Hemoglobin was assayed by finger prick between the third and sixth months of life. Anemia was defined as Hb < 10.3 g/dL (Saarinen or Hb < 10 g/dL (Brault-Dubuc for infants aged 3 to 5 months and as Hb < 11.0 g/dL (WHO for infants aged 6 months. RESULTS: Mean hemoglobin concentration was 11.3 and 11.4 g/dL at 3 and 4 months and 11.2 and 11.1 g/dL at 5 and 6 months, respectively. The percentage of anemic infants varied depending on age and the cutoff adopted, being 11.8, 10.2 and 8.3% at 3, 4 and 5 months, respectively, according to the Brault-Dubuc criteria, and 20.6, 14.8 and 10.4% by the Saarinen criteria. Anemia prevalence at 6 months was 37.5%. CONCLUSIONS: Anemia prevalence rates observed among infants aged between 3 and 6 months varied from 8.3 to 37.5%, justifying increased attention on the part of pediatricians to the hemoglobin levels of infants who are on exclusive breastfeeding, come from low-income families and present risk factors

  12. Observação do desenvolvimento de linguagem e funções auditiva e visual em lactentes

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    Lima Maria Cecília Marconi Pinheiro

    2004-01-01

    Full Text Available OBJETIVO: Investigar o desenvolvimento da linguagem e das funções auditiva e visual em lactentes de creche, a partir da avaliação realizada por educadores. MÉTODOS: Foram avaliados 115 lactentes, nos anos de 1998 a 2001, usuários de uma creche da área da saúde de uma universidade do Estado de São Paulo. Foi utilizado o "Protocolo da Observação do Desenvolvimento de Linguagem e das Funções Auditiva e Visual", com 39 provas no total, para a avaliação dos lactentes de 3 até 12 meses de idade. A aplicação desse Protocolo foi feita pelas educadoras da creche, devidamente treinadas. Utilizou-se o teste de Qui-quadrado ou Exato de Fisher. O nível de significância adotado foi de 5%. RESULTADOS: Os lactentes apresentaram um padrão diferente no desenvolvimento da linguagem quanto ao início do balbucio e das primeiras palavras, bem como na função visual, quanto à imitação e uso de jogos gestuais e de seguir ordem com uso de gestos. CONCLUSÕES: O ambiente creche propicia condições para um outro padrão de desenvolvimento de linguagem e das funções auditiva e visual. Ações de prevenção na creche devem integrar as áreas de saúde e educação num objetivo comum.

  13. Observação do desenvolvimento de linguagem e funções auditiva e visual em lactentes

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    Maria Cecília Marconi Pinheiro Lima

    2004-02-01

    Full Text Available OBJETIVO: Investigar o desenvolvimento da linguagem e das funções auditiva e visual em lactentes de creche, a partir da avaliação realizada por educadores. MÉTODOS: Foram avaliados 115 lactentes, nos anos de 1998 a 2001, usuários de uma creche da área da saúde de uma universidade do Estado de São Paulo. Foi utilizado o "Protocolo da Observação do Desenvolvimento de Linguagem e das Funções Auditiva e Visual", com 39 provas no total, para a avaliação dos lactentes de 3 até 12 meses de idade. A aplicação desse Protocolo foi feita pelas educadoras da creche, devidamente treinadas. Utilizou-se o teste de Qui-quadrado ou Exato de Fisher. O nível de significância adotado foi de 5%. RESULTADOS: Os lactentes apresentaram um padrão diferente no desenvolvimento da linguagem quanto ao início do balbucio e das primeiras palavras, bem como na função visual, quanto à imitação e uso de jogos gestuais e de seguir ordem com uso de gestos. CONCLUSÕES: O ambiente creche propicia condições para um outro padrão de desenvolvimento de linguagem e das funções auditiva e visual. Ações de prevenção na creche devem integrar as áreas de saúde e educação num objetivo comum.

  14. Burkitt-like lymphoma in an infant: a case report Linfoma burkitt-like em um lactente: relato de caso

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    Claudete Esteves Klumb

    2003-01-01

    Full Text Available Childhood non-Hodgkin's lymphomas, including Burkitt and Burkitt-like, are rarely diagnosed in infants. A case of B-cell lymphoma in a 13-month-old girl with extensive abdominal disease, ascites, pleural effusion, and tumor lysis syndrome is reported. Phenotypic analysis showed a germinal center B-cell phenotype, and a B-cell clonality was confirmed by polymerase chain reaction. There was no evidence of Epstein-Barr and HIV infection. The case herein reported emphasizes the need for considering the diagnosis of lymphoma even in very young children.Os linfomas não Hodgkin da infância, incluindo os linfomas de Burkitt e Burkitt-like são raros em lactentes. Um caso de linfoma não Hodgkin B em uma lactente de 13 meses de idade é descrito. Ao diagnóstico a paciente apresentava extenso comprometimento abdominal associado à ascite, derrame pleural e síndrome de lise tumoral. A análise imunofenotípica mostrou um fenótipo compatível com células linfóides oriundas do centro germinativo e a origem clonal dessas células foi demonstrada por reação em cadeia da polimerase. Não foi demonstrada associação do linfoma com infecção pelo vírus Epstein-Barr e/ou virus da imunodeficiência adquirida. O caso apresentado enfatiza a necessidade de considerar o diagnóstico de linfoma mesmo em lactentes.

  15. Espectroscopia de luz próxima ao infravermelho e processamento sensorial auditivo em lactentes

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    Aline Almeida Fontes

    Full Text Available RESUMO Objetivo: revisar sistematicamente, por meio de busca nas plataformas Medline e Lilacs o uso da espectroscopia de luz próxima ao infravermelho (NIRS como instrumento para a avaliação da audição a nível cortical em lactentes. Métodos: foi realizada uma revisão integrativa baseada nos critérios estabelecidos pela Cochrane Handbook, passando pelas etapas de definição da questão norteadora (o tema a ser pesquisado, definição das bases de dados para localização dos estudos, seleção e análise crítica dos artigos. A pesquisa bibliográfica foi realizada no período de setembro a dezembro de 2014. Os critérios de inclusão utilizados foram: artigos publicados nos idiomas inglês, português e espanhol, com a população infantil (bebês de 0 a 24 meses e tipo de estudo (coorte, caso controle, transversal. Resultados: foram identificados 1674 artigos e 12 atenderam os critérios de inclusão deste estudo. Todos os artigos utilizaram o estímulo auditivo para medir alterações na hemodinâmica cerebral, porém com áreas cerebrais de interesse diferentes. E foram agrupados em três categorias quanto ao tipo de estímulo: apenas sons vocais, sons vocais e outros estímulos auditivos e sons não vocais. Conclusão: a NIRS é um instrumento eficaz para investigação da audição a nível cortical na população infantil.

  16. Fatores de risco associados à sibilância em lactentes

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    Lillian S.L. Moraes

    2013-12-01

    Full Text Available OBJETIVO: identificar possíveis fatores de risco associados à sibilância em lactentes (12 a 15 meses no estado de Mato Grosso, Brasil. MÉTODOS: estudo transversal, utilizando o questionário escrito padronizado do Estudio Internacional de Sibilancia en Lactantes (EISL - fase 3. Pais e/ou responsáveis pela criança foram entrevistados em Unidades Básicas de Saúde quando as procuravam para imunização de rotina ou durante visitas nos domicílios de crianças matriculadas nos programas de saúde da família, no período de agosto de 2009 a novembro de 2010. Fatores associados à sibilância foram avaliados utilizando análise bivariada e multivariada e expressos como odds ratio (OR e intervalo de confiança 95% (IC95%. RESULTADOS: ao todo, um mil e sessenta (n = 1.060 pais e/ou responsáveis responderam o questionário escrito. Os fatores de risco para sibilância foram: história familiar de asma [mãe (OR = 1,62; IC95%= 1,07-2,43; pai (OR = 1,98; IC95% = 1,22-3,23; irmãos (OR = 2,13; IC95% = 1,18-3,87]; história prévia de pneumonia (OR = 10,8; IC 95% = 4,52-25,77; ter mais de seis infecções de vias aéreas superiores (IVAS (OR = 2,95; IC95% = 2,11-4,14 e a primeira IVAS antes dos três meses de idade (OR = 1,50; IC95% = 1,04-2,17; residir em local com moderada poluição (OR = 1,59; IC95% = 1,08-2,33; uso de paracetamol por IVAS (OR = 2,13; IC95% = 1,54-2,95; e uso de antibiótico por infecção na pele (OR = 2,29; IC 95% = 1,18-4,46. CONCLUSÕES: o estudo dos fatores de risco para sibilância no primeiro ano de vida é importante para auxiliar na identificação, entre os lactentes sibilantes, aqueles de alto risco para desenvolver asma, e para o desenvolvimento de estratégias de prevenção por políticas pública de saúde visando minimizar a morbidade da sibilância na infância.

  17. AVE isquêmico pós-traumático em lactente

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    Izilda das Eiras Tamega

    2016-10-01

    Full Text Available Introdução: Acidentes vasculares encefálicos (AVEs em crianças são eventos raros, mas estão se tornando condições cada vez mais importantes devido à gravidade de suas complicações e inúmeras etiologias. A incidência de AVEs isquêmicos em crianças varia de 1,52 casos por 100.000 hab/ano, sendo a predominância masculina um dos primeiros achados epidemiológicos do International Pediatric Stroke Study. Os AVEs em crianças diferem daqueles em adultos em 3 aspectos: Objetivo: Relatar um caso de um lactente admitida no Conjunto Hospitalar de Sorocaba com AVE pós-trauma. Metodologia: As informações contidas nesse trabalho foram obtidas por meio de análise de prontuário e revisão de literatura. Relato de caso: M.R.S, masculino, 23 meses, encaminhado de Buri/SP com queixa de Hemiparesia à esquerda e desvio de rima labial à direita há 21 dias. A mãe contou que 30 dias antes do episódio de queda, causando um hematoma subgaleal em região frontal esquerda, sem perda da consciência. Refere um episódio de crise convulsiva há 20 dias, com agitação psicomotora. chegou a levar o filho no PA de Buri devido a convulsão, porém não foi investigada. Ao exame neurológico: força muscular preservada (grau 5 em membros superiores e inferiores, porém tem dificuldade em realizar os movimentos finos das mãos (“pinça digital”. No dia da internação no PS: MSE grau 1 e MIE grau 3 com desvio de rima labial à direita e Babinsk presente à esquerda. No CHS, realizou uma tomografia de crânio que mostrou um isquemia nucleocapsular moderada à direita. Paciente recebeu alta hospitalar com melhora parcial do quadro, AAS 100mg 1comprimido no almoço e encaminhamento para o ambulatório de neurologia infantil para acompanhamento. Conclusão: Um AVE isquêmico de etiologia pós-traumática ficou como sendo a causa mais provável do quadro do paciente. Pelos altos índices de recorrência dos AVE (33%, deve ser feito o acompanhamento no

  18. Consumo alimentar de lactentes com fenilcetonúria em uso de aleitamento materno

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    Jacqueline Siqueira Santos

    2011-12-01

    Full Text Available OBJETIVO: O objetivo deste estudo foi avaliar a ingestão de calorias, fenilalanina, tirosina e proteína de lactentes com fenilcetonúria em uso de aleitamento materno. MÉTODOS: Um grupo de 39 crianças, com até 6 meses de idade, que fazia uso de aleitamento materno (grupo amamentado foi comparado a um grupo-controle que fazia uso de fórmula especial com baixo teor de fenilanina, por meio de um estudo de coorte histórico concorrente. Os grupos foram pareados por sexo e duração da amamentação. Foram revistos 719 recordatórios alimentares de pacientes do grupo amamentado e 628 do grupo-controle. Foi realizada avaliação antropométrica no início e no final do estudo. A análise da ingestão de nutrientes foi feita com a utilização dos programas Minitab e LogXact 4.0, e a avaliação antropométrica foi feita com a utilização do programa Epi Info 6.0. RESULTADOS: O grupo amamentado apresentou ingestão adequada de fenilalanina e tirosina e maior adequação de ingestão proteica e energética. A maioria das crianças dos dois grupos apresentou escore-Z dentro dos limites normais (Z ³-2, com evolução favorável dos indicadores estudados (peso/idade, estatura/idade, peso/estatura e perímetro cefálico. CONCLUSÃO: O aleitamento materno na fenilcetonúria proporcionou ingestão adequada de calorias, fenilalanina, tirosina e proteína. A chance de uma criança do grupo amamentado possuir recordatórios de 24h adequados de ingestão energética foi 10,64 vezes maior que a chance de uma criança do grupo-controle. Em relação à ingestão proteica a chance foi 5,34 vezes maior. O crescimento foi similar nos dois grupos.

  19. Bronquiolite aguda por rinovírus em lactentes jovens Rhinovirus and acute bronchiolitis in young infants

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    Paulo M. C. Pitrez

    2005-10-01

    Full Text Available OBJETIVO: Determinar a prevalência de infecção por rinovírus em lactentes menores de 6 meses hospitalizados por bronquiolite aguda. MÉTODOS: Foram selecionados de forma prospectiva lactentes hospitalizados com diagnóstico de bronquiolite aguda, no Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, no período entre maio e setembro de 2002. Foi pesquisada a presença de vírus respiratórios no aspirado nasofaríngeo (ANF, através de imunofluorescência direta para vírus sincicial respiratório, parainfluenza, influenza e adenovírus. Para detecção do rinovírus, foi utilizada a reação de transcrição reversa, seguida de reação em cadeia da polimerase, específicas para picornavírus, seguidas de hibridização com sonda específica para rinovírus. RESULTADOS: Foram selecionados 45 lactentes hospitalizados com diagnóstico de bronquiolite aguda. A mediana da idade dos pacientes selecionados foi de 2 meses. Foram encontradas amostras positivas para vírus respiratórios em 35/45 (77,8% casos. Foi detectado mais de um vírus em 7/35 (20% amostras. Das amostras positivas, o vírus sincicial respiratório foi detectado em 33/35 (94% casos. O rinovírus foi detectado em 6/35 casos (17%. CONCLUSÕES: O rinovírus foi o segundo agente mais freqüentemente detectado em secreção nasal de lactentes jovens hospitalizados por bronquiolite aguda.OBJECTIVE: To determine the prevalence of rhinovirus infection in hospitalized young infants with acute bronchiolitis. METHODS: Hospitalized children with acute bronchiolitis admitted to the Hospital São Lucas/PUCRS between May and September 2002 were selected prospectively. Nasopharyngeal samples were assayed for respiratory syncytial virus, parainfluenza, influenza and adenovirus by immunofluorescence. For rhinovirus test a reverse transcription-polymerase chain reaction for picornavirus was used, followed by hybridization with rhinovirus specific probes. RESULTS

  20. Frequência de chiado, características clínicas e tratamento em lactentes

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    Maiara Lanna Bouzas

    2012-08-01

    Full Text Available OBJETIVO: Estimar a frequência de história pregressa de chiado, descrevendo as características clínicas e formas de tratamento utilizadas. MÉTODOS: Coorte retrospectiva incluindo lactentes (6-23 meses de vida com sintomas de infecção de vias aéreas superiores e relato de episódio prévio de chiado. Os dados foram registrados em questionário anteriormente validado. RESULTADOS: Dos 451 avaliados, 164 (36,4%; IC95% = 31,9-41,0 apresentaram história pregressa de chiado, 148 (32,8%; IC95% = 28,5-37,4 no primeiro ano de vida. A média de idade no primeiro episódio de chiado foi de 5,3±3,9 meses. Para quem começou a chiar no primeiro ano de vida, 38,5% referiram entre três e seis episódios e 14,2% > seis episódios. A média da idade no primeiro episódio foi menor para os que apresentaram > três episódios em comparação aos que apresentaram até dois episódios (3,2±2,7 versus 5,7±2,5 meses, p < 0,001. CONCLUSÃO: Um terço dos lactentes apresentou chiado no primeiro ano de vida. Quanto mais cedo ocorre o primeiro episódio, mais frequente é a recorrência do chiado.

  1. Alimentação complementar: práticas inadequadas em lactentes Complementary feeding: inappropriate practices in infants

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    Michelle Cavalcante Caetano

    2010-06-01

    Full Text Available OBJETIVO: Avaliar as práticas e o consumo alimentar de lactentes saudáveis de três metrópoles do Brasil. MÉTODOS: Por meio de estudo prospectivo, analisaram-se registros alimentares de 7 dias consecutivos de amostra intencional, por cotas e ponderada, das cidades de Curitiba, São Paulo e Recife, de 179 lactentes saudáveis, entre 4 e 12 meses, que não se encontravam em aleitamento materno (AM exclusivo. As mães receberam orientação verbal e escrita, por nutricionista, visando a uniformização da anotação do registro alimentar. Para o cálculo de ingestão, utilizou-se o Programa de Apoio à Nutrição (NutWin. RESULTADOS: A mediana de idade dos lactentes foi de 6,8 meses (4,0-12,6 meses. Observou-se que 50,3% já não recebiam AM. Destes, 12,0 e 6,7% dos menores e maiores de 6 meses, respectivamente, utilizavam fórmulas infantis em substituição ao leite materno. A maioria dos lactentes, portanto, recebia leite de vaca integral. A diluição da fórmula infantil foi correta em apenas 23,8 e 34,7% das crianças menores e maiores de 6 meses, respectivamente. Em relação à alimentação complementar, observou-se que a mediana de idade foi de 4 meses para sua introdução e de 5,5 meses para a alimentação da família. Verificou-se elevada inadequação quantitativa na ingestão de micronutrientes para lactentes de 6 a 12 meses que não recebiam AM, destacando-se as de zinco (75% e ferro (45%. CONCLUSÃO: O presente estudo mostrou elevada frequência de práticas e consumo alimentar inadequados em lactentes muito jovens. É possível que essas práticas levem a aumento no risco de desenvolvimento futuro de doenças crônicas.OBJECTIVE: To assess feeding practices and dietary intake of healthy infants in three Brazilian municipalities. METHODS: By means of a prospective study, we analyzed the food record of 7 consecutive days of an intentional sample (quota and weighted sampling of 179 healthy infants, aged between 4 and 12 months

  2. Bezafibrato em lactente portador de lipodistrofia generalizada congênita e hipertrigliceridemia grave

    OpenAIRE

    Araújo,Rogério Santiago; Ramos,André de Paula Silva; Borges,Máriton de Araújo Sousa

    2013-01-01

    Lipodistrofia congênita generalizada (CGL) com hipertrigliceridemia extrema desde o primeiro ano de vida está associada a piores riscos metabólicos. Foram utilizados dados contidos no prontuário do paciente, bem como revisão bibliográfica para composição do texto. Relatamos o caso de um lactente com fenótipo típico e hipertrigliceridemia de 1.360 mg/dL, que foi tratado com bezafibrato na dose de 30 a 60 mg/dia dos 11 meses aos 5 anos e 6 meses de idade, aferindo um nadir de triglicérides de 5...

  3. Efeito de supressão das emissões otoacústicas em lactentes termo e pré-termo

    OpenAIRE

    2016-01-01

    RESUMO Objetivo Verificar a ocorrência e a magnitude do efeito de supressão das emissões otoacústicas evocadas por estímulo transiente, em lactentes a termo e pré-termo, estabelecendo-se níveis de referência para utilização clínica. Método A amostra foi composta por 40 lactentes, de 5 dias a 4 meses de idade, sem risco para alteração neurológica e auditiva e com emissões otoacústicas presentes ao nascimento, sendo 20 nascidos a termo e 20 nascidos pré-termo que permaneceram mais de cinco di...

  4. Infecções por vírus respiratórios em lactentes com suspeita clínica de coqueluche

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    Angela E. Ferronato

    2013-12-01

    Full Text Available OBJETIVO: avaliar a frequência das infecções por vírus respiratórios em lactentes hospitalizados com suspeita clínica de coqueluche e analisar suas características admissionais e evolutivas. MÉODOS: foi realizado um estudo de coorte histórica, em um serviço sentinela para coqueluche, no qual a pesquisa de vírus respiratórios também foi rotineira para os lactentes hospitalizados com problemas respiratórios. Foram incluídos todos os lactentes submetidos à notificação compulsória de suspeita de coqueluche. Foram realizadas pesquisas para Bordetela pertussis - BP (PCR/cultura e vírus respiratórios - VR (imunofluorescência. Foram excluídos os pacientes que haviam recebido macrolídeos previamente à internação. Os dados clínicos foram obtidos dos prontuários. RESULTADOS: dentre os 67 pacientes analisados, a pesquisa para BP foi positiva em 44% e para VR em 26%. Não houve identificação etiológica em 35% e em 5% houve codetecção de VR e BP. Todos os pacientes apresentaram características demográficas semelhantes. A presença de tosse seguida de guincho inspiratório ou cianose foi um forte preditor de coqueluche, assim como, leucocitose e linfocitose evidentes. Coriza e dispneia foram mais frequentes nas infecções virais. Houve suspensão do uso de macrolídeos em 40% dos pacientes com pesquisa positiva para VR e negativa para BP. CONCLUSÃO: os resultados sugerem que lactentes hospitalizados com suspeita de coqueluche podem apresentar infecção viral e a pesquisa etiológica pode possibilitar a redução do uso de macrolídeos em alguns casos. No entanto, salienta-se que o diagnóstico etiológico de infecção por vírus respiratórios, por si só, não exclui a possibilidade de infecção por Bordetella pertussis.

  5. Auditory evoked potentials in premature and full-term infants Potenciais evocados auditivos em lactentes pré-termo e a termo

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    Maria Angélica de Almeida Porto

    2011-10-01

    Full Text Available Accurate information about type, degree, and configuration of hearing loss are necessary for successful audiological early interventions. Auditory brainstem response with tone burst stimuli (TB ABR and auditory steady-state response (ASSR exams provide this information. AIM: To analyze the clinical applicability of TB ABR and ASSR at 2 kHz in infants, comparing responses in full-term and premature neonates. MATERIAL AND METHOD: The study was cross-sectional, clinical and experimental. Subjects consisted of 17 premature infants and 19 full-term infants. TB ABR and ASSR exams at 2000 Hz were done during natural sleep. RESULTS: The electrophysiological minimum response obtained with TB ABR was 32.4 dBnHL (52.4 dBSPL; the ASSR minimum was 13.8 dBHL (26.4 dBSPL. The exams required 21.1 min and 22 min, respectively. Premature and full-term infant responses showed no statistically significant differences, except for auditory steady-state response duration. CONCLUSIONS: Both exams have clinical applicability at 2 kHz in infants, with 20 min of duration, on average. In general, there are no differences between premature and full-term individuals.O sucesso de uma intervenção audiológica precoce depende de informações precisas quanto ao tipo, grau e configuração da perda auditiva. O potencial evocado auditivo de tronco encefálico com o estímulo tone burst (PEATE TB e a resposta auditiva de estado estável (RAEE proporcionam tais informações. OBJETIVO: Investigar a aplicabilidade clínica, em lactentes, do PEATE TB e da RAEE na frequência de 2 kHz, comparando as respostas dos lactentes nascidos a termo e prétermo. MATERIAL E MÉTODO: O estudo (transversal, clínico e experimental foi realizado com uma casuística de 17 lactentes pré-termo e 19 a termo submetidos ao PEATE TB e RAEE em 2000 Hz. RESULTADOS: A resposta eletrofisiológica mínima obtida com o PEATE TB foi de 32,4 dBnNA (52,4 dBNPS e com a RAEE de 13,8 dBNA (26,4 dBNPS, com dura

  6. Novo método de dosagem de soros antipeçonhentos em camundongos lactentes: I - dosagem do soro anticrotálico

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    Bruno Soerensen

    1984-08-01

    Full Text Available A atividade biológica dos soros antipeçonhentos pode ser determinada "in vivo" em pombos, coelhos, cobaios e camundongos adultos, não existindo, entretanto, nenhum método que possa ser recomendado internacionalmente. Estudou-se comparativamente aos métodos tradicionais de dosagem de soros em pombos e camundongos adultos, a validade do uso de camundongos lactentes de 6 a 7 dias, pesando 4 a 5g, inoculados pela via subcutânea. Inicialmente foi determinada a toxidez do veneno de Crotalus durissus terríficus através do estudo da sintomatologia do envenenamento e da atividade letal. O estudo comparativo dos três métodos forneceu maior concordância de resultados em DE100 entre as dosagens realizadas com camundongos lactentes e adultos. A DE100 e DL50 determinadas em camundongos lactentes forneceu resultados mais constantes que os dos métodos de camundongos adultos e pombos. O uso deste novo método permite eliminar a dificuldade de obtenção do atual animal de prova; a utilização de um maior número de animais por ponto de avaliação biológica, possibilitando uma maior precisão e conseguindo-se uma uniformidade nas características exigidas neste tipo de dosagem como peso, idade e linhagem, visando a reprodução sistemática dos resultados.

  7. Prevalência de sibilância recorrente em lactentes Prevalence of recurrent wheezing in infants

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    Herberto José Chong Neto

    2007-08-01

    Full Text Available OBJETIVO: Verificar a prevalência da sibilância recorrente em lactentes na cidade de Curitiba (PR. MÉTODOS: Estudo transversal pela aplicação de questionários aos pais de lactentes, idade entre 12 e 15 meses, que procuraram unidades de saúde para imunização no período entre agosto de 2005 e dezembro de 2006. Este instrumento padronizado e validado consiste de perguntas sobre características demográficas, sibilância, infecções respiratórias e fatores de risco. Durante o período de estudo, a Secretaria Municipal de Saúde possuía 107 unidades de saúde, das quais 35 foram selecionadas por sorteio e distribuídas homogeneamente no território municipal. RESULTADOS: Um total de 1.364 lactentes (45,4% apresentou um ou mais episódios de sibilância nos primeiros 12 meses de vida, com início aos 5,5±3,1 meses (média ± desvio padrão, e 678 (22,6% tiveram três ou mais episódios. Utilizaram β2-agonistas, corticóides inalatórios, corticóides orais e antagonistas do receptor de leucotrienos 84,6, 18,5, 24,3 e 5,4% dos sibilantes, respectivamente. Sintomas noturnos, dificuldade intensa para respirar e visitas a emergência estiveram presente em 58,9, 46,2 e 57,6% dos lactentes que sibilaram; destes, 12,7% foram hospitalizados por asma e 10,9% tiveram diagnóstico médico de asma. Sintomas noturnos, visitas à emergência, gravidade dos sintomas, hospitalização por asma e diagnóstico médico de asma foram mais freqüentes entre os que apresentaram três ou mais crises (p OBJECTIVE: To identify the prevalence of recurrent wheezing in infants in the city of Curitiba, PR, Brazil. METHODS: A cross-sectional study carried out by means of administering questionnaires to the parents of infants aged 12 to 15 months attending health centers for immunization during the period between August 2005 and December 2006. This is a standardized and validated instrument consisting of questions on demographic characteristics, wheezing

  8. Aspectos clínicos e laboratoriais de meningite piogênica em lactentes Clinical and laboratorial aspects of acute bacterial meningitis in infants

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    Rita Lucena

    2002-06-01

    Full Text Available OBJETIVO: descrever as características clínicas e laboratoriais da meningite piogênica em lactentes. MÉTODO: informações obtidas a partir do acompanhamento prospectivo dos lactentes com meningite piogênica, admitidos no Hospital Couto Maia no período de março a dezembro de 1997, foram inseridas em um banco de dados e analisadas com auxílio de programas estatísticos. RESULTADOS: meningite piogênica foi mais prevalente em lactentes com idade entre 6 meses e 1 ano, sendo o agente etiológico mais freqüente o Haemophilus influenzae. A letalidade global foi de 25,9% e, entre os sobreviventes, 39,3% deixaram o hospital apresentando alguma anormalidade compatível com envolvimento encefálico ao exame neurológico. CONCLUSÃO: meningite piogênica em lactentes se constitui em enfermidade com taxa de letalidade elevada, sendo, na maioria dos casos, passível de prevenção. Consideramos de grande relevância a adoção de medidas profiláticas de saúde visando redução da incidência desta enfermidade.OBJECTIVE: to describe clinical and laboratorial characteristics of acute bacterial meningitis in infants. METHOD: data from the prospective follow-up of infants with acute bacterial meningitis, admitted at the Hospital Couto Maia between March and December 1997, were analyzed with specific statistical software. RESULTS: acute bacterial meningitis was more prevalent in infants with ages varying from 6 months to 1 year. The most frequent etiologic agent was Haemophilus influenzae. The global lethality was 25.9% and among the survivors 39.3% left the hospital with some abnormality in the neurological exam compatible with the brain involvement. CONCLUSION: acute bacterial meningitis in infants is a high lethality disease that in the majority of cases can be prevented. We consider of great relevance the adoption of health prevention strategies in order to reduce the incidence of this disease.

  9. Avaliação do comportamento auditivo e neuropsicomotor em lactentes de baixo peso ao nascimento Assessment of auditory behaviour and neuropsychomotor development of low weight infants

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    I. Lichtig

    2001-03-01

    Full Text Available OBJETIVOS E MÉTODOS: Este estudo teve como objetivos detectar a presença de deficiência auditiva (DA de moderada a profunda em 60 lactentes de baixo peso ao nascimento, e na ausência desta, acompanhar o desenvolvimento da função auditiva (localização da fonte sonora, e acompanhar o desenvolvimento neuropsicomotor destas crianças durante os dois primeiros anos de vida, através da avaliação comportamental da audição (Hear Kit, Downs - 1984, avaliação clínica do desenvolvimento neuropsicomotor e ultra-sonografia de crânio. RESULTADOS: Os resultados obtidos mostraram que dos 60 lactentes, em um caso foi levantada a hipótese de DA e em nove crianças foi verificado atraso no desenvolvimento neuropsicomotor. Na análise transversal dos dados obtidos da avaliação auditiva, verificou-se que o comportamento auditivo dos lactentes apresentou respostas diferentes do que aquelas citadas na literatura americana. CONCLUSÃO: Concluiu-se que 5% dos lactentes apresentaram atraso na localização auditiva da fonte sonora e que os atendimentos médico e fonoaudiológico precoces, no berçário e ambulatório, nos dois primeiros anos de vida destas crianças de alto - risco são necessários.PURPOSES AND METHODS: The aims of this study were: to detect moderate to profound hearing loss in high risk infants for deafness, to follow up their auditory development (localization of the sound source- Hear Kit - Downs, 1984; and their neuropsychomotor development during the two first years of life. All subjects were submitted to cerebral ultra sound assessment. RESULTS: An infant with a suspected hearing loss was identified and nine infants presented neuropsychomotor development delay. In a transversal analysis of the hearing assessment data it was verified that infants in this study presented different response than the referred in the American literature. CONCLUSIONS: It was concluded that 5% of the infants were delayed in localizing the sound source

  10. Anestesia venosa total (AVT) em lactente com doença de Werdnig-Hoffmann: relato de caso

    OpenAIRE

    Marco Antonio Cardoso de Resende; Elizabeth Vaz da Silva; Osvaldo José Moreira Nascimento; Alberto Esteves Gemal; Giseli Quintanilha; Eliana Maria Vasconcelos

    2010-01-01

    JUSTIFICATIVA E OBJETIVOS: A doença de Werdnig-Hoffmann é a causa mais comum de hipotonia no lactente e quando presente logo após o nascimento tem pior prognóstico. Fraqueza muscular simétrica, arreflexia e fasciculações da língua são característicos. A maioria dos lactentes morre antes dos dois anos por insuficiência respiratória. O presente relato apresenta um caso com técnica venosa total durante anestesia. RELATO DO CASO: Paciente feminina, branca, um ano, 10 kg, estado físico ASA III, co...

  11. Prevenção da anemia ferropriva em lactentes da Zona da Mata Meridional de Pernambuco

    OpenAIRE

    de Lourdes Perez Diaz Teixeira, Maria

    2007-01-01

    Esta tese é apresentada sob a forma de um artigo de revisão da literatura e dois artigos originais. A revisão da literatura discorre sobre a importância da deficiência de ferro e a anemia dela decorrente para os lactentes, bem como das estratégias preventivas que têm sido preconizadas. O primeiro artigo original aborda o papel da alimentação, mais especificamente do aleitamento materno exclusivo, na prevenção da anemia no lactente. Aborda ainda a relação entre a anemia materna ...

  12. Candida spp. occurrence in oral cavities of breastfeeding infants and in their mothers' mouths and breasts Presença de Candida spp. em boca de lactentes em aleitamento materno e em bocas e mamas de suas nutrizes

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    Maria Stella Amorim da Costa Zöllner

    2003-06-01

    Full Text Available This study aimed to determine the occurrence of Candida spp. in the oral cavity of predominantly breastfed infants and in their mothers' mouths and breasts, as well as in the oral cavity of bottlefed infants and in non-lactating women. One hundred and sixty nine women and eighty-five milk-fed infants took part in this study and were divided into four groups: 1 infants predominantly on breastfeeding (n = 55 and their mothers (n = 55; 2 infants on bottlefeeding (n = 30; 3 non-lactating women on whom oral collections were performed (n = 80 and, 4 non-lactating women on whom breast collections were performed (n = 34. Oral and mammary swabs were cultured on Sabouraud agar dextrose with chloramphenicol. The Candida yeast strains found were isolated and identified through morphological and biochemical tests. Candida species were much less frequent in infants who were predominantly breastfed than in those who were bottlefed. Yeasts were much more frequent on the breasts of lactating women, with statistical difference in relation to the control group.O objetivo do estudo foi verificar a presença de leveduras do gênero Candida na cavidade bucal de lactentes em aleitamento materno predominante e nas bocas e mamas de suas mães, assim como na cavidade bucal de lactentes em aleitamento artificial e em mulheres na ausência de lactação. Participaram do estudo 169 mulheres e 85 lactentes divididos em quatro grupos: 1 crianças em aleitamento natural predominante (n = 55 e suas mães (n = 55; 2 crianças em aleitamento artificial (n = 30; 3 mulheres que não estavam amamentando, em que se realizaram coletas bucais (n = 80 e, 4 mulheres em ausência de lactação em que se realizaram coletas mamárias (n = 34. "Swabs" bucais e mamários, foram semeados em ágar Sabouraud dextrose com cloranfenicol, e as cepas de levedura isoladas foram identificadas utilizando-se provas morfológicas e bioquímicas. Espécies de Candida foram detectadas a partir de um n

  13. Gravidade das coinfecções virais em lactentes hospitalizados com infecção por vírus sincicial respiratório

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    Milena De Paulis

    2011-08-01

    Full Text Available OBJETIVO: Comparar a gravidade de infecções causadas por um único vírus (VSR com a gravidade de coinfecções. MÉTODOS: Este estudo avaliou uma coorte histórica de lactentes com infecção aguda por VSR. Secreção de nasofaringe foi coletada de todos os pacientes rotineiramente para pesquisa viral usando técnicas de biologia molecular. Os seguintes desfechos foram analisados: tempo total de internação, duração da oxigenioterapia, admissão em unidade de terapia intensiva e uso de ventilação mecânica. Os resultados foram ajustados para os fatores confundidores (prematuridade, idade e aleitamento materno. RESULTADOS: Foram incluídos no estudo 176 lactentes com idade média de 4,5 meses e diagnósticos de bronquiolite e/ou pneumonia. Cento e vinte e um tinham infecção única por VSR, e 55 tinham coinfecções (24 VSR + adenovírus, 16 VSR + metapneumovírus humano e 15 outras associações menos frequentes. Os quatro desfechos de gravidade avaliados foram semelhantes entre o grupo com infecção única por VSR e os grupos com coinfecções, independente do tipo de vírus associado com o VSR. CONCLUSÃO: As coinfecções virais não parecem alterar o prognóstico de lactentes hospitalizados com infecção aguda por VSR.

  14. Leucemia linfoblástica aguda em lactentes: 20 anos de experiência

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    Amanda Ibagy

    2013-02-01

    Full Text Available OBJETIVO: Analisar pacientes com menos de dois anos de idade com leucemia linfoblástica aguda atendidos no período de 1990 a 2010, em um centro de referência estadual. MÉTODOS: Estudo clínico, epidemiológico, transversal, descritivo e observacional. Pacientes incluídos tinham menos de dois anos de idade, com leucemia linfoblástica aguda, tratados no período de 1990 a 2010 na unidade de oncologia pediátrica de um centro de referência estadual, totalizando 41 casos. RESULTADOS: Todos os pacientes eram Caucasianos e 60,9% eram do sexo feminino. Com relação à idade, 24,38% tinham menos de seis meses, 17,07% tinham entre seis meses e um ano e 58,53% mais do que um ano de idade. A idade de seis meses foi estatisticamente significante para o desfecho de óbito. Os sinais e sintomas predominantes foram febre, hematomas e petéquias. Uma contagem de leucócitos superior a 100.000 foi observada em 34,14% dos casos; hemoglobina inferior a 11 em 95,13% e contagem de plaquetas inferior a 100.000, em 75,61% dos casos. Infiltração do sistema nervoso central estava presente em 12,91% dos pacientes. Em relação à linhagem, a linhagem B predominou (73%, mas a linhagem de células T foi estatisticamente significativa para o óbito. Trinta e nove por cento dos pacientes tiveram recorrência da doença. Em relação ao estado vital, 70,73% dos pacientes morreram, sendo choque séptico a principal causa. CONCLUSÕES: leucemia linfoblástica aguda em crianças tem uma alta taxa de mortalidade, principalmente em crianças menores de um ano e linhagem derivada de células T.

  15. Validade concorrente e confiabilidade da Alberta Infant Motor Scale em lactentes nascidos prematuros Concurrent validity and reliability of the Alberta Infant Motor Scale in premature infants

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    Kênnea Martins Almeida

    2008-10-01

    Full Text Available OBJETIVO: Verificar a validade concorrente e a confiabilidade interobservador da Alberta Infant Motor Scale (AIMS em lactentes prematuros acompanhados no ambulatório de seguimento do Instituto Fernandes Figueira, Fundação Oswaldo Cruz (IFF/Fiocruz. MÉTODOS: Foram avaliados 88 lactentes nascidos prematuros no ambulatório de seguimento do IFF/Fiocruz entre fevereiro e dezembro de 2006. No estudo de validade concorrente, 46 lactentes com 6 (n = 26 ou 12 (n = 20 meses de idade corrigida foram avaliados pela AIMS e pela escala motora da Bayley Scales of Infant Development, 2ª edição, por dois observadores diferentes, utilizando-se o coeficiente de correlação de Pearson para análise dos resultados. No estudo de confiabilidade, 42 lactentes entre 0 e 18 meses foram avaliados pela AIMS por dois observadores diferentes, utilizando-se o intraclass correlation coefficient (ICC para análise dos resultados. RESULTADOS: No estudo de validade concorrente, a correlação encontrada entre as duas escalas foi alta (r = 0,95 e estatisticamente significativa (p OBJECTIVE: To verify the concurrent validity and interobserver reliability of the Alberta Infant Motor Scale (AIMS in premature infants followed-up at the outpatient clinic of Instituto Fernandes Figueira, Fundação Oswaldo Cruz (IFF/Fiocruz, in Rio de Janeiro, Brazil. METHODS: A total of 88 premature infants were enrolled at the follow-up clinic at IFF/Fiocruz, between February and December of 2006. For the concurrent validity study, 46 infants were assessed at either 6 (n = 26 or 12 (n = 20 months' corrected age using the AIMS and the second edition of the Bayley Scales of Infant Development, by two different observers, and applying Pearson's correlation coefficient to analyze the results. For the reliability study, 42 infants between 0 and 18 months were assessed using the Alberta Infant Motor Scale, by two different observers and the results analyzed using the intraclass correlation

  16. Chlamydia trachomatis: um importante agente de infecções respiratórias em lactentes de famílias de baixa renda

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    Edna Lucia Souza

    2012-10-01

    Full Text Available OBJETIVOS: Determinar a prevalência de infecção do trato respiratório inferior (ITRI por Chlamydia trachomatis em lactentes internados e descrever as características clínicas, laboratoriais e radiológicas da doença. MÉTODOS: Este foi um estudo do tipo corte transversal, realizado durante um período de 12 meses. Foram incluídos todos os lactentes de até 6 meses internados consecutivamente no Centro Pediátrico Professor Hosannah de Oliveira da Universidade Federal da Bahia, em Salvador, BA, com diagnóstico clínico ou clínico-radiológico de ITRI. O diagnóstico de infecção por C. trachomatis foi realizado através da pesquisa de anticorpos da classe IgM, utilizando-se o ensaio imunoenzimático (ELISA. A prevalência de ITRI por C. trachomatis foi determinada, e foram calculadas as razões de prevalência para essa infecção e variáveis clínicas e laboratoriais. RESULTADOS: Cento e cinquenta e um lactentes realizaram sorologia para C. trachomatis, das quais 15 (9,9% foram positivas. A infecção por C. trachomatis ocorreu unicamente entre os menores de 5 meses, principalmente naqueles menores de 2 meses. Três crianças com infecção por C. trachomatis nasceram de parto cesáreo. Conjuntivite e eosinofilia ocorreram em 33,3% dos casos. As radiografias de tórax se mostraram alteradas em 92% dos casos. Demonstrou-se associação da infecção por C. trachomatis com duração de internação superior a 15 dias (p = 0,0398 e com oxigenoterapia (p = 0,0484. CONCLUSÕES: Houve alta prevalência de ITRI por C. trachomatis na população estudada. A infecção por esta bactéria foi associada a uma forma mais grave da doença, demonstrando a importância de se investigar essa infecção na gestante de forma a evitar o adoecimento de recém-nascidos.

  17. Estado nutricional de lactentes em áreas periféricas de Fortaleza

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    Nadia Tavares SOARES

    2000-08-01

    Full Text Available O presente estudo foi realizado com a finalidade de caracterizar a prevalência da má nutrição entre crianças menores de um ano vinculadas ao Fundo Cristão para Crianças em dois bairros periféricos de Fortaleza: Presidente Kennedy e Álvaro Weine. Desnutrição protéico-energética, obesidade e anemia ferropriva foram diagnosticadas através dos seguintes indicadores: peso ao nascer +2 desvios-padrão da mediana de referência do National Center for Health Statistics, hemoglobina < 11 g/dl, hematócrito < 32%, volume corpuscular médio <72 fl e hemoglobina corpuscular média < 24 pg. O peso ao nascer foi obtido através da entrevista domiciliar, enquanto que as demais medidas antropométricas e as amostras de sangue foram colhidas em uma das unidades do Fundo Cristão para Crianças, seguindo os procedimentos técnicos recomendados. Das 110 crianças catalogadas, 96 foram pesadas e medidas e 75 fizeram o exame de sangue. A análise dos dados revelou 7% de baixo peso ao nascer, 10% de desnutrição crônica, 8% de obesidade e 60% de anemia. Possivelmente, a dieta que as crianças receberam contribuiu para o comprometimento nutricional encontrado. Parece essencial a realização de mais estudos sobre prática alimentar nestas comunidades.

  18. Estado nutricional de lactentes em áreas periféricas de Fortaleza

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    SOARES Nadia Tavares

    2000-01-01

    Full Text Available O presente estudo foi realizado com a finalidade de caracterizar a prevalência da má nutrição entre crianças menores de um ano vinculadas ao Fundo Cristão para Crianças em dois bairros periféricos de Fortaleza: Presidente Kennedy e Álvaro Weine. Desnutrição protéico-energética, obesidade e anemia ferropriva foram diagnosticadas através dos seguintes indicadores: peso ao nascer +2 desvios-padrão da mediana de referência do National Center for Health Statistics, hemoglobina < 11 g/dl, hematócrito < 32%, volume corpuscular médio <72 fl e hemoglobina corpuscular média < 24 pg. O peso ao nascer foi obtido através da entrevista domiciliar, enquanto que as demais medidas antropométricas e as amostras de sangue foram colhidas em uma das unidades do Fundo Cristão para Crianças, seguindo os procedimentos técnicos recomendados. Das 110 crianças catalogadas, 96 foram pesadas e medidas e 75 fizeram o exame de sangue. A análise dos dados revelou 7% de baixo peso ao nascer, 10% de desnutrição crônica, 8% de obesidade e 60% de anemia. Possivelmente, a dieta que as crianças receberam contribuiu para o comprometimento nutricional encontrado. Parece essencial a realização de mais estudos sobre prática alimentar nestas comunidades.

  19. Glicerina bruta no suplemento para cordeiros lactentes em pastejo de azevém Crude glycerin in supplement to suckling lambs on ryegrass pasture

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    Ana Carolina Ribeiro Sanquetta de Pellegrin

    2012-08-01

    Full Text Available Avaliou-se o efeito de níveis de glicerina bruta sobre o consumo de suplemento e o desempenho de cordeiros lactentes mantidos a pasto, além das características quali-quantitativas do pasto de azevém. Foram utilizados 32 cordeiros lactentes distribuídos nos tratamentos: 0, 10, 20 e 30% de glicerina bruta, em substituição ao milho, no suplemento isoproteico (18% PB fornecido diariamente em quantidade equivalente a 2% do peso corporal. Não houve efeito (P>0,05 dos níveis de glicerina bruta sobre as características qualitativas e quantitativas do pasto, na composição de proteína bruta e fibra detergente neutro e na carga animal suportada pela pastagem, nem no consumo de suplemento, ganho de peso médio diário e o número de dias até o abate dos cordeiros. Níveis de até 30% de glicerina bruta, em substituição ao milho, no suplemento fornecido para cordeiros lactentes pastejando azevém não comprometem o consumo de suplemento, desempenho e período de terminação dos animais.The aim of this study was to evaluate the effect of levels of crude glycerin in the supplement intake and performance of suckling lambs on ryegrass pasture, beyond the qualitative and quantitative characteristics of ryegrass pastures. It was used 32 suckling lambs distributed between the treatments: 0, 10, 20 and 30% of crude glycerin, replacing corn, in the isoproteic supplement (18% CP offered daily in an amount equivalent to 2% of body weight. There was no effect (P>0.05 of the levels of crude glycerin on the qualitative and quantitative characteristics of pastures, composition of crude protein and neutral detergent fiber, stocking rate supported by ryegrass pasture, neither on supplement intake, average weight gain and number of days to slaughter the lambs. Levels up to 30% of crude glycerin, replacing corn, provided in the supplement to suckling lambs grazing ryegrass didn't compromise the supplement intake, performance and termination period of the

  20. Preferência podal em lactentes com síndrome de Down: fatores extrínsecos e intrínsecos Foot preference in infants with Down syndrome: extrinsic and intrinsic factors

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    Gabriela Lopes dos Santos

    2012-06-01

    Full Text Available Durante o processo de aquisição do chute em lactentes, a preferência podal pode ser influenciada de forma diferente pelos fatores extrínsecos e intrínsecos. O objetivo foi comparar a preferência podal e verificar a influência do peso adicional e do Reflexo Tônico Cervical Assimétrico (RTCA na preferência podal entre lactentes com síndrome de Down e típicos. Participaram do estudo cinco lactentes com síndrome de Down e cinco típicos aos três e quatro meses de idade. O experimento foi subdividido em quatro condições experimentais: Treinamento, Linha de Base, Peso e Pós-Peso. Os lactentes com síndrome de Down apresentaram preferência à esquerda ou indefinida e os típicos, preferência à direita. O RTCA influenciou na preferência podal em ambos os grupos, indicando que o lado de rotação da cabeça orientou o chute do mesmo lado. Nos lactentes com síndrome de Down a correlação entre RTCA e chutes foi positiva, sendo forte aos três meses e moderada aos quatro meses. Para os lactentes típicos foi observada correlação positiva fraca aos três meses, e aos quatro meses a correlação não foi estatisticamente significativa. Lactentes com síndrome de Down apresentam preferência podal contrária aos lactentes típicos. O RTCA exerce influência na preferência podal por um período mais longo em lactentes com síndrome de Down em comparação aos lactentes típicos.During the acquisition process of the kick in infants, foot preference may be influenced differently by extrinsic and intrinsic factors. The aim was to compare the foot preference and find the influence of additional weight and Asymmetrical Neck Tonic Reflex (ANTR on the foot preference of infants with Down syndrome and typical ones. Five infants with Down syndrome and five typical infants at three and four months of age participated of the sudy. The experiment was divided into four experimental conditions: Training, Baseline, Weight and After Weight. Infants

  1. Incidência da síndrome da morte súbita em coorte de lactentes The incidence of sudden death syndrome in a cohort of infants

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    Lorena T. C. Geib

    2006-02-01

    Full Text Available OBJETIVOS: Quantificar a incidência de síndrome da morte súbita do lactente no município de Passo Fundo (RS e descrever o perfil dos óbitos. MÉTODOS: Coorte de base populacional, de nascidos vivos no período de fevereiro de 2003 a janeiro de 2004, domiciliados na zona urbana. Excluíram-se lactentes hospitalizados desde o nascimento, crianças em processo de adoção e óbitos ocorridos antes da coleta de dados. Dos 2.634 nascidos vivos, foram incluídas 2.411 crianças, acompanhando-se 2.285 (94,8%. Os dados foram coletados no Sistema de Informações sobre Nascidos Vivos, declarações de óbito, registros do comitê de mortalidade infantil e mediante entrevistas domiciliares com a mãe social. Os instrumentos foram adaptados de formulários validados previamente. Os dados foram analisados no Epi-Info, com estatística descritiva. RESULTADOS: Foram registrados 10 óbitos (0,4%. Quatro de causa indeterminada puderam ser incluídos na categoria III de síndrome da morte súbita do lactente. Ocorreram entre os 2 e 5 meses, no domicílio, em crianças que dormiam na posição lateral, em cama com adultos, utilizando colchão macio, travesseiro e fralda sobre a face. Eram filhos de mãe jovens, fumantes, pré-natal incompleto, multíparas e de classes econômicas desfavorecidas. A incidência de suspeita dessa síndrome foi de 1,75/1.000. CONCLUSÃO: A taxa de incidência de suspeita de síndrome da morte súbita do lactente em Passo Fundo é compatível com os maiores coeficientes internacionais, sugerindo medidas de vigilância e prevenção de riscos.OBJECTIVES: To quantify the incidence of sudden infant death syndrome in the town of Passo Fundo, in Rio Grande do Sul, Brazil, and to describe the profile of the deaths observed. METHODS: A population-based cohort study of the live births from February 2003 to January 2004 to parents resident in the urban area. Infants were excluded if they had been hospitalized since birth, were in the

  2. Risk factors for sudden infant death syndrome in a developing country Fatores de risco para síndrome da morte súbita do lactente em um país em desenvolvimento

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    Ana Paula Silveira Pinho

    2008-06-01

    Full Text Available OBJECTIVE: To analyze whether previously identified risk factors for sudden death syndrome have a significant impact in a developing country. METHODS: Retrospective longitudinal case-control study carried out in Porto Alegre, Southern Brazil. Cases (N=39 were infants born between 1996 and 2000 who died suddenly and unexpectedly at home during sleep and were diagnosed with sudden death syndrome. Controls (N=117 were infants matched by age and sex who died in hospitals due to other conditions. Data were collected from postmortem examination records and questionnaires answers. A conditional logistic model was used to identify factors associated with the outcome. RESULTS: Mean age at death of cases was 3.2 months. The frequencies of infants regarding gestational age, breastfeeding and regular medical visits were similar in both groups. Sleeping position for most cases and controls was the lateral one. Supine sleeping position was found for few infants in both groups. Maternal variables, age below 20 years (OR=2, 95% CI: 1.1; 5.1 and smoking of more than 10 cigarettes per day during pregnancy (OR=3, 95% CI: 1.3; 6.4, significantly increased the risk for the syndrome. Socioeconomic characteristics were similar in both groups and did not affect risk. CONCLUSIONS: Infant-maternal and socioeconomic profiles of cases in a developing country closely resembled the profile described in the literature, and risk factors were similar as well. However, individual characteristics were identified as risks in the population studied, such as smoking during pregnancy and maternal age below 20 years.OBJETIVO: Analisar se fatores de risco previamente identificados para a síndrome da morte súbita do lactente têm impacto significativo em um país em desenvolvimento. MÉTODOS: Estudo retrospectivo, longitudinal, de caso-controle pareado realizado em Porto Alegre, RS. Os casos (N=39 foram lactentes nascidos entre 1996 e 2000 que morreram subitamente e inesperadamente em

  3. Relato de um caso de neutropenia congênita grave em um lactente jovem A case report of severe congenital neutropenia in a young infant

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    Lucas Fadel M. dos Santos

    2011-12-01

    Full Text Available OBJETIVO: Relatar um caso de neutropenia congênita grave e alertar os pediatras sobre tal diagnóstico em pacientes jovens, com infecções recorrentes. DESCRIÇÃO DO CASO: Lactente jovem com 45 dias de vida, com história de febre alta, letargia, recusa alimentar e hemogramas repetidos com leucopenia importante à custa de polimorfonucleares. A hipótese diagnóstica foi confirmada pelo aspirado de medula óssea, que mostrou hipoplasia de série granulocítica e completa ausência de neutrófilos maduros. Foi introduzida antibioticoterapia de largo espectro e estimulador da formação de colônias de granulócitos. O paciente evoluiu para óbito em decorrência de complicações infecciosas após 21 dias de internação. COMENTÁRIOS: Trata-se de um lactente jovem, portador de uma rara desordem congênita que leva à intensa neutropenia, deixando-o vulnerável a infecções graves e potencialmente fatais. À internação, o paciente apresentava sinais e sintomas sugestivos de sepse, sendo introduzido antibioticoterapia de amplo espectro, necessária por se tratar de lactente jovem, neutropênico e febril. A hipótese diagnóstica se baseou na história clínica e nos leucogramas alterados, sendo posteriormente confirmada pelo aspirado de medula óssea. Foi introduzido o estimulador da formação de colônias de granulócitos, que geralmente é efetivo, porém, nesse caso, não houve sucesso e o paciente evoluiu para óbito devido à grave infecção.OBJECTIVE: To report a case of severe congenital neutropenia and alert pediatricians about its diagnosis in young patients with recurrent infectious diseases. CASE DESCRIPTION: Young infant with 45 days of life, with a history of high fever, lethargy, poor feeding and repeated blood counts showing significant leucopenia due to a significant decrease of polymorphonuclear cells. The diagnosis was confirmed by bone marrow aspirate showing hypoplasia of the granulocytic series and complete absence of

  4. Suplementação em sistema de creep-feeding de bezerros de corte lactentes e avaliação nutricional de matrizes de corte

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    Lívia Vieira de Barros

    2015-10-01

    Full Text Available Este trabalho foi realizado para avaliar o desempenho produtivo e nutricional de bezerros lactentes recebendo apenas mistura mineral ou diferentes níveis de suplementos múltiplos e a produção de leite e os parâmetros nutricionais de vacas de corte em pastagens de Uruchloa decumbens. Utilizaram-se 32 bezerros de corte, lactentes, com idade média de 3 meses e peso médio inicial de 109,3 + 0,84 kg, e suas respectivas mães com peso inicial médio de 447,2 + 47,1 kg. O delineamento experimental foi o inteiramente casualizado. O suplemento continha aproximadamente 25% de proteína bruta (PB e os tratamentos consistiram-se do fornecimento de diferentes níveis de suplementos múltiplos para os bezerros. Os níveis de fornecimento de suplementos foram 0,2; 0,4 e 0,6% do peso corporal para os tratamentos N0,2, N0,4, e N0,6, respectivamente. Os animais do tratamento controle (MM receberam exclusivamente mistura mineral ad libitum. O ganho médio diário (g dos bezerros foi 731,2; 810,6; 822,7e 895,2, respectivamente, para os tratamentos MM, N0,2, N0,4, e N0,6. Os bezerros suplementadas apresentaram maior ganho em peso. Houve efeito linear positivo do nível de suplemento múltiplo fornecido aos bezerros (P<0,10 sobre o ganho médio diário. Os consumos em kg/dia de matéria seca (MS, matéria orgânica (MO, PB, carboidratos não fibrosos (CNF, MS digerida, fibra em detergente neutro digerida e nutrientes digestíveis totais foram superiores (P<0,10 para os animais que receberam suplementos múltiplos em relação aos animais que receberam apenas mistura mineral. Entre os níveis de fornecimento de suplementos múltiplos observou-se efeito linear crescente sobre o consumo de extrato etéreo e efeito quadrático sobre o consumo de MS, matéria seca de forragem, MO, matéria orgânica de forragem, PB, CNF, matéria seca digerida e NDT. Os coeficientes de digestibilidade aparente total da MS, MO, FDN, CNF e NDT foram superiores (P<0,10 para os animais

  5. Hiperoxalúria primária com insuficiência renal crônica terminal em lactente Primary hyperoxaluria with endstage renal failure in an infant

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    Célia S. Macedo

    2002-04-01

    Full Text Available Objetivo: descrever caso clínico de um lactente com insuficiência renal crônica terminal, causada por hiperoxalúria primária.Método: após revisão da literatura, verifica-se a raridade da doença; na França, a prevalência é de 1,05/milhão, com taxa de incidência de 0,12/milhão/ano. Pesquisa abordando centros especializados mundiais detectou, em 1999, 78 casos em lactentes; destes, em 14% o quadro inicial foi de uremia. A gravidade e a raridade da doença sugerem o relato deste caso.Resultados: criança de sexo feminino, com quadro de vômitos e baixo ganho de peso desde os primeiros meses de vida, desenvolveu insuficiência renal terminal aos 6 meses de idade, sendo mantida em tratamento dialítico desde então. Aos 8 meses, foi encaminhada para esclarecimento diagnóstico, apresentando déficit pôndero-estatural grave e os seguintes exames laboratoriais: uréia= 69 mg/dl, creatinina=2,2 mg/dl e clearance de creatinina= 12,5 ml/min/1.73m²SC. O exame de urina foi normal, a ultra-sonografia renal revelou tamanho normal e hiperecogenicidade de ambos os rins. A dosagem de oxalato urinário foi de 9,2mg/kg/dia ou 0,55 mmol/1.73m²SC, e a relação oxalato:creatinina, de 0,42. A biópsia renal diagnosticou presença de grande quantidade de depósitos de cristais de oxalato de cálcio no parênquima renal. A radiografia de ossos longos evidenciou sinais sugestivos de osteopatia oxalótica, e a fundoscopia indireta, sinais de retinopatia por oxalato. A criança foi mantida em diálise peritoneal ambulatorial contínua, tendo sido iniciado tratamento com piridoxina.Conclusões: a hiperoxalúria primária deve ser considerada como um dos diagnósticos diferenciais de insuficiência renal crônica em lactentes, especialmente na ausência de história sugestiva de outras patologias.Objective: to report a case of an infant with endstage renal failure caused by primary hyperoxaluria. Methods: the review of the literature showed the rarity of

  6. Penfigóide bolhoso no lactente

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    Quattrino,Ada Lobato; Silveira,Júlio César Gomes; Kawakubo,Susy Megumi; Xavier,Vera; Rochael, Mayra Carrijo

    2007-01-01

    O penfigóide bolhoso é doença que comumente acomete pessoas idosas. Desde o primeiro caso na infância, confirmado por imunofluorescência em 1970, cerca de 50 casos foram relatados e poucos ocorreram em crianças com menos de um ano de idade. Apresentase caso de penfigóide bolhoso em lactente de quatro meses de idade e discutem-se as características clínicas e imunopatológicas dessa rara bulose da infância.

  7. Avaliação funcional da disfagia de lactentes em UTI neonatal The functional evaluation of dysphagy in the neonatal intensive care unit

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    Maria Izabel Martins Redondo Botelho

    2003-09-01

    Full Text Available OBJETIVOS: Os objetivos deste trabalho foram: 1 detectar os critérios clínicos na avaliação da disfagia em lactentes sindrômicos e patológicos; 2 testar a hipótese de associação entre achados funcionais e/ou videoendoscópicos; 3 mostrar a importância da atuação conjunta entre o fonoaudiólogo e o médico otorrinolaringologista na avaliação da disfagia nesses lactentes. MÉTODOS: A amostra foi composta por 15 lactentes nascidos no Hospital Maternidade de Campinas (SP, para os quais houve solicitação de uma avaliação fonoaudiológica por parte do médico neonatologista responsável. Todos os lactentes foram avaliados uma vez pelo mesmo fonoaudiólogo e pelo mesmo médico otorrinolaringologista. A avaliação funcional da deglutição observou: a a sensibilidade táctil extra-oral, b a sensibilidade táctil intra-oral, c o reflexo nauseoso e d a movimentação dos bucinadores. A avaliação da deglutição videoendoscópica analisou: a sensibilidade na cartilagem aritenóidea, b o choro, c a aspiração, d a queda de saturação, e a penetração. Utilizou-se o teste exato de Fisher para pequenas amostras e cada hipótese foi testada com nível de significância de 0,05. RESULTADOS: Observou-se que existe uma relação de dependência estatisticamente significativa entre as variáveis: 1 aspiração após fase faríngea e a penetração (alta e baixa e 2 sensibilidade extra-oral nas bochechas e a sensibilidade na cartilagem aritenóidea. CONCLUSÕES: Este último resultado mostra a associação entre um achado funcional obtido pelo fonoaudiólogo e um achado videoendoscópico do médico otorrinolaringologista, o que evidencia a importância do trabalho conjunto desses dois profissionais da saúde.BACKGROUND: The objectives of this study were: 1 to detect clinical criteria on the evaluation of dysphagy in preterm newborns; 2 to analyze the association between the functional and the videoendoscopy findings and 3 to show the

  8. Análise da compliância e gradiente timpanométrico em lactentes com refluxo Analysis of compliance and tympanometric gradient in infants with reflux

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    Elizângela Dias Camboim

    2012-06-01

    Full Text Available OBJETIVO: Analisar e comparar o gradiente timpanométrico e a compliância obtida nas sondas de 226 Hz e 1 kHz entre os grupos de lactentes com e sem refluxo gastroesofágico. MÉTODOS: Cento e dezoito lactentes a termo e pré-termo, de recém-nascidos a 6 meses de idade - 63 com diagnóstico clínico de refluxo gastroesofágico fisiológico realizado por pediatras ou gastropediatras e 55 sem refluxo -, foram submetidos a timpanometria com sondas de 226 Hz e 1 kHz. RESULTADOS: Foram observados maiores valores de compliância com sonda de 1 kHz em ambos os grupos. Ao se comparar a média de compliância entre os grupos, observou-se que o grupo sem refluxo apresentou maiores valores. A média dos valores do gradiente timpanométrico foi maior no grupo sem refluxo, quando comparada ao grupo com refluxo. CONCLUSÃO: A sonda de 1 kHz apresenta maior compliância em lactentes com e sem refluxo, em relação à sonda de 226 Hz. Lactentes com refluxo apresentam compliância dentro dos padrões de normalidade, porém apresentando menor compliância quando comparados com lactentes sem refluxo. Com relação ao gradiente, lactentes com refluxo apresentam valores alterados e/ou dentro dos padrões limítrofes da normalidade, em ambas as orelhas.PURPOSE: To analyze and compare the tympanometric gradient and the compliance obtained in probe tones of 226 and 1 kHz between groups of infants with and without gastroesophageal reflux (GER. METHODS: Participants were 118 full-term and preterm infants, from newborns to 6-month-olds - 63 with clinical diagnosis of physiological GER performed by pediatricians or gastroenterologists, and 55 without GER -, who were submitted to tympanometry with probe tones of 226 and 1 kHz. RESULTS: Higher compliance values were found with 1 kHz in both groups. Comparing the average compliance between groups, we observed that the group without reflux showed higher values. The mean value of the tympanometric gradient was higher in the

  9. Diarréia aguda grave associada à Escherichia coli enteropatogênica clássica (EPEC: características clínicas e perdas fecais em lactentes hospitalizados

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    Oliva C.A.G.

    1997-01-01

    Full Text Available Escherichia coli enteropatogênica clássica (EPEC tem sido o agente enteropatogênico mais freqüentemente isolado nas fezes de lactentes, de baixo nível socioeconômico, hospitalizados com diarréia aguda grave, na cidade de São Paulo. OBJETIVOS. 1 Analisar as características clínicas de lactentes do sexo masculino, hospitalizados com diarréia aguda grave associada à EPEC; 2 quantificar suas perdas fluidas fecais, ingestão de fórmulas alimentares e variações de peso corporal durante a evolução intra-hospitalar. CASUÍSTICA E MÉTODOS. Estudaram-se 38 lactentes do sexo masculino. Foram avaliadas as características clínicas e epidemiológicas dos pacientes e a freqüência dos diferentes sorogrupos de EPEC identificados. As crianças foram mantidas em cama metabólica, e balanços metabólicos diários foram obtidos durante toda a duração do quadro diarréico. Os lactentes permaneceram, em média, 5,8 dias em estudo metabólico. Duzentos e vinte balanços diários foram acumulados e analisados. RESULTADOS. O grupo estudado apresentou como principais características clínicas: idade inferior a 12 meses, peso insuficiente ao nascer; desmame precoce e formas graves de desnutrição protéico-calórica. O sorogrupo O111 foi o mais freqüentemente identificado (68,4%, sendo a idade dos pacientes com tal agente significativamente maior que a dos portadores do sorogrupo O55. A média dos volumes fecais diários foi de 66mL/kg/dia, havendo diferenças segundo dias de estudo. A média de ingestão diária de fórmulas alimentares foi de 85,2mL/kg/dia. Leite de vaca foi a dieta mais precocemente utilizada e as crianças que dela fizeram uso apresentaram volumes fecais maiores que os que receberam caseinato ou nutrição parenteral e incremento de peso corporal menor que os que utilizaram hidrolisado protéico ou NPT. CONCLUSÕES. Os sorogrupos de EPEC acarretaram perdas fluidas fecais de moderada e grave intensidade nos lactentes

  10. Características das emissões otoacústicas em lactentes expostos à medicação ototóxica Characteristics of otoacoustic emissions in infants exposed to ototoxic drugs

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    Andreza Ferreira dos Santos

    2009-01-01

    Full Text Available OBJETIVO: Analisar as emissões otoacústicas (EOA em lactentes submetidos a tratamento por medicação ototóxica no período neonatal. MÉTODOS: Foi realizada a captação das EOA por transiente (EOAT e das EOA produto de distorção (EOAPD em 40 lactentes: 14 lactentes submetidos a drogas ototóxicas por, no mínimo, cinco dias (grupo estudo e 26 lactentes sem risco auditivo e sem intercorrências (grupo controle. A análise estatística do conjunto de dados foi efetuada utilizando-se os testes não-paramétricos de Wilcoxon e Mann-Whitney, e a técnica de intervalo de confiança para média. RESULTADOS: Foram observados menores níveis de resposta e relação sinal/ruído nas EOAPD para o grupo estudo, com valores estatisticamente significantes para as frequências de 3000, 6000 e 8000 Hz. CONCLUSÃO: A ação dos ototóxicos pode ser observada pela resposta típica das EOA em altas frequências, o que foi mais bem avaliado pelas EOAPD.PURPOSE: To analyze the otoacoustic emissions (OAE of infants exposed to ototoxic drugs during the neonatal period. METHODS: It was carried out the testing of transient OAE (TOAE and distortion product OAE (DPOAE with 40 infants: 14 infants exposed to ototoxic drugs for, at least, five days (study group, and 26 infants with no risks for hearing loss and no complications during the neonatal period (control group. The statistical analysis was performed using the non-parametric tests of Wilcoxon and Mann-Whitney, and the confidence interval for the average technique. RESULTS: Lower levels of response and signal/noise relation of DPOAE were observed in the study group, with statistically significant values for the frequencies of 3000, 6000 and 8000 Hz. CONCLUSION: The action of the ototoxic drugs can be observed by the typical response of OAE in high frequencies, which was better evaluated by the DPOAE.

  11. Eventração diafragmática congênita complicada por hérnia interna em lactente: uma rara combinação

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    Willy Marcus Gomes França

    2016-10-01

    Full Text Available Introdução: A eventração diafragmática (ED é um evento raro, caracterizado pela elevação anormal do diafragma. Em casos congênitos, ocorre defeito na muscularização do diafragma no período embrionário, o que afeta sua fixação e leva ao deslocamento do hemidiafragma enfraquecido para o tórax. Por outro lado, a hérnia diafragmática congênita (HDC decorre da falha de fusão das membranas pleuroperitoneais, resultando em um defeito diafragmático que permite a herniação visceral. Ao contrário da HDC, que apresenta maior gravidade, a ED congênita pode ser assintomática. Objetivo: Relatar um caso incomum de eventração diafragmática congênita complicada por hérnia interna. Metodologia: Informações obtidas pelo acompanhamento da paciente em enfermaria do Conjunto Hospitalar de Sorocaba (CHS, análise do prontuário e revisão de literatura. Relato do caso: Lactente feminina de 53 dias de vida, referenciada à Emergência Pediátrica do CHS por vômitos, gemência, irritação e diminuição da aceitação do leite materno há 2 dias. Ao exame: mau estado geral; ausculta cardíaca em hemitórax direito, pulsos finos; ausculta pulmonar rude e diminuída em hemitórax esquerdo (HTE; abdome globoso, distendido, com edema de parede abdominal. A radiografia revelou a presença de alças intestinais em HTE, além de grande distensão das alças de delgado, com discreto edema de parede em algumas delas, sugerindo quadro obstrutivo e provável hérnia diafragmática. Durante a cirurgia, foram observadas alças de delgado em saco herniário eventrado no HTE, formando uma eventração diafragmática, onde haviam encarceradas alças de jejuno e íleo, comprometendo alça de íleo terminal, de aspecto necrótico por uma extensão de 10 cm. O tratamento cirúrgico foi curativo e a paciente recebeu alta após 14 dias. Conclusão: A eventração diafragmática congênita é diagnóstico diferencial com HDC, e sua correção cir

  12. Complicação decorrente da presença de brônquio traqueal em lactente: relato de caso

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    Reis Jaqueline Costa

    2006-01-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O brônquio traqueal é uma anomalia congênita com incidência aproximada de 2% na população geral, habitualmente assintomática e de diagnóstico usualmente incidental. Esta anomalia caracteriza-se pela presença de brônquio para o lobo superior direito emergindo diretamente da traquéia, junto à carina. Em vigência de intubação traqueal, este brônquio pode ter sua luz obliterada pela cânula, levando a atelectasia isolada do lobo superior direito. O objetivo deste artigo foi relatar um caso de atelectasia isolada de lobo superior direito em lactente, percebida após intubação orotraqueal, bem como fazer uma revisão de literatura sobre esta anomalia, destacando suas implicações anestésicas. RELATO DO CASO: Paciente do sexo masculino, pardo, 5 meses de idade, 5 kg, estado físico ASA I, portador de fístula anorretal, em programação para correção da fístula (Mini-Peña. Após intubação orotraqueal realizou-se punção de veia subclávia direita, que foi seguida de dessaturação e diminuição do murmúrio vesicular no ápice direito. As hipóteses iniciais foram de hemotórax, pneumotórax, secreção brônquica e intubação seletiva. Foi realizada radiografia de tórax, que mostrou atelectasia de lobo superior direito. Realizada broncoscopia, que revelou brônquio traqueal. A cânula foi reposicionada, com re-expansão do lobo atelectasiado. CONCLUSÕES: Por ser uma anomalia de incidência relativamente alta (2%, o brônquio traqueal deve ser incluído entre os diagnósticos diferenciais de atelectasia de lobo superior direito.

  13. Indicadores de risco para perda auditiva em neonatos e lactentes atendidos em um programa de triagem auditiva neonatal Risk indicators for hearing loss of newborns and infants in a newborn hearing screening program

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    Silvana Maria Sobral Griz

    2011-04-01

    Full Text Available OBJETIVO: descrever os indicadores de risco para perda auditiva presentes em neonatos e lactentes que realizaram a Triagem Auditiva Neonatal no Hospital das Clínicas da Universidade Federal de Pernambuco, nascidos em 2008. MÉTODOS: foram pesquisados os 787 neonatos e lactentes que realizaram a Triagem Auditiva Neonatal no citado Hospital, nascidos em 2008. Foi montado um banco de dados com informações do formulário com histórico familiar e clínico dos pesquisados e resultado da triagem, para análise dos indicadores de risco. RESULTADOS: os indicadores de risco mais prevalentes na população estudada foram presença de hiperbilirrubinemia, nascimento pré-termo, baixo peso ao nascimento, uso de medicamento durante o período gestacional, permanência em Unidade de Terapia intensiva e presença de infecções intra-uterinas durante a gestação. Os indicadores de risco para perda auditiva com associação estatisticamente significante com o resultado falha na triagem foram nascimento pré-termo, baixo peso, permanência em Unidade de Terapia Intensiva, uso de ventilação mecânica e uso de medicamento ototóxicos. CONCLUSÃO: houve ocorrência de indicadores de risco pré, peri e pós-natais, porém apenas foi encontrada significância estatística entre alguns indicadores peri e pós-natais e a falha na triagem.PURPOSE: to characterize neonates and infants who were born in 2008 and have been submitted to the Newborn Hearing Screening Program of the Federal University of Pernambuco Hospital according to the presence of risk factors related to hearing loss. METHODS: a total of 787 newborns took part in the study. Information from clinical charts and tests results were collected in order set up a database. RESULTS: the most prevalent risk factors for hearing loss in the related population was hyperbilirubinemia, prematurity, low weigh at birth, use of medication during pregnancy, presence of diseases during pregnancy and permanence in a

  14. Novo método de dosagem de soros antipeçonhentos em camundongos lactentes: I - dosagem do soro anticrotálico New method for dosage of antivenoms sera in baby mice: I-Anticrotalic serum's dosage

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    Bruno Soerensen

    1984-08-01

    Full Text Available A atividade biológica dos soros antipeçonhentos pode ser determinada "in vivo" em pombos, coelhos, cobaios e camundongos adultos, não existindo, entretanto, nenhum método que possa ser recomendado internacionalmente. Estudou-se comparativamente aos métodos tradicionais de dosagem de soros em pombos e camundongos adultos, a validade do uso de camundongos lactentes de 6 a 7 dias, pesando 4 a 5g, inoculados pela via subcutânea. Inicialmente foi determinada a toxidez do veneno de Crotalus durissus terríficus através do estudo da sintomatologia do envenenamento e da atividade letal. O estudo comparativo dos três métodos forneceu maior concordância de resultados em DE100 entre as dosagens realizadas com camundongos lactentes e adultos. A DE100 e DL50 determinadas em camundongos lactentes forneceu resultados mais constantes que os dos métodos de camundongos adultos e pombos. O uso deste novo método permite eliminar a dificuldade de obtenção do atual animal de prova; a utilização de um maior número de animais por ponto de avaliação biológica, possibilitando uma maior precisão e conseguindo-se uma uniformidade nas características exigidas neste tipo de dosagem como peso, idade e linhagem, visando a reprodução sistemática dos resultados.The biological activity of antiserum against venoms can be assessed by "in vivo" tests using pigeons, rabbits, guinea-pigs and adult mice although there is no International standardized reaction for it. The traditional methods using pigeons and adult mice were comparatively studied with those using mice of 4-5 g (6-7 days of age, inoculated by subcutaneous injection. The toxicity of the Crotalus durissus terrificus venom was initially determined by studying the symptomatology after administration of venom and lethal activity. The comparative study of these three methods showed that the best concordance in the results of the ED100 was obtained using adult and baby mice. The most homogeneous ED100

  15. Desempenho motor de lactentes frequentadores de berçários em creches públicas Motor performance of infants attending the nurseries of public day care centers

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    Letícia Baltieri

    2010-09-01

    Full Text Available OBJETIVO: Analisar o desempenho motor axial, apendicular e global e sua correlação com as características neonatais, familiares e de tempo de exposição à creche em crianças com idade entre 12-24 meses, frequentadoras de creches públicas. MÉTODOS: Estudo transversal com 40 lactentes (idade média 14,3±2,4 meses frequentadores de creches públicas. Os participantes foram avaliados quanto ao desempenho motor com a Bayley Scales of Infant and Toddler Development-III, a qual possibilita análise do desempenho motor e comparação dos domínios motores axial e apendicular. Foram coletados dados neonatais, familiares e de exposição à creche e pesquisou-se a correlação destes fatores ao desempenho motor. Foi utilizado o teste t pareado para comparar médias e a correlação de Pearson. RESULTADOS: O desempenho motor do grupo esteve, em média, abaixo da referência, com 22,5% das crianças classificadas como suspeitas de atraso nos desempenhos axial e global, contrastando com nenhuma no domínio apendicular. A comparação axial e apendicular apontou diferença significativa, com desempenho axial aquém do apendicular, além de 35% do grupo ter apresentado discrepância significativa entre esses domínios. Não foi encontrada correlação linear entre os domínios motores avaliados e as variáveis neonatais, familiares e de exposição à creche. CONCLUSÕES: O desempenho motor global do grupo esteve abaixo da média de referência, com desempenho motor axial inferior ao apendicular e importante discrepância entre esses. Recomenda-se atenção às habilidades motoras axiais e às oportunidades de exploração que o ambiente em creches pode propiciar, especialmente no decorrer dos dois primeiros anos de vida.OBJECTIVE: To analyze gross, fine and global motor performance and its correlation with neonatal and familial variables and day care exposure among children between 12-24 months of age attending public day care centers. METHODS: This

  16. Educação em saúde auditiva do neonato e lactente para profissionais de enfermagem Newborn and infant hearing health education for nursing professionals

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    Camila Padilha Barbosa

    2013-04-01

    Full Text Available A perda auditiva é uma privação sensorial e, entre suas consequências, pode-se citar: atraso no desenvolvimento de linguagem, problemas socioemocionais e escolar. Neste cenário, destacam-se os profissionais de enfermagem, que podem multiplicar os conhecimentos sobre saúde auditiva infantil, desde o pré-natal. OBJETIVO: Verificar o conhecimento dos profissionais de enfermagem após ações educativas em saúde auditiva infantil. MÉTODO: Estudo quase-experimental com delineamento tempo-série. Participaram 82 profissionais de enfermagem (enfermeiros, técnicos e auxiliares, que trabalhavam em um hospital universitário, no período entre março e setembro de 2011. Todos responderam a um questionário semiestruturado, antes e após ações educativas desenvolvidas. RESULTADOS: Pôde-se observar mudança significativa de conhecimento dos profissionais de enfermagem após a ação educativa na maioria das variáveis analisadas, a exemplo, idade ideal para realizar a Triagem Auditiva Neonatal; idade ideal para realizar o diagnóstico da perda auditiva; idade ideal para iniciar a intervenção ante a perda auditiva e os indicadores de risco para perda auditiva. CONCLUSÃO: Acredita-se que a metodologia utilizada nas ações educativas, baseadas na problematização da prática profissional, pode ter contribuído sobremaneira para o aumento do conhecimento sobre saúde auditiva, especialmente da população neonatal e lactente.Hearing loss is a sensory deprivation, which can brings several consequences, among them: language development delay, emotional and social problems, and school difficulties. In such settings, we stress the role of nursing professional, who can expand their knowledge about children's hearing health, all the way from pre-natal care. OBJECTIVE: To check the knowledge of nursing professional after the educational actions on pediatric hearing. METHOD: A quasi-experimental design with timeseries outline. We had 82 nursing

  17. Introdução alimentar e anemia em lactentes do município de Campinas (SP Feeding pattern and anemia in infants in the city of Campinas, São Paulo, Brazil

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    Regina Esteves Jordão

    2009-12-01

    Full Text Available OBJETIVO: Verificar a prevalência de anemia em crianças do município de Campinas, levando-se em consideração a introdução de alimentos complementares. MÉTODOS: Estudo transversal realizado com 354 crianças de seis a 12 meses de idade, sorteadas do Sistema de Informações de Nascidos Vivos da cidade de Campinas. Profissionais da área da saúde devidamente treinados realizaram entrevista domiciliar com as mães dos lactentes, as quais responderam a um questionário contendo dados sobre a introdução de alimentos e condições socioeconômicas. Ao final, coletou-se sangue capilar do lactente, para dosagem de hemoglobina com o Hemocue®. Foram consideradas anêmicas as crianças com concentrações de hemoglobina inferiores a 11g/dL. Os dados foram avaliados por análise de sobrevida para verificar a associação da introdução alimentar com a anemia. RESULTADOS: Dos lactentes estudados, 66,5% apresentaram níveis de hemoglobina OBJECTIVE: To verify the prevalence of anemia associated with the introduction of complementary food in children less than two years old in the city of Campinas, São Paulo, Brazil. METHODS: A cross-sectional survey was performed in 354 children between 6 and 12 months of age which were registered in the Live Births Information System from Campinas area. Health professionals interviewed the mothers, who answered a questionnaire about food introduction and socioeconomic status. Capillary blood was collected and the hemoglobin level was determined by Hemocue®. Anemia was diagnosed if hemoglobin level was below 11g/dL. Survival analysis was performed to determine the influence of complementary food introduction on anemia. RESULTS: 66.5% of the children had hemoglobin levels lower than 11g/dl. Anemia was associated to early introduction of the family diet (p=0.036, bread (p=0.012, yogurt (p=0.006, soft drinks (p=0.005, candies (p=0.005 and snacks (p=0.013. CONCLUSIONS: Inadequate complementary food introduction is

  18. AVALIAÇÃO BIOLÓGICA DE UM ALIMENTO EM PÓ A BASE DE CARNE DE FRANGO UTILIZADO PARA O TRATAMENTO DE LACTENTES COM INTOLERÂNCIA ALIMENTAR

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    MARIA LUIZA FERREIRA STRINGHINI

    2009-07-01

    Full Text Available

    RESUMO: O presente trabalho consistiu na avaliação biológica, determinada pelo coeficiente de eficiência protéica (CEP, pelo coeficiente de eficácia alimentar (CEA e pela digestibilidade aparente (Dap, de um produto desenvolvido a base de carne de frango em pó, utilizado para o tratamento de lactentes com intolerância alimentar, especialmente na diarréia protraída. PALAVRAS-CHAVE: Intolerância alimentar; diarréia protraída; carne de frango; utilização protéica.

  19. Fatores de risco para diárreia persistente em lactentes Risk factors to persistent diarrhea in infants

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    Maria das Graças Moura Lins

    2003-12-01

    Full Text Available RACIONAL: A diarréia persistente é uma doença multicausal. A análise do risco para o prolongamento do quadro diarréico envolve variáveis ambientais, biológicas e do manejo clínico. OBJETIVO: Identificar fatores de risco para a diarréia persistente em crianças hospitalizadas na fase aguda do quadro diarréico. PACIENTES E MÉTODOS: O estudo foi do tipo caso-controle. A amostra consistiu de 216 crianças menores de 24 meses hospitalizadas por diarréia de início abrupto, no Instituto Materno-Infantil de Pernambuco, Recife, PE. O grupo de casos incluiu as crianças com diarréia persistente e o de controles aquelas com diarréia aguda. Foram analisadas variáveis socioeconômicas, biológicas, de morbidade anterior, clínicas e do manejo terapêutico prévio à admissão. Utilizou-se o odds ratio não ajustado e ajustado, com seus respectivos intervalos de confiança de 95%, observando-se o nível de significância de 5%. A análise multivariada foi feita através de regressão logística. RESULTADOS: O risco de persistência da diarréia foi maior nas crianças com: disenteria, febre no início do quadro, dieta suspensa e uso de antibiótico à admissão hospitalar. O risco de diarréia persistente foi cerca de três vezes maior para crianças sem geladeira no domicílio e que apresentavam hiperemia perianal ao exame físico na admissão hospitalar, sendo estas as variáveis que apresentaram significância estatística após o ajuste para fatores de confusão. CONCLUSÕES: A melhoria das condições ambientais e o manejo adequado e individualizado da criança hospitalizada por diarréia pode contribuir para a redução da morbidade da doença.BACKGROUND: Persistent diarrhea is a multicausal disease. The analysis of risk factors for persistent diarrhea includes environmental and biological variables as well as therapeutical management. AIM: To identify risk factors for persistent diarrhea among children hospitalized with acute diarrhea

  20. Aerobic bacteria, Chlamydia trachomatis, Pneumocystis carinii and Cytomegalovirus as agents of severe peneumonia in small infants Bactérias aeróbias, Chlamydia trachomatis, Pneumocystis carinii e Cytomegalovirus: agentes causadores de pneumonia grave em pequenos lactentes

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    Bernardo Ejzenberg

    1996-02-01

    Full Text Available The authors studied 58 infants hospitalized for pneumonia in a semi-intensive care unit. Age ranged from 1 complete to 6 incomplete months. The infants were sent from another hospital in 20 cases and from home in a further 38. Pulmonary involvement, which was alveolar in 46 cases and interstitial in 12, was bilateral in 31 children. The investigation was carried out prospectively on the etiological agents associated with respiratory infection to look for evidence of aerobic bacteria (blood cultures, Chlamydia trachomatis and Cytomegalovirus (serology, and Pneumocystis carinii (direct microscopy of tracheal aspirated material. The following infectious agents were diagnosed in 21 children (36.2%: Aerobic bacteria (8, Chlamydia trachomatis (5, Pneumocystis carinii (3, Cytomegalovirus (3, Cytomegalovirus and Chlamydia trachomatis (1, Aerobic bacteria and Cytomegalovirus (1. Seven cases of infection by Chlamydia trachomatis and/or Cytomegalovirus were diagnosed out of the 12 cases with pulmonary interstitial involvement.Os autores estudaram prospectivamente 58 lactentes internados por pneumonia em unidade semi-intensiva. A idade foi limitada entre 1 mês completo e 6 meses incompletos. A procedência das crianças foi de outro hospital em 20 casos e domiciliar em 38. O acometimento pulmonar era alveolar em 46 casos, intersticial em 12 e bilateral em 31 crianças. Foram pesquisados agentes etiológicos associados à infecção respiratória dos lactentes jovens: Bactérias aeróbias (Hemoculturas, Chlamydia trachomatis e Cytomegalovirus (sorologia, e Pneumocystis carinii (microscopia direta do aspirado traqueal. Foram diagnosticadas infecções em 21 crianças (36,2%: Bactérias aeróbias (8, Chlamydia trachomatis (5, Cytomegalovirus (3, Pneumocystis carinii (3, Cytomegalovirus e Chlamydia trachomatis (1, Bactéria aeróbia e Cytomegalovirus (1. Foram diagnosticadas 7 infecções por Chlamydia trachomatis e/ou Cytomegalovirus entre as 12 crianças com

  1. Avaliação do desempenho motor global e em habilidades motoras axiais e apendiculares de lactentes frequentadores de creche Assessment of global motor performance and gross and fine motor skills of infants attending day care centers

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    Carolina T Souza

    2010-08-01

    Full Text Available OBJETIVO: Analisar o desempenho motor global em habilidades motoras axiais e apendiculares de lactentes que frequentavam, em tempo integral, duas Escolas Municipais de Educação Infantil. MÉTODOS: Estudo longitudinal do qual participaram 30 lactentes avaliados aos 12 e 17 meses de vida com a escala motora das Bayley Scales of Infant and Toddler Development-III, que possibilita a análise do desempenho motor global, apendicular e axial e a discrepância entre eles. Utilizaram-se o teste de Wilcoxon e o Coeficiente de Correlação de Spearman. RESULTADOS: A maioria dos participantes apresentou desempenho motor global dentro dos limites de normalidade, porém abaixo da média de referência aos 12 e 17 meses, com 30% classificados como suspeitos de atraso em pelo menos uma das avaliações. O desempenho motor axial foi inferior ao apendicular aos 12 e aos 17 meses, com grande discrepância entre eles especialmente na 2ª avaliação. Observou-se marcada variabilidade individual nas habilidades motoras apendiculares, com fraca correlação linear no desempenho entre a 1ª e a 2ª avaliações nesse domínio. Nas habilidades axiais e no desempenho motor global, encontrou-se menor variabilidade individual, com correlações moderadas e positivas entre a 1ª e a 2ª avaliações. Identificaram-se quatro lactentes com suspeita de atraso no desenvolvimento motor em ambas as avaliações. CONCLUSÕES: O estudo aponta necessidade de maior atenção ao desenvolvimento motor durante os primeiros 17 meses de crianças que frequentam creches, com especial vigilância à motricidade axial (considerando que ela é parte integrante do desenvolvimento global da criança e às crianças com desempenho suspeito de atraso em duas avaliações consecutivas.OBJECTIVE: To analyze the global motor performance and the gross and fine motor skills of infants attending two public child care centers full-time. METHODS: This was a longitudinal study that included 30 infants

  2. Observação do desenvolvimento de linguagem e funções auditiva e visual em lactentes Observation of language, visual and hearing function development in infants

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    Maria Cecília Marconi Pinheiro Lima

    2004-02-01

    Full Text Available OBJETIVO: Investigar o desenvolvimento da linguagem e das funções auditiva e visual em lactentes de creche, a partir da avaliação realizada por educadores. MÉTODOS: Foram avaliados 115 lactentes, nos anos de 1998 a 2001, usuários de uma creche da área da saúde de uma universidade do Estado de São Paulo. Foi utilizado o "Protocolo da Observação do Desenvolvimento de Linguagem e das Funções Auditiva e Visual", com 39 provas no total, para a avaliação dos lactentes de 3 até 12 meses de idade. A aplicação desse Protocolo foi feita pelas educadoras da creche, devidamente treinadas. Utilizou-se o teste de Qui-quadrado ou Exato de Fisher. O nível de significância adotado foi de 5%. RESULTADOS: Os lactentes apresentaram um padrão diferente no desenvolvimento da linguagem quanto ao início do balbucio e das primeiras palavras, bem como na função visual, quanto à imitação e uso de jogos gestuais e de seguir ordem com uso de gestos. CONCLUSÕES: O ambiente creche propicia condições para um outro padrão de desenvolvimento de linguagem e das funções auditiva e visual. Ações de prevenção na creche devem integrar as áreas de saúde e educação num objetivo comum.OBJECTIVE: To investigate language, visual and hearing function development among infants in a day-care center based on educators' assessments. METHODS: One hundred and fifteen infants who attended a day-care center at one university of the São Paulo State, Brazil, were assessed during the period between 1998 and 2001. The "Protocol for Observation of Language, Visual and Hearing Function Development," containing a total of 39 standardized tests, was utilized to assess infants from three to twelve months old. The protocol was applied by trained educators, members of the day-care center staff. Statistical analysis was carried out using Chi-square test or Fischer's exact test at p <0.05. RESULTS: Infants showed different language development patterns as for

  3. Secreção na orelha média em lactentes - ocorrência, recorrência e aspectos relacionados Secretion of middle ear in infants - occurrence, recurrence and related factors

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    Sandra de O. Saes

    2005-04-01

    Full Text Available OBJETIVO: O presente estudo objetivou avaliar a ocorrência e recorrência de secreção na orelha média e os possíveis fatores associados, em 190 recém-nascidos e lactentes observados nos 2 primeiros anos de vida, participantes de um programa de prevenção, detecção e intervenção interdisciplinar desenvolvido na Clínica de Educação para Saúde da Universidade do Sagrado Coração. MÉTODOS: Os recém-nascidos e lactentes foram submetidos mensalmente a anamnese, otoscopia, avaliação audiológica comportamental por meio de instrumentos sonoros e tons puros (audiometria pediátrica e timpanometria. RESULTADOS: Os resultados revelaram que 68,4% dos lactentes apresentaram um ou mais episódios de secreção na orelha média nos 2 primeiros anos, com maior recorrência para o sexo masculino. A idade de maior ocorrência foi entre 4 e 12 meses. Quanto mais cedo ocorreu o primeiro episódio, maior foi a probabilidade de recorrência. Os meses do ano de maior incidência foram de maio a agosto. Das variáveis estudadas, constatou-se que o período de aleitamento materno exclusivo atuou como um fator protetor. Quanto aos fatores de risco, verificou-se que a presença tabagismo passivo, refluxo gastroesofágico, alergia respiratória esteve relacionada à recorrência de efusão. CONCLUSÃO: Os achados revelaram a importância do acompanhamento auditivo periódico para lactentes nos 2 primeiros anos de vida, considerando ser o período crítico para o processo de maturação do sistema auditivo, no qual privações sensoriais auditivas podem ser responsáveis por seqüelas para o desenvolvimento de fala e linguagem.OBJECTIVE: The present study aimed at evaluating the occurrence and recurrence of middle ear secretion and possible associated factors in the first two years of life of 190 newborns and infants, participants in the interdisciplinary prevention, detection, and intervention program at the Clínica de Educação para Saúde of

  4. Probiotic liquid for piglets in different ages Probiótico líquido para leitões lactentes em diferentes idades

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    Joadil Gonçalves de Abreu

    2010-09-01

    Full Text Available The purpose in this study was to evaluate the effect of oral administration of liquid composed by probiotic Lactobacillus reuteri (1.5 x 109 CFU/g and Bifidobacterium pseudolongum (1.5 x 109 CFU/g, at different ages of piglets on the number of weaners, mortality rate, weight gain, consumption of feed, occurrence of diarrhea and colonization of fecal microbiotic at the stage of lactation. It was used a completely randomized design with six treatments, six repetitions. Regarding the assessment of fecal microbiotic, three repetitions were held. Treatments consisted of: negative control; administration of chemotherapy (bacteriostatic and bactericide; administration of probiotic before the intake of colostrums; administration of probiotic six hours after ingestion of colostrums; administration of probiotic three days of age; administration of probiotic ten days old. There were no significant differences among treatments on the number of weaners and mortality. The administration of probiotic before receiving the colostrum and six hours post-colostrum provided a higher consumption of diet in the first phase of lactation. In the assessment of occurrences of diarrhea and the microbiological evaluation at seven days of age, there was no significant difference between treatments. At fourteen days, the piglets who received probiotic before the colostrum and probiotic to 10 days old showed a higher concentration of Clostridium perfringens. The pigs that received the probiotic at three days of age had lower concentrations of Lactobacillus. There was no significant difference (p<0.05 among treatments in relation to the concentrations of Enterobacteriaceae and total anaerobic bacteria.O objetivo, neste estudo, foi avaliar o efeito da administração oral de probiótico líquido composto por Lactobacillus reuteri (1,5 x 109 UFC/g e Bifidobacterium pseudolongum (1,5 x 109 UFC/g, em diferentes idades de leitões lactentes, sobre o número de leitões desmamados

  5. Efeito da suplementação sobre a digestibilidade dos nutrientes e desempenho de bezerros lactentes mantidos em pastagens de Brachiaria brizantha = Effect of supplementation on nutrient digestibility and performance of lactating calves fed with Brachiaria brizantha pastures

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    Alexandre Amstalden Moraes Sampaio

    2010-01-01

    Full Text Available Foi avaliado o efeito da suplementação e do tipo do suplemento sobre adigestibilidade dos nutrientes e o desempenho de bezerros Canchim lactentes mantidos em pastagem de Brachiaria brizantha cv. Marandu durante os meses de fevereiro a maio. Os tratamentos foram: sem e com suplementação em creep-feeding com concentrado proteico, comconcentrado energético e com concentrado energético-proteico. Em quadrado latino, foi avaliada a digestibilidade dos nutrientes, utilizando-se quatro bezerros mantidos em baias individuais, recebendo feno da mesma forrageira e com mamadas controladas duas vezes ao dia. O desempenho foi avaliado em delineamento inteiramente casualizado, sendo os 23 bezerros mantidos junto com as matrizes. A suplementação com concentrado energético-proteico determinou melhor ingestão e aproveitamento dos nutrientes (65% de digestibilidade da matéria seca, desempenho dos bezerros (ganhos de peso de 0,98 kg dia-1 e manutenção do peso e das reservas corporais das matrizes. A utilização de suplemento proteico não mostrou bons resultados, sendo estes inferiores inclusive ao desempenho dos bezerros que não receberam suplementação, 0,56 e 0,77 kg dia-1, respectivamente. O desempenho dos bezerros no tratamento sem suplementação foi semelhante àqueles que receberam suplemento energético, porém asmatrizes tiveram redução mais acentuada do peso corporal e das reservas energéticas. A suplementação com concentrado energético-proteico para bezerros lactentes mantidos em pastagens de Brachiaria brizantha cv. Marandu no início da seca mostrou ser uma técnica quebeneficia o desempenho desses animais e das matrizes.This study evaluated the effect of supplementation and the type of supplement on nutrient digestibility and performance of lactating calves fed with Brachiara brizantha cv. Marandu pasture from February to May. The treatments were: supplementation in creep-feeding with protein concentrate, with energy concentrate

  6. Fatores de risco associados ao desmame precoce e ao período de desmame em lactentes matriculados em creches Risk factors associated to early weaning and to weaning period of infants enrolled in daycare centers

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    Marina Borelli Barbosa

    2009-09-01

    Full Text Available OBJETIVO: Avaliar os fatores de risco no processo de desmame de lactentes matriculados em creches. MÉTODOS: Estudo analítico transversal com 56 crianças de nove a 18 meses de idade matriculadas em cinco creches de São Paulo. As mães das crinaças responderam ao questionário pré-testado que abordava questões demográficas, socioeconômicas, de gestação e nascimento, morbidade, aleitamento materno, alimentação complementar (quando/como foram introduzidos novos alimentos e atividades da criança na creche. Os fatores associados ao desmame precoce e menor período de desmame (variável definida pela diferença entre tempo de aleitamento exclusivo e tempo de aleitamento total foram avaliados em análises bivariadas. As variáveis com p25 anos (OR 4,91; IC95% 1,35-17,95; mãe morar sem companheiro (OR 6,42; IC95% 1,28-32,20 e uso de chupeta antes dos 30 dias de vida (OR 8,75; IC95% 1,90-40,23. Os fatores de risco para tempo insuficiente de desmame foram: frequentar creche pública (OR 3,20; IC95% 0,77-14,29 e início tardio do pré-natal (OR 4,13; IC95% 0,70-31,29. CONCLUSÕES: Características relacionadas à família e à instituição creche são fatores de risco para o desmame de crianças institucionalizadas. A abordagem desses determinantes para definir ações de saúde e nutrição é estratégica para favorecer a prática do aleitamento e qualificar o papel da creche como promotora de saúde e nutrição infantil.OBJECTIVE: To evaluate risk factors associated with weaning of infants enrolled in daycare centers. METHODS: Analytical cross-sectional study comprising 56 children aged nine to 18 months in five daycare centers of São Paulo. A pre-tested questionnaire was applied to their mother, including questions on demographics and socioeconomic issues, gestation and birth, illness, breastfeeding, complementary feeding (when and how new foods were introduced and children activities in daycare centers. Factors associated with early

  7. Medidas de imitância acústica em lactentes com 226hz e 1000hz: correlação com as emissões otoacústicas e o exame otoscópico Accoustic immitance measures in infants with 226 and 1000 hz probes: correlation with otoacoustic emissions and otoscopy examination

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    Michele Vargas Garcia

    2009-02-01

    Full Text Available A avaliação audiológica do lactente deve ser composta pela verificação das condições de orelha média (medidas de imitância acústica e otoscopia e pela avaliação coclear (Emissões Otoacústicas. OBJETIVO: Verificar qual tom teste da timpanometria (226Hz ou 1000Hz tem maior correlação com o exame otoscópico e com o resultado das Emissões Otoacústicas por estímulo transiente. MÉTODO: Realizou-se emissões otoacústicas nos 60 lactentes da amostra, com idade entre de zero e quatro meses. Foram distribuídos em dois grupos, sendo o grupo I 30 lactentes com EOA presente e o grupo II 30 lactentes com EOA ausente. Foram submetidos à timpanometria de múltiplas freqüências, com tom teste de 226Hz e 1000Hz e avaliação otoscópica. RESULTADOS: Na timpanometria, o tom teste de 1000Hz apresentou mais sensibilidade para identificar as alterações de orelha média. Nas crianças com curva timpanométrica dentro da normalidade, ambos os tons-teste (226 e 1000Hz apresentaram alta especificidade. Todas as correlações foram significantes com o tom teste de 1000Hz. CONCLUSÃO: O tom teste de 1000Hz apresentou maior correlação estatisticamente significante com as EOA e com a avaliação otoscópica para lactentes de zero a quatro meses.Audiological evaluation in infants should include the middle ear (immitance measures and otoscopy and also a cochlear evaluation. AIM: To check which tympanometry tone test (226 Hz or 1000 Hz, transient otoacoustic emissions and otoscopy. METHODS: Transient otoacoustic emissions were taken from sixty infants ranging from zero to four months of age. The babies were assigned to two groups of 30 infants each, according to the presence or absence of otoacoustic emissions (OAE. All babies have undergone tympanometry with probe tones of 226 and 1000 Hz and ENT evaluation. RESULTS: Tests performed with 1000 Hz probe tone were more sensitive in identifying middle ear disorders. In children with normal

  8. Leucemia linfoblástica aguda em lactentes: 20 anos de experiência Acute lymphoblastic leukemia in infants: 20 years of experience

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    Amanda Ibagy

    2013-02-01

    Full Text Available OBJETIVO: Analisar pacientes com menos de dois anos de idade com leucemia linfoblástica aguda atendidos no período de 1990 a 2010, em um centro de referência estadual. MÉTODOS: Estudo clínico, epidemiológico, transversal, descritivo e observacional. Pacientes incluídos tinham menos de dois anos de idade, com leucemia linfoblástica aguda, tratados no período de 1990 a 2010 na unidade de oncologia pediátrica de um centro de referência estadual, totalizando 41 casos. RESULTADOS: Todos os pacientes eram Caucasianos e 60,9% eram do sexo feminino. Com relação à idade, 24,38% tinham menos de seis meses, 17,07% tinham entre seis meses e um ano e 58,53% mais do que um ano de idade. A idade de seis meses foi estatisticamente significante para o desfecho de óbito. Os sinais e sintomas predominantes foram febre, hematomas e petéquias. Uma contagem de leucócitos superior a 100.000 foi observada em 34,14% dos casos; hemoglobina inferior a 11 em 95,13% e contagem de plaquetas inferior a 100.000, em 75,61% dos casos. Infiltração do sistema nervoso central estava presente em 12,91% dos pacientes. Em relação à linhagem, a linhagem B predominou (73%, mas a linhagem de células T foi estatisticamente significativa para o óbito. Trinta e nove por cento dos pacientes tiveram recorrência da doença. Em relação ao estado vital, 70,73% dos pacientes morreram, sendo choque séptico a principal causa. CONCLUSÕES: leucemia linfoblástica aguda em crianças tem uma alta taxa de mortalidade, principalmente em crianças menores de um ano e linhagem derivada de células T.OBJECTIVE: To analyze patients younger than 2 years with acute lymphoblastic leukemia, treated in the period between 1990 and 2010 in a state reference center. METHODS: This was a clinical-epidemiological, cross-sectional, observational, and descriptive study. It included patients younger than 2 years with acute lymphoblastic leukemia, treated in the period of 1990 to 2010 in a

  9. Visual function and fine-motor control in small-for-gestational age infants Função visual e controle motor apendicular em lactentes pequenos para a idade gestacional

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    Heloisa G.R.G. Gagliardo

    2004-12-01

    Full Text Available OBJECTIVE: To compare visual function and fine-motor control of full-term infants small-for-gestational age (SGA and appropriate for gestational age (AGA, in the first three months. METHOD: We evaluated prospectively 31 infants in the 1st month; 33 in the 2nd and 34 infants in the 3rd month, categorized as full-term; birth weight less than 10th percentile for SGA and 25th to 90th percentile for the AGA group. Genetic syndromes, infections, multiple congenital malformations were excluded. The Bayley Scales of Infant Development-II were used, especially items related to visual function and to fine-motor control outcomes. RESULTS: The Motor Index Score (IS was significantly lower in the SGA group in the 2nd month. The items "attempts to bring hands to mouth", in the 1st month and "reaches for suspended ring", in the 3rd month showed higher frequency in the SGA group. CONCLUSION: The Motor IS was lower in the 2nd month and items of fine-motor control in the 1st month and in the 3rd month showed higher frequency in the SGA group.OBJETIVO: Comparar a função visual e o controle motor apendicular de lactentes nascidos a termo pequenos para a idade gestacional (PIG com lactentes adequados para a idade gestacional (AIG, no primeiro trimestre. MÉTODO: Amostra de 31 lactentes no 1º mês, 33 no 2º e 34 lactentes no 3º mês, nascidos a termo; peso de nascimento < percentil 10 para o grupo PIG e percentil 25 a 90 para o grupo AIG. Síndromes genéticas, infecções ou malformações congênitas múltiplas foram excluídas. Foram utilizadas as Bayley Scales of Infant Development-II, especialmente itens relacionados com a evolução da função visual e controle motor apendicular. RESULTADOS: Houve diferença significativa no Index Score (IS Motor no 2º mês, havendo pontuação menor no grupo PIG. Os itens "tenta trazer mão à boca", no 1º mês e "alcança aro suspenso" no 3º mês foram mais freqüentes no grupo PIG. CONCLUSÃO: No grupo PIG, o IS

  10. Fatores de risco de anemia em lactentes matriculados em creches públicas ou filantrópicas de São Paulo Risk factors for anemia in infants enrolled in public or philanthropic day-care centers in São Paulo city, Brazil

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    Tulio Konstantyner

    2007-08-01

    Full Text Available OBJETIVO: Identificar e quantificar os fatores de risco de anemia em lactentes matriculados em creches públicas ou filantrópicas no município de São Paulo e discutir o impacto das ações da creche no controle desta carência nutricional específica. MÉTODO: Estudo seccional compreendendo 212 lactentes de duas creches públicas e três filantrópicas. Foram realizadas entrevistas com as mães, coleta de sangue por punção digital e antropometria. Considerou-se como anemia, hemoglobina inferior a 11g/dL. Foi ajustado um modelo de regressão logística para fatores de risco entre grupos de lactentes com e sem anemia. RESULTADOS: A prevalência de anemia foi de 51,9%. O modelo logístico final foi composto por 4 variáveis: presença de 1 ou mais irmãos menores que 5 anos (Odds Ratio=2,57; p=0,005; estar freqüentando creche de administração exclusivamente pública (Odds Ratio=2,12; p=0,020; uso de aleitamento materno exclusivo inferior a 2 meses (Odds Ratio=1,88; p=0,044, e idade inferior a 15 meses (Odds Ratio=2,32; p=0,006. CONCLUSÃO:Concluiu-se que a alta prevalência de anemia evidencia a ineficiência das creches estudadas para controlar e prevenir esta carência nutricional; portanto, cabe ao planejador de saúde considerar os riscos de anemia identificados e quantificados quando da elaboração de programas de controle e prevenção.OBJECTIVE: To identify and quantify the risk factors for anemia in infants enrolled in public or philanthropic day care centers in São Paulo city and discuss the impact of the actions of day care centers in controlling this specific nutritional deficiency. METHODS: Cross-sectional study comprising 212 infants of two public and three philanthropic day care centers. Interviews with the mothers, collection of blood by digital puncture and anthropometry were performed. Anemia was characterized by hemoglobin levels below 11g/dL. A logistic regression model for risk factors between groups of infants with

  11. Diagnóstico de esofagite de refluxo em lactentes: a histologia do esôfago distal deve complementar a endoscopia digestiva alta Diagnosis of reflux esophagitis in infants: histology of the distal esophagus must complement upper gastrointestinal endoscopy

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    Mário C. Vieira

    2004-06-01

    Full Text Available OBJETIVO: O objetivo deste estudo foi o de validar os resultados do exame de endoscopia digestiva alta contra a histologia do esôfago distal para o diagnóstico da esofagite de refluxo em lactentes. MÉTODOS: Foram revisados os prontuários de 167 pacientes (88 do sexo masculino e 79 do sexo feminino com idade de 38 a 364 dias, encaminhados para investigação de esofagite de refluxo no período de janeiro de 1995 a dezembro de 2000. Analisou-se a associação entre as variáveis nominais (presença ou ausência de esofagite e ordinais (graus de esofagite através da comparação entre os resultados da endoscopia digestiva alta e histologia. RESULTADOS: A endoscopia digestiva alta, quando comparada à histologia, apresentou sensibilidade de 45%, especificidade de 71%, valores preditivos positivo de 89% e negativo de 21%, e acurácia de 50%. Verificou-se baixa concordância entre os achados endoscópicos e histológicos na endoscopia digestiva alta normal ou na esofagite grau I (eritema leve ao nível da transição epitelial, apagamento, friabilidade e perda do brilho da mucosa (p = 0,10. A endoscopia digestiva alta normal não identificou 79,2% dos pacientes com esofagite histológica. Entre os pacientes com esofagite grau I à endoscopia digestiva alta, 12,1% não apresentaram alterações histológicas. CONCLUSÕES: Concluiu-se que, enquanto a endoscopia digestiva alta apresentou especificidade de 71%, não atingiu sensibilidade aceitável (45% para justificar sua realização sem biópsia; e que a presença de esofagite grau I (não-erosiva na endoscopia digestiva alta não aumentou a capacidade deste exame de prever a anormalidade histológica.OBJECTIVE: The aim of this study was to validate the endoscopic findings against histologic features of the distal esophageal mucosa for the diagnosis of reflux esophagitis in infants. METHODS: The data records of 167 patients (88 M; 79F aged 38-364 days, referred for investigation of reflux

  12. Influência da posição do objeto na frequência de alcances manuais em lactentes com desenvolvimento típico Influence of object position on the frequency of manual reaching in typically developing infants

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    Jaqueline da Silva Frônio

    2011-06-01

    Full Text Available O objetivo deste estudo foi verificar a frequência de alcances no período de três a cinco meses de idade e se há influência da posição de apresentação do objeto. Treze lactentes com desenvolvimento típico foram avaliados aos três, quatro e cinco meses, em supino, sendo o objeto apresentado na linha média e nas linhas axilares direita e esquerda. O procedimento foi filmado e analisado para registro do número de alcances realizados nas posições de apresentação. Para análise foram utilizados os testes de Friedman e Wilcoxon, considerando o nível de significância α=0,05. As frequências médias de alcances aumentaram até o quinto mês, sendo encontrada diferença significativa entre o terceiro e o quinto (p=0,011 e entre o quarto e o quinto meses (p=0,008. O número de alcances na linha média aumentou significativamente do terceiro para o quinto (p=0,011 e do quarto para o quinto mês (p=0,025, e houve tendência de diferenciação (0,1>p>0,05 entre o terceiro e o quarto mês (p=0,058. Aos três meses, encontrou-se tendência de diferenciação (p=0,066 entre a frequência de alcances nas linhas axilar (D ou E e média. Aos quatro e cinco meses, não foi encontrada diferença estatisticamente significativa entre as posições. Concluiu-se que a frequência de alcances aumenta significativamente de três a cinco meses e a posição de apresentação do objeto parece influenciá-la na fase inicial de aquisição desta habilidade.The aim of this study was to evaluate the frequency of reaching in the period of three to five months of age and if the object presentation position has an influence on it. Thirteen typically developing infants were assessed at three, four, and five months of age. The frequency of reaching was evaluated with the infants in the supine position, with the object presented at midline, right, and left axillary lines. The procedure was shot and further analyzed to determine all reaching numbers at the

  13. Tuberculomas cerebrais múltiplos em lactente

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    Lígia M. Larré Barbosa

    1972-03-01

    Full Text Available É relatado um caso de uma menina com 11 meses de idade, apresentando distrofia de III.º grau, desidratação e processo pleuro-pulmonar grave. Após a hospitalização ocorreu paralisia facial periférica à direita, progredindo e quadro neurológico para paralisia de ambos os nervos motores oculares externos, do pneumogástrico e do glossofaríngeo. Após evolução rápida para o coma, ocorreu o óbito, tendo a autópsia mostrado tuberculose pulmonar, mesentérica e cerebral. O caso é discutido quanto à idade da paciente, à multiplicidade e localização dos tuberculomas encefálicos, ao quadro clínico apresentado, ao encontro de bacilos de Koch nos tuberculomas intracranianos e à normalidade do líquido cefalorraqueano.

  14. Comparação dos efeitos de duas técnicas fisioterapêuticas respiratórias em parâmetros cardiorrespiratórios de lactentes com bronquiolite viral aguda Comparison of the effects that two different respiratory physical therapy techniques have on cardiorespiratory parameters in infants with acute viral bronchiolitis

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    Melissa Karina Pupin

    2009-09-01

    Full Text Available OBJETIVO: Comparar os efeitos das técnicas de aumento do fluxo expiratório (AFE e vibração associada à drenagem postural (DP nos parâmetros cardiorrespiratórios de frequência cardíaca (FC, frequência respiratória (FR e SpO2 de lactentes com bronquiolite viral aguda (BVA. MÉTODOS: Foram analisados lactentes com diagnóstico clínico e radiológico de BVA. A FC, FR e SpO2 foram registradas em quatro tempos: antes do procedimento e após 10, 30 e 60 min do término do procedimento. Os pacientes foram divididos em três grupos: submetido à AFE; submetido à vibração/DP; e controle. RESULTADOS: Foram incluídos no estudo 81 lactentes, 27 em cada grupo de estudo, com média de idade de 4,52 meses e peso médio de 6,56 kg. Na comparação por ANOVA, as médias da FR, FC e SpO2 nos grupos AFE e vibração/DP não apresentaram diferenças significantes em relação ao grupo controle (p > 0,05. Considerando somente os quatro tempos, houve queda significante dos valores médios de FR nos grupos AFE e vibração/DP em relação ao controle (p OBJECTIVE: To compare the expiratory flow increase technique (EFIT and vibration accompanied by postural drainage (PD in terms of their effects on the heart rate (HR, respiratory rate (RR and SpO2 of infants with acute viral bronchiolitis (AVB. METHODS: Infants with clinical and radiological diagnosis of AVB were analyzed. The HR, RR and SpO2 were registered at four time points: prior to the procedure; and at 10, 30 and 60 min after the procedure. The patients were divided into three groups: submitted to the EFIT; submitted to vibration/PD; and control. RESULTS: We included 81 infants, 27 per group, with a mean age of 4.52 years and a mean weight of 6.56 kg. Using ANOVA, we found that the EFIT and vibration/PD groups presented no significant differences in relation to the control group in terms of the mean values for HR, RR or SpO2 (p > 0.05. Considering only the four time points evaluated, the mean RR

  15. Efeito do feno de leguminosas no desempenho de bezerros lactentes

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    Marcus Vinícius Morais de Oliveira

    Full Text Available RESUMOO objetivo deste estudo foi avaliar o desempenho de bezerros lactentes submetidos a dietas com e sem feno de leguminosas. O período experimental foi de 60 dias, sendo o fornecimento dos alimentos sólidos ad libitum e disponibilizados a partir do 10º dia de vida do animal, e o leite in natura fornecido de maneira restrita na porção de 4 litros/dia, divididos em duas refeições equitativas. Foram avaliadas as dietas: ração concentrada; ração concentrada mais feno de leucena (Leucaena leucocephala Lam. De Wit e ração concentrada mais feno de alfafa (Medicago sativa L.. Utilizou-se 15 animais Girolando, distribuídos em três tratamentos, em um delineamento em blocos ao acaso desbalanceados. Os parâmetros avaliados foram peso corpóreo inicial (nascimento - PCI e final (PCF, ganho médio diário (GMD, alturas de cernelha (AC e garupa (AG, perímetro torácico (PT, consumo de matéria seca (CMS e conversão alimentar (CA. Não foram observadas diferenças no desempenho dos animais em relação aos tratamentos, com médias 32,9 (±2,9 kg; 67,7(±1,2 kg; 0,58(±0,02 kg; 13,1(±0,5 cm; 13,7(±0,3 cm; 20,6(±0,7 cm; 0,46(±0,1 kg e 0,79(±0,1, para os parâmetros PCI, PCF, GMD, AC, AG, PT, CMS e CA, respectivamente. As exigências nutricionais de bezerros lactentes são atendidas com o fornecimento de leite e ração concentrada, não havendo necessidade de inclusão de feno de leguminosas na dieta.

  16. Avaliação eletromiográfica com eletrodos de captação de superfície dos músculos masseter, temporal e bucinador de lactentes em situação de aleitamento natural e artificial Surface electromyography of facial muscles during natural and artificial feeding of infants

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    Cristiane F. Gomes

    2006-04-01

    Full Text Available OBJETIVO: Mensurar e comparar a atividade dos músculos masseter, temporal e bucinador em diferentes métodos de alimentação de lactentes. MÉTODO: Estudo transversal, com participação de 60 lactentes nascidos a termo e sem intercorrências, entre 2 e 3 meses de idade, divididos em três grupos: 1 aleitamento materno exclusivo; 2 aleitamento misto com uso de mamadeira; e 3 aleitamento materno exclusivo com uso de copo. Foi realizada eletromiografia com eletrodos de captação de superfície durante a alimentação. O teste estatístico utilizado é o Kruskal-Wallis, complementado com as comparações múltiplas entre pares de grupos, e todas as discussões são realizadas no nível de 5% de significância. RESULTADOS: Verificam-se maiores resultados no grupo de aleitamento materno em relação ao grupo de aleitamento por mamadeira, tanto na amplitude quanto na média de contração do músculo masseter. No que se refere ao músculo temporal, há resultados maiores na amplitude do grupo de aleitamento materno e na média de contração do grupo de aleitamento por copo, quando comparados ao grupo de aleitamento por mamadeira. Quanto ao músculo bucinador, observam-se resultados maiores no grupo de aleitamento por mamadeira com relação ao aleitamento materno, sendo que tal diferença ocorre apenas na amplitude de contração. CONCLUSÃO: As semelhanças entre a atividade muscular do grupo de aleitamento materno e aleitamento por copo permitem sugerir o uso do copo como método alternativo na alimentação de lactentes, ao contrário do aleitamento por mamadeira, devido à hiperfunção do músculo bucinador, podendo resultar em alterações motoras orais e das funções neurovegetativas.OBJECTIVE: To measure and compare the activity of the masseter, temporalis and buccinator muscles in different infant feeding methods METHODS: Cross-sectional study of 60 full-term infants with no intercurrent diseases, aged between two and three months

  17. Lactato sérico como marcador de morbimortalidade no pós-operatório de operação de Jatene em lactentes Serum lactate as mortality and morbidity marker in infants after Jatene's operation

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    Taís Sica da Rocha

    2010-09-01

    Full Text Available OBJETIVO: Avaliar a morbidade e mortalidade após a operação de Jatene utilizando a dosagem de lactato sérico como principal marcador. MÉTODOS: Foi realizada uma coorte histórica com lactentes da UTI no período de 1995 a 2005 submetidos a essa cirurgia. Foram avaliados o lactato do pré-operatório, pós-operatório imediato (POI, da terceira hora de PO (3ªh, sexta hora (6ªh de PO e do 1º dia de PO; bem como outros fatores como sepse, sangramento aumentado, síndrome de baixo débito, insuficiência renal, hipertensão pulmonar, arritmias cardíacas, quilotórax, isquemia miocárdica, convulsões e outras complicações. Também foram coletadas informações referentes ao tempo de internação na UTI e ao desfecho (se o paciente morreu ou teve alta da UTI. RESULTADOS: A média de idade dos 76 pacientes foi de 14,59 ± 19,09 dias, peso ao nascimento de 3,128 ± 0,48 kg. Quarenta e quatro pacientes tinham o diagnóstico anatômico exclusivo de transposição de grandes artérias. O tempo médio de CEC foi de 143,78 ± 28,77 minutos, de pinçamento de 87,68 ± 22,3 minutos e de internação na UTI de 20,28 ± 15,62 dias. Vinte quatro (31,58% pacientes foram a óbito. O lactato aumentou no POI, retornando aos níveis basais em 24h. Os pacientes que foram a óbito apresentaram e mantiveram a partir do POI níveis de lactato mais elevados. O lactato da 3ªh foi o que melhor discriminou mortalidade, área sob a curva 0,68 (IC 0,54-0,83 P=0,035. Entretanto, considerando um ponto de corte para o lactato maior ou igual a 5,8 mmol/dl na 3ªh de PO, obteve-se apenas sensibilidade de 67% e especificidade de 64% para mortalidade. Existe correlação positiva entre o número de complicações e os níveis de lactato. A síndrome de baixo débito com odds ratio (OR de 7,67 (2,38-24, sangramento aumentado com OR de 2,91 (1,07-7,94 e complicações respiratórias com OR de 1,67 (1,35-2,05 são fatores de risco de óbito quando somados. CONCLUSÃO: Ap

  18. Triagem auditiva em hospital público de Belo Horizonte, Minas Gerais, Brasil: deficiência auditiva e seus fatores de risco em neonatos e lactentes Hearing screening in a public hospital in Belo Horizonte, Minas Gerais State, Brazil: hearing impairment and risk factors in neonates and infants

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    Luciana Oliveira Tiensoli

    2007-06-01

    Full Text Available O objetivo do trabalho foi estimar a prevalência de deficiência auditiva em crianças de hospital público de Belo Horizonte, Minas Gerais, Brasil, e investigar sua associação com fatores de risco descritos na literatura. O estudo transversal, retrospectivo, analisou 798 neonatos e lactentes, avaliados no Programa de Triagem Auditiva Neonatal Universal entre junho de 2002 e dezembro de 2003. Foram pesquisados os fatores de risco estabelecidos pelo Joint Committee on Infant Hearing em 1994, e por Azevedo em 1996, além da prematuridade. A prevalência de deficiência auditiva foi de 1,8% (15 casos. Foi realizada análise multivariada por regressão logística para verificação da associação entre fatores de risco e perda auditiva, que revelou associação estatisticamente significativa (valor p The objective of this study was to estimate the prevalence of hearing impairment in children in a public hospital in Belo Horizonte, Minas Gerais, Brazil, and to investigate the association with risk factors described in the literature. This study was cross-sectional and retrospective and analyzed 798 newborns and infants evaluated in the Universal Neonatal Hearing Screening Program from June 2002 to December 2003. The risk factors established by the Joint Committee on Infant Hearing in 1994 and Azevedo in 1996 were studied, besides prematurity. Prevalence of hearing impairment was 1.8% (15 cases. A multivariate logistic regression analysis was used to verify associations between risk factors and hearing impairment, showing a significant statistical association (p < 0.05 between hearing loss and suspicion of hearing loss by relatives, hyperbilirubinemia (serum level requiring exchange transfusion, ototoxic drugs, and low birth weight. A significant prevalence of hearing impairment in neonates and infants was confirmed. Attention should thus be focused on risk factors for hearing impairment, using hearing programs that ensure prevention, early

  19. Desenvolvimento neuropsicomotor de lactentes desnutridos Neuropsychomotor development of malnourished babies

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    SS Mansur

    2006-01-01

    Full Text Available OBJETIVOS: O objetivo deste estudo foi analisar o desenvolvimento neuropsicomotor de lactentes com desnutrição leve e caracterizar seu perfil nutricional. MÉTODOS: A pesquisa foi do tipo transversal, numa população de 374 lactentes e amostra de 31 desnutridos leve, entre 7 e 24 meses de idade, matriculados em creches municipais. O estado nutricional foi identificado pelo critério de Gómez e caracterizado por um questionário. Para a avaliação neuropsicomotora utilizou-se a Escala de Desenvolvimento Psicomotor da Primeira Infância de Brunet e Lézine. RESULTADOS: Os principais resultados do questionário mostraram: infecções respiratórias (48,4%; diarréias (71,0%; pais em união estável (61,3%; pais com ensino fundamental incompleto (74,2% das mães, 83,8% dos pais; renda familiar de 1 a 3 salários-mínimos (80,6%; aleitamento materno satisfatório (67,7%; reação adversa a algum alimento (41,9%. Entre os dados neuropsicomotores, as médias das Idades de Desenvolvimento da Linguagem (14,45 meses e da Sociabilidade (14,74 meses foram as que obtiveram os valores mais abaixo da média da Idade Cronológica (16,41 meses. Todas as áreas avaliadas obtiveram Quocientes de Desenvolvimento dentro da normalidade, porém, as áreas da Linguagem e da Sociabilidade foram classificadas em nível "normal baixo" e as outras em nível "normal médio". CONCLUSÕES: A avaliação neuropsicomotora é instrumento fundamental na assistência ao lactente desnutrido, que tende a apresentar deficiências nas áreas da Linguagem e Sociabilidade, fornecendo subsídios para observar sua atuação exploratória, efeito de seu pensamento, e planejar o trabalho intervencionista.OBJECTIVE: The purpose of this study was to analyze the neuropsychomotor development of babies with slight malnutrition and to characterize their nutritional profile. METHOD: This was a cross-sectional survey on a population of 374 babies and a sample of 31 babies with slight

  20. Fatores de risco para anemia em lactentes atendidos nos serviços públicos de saúde: a importância das práticas alimentares e da suplementação com ferro Risk factors for anemia in infants assisted by public health services: the importance of feeding practices and iron supplementation

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    Danielle G. Silva

    2007-04-01

    Full Text Available OBJETIVO: Investigar os fatores de risco para anemia em lactentes atendidos nos serviços públicos de saúde. MÉTODOS: Em estudo transversal, foram avaliadas 205 crianças de 6 a 12 meses no município de Viçosa (MG. A coleta de dados envolveu variáveis socioeconômicas, ambientais e biológicas, bem como aquelas relacionadas ao estado nutricional, à mãe, ao nascimento, ao cuidado com a saúde infantil, às práticas alimentares e à suplementação com ferro. O diagnóstico da anemia baseou-se nos valores de hemoglobina inferiores a 11 g/dL, utilizando o fotômetro portátil Hemocue. Na análise da associação das variáveis com a anemia, foi utilizada a regressão logística múltipla hierarquizada. RESULTADOS: A prevalência de anemia foi de 57,6%. Apresentaram maior chance de anemia os lactentes que pertenciam às famílias com renda per capita inferior a 0,5 salário mínimo, não consumiam frutas diariamente e não ingeriam suplementos medicamentosos com ferro. CONCLUSÃO: A adequada assistência à saúde e nutrição das famílias de baixa renda, o incentivo às práticas alimentares saudáveis e a prescrição de suplementos medicamentosos com ferro são medidas de grande importância para a prevenção e o controle da anemia entre os lactentes atendidos nos serviços públicos de saúde.OBJECTIVE: To investigate risk factors for anemia in infants assisted by public health services. METHODS: In a cross-sectional study carried out in Viçosa, state of Minas Gerais, Brazil, 205 children from 6 to 12 months were evaluated. Socioeconomic, environmental and biological data were collected, as well as information on child's birth, nutritional status, maternal data, child health care practices, feeding practices, and iron supplementation. Diagnosis of anemia was based on hemoglobin levels under 11 g/dL, using a portable Hemocue photometer. To analyze variables associated with anemia, a hierarchical logistic regression model was used

  1. Alimentos complementares e fatores associados ao aleitamento materno e ao aleitamento materno exclusivo em lactentes até 12 meses de vida em Itapira, São Paulo, 1999 Complementary feeding and factors associated to breast-feeding and exclusive breast-feeding among infant up to 12 months of age, Itapira, São Paulo, 1999

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    Celene Aparecida Ferrari Audi

    2003-03-01

    Full Text Available OBJETIVOS: analisar as práticas alimentares no primeiro ano de vida e fatores associados ao aleitamento materno e ao aleitamento materno exclusivo, no município de Itapira, SP. MÉTODOS: inquérito realizado em 1999 com 679 lactentes menores de 12 meses no Dia Nacional de Vacinação como parte do projeto Amamentação & Municípios. A associação entre o aleitamento e as variáveis independentes condições de nascimento, uso de mamadeira, chupeta e característica maternas, foi verificada por meio de regressão logística múltipla. RESULTADOS: a idade média da mãe foi de 25,5 anos, sendo 41,8% primíparas e 51,7% dos partos cirúrgicos. O peso médio ao nascer foi de 3.223g. Observou-se que 98,1% dos lactentes foram amamentados nos primeiros 30 dias, porém houve introdução precoce de chá, água e outros leites. A prevalência do aleitamento materno exclusivo foi de 64,8% no primeiro mês, caindo para 45% e 30,1% aos quatro e seis meses, respectivamente. Aos 12 meses 61,6% dos lactentes eram amamentados. As variáveis associadas ao desmame foram: usar chupeta (OR 5,58; IC95%: 3,94 -7,89, baixo peso ao nascer (OR 2,74; IC95%: 1,46 - 5,13 e hospital de nascimento (OR 1,76; IC95%: 1,22 - 2,52. Para interrupção da amamentação exclusiva, nos primeiros seis meses, os resultados foram: usar chupeta (OR 4,41; IC95%: 2,57 - 7,59 e parto cesárea (OR 1,78; IC95%: 1,09-2,91. CONCLUSÕES: a prevalência observada, do aleitamento materno e aleitamento materno exclusivo, ainda está distante das atuais recomendações da OMS.OBJECTIVES: to analyze feeding practices in the first year of life and factors associated to breast-feeding and exclusive breast-feeding in the municipality of Itapira. METHODS: survey performed in 1999 with 679 infants under twelve months old in the National Vaccination Day as part of the Project Breast-Feeding & Municipalities. Association between breast-feeding and independent variables of birth conditions, bottle use

  2. Efeito da suplementação sobre a digestibilidade dos nutrientes e desempenho de bezerros lactentes mantidos em pastagens de Brachiaria brizantha - DOI: 10.4025/actascianimsci.v32i1.4849 Effect of supplementation on nutrient digestibility and performance of lactating calves fed with Brachiaria brizantha pastures - DOI: 10.4025/actascianimsci.v32i1.4849

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    Glauco Mora Ribeiro

    2009-12-01

    Full Text Available Foi avaliado o efeito da suplementação e do tipo do suplemento sobre a digestibilidade dos nutrientes e o desempenho de bezerros Canchim lactentes mantidos em pastagem de Brachiaria brizantha cv. Marandu durante os meses de fevereiro a maio. Os tratamentos foram: sem e com suplementação em creep-feeding com concentrado proteico, com concentrado energético e com concentrado energético-proteico. Em quadrado latino, foi avaliada a digestibilidade dos nutrientes, utilizando-se quatro bezerros mantidos em baias individuais, recebendo feno da mesma forrageira e com mamadas controladas duas vezes ao dia. O desempenho foi avaliado em delineamento inteiramente casualizado, sendo os 23 bezerros mantidos junto com as matrizes. A suplementação com concentrado energético-proteico determinou melhor ingestão e aproveitamento dos nutrientes (65% de digestibilidade da matéria seca, desempenho dos bezerros (ganhos de peso de 0,98 kg dia-1 e manutenção do peso e das reservas corporais das matrizes. A utilização de suplemento proteico não mostrou bons resultados, sendo estes inferiores inclusive ao desempenho dos bezerros que não receberam suplementação, 0,56 e 0,77 kg dia-1, respectivamente. O desempenho dos bezerros no tratamento sem suplementação foi semelhante àqueles que receberam suplemento energético, porém as matrizes tiveram redução mais acentuada do peso corporal e das reservas energéticas. A suplementação com concentrado energético-proteico para bezerros lactentes mantidos em pastagens de Brachiaria brizantha cv. Marandu no início da seca mostrou ser uma técnica que beneficia o desempenho desses animais e das matrizesThis study evaluated the effect of supplementation and the type of supplement on nutrient digestibility and performance of lactating calves fed with Brachiara brizantha cv. Marandu pasture from February to May. The treatments were: supplementation in creep-feeding with protein concentrate, with energy

  3. Fatores de risco e proteção à infecção respiratória aguda em lactentes Factores de riesgo y protección de la infección respiratoria aguda en lactantes Risk and protective factors of acute respiratory infections in infants

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    Claudia Regina Cachulo Lopes

    2009-12-01

    Full Text Available OBJETIVO: Analisar a efetividade da vacina pneumocócica polissacarídica e fatores de risco e proteção para infecções por pneumococo em lactentes. MÉTODOS: Estudo transversal aninhado em ensaio clínico com filhos de 139 mulheres selecionadas no pré-natal um serviço público de saúde em São Paulo, SP, de 2005 a 2006. As participantes foram randomizadas em três grupos: o primeiro não recebia nenhuma vacina (n=46, o segundo recebia a vacina pneumocócica polissacarídica no último trimestre de gravidez (n=42, e o terceiro a recebia no pós-parto imediato (n=45. As infecções presumivelmente causadas pelo pneumococo nos lactentes foram acompanhados aos três e seis meses de vida e colhidas amostras de nasofaringe. Foram investigados fatores de risco como: fumantes no domicílio, outras crianças no domicílio e aleitamento materno exclusivo. RESULTADOS: A vacina pneumocócica polissacarídica não mostrou proteção contra infecções causadas por pneumococo. No entanto, o aleitamento materno exclusivo até os seis meses protegeu os lactentes contra as infecções respiratórias (OR= 7,331. A colonização da nasofaringe por pneumococo aos três ou seis meses aumentou a chance de infecções respiratórias (OR= 2,792. CONCLUSÕES: Lactentes amamentados exclusivamente com leite materno até seis meses são significativamente protegidos contra infecções por pneumococos, independentemente da vacinação pneumocócica.OBJETIVO: Analizar la efectividad de la vacuna pneumocóccica polisacarídica y factores de riesgo y protección para infecciones por pneumococo en lactantes. MÉTODOS: Estudio transversal anidado en ensayo clínico con hijos de 139 mujeres seleccionadas en el prenatal en servicio público de salud en Sao Paulo, SP, de 2005 a 2006. Las participantes fueron aleatorizadas en tres grupos: el primero no recibía ninguna vacuna (n=46, el segundo recibía la vacuna pneumocóccica polisacarídica en el último trimestre del

  4. Avaliação do nível mínimo de audição em lactentes de seis a 24 meses por meio do reforço visual Measurement of the minimal hearing level in infants from six to 24 months through visual reinforcement

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    Isabel Cristina Cavalcanti Lemos

    2007-06-01

    Full Text Available OBJETIVO: Investigar, em campo livre, o comportamento auditivo de lactentes ouvintes de seis a 24 meses de idade cronológica, quanto aos aspectos de duração da avaliação, nível mínimo de resposta e análise crítica do método utilizado. MÉTODOS: Foram avaliados 30 lactentes, de ambos os gêneros, subdivididos em grupos etários: Grupo I - 6 meses a 11 meses 29 dias (n= 11; Grupo II - 12 meses a 17 meses 29 dias (n= 9; Grupo III - 18 meses a 24 meses (n= 10. Foram avaliadas as freqüências de 500, 1000, 2000 e 4000 Hz, bilateralmente, não seqüenciais, em campo livre. RESULTADOS: A mediana do nível mínimo de audição foi de 30 dB em todas as freqüências e todos os grupos. Observou-se que os Grupos I e III tiveram maior variabilidade dos níveis mínimos de audição enquanto o Grupo II mostrou-se mais homogêneo. O Grupo I necessitou de maior tempo de condicionamento, apresentando cansaço, agitação e tempo de atenção reduzido sendo necessário maior número de interrupções no exame. Já o Grupo III evidenciou menor motivação para responder ao teste, já que a técnica do reforço visual não é tão interessante nessa faixa etária, fazendo com que o desinteresse pelo reforço aconteça mais rapidamente. Estes aspectos não inviabilizam o procedimento, no entanto requerem maior experiência dos avaliadores. CONCLUSÕES: O método mostrou-se eficiente para a faixa etária pesquisada, não somente como um método de triagem, mas também para auxiliar a investigação do nível mínimo de audição, em campo livre, durante o processo diagnóstico.PURPOSE: To investigate the auditory behavior of hearing infants with ages ranging from six to 24 months, on the aspects of evaluation length, minimum level of response and critical analysis of the method. METHODS: Thirty infants of both genders were divided in three age groups: Group I - 11 infants aged 6 to 11 months 29 days; Group II - 9 infants aged 12 to 17 months 29 days

  5. Medidas imitanciométricas em crianças com ausência de emissões otoacústicas Acoustic immittance in children without otoacoustic emissions

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    Ana Emilia Linares

    2008-06-01

    Full Text Available Partindo da hipótese de que alterações da função de orelha média possam prejudicar a captação das EOAs, é possível que a ausência destas, em lactentes, esteja associada a discretas alterações timpanométricas. OBJETIVO: Verificar a associação entre resposta de EOAT e alteração imitanciométrica com a sonda de 226Hz em lactentes. MÉTODOS: Estudo de coorte contemporânea com corte transversal. Foram avaliados 20 lactentes com ausência de EOAT (grupo pesquisa e 101 lactentes com presença de EOAT (grupo comparação, com idades variando entre o nascimento e oito meses. Os lactentes foram submetidos a: timpanometria; pesquisa dos limiares de reflexo acústico contralateral com estímulos de 0,5k, 1k, 2k, 4kHz e ruído de faixa larga; emissões otoacústicas (transiente e por produtos de distorção. O potencial evocado auditivo de tronco encefálico para pesquisa do limiar de resposta foi realizado no grupo pesquisa. RESULTADOS: Observou-se diferença estatisticamente significante entre os grupos (pConsidering the hypothesis that middle ear changes can impair the recording of otoacoustic emissions, it is possible that absent otoacoustic emissions in infants could be associated with a light tympanometric change. AIM: To study the association between transient otoacoustic emissions and changes in acoustic immittance measurements with 226Hz probe tone in neonates. METHODS: Cross-sectional contemporary cohort study. 20 infants with no transient otoacoustic emissions (study group and 101 infants with transient otoacoustic emissions (control group, with ages ranged from birth to eight months, were assessed. Infants were submitted to: admittance tympanometry; contralateral acoustic reflex threshold with stimulus of 0.5, 1, 2, 4 kHz and broad band noise; transient and distortion product otoacoustic emissions. The auditory brain response was used to study the threshold in neonates without transient otoacoustic emissions. RESULTS

  6. Características clínicas e da saturação transcutânea de oxigênio em lactentes hospitalizados com bronquiolite viral aguda Clinical and transcutaneous oxygen saturation characteristics in hospitalized infants with acute viral bronchiolitis

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    Fernanda M. Rubin

    2003-10-01

    Full Text Available OBJETIVOS: Descrever as características clínicas de lactentes com bronquiolite viral aguda (BVA e verificar a influência do tempo de dessaturação de oxigênio (TD como teste preditivo para estimar a evolução desses pacientes. MÉTODOS: Estudo de coorte realizado com 111 lactentes hospitalizados com diagnóstico de BVA e em oxigenoterapia por cateter nasal. Os desfechos foram: tempo de internação, tempo de oxigenoterapia e tempo para saturar 95% em ar ambiente. Foi aplicado, duas vezes ao dia, um escore de gravidade com os sinais clínicos verificados durante o período em que o paciente necessitou de oxigênio suplementar. Após suspender o oxigênio do paciente, foi observado o tempo necessário para a saturação transcutânea de oxigênio decrescer até 90% e 85%. Utilizou-se o teste do qui-quadrado ou teste exato de Fisher, para comparar entre si os grupos de variáveis categóricas, e o teste t ou Mann-Whitney, para as variáveis numéricas. A correlação de Spearman foi utilizada para avaliar associações entre variáveis contínuas de distribuição assimétrica. RESULTADOS: Houve predominância de idade inferior a quatro meses (61,3%. Os pacientes com história de sibilância prévia (45% foram analisados separadamente e tiveram resultados semelhantes ao grupo com BVA (pOBJECTIVE: To describe the clinical characteristics of infants with acute viral bronchiolitis (AVB and to assess the influence of oxygen desaturation time (DT as a prognostic test to estimate the evolution of such patients. METHODS: We performed a cohort study with 111 hospitalized patients diagnosed with AVB receiving oxygen therapy through nasal prong. The outcomes were: length of admission, length of oxygen therapy and time elapsed to read 95% saturation in room air. A severity score was obtained twice a day based on clinical signs during the time when the patient required oxygen supplementation. After the supply of oxygen was interrupted, the time required

  7. Associação entre índice de ventilação e tempo de ventilação mecânica em lactentes com bronquiolite viral aguda Association between ventilation index and time on mechanical ventilation in infants with acute viral bronchiolitis

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    Armando A. Almeida-Júnior

    2005-12-01

    Full Text Available OBJETIVO: Avaliar a associação entre tempo de ventilação mecânica e variáveis antropométricas, clínicas e de função pulmonar, precocemente, em lactentes com insuficiência respiratória por bronquiolite viral aguda em ventilação mecânica invasiva, e a evolução temporal das variáveis significativamente correlacionadas. MÉTODOS: Foram estudados 29 lactentes admitidos na unidade de terapia intensiva pediátrica do Hospital de Clínicas da UNICAMP, com diagnóstico de bronquiolite viral aguda, definido por critérios clínicos e radiológicos. Lactentes com doenças crônicas ou instabilidade hemodinâmica foram excluídos. Todas as medidas foram feitas entre 24 e 72 horas em ventilação mecânica, usando capnografia volumétrica e análise dos gases sangüíneos. O tempo de ventilação mecânica foi dividido em: menor ou igual que 7 dias e maior que 7 dias. A associação entre o tempo de ventilação e as variáveis analisadas foi determinada pelo coeficiente de correlação de Spearman (r s RESULTADOS: O tempo de ventilação mecânica apresentou correlação positiva significativa com a PaCO2 (r s = 0,45, p = 0,01 e com o índice de ventilação (r s = 0,51, p = 0,005, e negativa com o pH (r s = -0,40, p = 0,03. Índice de ventilação com valor de 37, avaliado do primeiro ao quinto dia, foi associado a risco progressivamente aumentado de tempo de ventilação mecânica maior que 7 dias (OR = 4,2 no primeiro dia a 15,71 no quarto dia CONCLUSÕES: Índice ventilatório, PaCO2 e pH, precocemente medidos, foram associados com tempo prolongado em ventilação mecânica, refletindo a gravidade do distúrbio ventilatório e necessidade de suporte.OBJECTIVE: To evaluate the association between time on mechanical ventilation and anthropometric, clinical and pulmonary function variables, measured early, in infants on invasive mechanical ventilation with acute respiratory failure due to viral bronchiolitis, and the temporal progression

  8. Penfigóide bolhoso no lactente Bullous pemphigoid in childhood

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    Ada Lobato Quattrino

    2007-02-01

    Full Text Available O penfigóide bolhoso é doença que comumente acomete pessoas idosas. Desde o primeiro caso na infância, confirmado por imunofluorescência em 1970, cerca de 50 casos foram relatados e poucos ocorreram em crianças com menos de um ano de idade. Apresentase caso de penfigóide bolhoso em lactente de quatro meses de idade e discutem-se as características clínicas e imunopatológicas dessa rara bulose da infância.Bullous pemphigoid typically affects the elderly. Since the first description of bullous pemphigoid in childhood in 1970, about 50 cases have been reported, but only 10 were reported in children under the first year of age. We report a case of bullous pemphigoid in a 4-month-old girl and discuss the clinical and immunopathological features of this rare bullous disease of infancy.

  9. Avaliação do impacto da vacina antipneumocócica conjugada na ocorrência de doenças respiratórias em lactentes

    OpenAIRE

    Wanderci Marys Oliveira Abrão

    2014-01-01

    Estudos realizados e recomendados pela OMS e UNICEF, indicam alta prevalência de infecções pneumocócicas e meningocócicas, sobretudo em crianças abaixo dos dois anos de idade. O Streptococcus pneumoniae é um dos agentes mais frequentes de pneumonia, otite média aguda (OMA), meningite e sinusite em crianças. O número global de mortes em crianças menores de cinco anos de idade causadas por pneumonia foi de 8,8 milhões, em 2008. O Ministério da Saúde, devido ao alcance de bons resultados com sor...

  10. Anestesia venosa total (AVT em lactente com doença de Werdnig-Hoffmann: relato de caso Anestesia venosa total (AVT en lactante con enfermedad de Werdnig-Hoffmann: relato de caso Total intravenous anesthesia (TIVA in an infant with Werdnig-Hoffmann disease: case report

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    Luis Otavio Esteves

    2010-10-01

    Full Text Available Foi com grande interesse que li o artigo "Anestesia Venosa Total (AVT em Lactente com Doença de Werdnig-Hoffmann. Relato de Caso", de Resende e col. ¹, publicado nesta revista. Gostaria, em primeiro lugar, de parabenizar os autores pela iniciativa. Entretanto, dois pontos me chamaram a atenção. O primeiro refere-se à definição de lactente, a qual compreende o período de 1 a 12 meses de idade. A partir de 12 meses, define-se como pré-escolar ou apenas criança. No artigo, o autor coloca a idade do paciente como 1 ano, mas não especifica meses ou dias. Provavelmente, esse paciente tem mais de 12 meses, sendo, dessa forma, a definição de lactente inadequada. O segundo e mais importante ponto diz respeito à técnica usada e ao título do artigo. No título, utilizou-se a expressão "anestesia venosa total", mas no relato foi dito que, além de propofol e remifentanil, a anestesia foi mantida com oxigênio e N2O. Se foi usado um gás com propriedades anestésicas (N2O, não seria correto classificar essa técnica como venosa total. Além disso, ele cita o artigo de Crawford e col. ², que definiu doses de remifentanil para intubação em crianças. Esse estudo foi realizado utilizando-se oxigenação na concentração de 100%, pois os autores provavelmente entendem que a adição de gases com propriedades anestésicas interferiria nos resultados obtidosFue con un gran interés que leí el artículo "Anestesia Venosa Total (AVT en Lactante con Enfermedad de Werdnig-Hoffmann. Relato de Caso", de Resende y col. ¹, publicado en esta revista. Y de hecho quiero, en primer lugar, felicitar a los autores por la iniciativa. Sin embargo, dos puntos me llamaron la atención. El primero, se refiere a la definición de lactante, la cual abarca el período de 1 a 12 meses de edad. A partir de los 12 meses, se define como preescolar o apenas como niño. En el artículo, el autor coloca la edad del paciente como de 1 año, pero no especifica meses o d

  11. Anestesia venosa total (AVT) em lactente com doença de Werdnig-Hoffmann: relato de caso Anestesia general intravenosa (AVT) en lactante con enfermedad de Werdnig-Hoffmann: relato de caso Total intravenous anesthesia (TIVA) in an infant with Werdnig-Hoffmann disease: case report

    OpenAIRE

    Marco Antonio Cardoso de Resende; Elizabeth Vaz da Silva; Osvaldo José Moreira Nascimento; Alberto Esteves Gemal; Giseli Quintanilha; Eliana Maria Vasconcelos

    2010-01-01

    JUSTIFICATIVA E OBJETIVOS: A doença de Werdnig-Hoffmann é a causa mais comum de hipotonia no lactente e quando presente logo após o nascimento tem pior prognóstico. Fraqueza muscular simétrica, arreflexia e fasciculações da língua são característicos. A maioria dos lactentes morre antes dos dois anos por insuficiência respiratória. O presente relato apresenta um caso com técnica venosa total durante anestesia. RELATO DO CASO: Paciente feminina, branca, um ano, 10 kg, estado físico ASA III, co...

  12. Efetividade superior do esquema diário de suplementação de ferro em lactentes Efectividad superior del esquema diario de suplementación de hierro en lactantes Greater effectiveness of daily iron supplementation scheme in infants

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    Catarina Machado Azeredo

    2010-04-01

    Full Text Available OBJETIVO: Avaliar a efetividade de esquemas, diário e semanal, de suplementação profilática de ferro medicamentoso na prevenção da anemia ferropriva em lactentes não anêmicos. MÉTODOS: Estudo populacional, prospectivo, de abordagem quantitativa com intervenção profilática, realizado no município de Viçosa, MG, em 2007/8. Foram selecionadas 103 crianças não anêmicas, entre seis e 18 meses de idade, correspondendo a 20,2% das crianças cadastradas e atendidas pelas Equipes de Saúde da Família. As crianças foram divididas em dois grupos de suplementação: dosagem diária recomendada pela Sociedade Brasileira de Pediatria (grupo 1, n=34 e dosagem semanal preconizada pelo Ministério da Saúde (grupo 2, n=69. As avaliações ocorreram no início do estudo e após seis meses, sendo realizadas dosagem de hemoglobina (ß-hemoglobinômetro portátil, avaliação antropométrica e dietética, e aplicação de questionário socioeconômico. Os indicadores de impacto utilizados foram a prevalência de anemia, variação de hemoglobina, adesão e efeitos adversos aos suplementos. RESULTADOS: Os grupos se mostraram homogêneos quanto às variáveis socioeconômicas, biológicas e de saúde anteriores à intervenção. Após seis meses de suplementação, observaram-se maiores médias de hemoglobina no grupo 1 em relação ao grupo 2, (11,66; DP=1,25 e 10,95; DP=1,41, respectivamente, p=0,015; além de menores prevalências de anemia (20,6% e 43,5%, respectivamente, p=0,04. Apenas o tempo de suplementação influenciou na anemia grave (p=0,009. Não foram encontradas diferenças estatisticamente significantes para as variáveis adesão ao suplemento e efeitos adversos. CONCLUSÕES: A dosagem diária recomendada pela Sociedade Brasileira de Pediatria mostrou-se mais efetiva na prevenção da anemia em lactentes, quando comparada à dosagem utilizada pelo Ministério da Saúde. A dosagem semanal recomendada pelo programa do governo

  13. Efeitos do clampeamento tardio do cordão umbilical sobre os níveis de hemoglobina e ferritina em lactentes aos três meses de vida

    OpenAIRE

    Venâncio,Sonia Isoyama; Levy,Renata Bertazzi; Saldiva,Sílvia Regina Dias Médici; Mondini,Lenise; Alves, Maria Cecília Goi Porto; Leung,Siu Lum

    2008-01-01

    Este estudo verificou o efeito do clampeamento tardio (um minuto após o nascimento) do cordão umbilical sobre os níveis de hemoglobina e ferritina em crianças aos três meses de vida. Foram alocadas 325 mães e crianças, nascidas a termo, de parto vaginal e sem patologias (164 no grupo do clampeamento imediato e 161 no tardio) em um hospital do Município de São Paulo, Brasil, em 2006. Realizaram-se dosagens de hemoglobina da mãe no pré-parto e de hemoglobina e ferritina do cordão umbilical. As ...

  14. Efeitos do clampeamento tardio do cordão umbilical sobre os níveis de hemoglobina e ferritina em lactentes aos três meses de vida Effects of delayed cord clamping on hemoglobin and ferritin levels in infants at three months of age

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    Sonia Isoyama Venâncio

    2008-01-01

    Full Text Available Este estudo verificou o efeito do clampeamento tardio (um minuto após o nascimento do cordão umbilical sobre os níveis de hemoglobina e ferritina em crianças aos três meses de vida. Foram alocadas 325 mães e crianças, nascidas a termo, de parto vaginal e sem patologias (164 no grupo do clampeamento imediato e 161 no tardio em um hospital do Município de São Paulo, Brasil, em 2006. Realizaram-se dosagens de hemoglobina da mãe no pré-parto e de hemoglobina e ferritina do cordão umbilical. As crianças (69% foram acompanhadas no ambulatório, após três meses, ocorrendo coleta de sangue venoso para dosagem de hemoglobina e ferritina. Variáveis sócio-econômicas, reprodutivas, antropométricas e de alimentação da criança foram estudadas. Utilizou-se a regressão linear múltipla para a análise dos dados. O efeito do clampeamento tardio do cordão umbilical foi significativo somente para os níveis de ferritina das crianças aos três meses de idade (p = 0,040, sendo superior em 23,29ng/mL quando comparado às crianças submetidas ao clampeamento imediato. O procedimento pode se constituir em uma estratégia para prevenir a deficiência de ferro em lactentes.This study assessed the effect of delayed (1 minute after delivery clamping of the umbilical cord on hemoglobin and ferritin levels in infants at three months of age. Mothers and their infants born through vaginal delivery, at term, and without congenital anomalies (325 pairs were recruited at a hospital in São Paulo, Brazil, in 2006 (164 in the delayed clamping subgroup and 161 in the early clamping subgroup. Maternal hemoglobin at delivery, umbilical cord hemoglobin, and ferritin were recorded. At three months follow-up, venous blood samples were drawn from 224 (69% infants for hemoglobin and ferritin measurement. Socioeconomic, maternal reproductive, anthropometric, and infant feeding variables were studied. Multiple linear regression models were used to analyze the data

  15. Resultados clínicos e funcionais da cirurgia de reconstrução do LCA contralateral em médio prazo - doi: 10.5102/ucs.v11i1.1962

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    Gabriela Ataides

    2013-07-01

    Full Text Available Lesões na articulação do joelho têm grande impacto na vida das pessoas devido à sua alta prevalência e sua repercussão clínica. Estudos comprovam a eficácia da cirurgia e do tratamento em curto prazo utilizando o tendão contralateral como enxerto. O presente estudo é do tipo transversal e tem como objetivo analisar a condição de pacientes que foram submetidos à cirurgia com enxerto contralateral e reabilitação do Ligamento Cruzado Anterior (LCA após um período de 3 a 10 anos. Foram avaliados vinte e dois (n=22 pacientes, selecionados aleatoriamente por meio de um banco de dados. Nos resultados encontrados, observou-se alteração apenas no Single Leg Hop Test (p-valor= 0,003 e Pico de Torque (PT de extensão a 60°/s e 180°/s (0,00 e 0,04. Nos parâmetros de estado clínico, os resultados obtidos foram benéficos. Portanto, o tratamento com o enxerto do tendão patelar contralateral apresentou bons resultados, visto que houve melhora da condição clínica esperada ao longo desses anos.

  16. Anestesia venosa total (AVT em lactente com doença de Werdnig-Hoffmann: relato de caso Anestesia general intravenosa (AVT en lactante con enfermedad de Werdnig-Hoffmann: relato de caso Total intravenous anesthesia (TIVA in an infant with Werdnig-Hoffmann disease: case report

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    Marco Antonio Cardoso de Resende

    2010-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A doença de Werdnig-Hoffmann é a causa mais comum de hipotonia no lactente e quando presente logo após o nascimento tem pior prognóstico. Fraqueza muscular simétrica, arreflexia e fasciculações da língua são característicos. A maioria dos lactentes morre antes dos dois anos por insuficiência respiratória. O presente relato apresenta um caso com técnica venosa total durante anestesia. RELATO DO CASO: Paciente feminina, branca, um ano, 10 kg, estado físico ASA III, com doença de Werdnig-Hoffmann diagnosticada desde os dois meses de idade. Candidata à gastrostomia e fundogastroplicatura na técnica aberta e traqueostomia. Monitorização com cardioscópio, pressão arterial não invasiva, oxímetro de pulso, estetoscópio precordial e temperatura retal após venóclise. Foi préoxigenada e após bolus de atropina (0,3 mg foi realizada indução anestésica com remifentanil bolus (20 µg e propofol (30 mg. Após intubação traqueal foi ventilada de forma controlada manual, em sistema sem absorvedor de CO2, Baraka (sistema Mapleson D, FGF de 4 L.min-1, FiO2 0,5 (0(2/N(20. Mantida sob anestesia com propofol 250 µg.kg-1.min-1 e remifentanil 0,3 µg.kg-1.min-1 em infusão contínua manual. O tempo cirúrgico foi de 150 minutos. O despertar ocorreu 8 minutos após o término da infusão, com ventilação espontânea. Duas horas depois foi transferida para unidade pediátrica e recebeu alta hospitalar no 4º dia de pós-operatório. CONCLUSÕES: A escolha da técnica anestésica prioriza a segurança que advém da familiaridade do manuseio dos fármacos existentes. Em crianças com doenças neuromusculares, a anestesia venosa total com remifentanil e propofol em sistemas de infusão, pela duração de ação extremamente curta, pode influenciar a evolução da doença favoravelmente.JUSTIFICATIVA Y OBJETIVOS: La enfermedad de Werdnig-Hoffmann es la causa más común de hipotonía en el lactante y cuando est

  17. Colite alérgica: características clínicas e morfológicas da mucosa retal em lactentes com enterorragia Allergic colitis: clinical and morphological aspects in infants with rectal bleeding

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    Norys Josefina Diaz

    2002-10-01

    Full Text Available RACIONAL: Recentes estudos indicam a importância do infiltrado eosinofílico na mucosa retal que, juntamente com os dados clínicos, pode servir para estabelecer o diagnóstico de colite alérgica. OBJETIVOS: Descrever, prospectivamente, as características clínicas e a morfologia da mucosa retal em pacientes com enterorragia e suspeita diagnóstica de alergia às proteínas do leite de vaca. MATERIAL E MÉTODOS: Foram estudados 20 pacientes, menores de 6 meses para descrever suas características clínicas e a histologia da mucosa retal que foi comparada com um grupo controle, com suspeita de megacólon congênito. RESULTADOS: A idade média dos pacientes foi 97 ± 47 dias; enterorragia teve início antes dos 120 dias em 85% deles; em vigência de aleitamento materno (40% artificial ou misto (60%. O achado histológico, estatisticamente significativo, foi o infiltrado aumentado de eosinófilos, na mucosa retal, em 18 pacientes. CONCLUSÃO: Pode-se afirmar que esses achados constituem, associados aos dados clínicos, os mais importantes elementos no diagnóstico de colite alérgica, em pacientes menores de 6 meses com enterorragia, que estejam recebendo aleitamento materno e/ou aleitamento artificial.BACKGROUND: Recent studies indicate the importance of eosinophilis infiltrated in the rectal mucous which jointly with the clinical features can serve to establish the diagnostic of allergic colitis. AIM: To describe prospectively, the clinical features and morphological abnormalities of the rectal mucosa in patients with rectal bleeding and clinical diagnosis of cow's milk allergy. METHODS: Clinical features of 20 infants under 6 months of age were described. Morphological findings in rectal mucosa were compared with control group, with suspicion of congenital megacolon. RESULTS: The mean age of the patients was 97 ± 47 days, rectal bleeding started before 120 days in 85% of them; 40% were breastfed, 60% cow's milk formula or both. The most

  18. Efetividade da suplementação diária ou semanal com ferro na prevenção da anemia em lactentes Efectividad en el suplemento diario o semanal de hierro en la prevención de anemia en lactantes Effectiveness of daily and weekly iron supplementation in the prevention of anemia in infants

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    Elyne Montenegro Engstrom

    2008-10-01

    Full Text Available OBJETIVO: Avaliar a efetividade da suplementação universal profilática com sulfato ferroso, em administração diária ou semanal, na prevenção da anemia em lactentes. MÉTODOS: Ensaio de campo randomizado com crianças de seis a 12 meses de idade, atendidas em unidades básicas de saúde do município do Rio de Janeiro, em 2004-2005. Foram formadas três coortes concorrentes com suplementação universal com sulfato ferroso com grupos: diário (n=150; 12,5mgFe/dia, semanal (n=147; 25mgFe/semana e controle (n=94. A intervenção durou 24 semanas e foi acompanhada por ações educativas promotoras de adesão. A concentração de hemoglobina sérica foi analisada segundo sua distribuição, média e prevalência de anemia (HbOBJETIVO: Evaluar la efectividad del suplemento universal profiláctico con sulfato ferroso, en administración diaria o semanal, en la prevención de la anemia en lactantes. MÉTODOS: Se realizo un ensayo de campo aleatorio con niños de seis a 12 meses de edad, atendidos en unidades básicas de salud del municipio de Río de Janeiro (Sureste de Brasil, en 2004-2005. Se formaron tres cohortes coincidentes con suplemento universal con sulfato ferroso con grupos: diario (n=150; 12,5mgFe/dia, semanal (n=147; 25mgFe/semana y control (n=94. La intervención duró 24 semanas y fue acompañada por acciones educativas promotoras de adhesión. La concentración de hemoglobina sérica fue analizada de acuerdo a su distribución, promedio y prevalencia de anemia (HbOBJECTIVE: To evaluate the effectiveness of universal prophylactic targeting with iron sulfate on daily or weekly basis in the prevention of anemia in infants. METHODS: Randomized clinical field trial with children between ages six and 12 months seen at primary health care units in the municipality of Rio de Janeiro, Brazil, between 2004 and 2005. Three concurrent cohorts were compared: daily group (n=150; 12.5mg Fe/day; weekly group (n=147; 25mg Fe/week and control

  19. Anemia do lactente: etiologia e prevalência Anemia in infancy: etiology and prevalence

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    Maria Claret C.M. Hadler

    2002-01-01

    Full Text Available Objetivo: verificar a prevalência de anemia, anemia ferropriva e deficiência de ferro em lactentes, de unidade pública de saúde, no município de Goiânia, Brasil, analisar e correlacionar as variáveis bioquímicas e hematológicas. Métodos: realizou-se estudo transversal. De 120 mães entrevistadas, foram incluídos 110 lactentes de 6 a 12 meses de idade, a termo e não gemelares. Dados socioeconômicos e hematológicos foram obtidos. Colheu-se sangue venoso dos lactentes em jejum para realização do hemograma completo por contagem eletrônica, ferro sérico, ferritina sérica e proteína C-reativa, os quais foram utilizados na avaliação da etiologia ferropriva nos anêmicos. Crianças com hemoglobina Objective: To verify the prevalence of anemia, iron deficiency anemia and iron deficiency in infants, at a Public Health Unit in the city of Goiânia - Brazil; to analyze and to correlate the hematologic and biochemical variables. Methods: A cross-sectional study was carried out. One hundred and ten full-term infants of the 120 mothers interviewed were included. The infants aged between six and twelve months and there were not twins. Socioeconomic and hematologic data was obtained. Venous blood was taken from fasting infants in order to carry out a complete hemogram through electronic cell counting, serum iron, serum ferritin and C-reactive protein, which were used in the evaluation of the etiology of iron deficiency in the anemic infants. Children with hemoglobin < 11g/dL were considered anemic. Results: The prevalence of anemia was 60.9%. In the diagnosis of the iron deficiency etiology in infants without an inflammation process, when considering the alteration of hemoglobin plus two more indices among mean corpuscular volume (MCV or mean corpuscular hemoglobin (MCH or serum ferritin or serum iron, the prevalence of the iron deficiency was 87%. Nevertheless, when red cell distribution width (RDW was included in the indices, the

  20. Fatores associados à concentração de retinol sérico em lactentes Factores asociados a la concentración de retinol sérico en lactantes Factors associated with the concentration of serum retinol in infants

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    Michele Pereira Netto

    2012-01-01

    Full Text Available OBJETIVO: Verificar os fatores associados à concentração de retinol em lactentes atendidos em serviço público de saúde. MÉTODOS: Estudo de corte transversal realizado com 101 crianças de 18 a 24 meses, atendidas no serviço público de saúde da área urbana da cidade de Viçosa. A análise da concentração de retinol no sangue venoso foi realizada por cromatografia líquida de alta eficiência. Para avaliação da prática alimentar, utilizou-se o recordatório de 24 horas. As entrevistas foram realizadas com os pais ou responsáveis pelas crianças em seus domicílios. Para avaliar as variáveis associadas ao retinol sérico, foi utilizada análise de regressão linear múltipla. RESULTADOS: Identificou-se 39,6% de prevalência da deficiência de vitamina A. Os fatores associados positivamente ao nível sérico de retinol foram tempo de escolaridade paterna e ingestão de proteína. Por outro lado, o número de moradores no domicílio e a idade da criança estiveram negativamente associados. CONCLUSÕES: A hipovitaminose A se apresenta como um problema de Saúde Pública entre os lactentes do município de Viçosa. Fatores socioeconômicos, dietéticos e biológicos se associam à deficiência da vitamina A na população infantil.OBJETIVO: Verificar los factores asociados a la concentración de retinol en lactantes atendidos en el servicio público de salud del área urbana de la ciudad de Viçosa (Minas Gerais, Brasil. MÉTODOS: Estudio de corte transversal realizado con 101 niños, de 18 a 24 meses, atendidos en el servicio de salud del área urbana de la ciudad de Viçosa. El análisis de la concentración de retinol en la sangre venosa fue realizado por cromatografía líquida de alta eficiencia. Para evaluación de la práctica alimentar, se utilizó el recordatorio de 24 horas. Las entrevistas fueron realizadas con los padres o responsables de los niños en sus domicilios. Para evaluar las variables asociadas al retinol s

  1. Variabilidade do risco do tempo de permanência ajustado para lactentes de muito baixo peso ao nascer entre centros da Neocosur South American Network

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    Guillermo Marshall

    2012-12-01

    Full Text Available OBJETIVOS: Desenvolver um modelo de predição para o tempo de permanência hospitalar (TPH em lactentes de muito baixo peso ao nascer (MBPN e comparar esse resultado entre 20 centros de uma rede neonatal, visto que o TPH é utilizado como uma medida da qualidade da assistência em lactentes de MBPN. MÉTODOS: Utilizamos dados coletados prospectivamente de 7.599 lactentes com peso ao nascer entre 500 e 1.500 g no período entre os anos de 2001 a 2008. O modelo de regressão de Cox foi empregado para desenvolver dois modelos de predição: um modelo prévio com dados do nascimento e outro posterior, que acrescenta morbidades relevantes dos primeiros 30 dias de vida. RESULTADOS: A mediana do TPH estimado e ajustado a partir do nascimento foi de 59 dias; 28 dias depois do tempo de sobrevida de 30 dias. Houve uma alta correlação entre os modelos (r = 0,92. O TPH esperado e o TPH observado variaram bastante entre os centros, mesmo depois de correção para as morbidades relevantes após 30 dias. O TPH mediano (variação: 45-70 dias e a idade concepcional na alta hospitalar (variação: 36,4-39,9 semanas refletem uma variabilidade alta entre centros. CONCLUSÃO: Um modelo simples, com fatores apresentados no nascimento, pode predizer o TPH de um lactente de MBPN em uma rede neonatal. Observou-se uma variabilidade nos TPHs considerável entre unidades de terapia intensiva neonatal. Especulamos que os resultados sejam provenientes das diferenças entre as práticas dos centros.

  2. Sibilância no lactente: epidemiologia, investigação e tratamento Wheezing in infancy: epidemiology, investigation, and treatment

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    Herberto José Chong Neto

    2010-06-01

    Full Text Available OBJETIVO: Realizar revisão de aspectos epidemiológicos, de investigação e tratamento da sibilância em lactentes. FONTES DOS DADOS: Foram avaliados os estudos disponíveis na base de dados MEDLINE utilizando os descritores "sibilosc, "lactentes", "diagnóstico", "tratamento" e "crianças", e estudos encontrados com a ferramenta Google utilizando o tema "Estudio Internacional de Sibilancias en Lactantes". SÍNTESE DOS DADOS: Foi observada globalmente grande variabilidade na prevalência de sibilância em lactentes. Os fatores associados à sibilância na infância diferem entre os centros. O tratamento de lactentes sibilantes ainda é controverso e depende de diagnóstico preciso. A história clínica e o exame físico são fundamentais para o diagnóstico. CONCLUSÕES: A padronização de método pode demonstrar dados relevantes sobre a epidemiologia e o tratamento da sibilância em nosso país para comparação entre os centros envolvidos.OBJECTIVE: To perform a review of the epidemiological aspects of investigating and treating wheezing in infants. SOURCES: A search was run on MEDLINE using the keywords "wheezing," "infants," "diagnosis," "treatment," and "children," and Google was also used to search for "Estudio Internacional de Sibilancias en Lactantes." SUMMARY OF THE FINDINGS: The prevalence of wheezing in infants varies greatly around the world. The factors associated with wheezing in infants are different at different research centers. Treatment of wheezing infants is still controversial and is dependent on a precise diagnosis. Clinical history and physical examination are fundamental to diagnosis. CONCLUSIONS: A standardized method could reveal data of relevance to the epidemiology and treatment of wheezing in Brazil and allow comparisons between different participating centers.

  3. Acompanhamento do desenvolvimento da linguagem de lactentes de risco para surdez Follow-up of language development in infants with risk factors for hearing loss

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    Denise Maria Zaratini Fernandes

    2011-03-01

    Full Text Available OBJETIVO: Comparar o desenvolvimento da linguagem, de acordo com o gênero, idade gestacional e peso ao nascimento, aos quatro, oito e 12 meses, de lactentes que permaneceram em UTI Neonatal e que apresentaram um ou mais indicadores de risco para perda auditiva de aparecimento tardio. MÉTODOS: Estudo longitudinal de lactentes nascidos entre agosto de 2007 e julho de 2008 que, na UTI, apresentaram resultado normal no Potencial Evocado Auditivo de Tronco Encefálico, e que necessitaram de monitoramento audiológico e de linguagem, por apresentarem indicadores de risco para perda auditiva. Os lactentes foram avaliados no 4º, 8º e 12° meses de vida por meio da Escala de Aquisições Iniciais de Linguagem. RESULTADOS: Compareceram a todas as avaliações 87 lactentes e 60 (69% apresentaram como indicador de risco a permanência na UTI associada à hipertensão pulmonar. Na Escala de Aquisições Iniciais de Linguagem, nove lactentes apresentaram alterações aos quatro meses e 11 lactentes aos oito meses de idade. Aos 12 meses, 18 (20,6% lactentes apresentaram alteração e desses, cinco tiveram atraso nos meses anteriores. Os dados estatísticos demonstraram que resultados alterados aos quatro e oito meses podem predizer dificuldades nas respostas dos lactentes aos 12 meses. Houve o aparecimento de desvios transitórios no desenvolvimento da linguagem oral, normalizados na maioria dos casos. CONCLUSÃO: Deve-se realizar a avaliação de linguagem no primeiro ano de vida a fim de monitorar possíveis atrasos em lactentes com indicador de risco para surdez.PURPOSE: To compare language development, according to gender, gestational age and birth weight, at four, eight and 12 months of life, of infants who remained in the Neonate Intensive Care Unit, who presented at least one risk factor for hearing loss with delayed onset. METHODS: Longitudinal study of infants born between August 2007 and July 2008, who, in the Intensive Care Unit (ICU, showed

  4. Prevalência de tabagismo e consumo de bebida alcoólica em mães de lactentes menores de seis meses de idade Prevalence of smoking and alcohol consumption among mothers of infants under six months of age

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    Luiz Antonio Del Ciampo

    2009-12-01

    Full Text Available OBJETIVO: Conhecer a prevalência de tabagismo e consumo de bebida alcoólica em mães de lactentes menores de seis meses de idade. MÉTODOS: Estudo transversal e descritivo com mães de crianças com idade entre zero e seis meses completos, matriculadas em programas de puericultura das Unidades Básicas de Saúde da cidade de Ribeirão Preto (SP, ligadas aos seis Centros de Saúde Escola da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo. Foi aplicado um questionário em que constavam informações como idade materna, grau de escolaridade, paridade, ocupação, tempo de aleitamento materno exclusivo e complementado, consumo de bebidas alcoólicas e cigarros e existência de algum tabagista no domicílio. RESULTADOS: Foram entrevistadas 504 mulheres; 324 (64,3% tinham algum contato com cigarro sendo 97 (19,2% tabagistas ativas, 142 (28,2% tabagistas passivas e 85 (16,8% tabagistas ativas e passivas. Dentre as 97 tabagistas ativas, 78 (80,4% estavam amamentando. Também estavam amamentando 118 (83,1% das 142 mães tabagistas passivas. Quanto às bebidas alcoólicas, 56 (11,1% mães responderam que as consumiam e, destas, 45 (80,3% estavam amamentando. Quinze (26,8% mães que consumiam bebidas alcoólicas também eram tabagistas. CONCLUSÕES: O estudo encontrou alta prevalência de mães com algum tipo de contato com tabagismo e que consumiam bebidas alcoólicas, sendo imprescindível investir na prevenção dessas práticas nos programas de assistência pré-natal e de puericultura.OBJECTIVE: To study the prevalence of smoking and alcoholic beverage consumption among mothers of infants under six months of age. METHODS: This is a descriptive cross-sectional study of mothers of all infants up to six months of age who were enrolled in child care programs at the Basic Care Units of Ribeirão Preto city, linked to the six Health Care Centers of Ribeirão Preto School of Medicine of São Paulo University, Brazil. Mothers answered

  5. Validação clínica do diagnóstico de enfermagem "Disposição para desenvolvimento melhorado do lactente"

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    Flávia Paula Magalhães Monteiro

    Full Text Available RESUMO Objetivo: realizar a validação clínica do diagnóstico de enfermagem "Disposição para desenvolvimento melhorado do lactente". Método: estudo transversal, desenvolvido no Centro de Saúde da Família, com 45 lactentes saudáveis. O instrumento de coleta de dados foi construído com base na literatura e validado por enfermeiros. Nele, continham as variáveis: sociodemográficas, gestacionais e obstétricas; perfil alimentar do lactente; avaliação das características definidoras do diagnóstico de enfermagem proposto. Resultados: todas as características definidoras obtiveram valores de sensibilidade elevados (>90%, valores preditivos positivos (>65%, valores preditivos negativos (>66%; entretanto, valores baixos de especificidade (0,50 na curva ROC, o que confere boa sensibilidade e especificidade. Conclusão: este estudo verifica os elementos estruturais do diagnóstico de enfermagem proposto como relevante no contexto clínico, o que justifica a necessidade de ser empregado na clientela infantil, tendo em vista sua contribuição para o aperfeiçoamento do cuidado em enfermagem.

  6. Efetividade da Estratégia Nacional para Alimentação Complementar Saudável na melhoria da alimentação complementar de lactentes em um município do Sul do Brasil

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    Rosane Baldissera

    Full Text Available Resumo: O objetivo do presente trabalho foi avaliar a efetividade da Estratégia Nacional para Alimentação Complementar Saudável (ENPACS na melhoria da alimentação complementar no primeiro ano de vida em um município brasileiro. Trata-se de um estudo avaliativo de impacto, envolvendo 340 crianças com idades entre 6 e 12 meses, acompanhadas nas unidades básicas de saúde. Os desfechos avaliados foram prevalência do consumo de verduras, legumes, frutas e alimentos não saudáveis, e prevalência de alimentos com consistência adequada para a idade. A regressão de Poisson revelou que a ENPACS esteve associada a uma redução de 32% no consumo de refrigerante e/ou suco industrializado, 35% no de comidas industrializadas e 5% no consumo de alimentos não saudáveis. Não houve aumento no consumo de frutas, legumes, verduras e alimentos com consistência adequada para a idade. Conclui-se que o efeito positivo da estratégia foi parcial, mas que ela tem potencial de contribuir para a melhoria da alimentação infantil, haja vista sua efetividade na redução do consumo de alimentos não saudáveis.

  7. Influência do nível de habilidade e posição corporal no alcance de lactentes Influence of skill level and body position on infants’ reaching

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    RP Carvalho

    2008-06-01

    Full Text Available CONTEXTUALIZAÇÃO: Embora o desenvolvimento do alcance em diferentes posições corporais tem sido amplamente estudado, há poucas pesquisas sobre este assunto, considerando o nível de habilidade do lactente. Objetivo: Verificar como as posições corporais afetam os ajustes proximais e distais do alcance manual de lactentes de quatro a seis meses. MATERIAIS E MÉTODOS: Dez lactentes classificados como menos (n=6 e mais habilidosos (n=4 foram avaliados no mês de aquisição do alcance (M1 e após um mês de prática espontânea (M2, nas posições supina (0º, reclinada (45º e sentada (70º. Foram analisados os ajustes proximais (alcances uni ou bimanuais e distais (mão aberta, semi-aberta ou fechada, posição das mãos no início do movimento (perto ou longe do corpo e movimentos de preensão. RESULTADOS: Houve predomínio de alcances unimanuais para os lactentes mais habilidosos. Os lactentes menos habilidosos apresentaram maior freqüência de alcances unimanuais em M1 (sentado e M2 (supino e sentado. Houve predomínio de alcances com as mãos semi-abertas, exceto para lactentes mais habilidosos em M2 na posição reclinada. Lactentes menos habilidosos apresentaram mãos próximas ao corpo em M1 (reclinado e sentado e M2 (reclinado, enquanto os mais habilidosos iniciaram seus alcances com as mãos longe do corpo em M2 (supino. Lactentes mais habilidosos fizeram mais alcances seguidos de preensão em M2 nas posições supina e sentada. CONCLUSÕES: A posição corporal afeta os ajustes proximais e distais do alcance, de acordo com o nível de habilidade do lactente.BACKGROUND: Although the development of reaching under different body position conditions has been widely studied, little research has addressed this issue considering the infant’s skill level. OBJECTIVE: To investigate how different body positions affect proximal and distal reaching adjustments among four to six-month-old infants. Methods: Ten infants classified as less (n

  8. Vacina difteria, tétano e pertussis acelular (dTpa na gravidez: prevenção da tosse convulsa no lactente

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    Vera Amaral

    2015-09-01

    Full Text Available Introdução: Atualmente observa-se uma reemergência de tosse convulsa em países com elevadas coberturas vacinais, incluindo Portugal. Os lactentes com menos de três meses de idade constituem o grupo mais vulnerável. Novas estratégias vacinais têm sido propostas, entre as quais a vacinação no terceiro trimestre de gravidez. No entanto, a sua implementação é ainda limitada, existindo dúvidas quanto à sua eficácia e segurança. Objectivo: Rever a evidência quanto à eficácia e segurança da vacina difteria, tétano e pertussis acelular (dTpa administrada na gravidez na prevenção da tosse convulsa no lactente. Métodos: Foram pesquisadas normas de orientação clínica (NOC, revisões sistemáticas e estudos originais (EO na Medline, bases de dados de medicina baseada na evidência e sítios da Direção-Geral da Saúde e Sociedade Portuguesa de Pediatria. Utilizaram-se os termos MeSH pertussis vaccine e pregnancy e foram selecionados artigos publicados entre 01/07/09 e 15/07/2014 nas línguas portuguesa, inglesa e espanhola. Desenvolvimento: A maioria das NOC recomenda a vacinação de todas as grávidas no terceiro trimestre. Os EO mostram que a dTpa administrada na gravidez é eficaz no aumento da concentração de anticorpos anti-pertussis maternos e do lactente e na diminuição dos casos de doença e de hospitalizações em lactentes. A vacina não parece associar-se a aumento de efeitos adversos materno-fetais ou nas crianças. Conclusões: A vacinação com dTpa durante o terceiro trimestre de gravidez parece ser segura e eficaz na prevenção da tosse convulsa no lactente.

  9. Formação do enfermeiro para detecção precoce de desvios psicomotores em lactentes - Fortaleza, estado do Ceará, Brasil - DOI: 10.4025/actascihealthsci.v25i2.2230 Nurse formation for precocious detection of psychomotor deviations in suckling - Fortaleza, state of Ceará, Brazil - DOI: 10.4025/actascihealthsci.v25i2.2230

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    Maria Teresa Moreno Valdés

    2003-04-01

    Full Text Available Objetivou-se identificar a formação dos enfermeiros para detecção precoce dos desvios psicomotores em lactentes, os fatores que interferem na atuação profissional e elaborar um roteiro para subsidiá-lo. Trata-se de estudo exploratório-descritivo realizado em cinco Unidades do Programa de Saúde da Família (Fortaleza - CE. Foram entrevistados 17 enfermeiros que realizam consulta em puericultura. A coleta dos dados ocorreu de julho a outubro de 2001, por meio de observação e entrevista semi - estruturada. Os dados foram analisados, discutidos e apresentados por meio de Tabelas. Onze enfermeiros consideram-se despreparados para a detecção precoce de tais desvios. Os obstáculos apontados foram: falta de treinamento, tempo reduzido para aperfeiçoamento e carga horária excessiva de trabalho. Os enfermeiros sugerem aperfeiçoamento profissional, associado à melhoria das condições de trabalho e aquisição de material didático e audiovisual para implementação de programas preventivos. Conclui-se ser necessária a implementação de um plano com ações que capacitem o enfermeiro para a detecção precoce desses desvios.This paper aimed to identify nurses formation for precocious detection of psychomotor deviations in suckling, the factors that interfere in their performance and to make a proposal of a schedule to subsidize them. Exploratory-descriptive study was carried out in five Units of Family Health Program, in the city of Fortaleza, state of Ceará, Brazil. Seventeen nurses who had accomplished consultation in puericulture were interviewed. Data were collected from July to October 2001, through observation and semi-structured interview. The data were analyzed, debated, and presented through tables. Eleven nurses considered themselves unprepared for precocious identification of such deviations. The obstacles pointed were: insufficient training, reduced time to improvement and excessive work routine. The nurses suggest the

  10. Comportamento de lactentes nascidos a termo pequenos para a idade gestacional no primeiro trimestre da vida

    OpenAIRE

    2004-01-01

    O objetivo foi comparar o comportamento de lactentes nascidos a termo com peso adequado (AIG) a lactantes pequenos para a idade gestacional (PIG), no primeiro trimestre de vida. A amostra foi de 20 lactentes, avaliados no 1º, 2º e 3º meses. Foram utilizadas as Escalas Bayley de Desenvolvimento Infantil - II, com ênfase na Escala de Classificação do Comportamento (ECC). Houve diferença significativa entre os grupos no 2º mês, com maior número de lactentes PIG classificados como alterados na EC...

  11. Recrudescência fatal de hipertermia maligna em lactente com síndrome de Moebius. Relato de caso Recrudescencia fatal de hipertermia maligna en lactante con el síndrome de Moebius. Relato de caso Fatal recrudescence of malignant hyperthermia in an infant with Moebius syndrome

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    Cláudia Regina Fernandes

    2013-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A hipertermia maligna (HM é uma desordem farmacogenética da musculatura esquelética, caracterizada por estado hipermetabólico após anestesia com succinilcolina e/ou agentes anestésicos voláteis. Várias síndromes neuromusculares estão associadas com susceptibilidade, no entanto a síndrome de Moebius não é descrita. O dantrolene é o fármaco de escolha para o tratamento. Recrudescência pode ocorrer em até 20% dos casos após o tratamento do evento inicial. RELATO DO CASO: Lactente, masculino, primeiro gemelar, sete meses, 6,5 kg. Portador da síndrome de Moebius. Internado para correção de pé torto congênito. Apresentou HM após exposição à sevoflurano e succinilcolina, prontamente revertida com dantrolene, sendo o fármaco mantido por 24 horas. Dez horas após a interrupção do dantrolene, houve recrudescência da HM, a qual não respondeu satisfatoriamente ao tratamento, evoluindo para óbito. DISCUSSÃO: Doenças musculoesqueléticas em crianças estão associadas a aumento de risco para desenvolvimento de MH, embora a síndrome de Moebius ainda não tenha sido descrita. O dantrolene é fármaco de eleição para o tratamento da síndrome, está indicada profilaxia durante as primeiras 24-48 horas do episódio inicial. Os principais fatores associados à recrudescência são: tipo muscular, longa latência após exposição anestésica e aumento da temperatura. A criança tinha apenas um fator de risco. Este caso nos remete à reflexão de que devemos estar atentos a crianças com doença musculoesquelético e que devemos manter o tratamento durante 48 horas.JUSTIFICATIVA Y OBJETIVOS: La hipertermia maligna (HM es un trastorno farmacogenético de la musculatura esquelética, caracterizado por un estado hipermetabólico después de la anestesia con la succinilcolina y/o agentes anestésicos volátiles. Varios síndromes neuromusculares están asociados con la susceptibilidad, sin embargo el s

  12. Irradiação contralateral de força para a ativação do músculo tibial anterior em portadores da doença de Charcot-Marie-Tooth: efeitos de um programa de intervenção por FNP Contralateral force irradiation for the activation of tibialis anterior muscle in carriers of Charcot-Marie-Tooth disease: effect of PNF intervention program

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    Paula C. Meningroni

    2009-10-01

    Full Text Available OBJETIVO: Avaliar a resposta do músculo tibial anterior (TA após um protocolo de cinco semanas com irradiação contralateral de força através de diagonais de facilitação neuromuscular proprioceptiva (FNP em pacientes com polineuropatia desmielinizante associada à doença de Charcot-Marie-Tooth do tipo 1A (CMT-1A. MÉTODOS: Participaram deste estudo 12 pacientes, de ambos os sexos. Eles foram tratados em uma frequência de duas vezes por semana, durante cinco semanas. Em cada sessão, foram utilizadas as diagonais de Chopping, extensão-adução com rotação interna (EARI e flexão-abdução com rotação interna (FARI. As diagonais foram repetidas quatro vezes, em ambos os membros superiores e inferiores; cada diagonal tinha duração média de 6 segundos. Durante as execuções, a resposta muscular do TA foi registrada por um eletromiógrafo de superfície, desprezando-se os 2 segundos iniciais e finais de cada diagonal. A média dos valores de Root Mean Square (RMS das quatro repetições foi normalizada em porcentagem. Os dados iniciais e finais foram submetidos ao teste em t para amostras pareadas com valores de p significativos OBJECTIVE: To evaluate the response of the tibialis anterior (TA muscle following a five-week protocol with contralateral irradiation force through Proprioceptive Neuromuscular Facilitation (PNF diagonals in patients with demyelinating polyneuropathy associated with Charcot-Marie-Tooth disease type 1A (CMT-1A. METHODS: The study included 12 patients of both sexes. They were treated twice-weekly for 5 weeks. At each session, they performed the following diagonal patterns: chopping, extension-adduction with internal rotation (EAIR and flexion-abduction with internal rotation (FAIR. The diagonals were repeated four times, in both upper and lower limbs, with each repetition lasting six seconds on average. During execution, the response of the TA muscle was recorded by a surface electromyograph disregarding the

  13. The contralateral ear in cholesteatoma.

    Science.gov (United States)

    da Costa, Sady Selaimen; Teixeira, Adriane Ribeiro; Rosito, Letícia Petersen Schmidt

    2016-07-01

    Middle ear cholesteatoma has been extensively studied. Theories of cholesteatoma pathogenesis involving previous tympanic membrane retraction are the most widely accepted, but the contralateral ear in patients with cholesteatoma remains unstudied. This study aimed to investigate the contralateral ear in patients with cholesteatoma, and to determine whether the characteristics of it differ according to patient age and cholesteatoma growth patterns. This study was cross sectional. We evaluated 356 patients with middle ear cholesteatoma in at least one ear, and no history of surgery, between August 2000 and March 2013. Otoendoscopy was conducted on both the affected and the contralateral ear. They were classified as normal, tympanic membrane perforation, moderate to severe tympanic membrane retraction and cholesteatoma. The mean age of the patients was 32.77 years, and 53.1 % of the cohort were female. Only 34.8 % of the contralateral ears were normal. The most common abnormality was moderate to severe tympanic membrane retraction (41.6 %). Cholesteatoma was identified in 16 %. Children exhibited a greater frequency of tympanic membrane retractions, whereas adults exhibited a greater frequency of cholesteatoma. All of the contralateral ears in the anterior epitympanic group were normal, but otherwise there were no differences in the contralateral ear when we compared the cholesteatoma growth patterns. We conclude that patients diagnosed with acquired cholesteatoma of one ear are significantly more likely to exhibit abnormalities of the contralateral ear.

  14. Contralateral hemimicrencephaly in neonatal hemimegalencephaly.

    Science.gov (United States)

    Shiroishi, Mark S; Jackson, Hollie A; Nelson, Marvin D; Bluml, Stefan; Panigrahy, Ashok

    2010-11-01

    Identification of abnormalities in the contralateral hemisphere in patients with hemimegalencephaly is critical in their management. In this report, we present a 5-day-old neonate with hemimegalencephaly who demonstrated an enlarged ipsilateral cerebral hemisphere and diffuse volume loss in the contralateral hemisphere on conventional MR imaging sequences. The ipsilateral frontal white matter demonstrated relatively increased NAA, fractional anistropy, and cerebral blood volume values compared to published normative data. In addition, the white matter of the contralateral hemisphere demonstrated elevated lactate and increased mean diffusivity compared to published normative data, supporting the abnormal conventional MR findings. Advanced MR neuroimaging techniques may help further confirm and characterize abnormalities in the smaller contralateral hemisphere in neonatal hemimegalencephaly.

  15. Contralateral hemimicrencephaly in neonatal hemimegalencephaly

    Energy Technology Data Exchange (ETDEWEB)

    Shiroishi, Mark S.; Jackson, Hollie A.; Nelson, Marvin D. [Childrens Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); Bluml, Stefan [Childrens Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); Rudi Schulte Research Institute, Santa Barbara, CA (United States); Panigrahy, Ashok [Childrens Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States); Children' s Hospital of Pittsburgh of UPMC, Department of Pediatric Radiology, Pittsburgh, PA (United States)

    2010-11-15

    Identification of abnormalities in the contralateral hemisphere in patients with hemimegalencephaly is critical in their management. In this report, we present a 5-day-old neonate with hemimegalencephaly who demonstrated an enlarged ipsilateral cerebral hemisphere and diffuse volume loss in the contralateral hemisphere on conventional MR imaging sequences. The ipsilateral frontal white matter demonstrated relatively increased NAA, fractional anistropy, and cerebral blood volume values compared to published normative data. In addition, the white matter of the contralateral hemisphere demonstrated elevated lactate and increased mean diffusivity compared to published normative data, supporting the abnormal conventional MR findings. Advanced MR neuroimaging techniques may help further confirm and characterize abnormalities in the smaller contralateral hemisphere in neonatal hemimegalencephaly. (orig.)

  16. Aspectos da função tireóidea em lactentes submetidos à cirurgia cardíaca com circulação extracorpórea Aspectos de la función tiroidea en lactantes sometidos a cirugía cardíaca con circulación extracorpórea Thyroid function profile in infants submitted to cardiac surgery with cardiopulmonary bypass

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    Paula Maria da Cruz

    2004-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A cirurgia cardíaca com circulação extracorpórea (CEC relaciona-se à doença eutireóidea ou à depressão do eixo hipotálamo-hipofisário-tireóideo. O estado hemodinâmico incomum imposto pela CEC é responsável por diversas alterações endócrino-metabólicas, acarretando complexa resposta inflamatória sistêmica. Esta investigação teve como objetivo analisar o comportamento da triiodotironina (T3, tetraiodotironina (T4 e tireotrofina (TSH em lactentes submetidos à cirurgia cardíaca com CEC. MÉTODO: Foram estudados 15 lactentes. As amostras de sangue para pesquisa de T3, T4 e TSH foram obtidas em 4 momentos designados: M1 - após a indução da anestesia; M2 - após o final da cirurgia; M3 - 6 horas após o final da cirurgia e M4 - 24 horas após o M1. Para complementar esta investigação, foram estudadas as variações dos seguintes parâmetros: pressão arterial média (PAM, temperatura sangüínea central (ºC, atributos da oxigenação tecidual e do equilíbrio ácido-base (M1, CEC, M2, M3 e M4. RESULTADOS: As médias de idade, peso, altura e superfície corpórea dos pacientes foram 3,9 meses; 4,708 kg; 0,65 m e 0,3 m², respectivamente. As concentrações plasmáticas de T3 (p JUSTIFICATIVA Y OBJETIVOS: La cirugía cardíaca con circulación extracorpórea (CEC relacionase a la enfermedad eutiroidea o a la depresión del eje hipotálamo-hipofisário-tiroideo. El estado hemodinámico incomún impuesto por la CEC es responsable por diversas alteraciones endócrino-metabólicas, acarreando compleja respuesta inflamatoria sistémica. Esta investigación tuvo como objetivo analizar el comportamiento de la triiodotironina (T3, tetraiodotironina (T4 y tireotrofina (TSH en lactantes sometidos a cirugía cardíaca con CEC. MÉTODO: Fueron estudiados 15 lactantes. Las muestras de sangre para pesquisa de T3, T4 y TSH fueron obtenidas en 4 momentos designados: M1 - después de la inducción de la anestesia

  17. Neuropsychomotor development before and after open-heart surgery in infants Desenvolvimento neuropsicomotor de lactentes antes e após cirurgia cardíaca

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    Taís Sica da Rocha

    2009-06-01

    Full Text Available There are few Brazilian studies on neuropsychomotor follow-up after open-heart surgery with circulatory bypass in infants. Twenthy infants had neurodevelopmental outcomes (neurological exam and Denver II test assessed before open-heart surgery, after intensive care unit discharge and 3-6 months after hospital discharge. Heart lesions consisted of septal defects in 11 cases (55%. The mean circulatory bypass time was 67 ± 23.6 minutes. Fifteen infants had altered neurological examination and also neurodevelopment delay before surgery. After 6 months it was observed normalization in 6 infants. When Denver II test indexes were analysed, it was observed an improvement in all domains except personal-social. Although those infants were in risk of new neurological findings, an early improvement on neuropsychomotor indexes were seen.As alterações neurológicas em lactentes com cardiopatia congênita podem agravar seu quadro clínico e levar a seqüelas permanentes. Foi realizada uma coorte prospectiva, com 20 lactentes, com idade média de 6,7 ± 4,2 meses, avaliando-se o perfil de desenvolvimento e o estado nutricional. Utilizou-se o exame neurológico e o teste de Denver II. Os testes foram aplicados 24h antes da cirurgia, na alta da unidade de terapia intensiva e 3 a 6 meses após. Os defeitos septais ocorreram em 11 casos (55%. O tempo médio de circulação extra-corpórea foi de 67ffl23,6 minutos. Quinze crianças tinham exame neurológico alterado e atraso no desenvolvimento neuropsicomotor antes da cirurgia, cuja normalização foi observada somente em seis após 6 meses .Quanto aos índices de Denver II, houve aumento em todos domínios, exceto o pessoal-social. O escore Z médio para peso antes da cirurgia foi -2,814 ± 1,98 e após -1,08 ± 1,47 (p<0.05, o qual foi realizado em média 5.2 ± 1.5 meses após a alta hospitalar. Melhora precoce tanto no desenvolvimento como no estado nutricional pôde ser observada neste grupo de lactentes ap

  18. Avaliação nutricional de lactentes hospitalizados Nutritional evaluation of hospitalized suckling childrem

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    João Guilherme Bezerra Alves

    2001-03-01

    Full Text Available Investigou-se a evolução ponderal, conforme o valor das quotas calóricas de dietas prescritas (QCP e aceitas (QCA de lactentes internados por diarréia ou broncopnemonia no Instituto Materno Infantil de Pernambuco, Brasil. A proporção de crianças que ganharam ou não ganharam peso foi avaliada em função das QCP E QCA que atingiram as quotas calóricas ideais (QCI durante o internamento, verificando-se que 46% das crianças perderam ou mantiveram o peso nos dois primeiros dias. Houve maior freqüência de ganho de peso associado às QCP e QCA que atingiram as QCI, bem como entre as crianças amamentadas. Concluiu-se existir deficiente evolução ponderal relacionada às baixas quotas calóricas oferecidas ou aceitas durante a hospitalização.This work investigated the body weight evolution according to prescribed or accepted dietetic caloric value, in children with diarrhea or bronchopneumonia, admitted at Instituto Materno Infantil de Pernambuco, Brazil. The proportions of children who increased or did not increase body weight were evaluated as a function of the prescribed caloric quota (PCQ and the accepted caloric quota (ACQ that attained the ideal caloric quota (ICQ during hospitalization. 46% children lost or maintained the weight during the two first days. A higher frequency of increased weight was observed when PCQ or ACQ attained the ICQ, as well as in breast feeding children. Therefore, this study confirmed the relationship between low caloric values offered or accepted with a deficient body weight evolution.

  19. Influência de práticas maternas no desenvolvimento motor de lactentes do 6º ao 12º meses de vida Influence of child-rearing practices on infants' motor development between the sixth and twelfth months of life

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    PL Silva

    2006-01-01

    Full Text Available CONTEXTO: Práticas maternas são comportamentos específicos, por meio dos quais as mães/cuidadores desempenham suas tarefas maternais. Estas práticas poderiam influenciar o desenvolvimento motor de lactentes. OBJETIVO: verificar a influência de práticas maternas, utilizadas no cuidado diário de lactentes saudáveis, sobre seu desenvolvimento motor do 6º ao 12º meses de vida. MÉTODO: Selecionados 14 lactentes, nascidos a termo e saudáveis, avaliados longitudinalmente no 6º, 9º e 12º meses de vida, utilizando-se a Alberta Infant Motor Scale. Em cada avaliação/idade a mãe respondeu a um questionário fechado sobre práticas, predominantemente adotadas no cuidado diário do lactente durante os períodos de vigília. Considerou-se neste estudo a postura predominantemente adotada pelo lactente, local preferencial de permanência e a forma de carregar o lactente no colo. RESULTADOS: No 9º mês de vida o desempenho motor dos lactentes foi influenciado positivamente pela predominância na postura de quatro apoios, em relação à sentada e prono ou supino e pela permanência no chão em relação ao carrinho de bebê. No 12º mês houve influência positiva da predominância na postura de quatro apoios e em pé. A postura predominante no 6º mês de vida e a forma de carregar o lactente no 6º, 9º e 12º meses de vida não influenciaram o desempenho motor do grupo estudado. CONCLUSÃO: Os resultados sugerem que as práticas que estimulam a adoção da postura de quatro apoios e a utilização do chão como local de permanência influenciam positivamente o desenvolvimento motor de lactentes saudáveis a partir do 6º mês de vida.BACKGROUND: Child-rearing practices are defined as specific behavioral patterns used during maternal duties. These practices could influence infants' motor development. OBJECTIVE: To verify the influence of daily child-rearing practices on the motor development of healthy infants from their sixth to twelfth

  20. Fatores associados ao uso de chupeta por lactentes nascidos pré-termo

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    Elâine Cristina Vargas Dadalto

    Full Text Available RESUMO: Objetivo: investigar a avaliação de mães de recém-nascidos pré-termo acerca da introdução e uso de chupeta e sua relação com variáveis socioeconômicas, prematuridade e aleitamento materno, partindo-se do contexto da internação de seus filhos em unidade de terapia intensiva neonatal. Métodos: na etapa inicial, participaram 62 mães de recém-nascidos pré-termo, tendo comparecido 52 para acompanhamento aos seis meses de idade e 40 aos 24 meses. Os dados foram tabulados utilizando o programa SPSS versão 18.0 e análise estatística com testes Qui-quadrado, Fisher e Mann-Whitney. Resultados: a tentativa de introdução da chupeta ocorreu para 96,2% dos bebês nascidos pré-termo, egressos de unidade de terapia intensiva neonatal, e seu uso em 50%; o hábito de sucção de chupeta foi alto entre crianças da família (irmãos - 51,9%; primos - 76,9%, reforçando aspectos culturais. Apresentaram associação estatisticamente significante com maior uso de chupeta: prematuridade avaliada pela relação peso/idade-gestacional (p=0,044, dificuldade para estabelecer ou manter o aleitamento materno após a alta hospitalar (p=0,012 e primiparidade (p=0,02; relação com menor frequência de chupeta: aleitamento materno exclusivo ≥3 meses (p=0,026 e tempo de aleitamento materno ≥6 meses (p=0,004. A dificuldade para o aleitamento materno após a alta hospitalar foi associada com maior tempo de internação (p=0,007 e maior tempo de sonda orogástrica (p=0,006. Conclusão: a oferta da chupeta para lactentes nascidos pré-termo, egressos de unidade de terapia intensiva neonatal, apresentou grande influência cultural, mas sua aceitação pelo bebê ocorreu principalmente devido às dificuldades encontradas pelas mães para estabelecerem o aleitamento materno.

  1. Contralateral tactile masking between forearms.

    Science.gov (United States)

    D'Amour, Sarah; Harris, Laurence R

    2014-03-01

    Masking effects have been demonstrated in which tactile sensitivity is affected when one touch is close to another on the body surface. Such effects are likely a result of local lateral inhibitory circuits that sharpen the spatial tuning of a given tactile receptor. Mutually inhibitory pathways have also been demonstrated between cortical tactile maps of the two halves of the body. Occasional reports have indicated that touches on one hand or forearm can affect tactile sensitivity at contralateral locations. Here, we measure the spatial tuning and effect of posture on this contralateral masking effect. Tactile sensitivity was measured on one forearm, while vibrotactile masking stimulation was applied to the opposite arm. Results were compared to sensitivity while vibrotactile stimulation was applied to a control site on the right shoulder. Sensitivity on the forearm was reduced by over 3 dB when the arms were touching and by 0.52 dB when they were held parallel. The masking effect depended on the position of the masking stimulus. Its effectiveness fell off by 1 STD when the stimulus was 29 % of arm length from the corresponding contralateral point. This long-range inhibitory effect in the tactile system suggests a surprisingly intimate relationship between the two sides of the body.

  2. Prevalência do uso de chupeta em lactentes amamentados e não amamentados atendidos em um hospital universitário Prevalencia del uso de chupete en lactantes amamantados y no amamantados atendidos en un hospital universitario Prevalence of pacifier among breastfed and not breastfed infants attending a university hospital

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    Silvia Diez Castilho

    2012-06-01

    Full Text Available OBJETIVO: Avaliar a prevalência do uso da chupeta em relação ao tipo de aleitamento, as razões das mães para introduzi-la ou não e os fatores associados à mudança de opinião quanto à sua intenção inicial a esse respeito. MÉTODOS: Estudo transversal que avaliou 642 crianças (0-12 meses atendidas no Hospital da Pontifícia Universidade Católica de Campinas quanto ao tipo de alimentação e uso de chupeta. A mãe foi questionada sobre sua intenção inicial quanto à chupeta, quanto ao seu uso e, se utilizada, porquê. Após análise descritiva, aplicou-se a regressão logística para verificar a associação da chupeta com a amamentação. RESULTADOS: A prevalência de uso de chupeta foi de 48% (IC95% 44-52, sendo maior entre as crianças não amamentadas (70% comparadas às amamentadas (36%; p=0,029. Das que estavam em aleitamento exclusivo, 29% usavam chupeta (pOBJETIVO: Evaluar la prevalencia del uso de chupete respecto al tipo de lactancia, los motivos de las madres para introducirlo o no y los factores que hicieron con que mudara de opinión respecto a su intención inicial con relación a eso. MÉTODOS: Estudio transversal que evaluó a 642 niños (0-12 meses atendidos en el Hospital de la Pontificia Universidad Católica de Campinas (São Paulo, Brasil, respecto al tipo de alimentación y uso de chupete. La madre fue cuestionada sobre su intención inicial respecto al chupete, a su uso y, si lo utiliza, el porqué. Tras análisis descriptivo, se aplicó la regresión logística para verificar la asociación del chupete con la amamantación. RESULTADOS: La prevalencia de uso de chupete fue de 48% (IC95% 44-52%, siendo mayor entre los niños no amamantados (70% si comparado a los amamantados (36%; p=0,029. De los que estaban en lactancia exclusiva, el 29% usaban chupete (pOBJECTIVE: To evaluate the prevalence of pacifier use in relation to breastfeeding, to find out the reasons why mothers planned or not to introduce this habit

  3. Método para avaliação da conduta visual de lactentes A method to evaluate visual ability in infants

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    Heloisa G.R. Gardon Gagliardo

    2004-06-01

    Full Text Available O objetivo deste estudo é apresentar um método para avaliação de funções visuais em lactentes no primeiro trimestre de vida. Utilizou-se o Roteiro de Avaliação da Conduta Visual em Lactentes, modificado de Gagliardo (1997. O material foi aro suspenso por cordão. Realizou-se estudo piloto com 33 lactentes, segundo os critérios de inclusão: neonatos assintomáticos, sem necessidade de cuidados especiais nas primeiras 48 horas; idade cronológica variando entre 1 e 3 meses; avaliação mensal sem nenhuma falta; procedência da região de Campinas/SP. No 1º mês destacaram-se as provas: fixação visual-93,9%; contato de olho-90,9%; seguimento visual horizontal-72,7% e exploração visual do ambiente-97,0%. No 3º mês: exploração visual da mão-42,4% e aumento da movimentação de braços-36,4%. Este Roteiro permitiu observar a função visual segundo a idade cronológica; desvio dessa função possibilitará pronto encaminhamento a serviços médicos para diagnóstico.The purpose of this study is to introduce a method to evaluate visual functions in infants in the first three months of life. An adaptation of the Guide for the Assessment of Visual Ability in Infants (Gagliardo, 1997 was used. The instrument was a ring with string. It was implemented a pilot study with 33 infants, selected according to the following criteria: neonates well enough to go home within two days of birth; 1 to 3 months of chronological age; monthly evaluation with no absence; subjects living in Campinas/SP metropolitan area. In the first month we observed: visual fixation (93,9%; eye contact (90,9%; horizontal tracking (72,7%; inspects surroundings (97,0%. In the third month, we observed: inspects own hands (42,4% and increased movements of arms (36,4%. This method allowed the evaluation of visual functions in infants, according to the chronological age. Alterations in this function will facilitate immediate referral to medical services for diagnoses.

  4. Desempenho motor e sensorial de lactentes com e sem síndrome de Down: estudo piloto Motor and sensory performance of infants with and without Down syndrome: a pilot study

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    Ana Carolina de Campos

    2010-09-01

    Full Text Available O estudo visou avaliar o desempenho motor e sensorial de lactentes com e sem síndrome de Down (SD aos seis meses de vida. Foram avaliados oito lactentes, sendo quatro com SD e quatro típicos, com 24 semanas de vida. Para verificar o desempenho motor foi utilizada a escala motora infantil de Alberta (AIMS, nas posturas supina, prona, sentada e em pé. O desempenho sensorial foi avaliado por meio de entrevista com o cuidador da criança utilizando o perfil sensorial infantil ITSP (infant/toddler sensory profile, que classifica comportamentos sensoriais como de"baixo registro" (dificuldade em registrar estímulos sensoriais, busca de estímulos, excessiva sensibilidade a estímulos e comportamentos de evitar estímulos. Os resultados no ITSP mostram que os lactentes com SD obtiveram piores escores em baixo registro, possivelmente por apresentarem altos limiares neurológicos, demorando mais para responder aos estímulos. Na AIMS os lactentes com SD tiveram um desempenho inferior quando comparados aos típicos na subescala prono, o que pode advir de dificuldades no controle postural e antigravitacional. Não foi encontrada correlação entre os escores do ITSP e da AIMS. Os resultados sugerem que os lactentes com SD podem se engajar com menos freqüência em atividades de interação com o ambiente, tanto por dificuldade em registrar estímulos cotidianos (como diferentes sons e pessoas, quanto por dificuldade em explorar o meio utilizando habilidades motoras.The study aimed at assessing motor and sensory performance of infants with Down syndrome (DS comparing them to typical infants at the age of six months. Eight infants - 4 with typical development, 4 with DS - were assessed as to motor performance by the Alberta infant motor scale (AIMS at supine, prone, sitting, and standing positions. Sensory performance was assessed by using the Infant/toddler sensory profile (ITSP, which classifies sensorial behaviours as"low registration" (difficulty in

  5. Contralateral prophylactic mastectomy: current perspectives

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    Yao K

    2016-06-01

    Full Text Available Katharine Yao,1 Mark Sisco,2 Isabelle Bedrosian3 1Division of Surgical Oncology, Department of Surgery, 2Division of Plastic Surgery, Department of Surgery, NorthShore University HealthSystem, Evanston, IL, 3Department of Surgery, MD Anderson Cancer Center, Houston, TX, USA Abstract: There has been an increasing trend in the use of contralateral prophylactic mastectomy (CPM in the United States among women diagnosed with unilateral breast cancer, particularly young women. Approximately one-third of women ,40 years old are undergoing CPM in the US. Most studies have shown that the CPM trend is mainly patient-driven, which reflects a changing environment for newly diagnosed breast cancer patients. The most common reason that women choose CPM is based on misperceptions about CPM’s effect on survival and overestimation of their contralateral breast cancer (CBC risk. No prospective studies have shown survival benefit to CPM, and the CBC rate for most women is low at 10 years. Fear of recurrence is also a big driver of CPM decisions. Nonetheless, studies have shown that women are mostly satisfied with undergoing CPM, but complications and subsequent surgeries with reconstruction have been associated with dissatisfaction with CPM. Studies on surgeon’s perspectives on CPM are sparse but show that the most common reasons surgeons discuss CPM with patients is because of a suspicious family history or for a patient who is a confirmed BRCA mutation carrier. Studies on the cost–effectiveness of CPM have been conflicting and are highly dependent on patient’s quality of life after CPM. Most recent guidelines for CPM are contradictory. Future areas of research include the development of interventions to better inform patients about CPM, modification of the guidelines to form a more consistent statement, longer term studies on CBC risk and CPM’s effect on survival, and prospective studies that track the psychosocial effects of CPM on body image and

  6. Expandindo a aplicação de questionário padronizado para sibilância recorrente no lactente Expanding the application of a standardized questionnaire on recurrent wheezing in infancy

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    Herberto José Chong Neto

    2009-04-01

    Full Text Available OBJETIVO: Estender a aplicação de um instrumento para avaliar a prevalência e as características clínicas da sibilância em lactentes. MÉTODOS: Estudo transversal, como parte do projeto Estudio Internacional de Sibilancias en Lactantes (EISL, aplicando questionário aos pais de lactentes entre 12 e 15 meses (grupo I e 16 e 24 meses de vida (grupo II. RESULTADOS: Mil trezentos e sessenta e quatro lactentes (45,4% do grupo I e 250 (46,7% do grupo II apresentaram pelo menos um episódio de sibilância (p = 0,58. O uso de β2-agonistas inalados, corticoides inalatórios ou orais e modificadores de leucotrienos foi semelhante entre os grupos (p = 0,52, 0,12, 0,06 e 0,75. Sintomas noturnos, dificuldade para respirar, visitas à emergência, hospitalização por sibilância e diagnóstico médico de asma não foram diferentes nos grupos (p = 0,09, 0,28, 0,69, 0,54 e 0,45. CONCLUSÃO: A aplicação do questionário pode ser estendida aos lactentes com até 24 meses de vida.OBJECTIVE: To verify the possibility of extending the application of an instrument to investigate the prevalence and clinical characteristics of wheezing in infants. METHODS: A cross-sectional study conducted as part of the International Study on Wheezing in Infants (EISL, Estudio Internacional de Sibilancias en Lactantes. A questionnaire was administered to parents of infants aged 12 to 15 months (group I and 16 to 24 months (group II infants. RESULTS: One thousand, three hundred and sixty-four infants (45.4% in group I and 250 (46.7% in group II had had at least one episode (p = 0.58. The numbers of patients on inhaled β2-agonists, inhaled or oral steroids and/or leukotriene modifiers were similar in both groups (p = 0.52, 0.12, 0.06, and 0.75. There were no differences between the groups in terms of night-time symptoms, shortness of breath, emergency room visits, asthma hospitalization or asthma diagnosed by a doctor (p = 0.09, 0.28, 0.54, and 0.45. CONCLUSION: The

  7. Alimentos utilizados ao longo da história para nutrir lactentes The history of infant nutrition

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    Silvia Diez Castilho

    2010-06-01

    Full Text Available OBJETIVO: Resgatar a história da alimentação infantil, com o intuito de compreender a prática da amamentação. FONTES DOS DADOS: O levantamento bibliográfico foi realizado nas bases MEDLINE, LILACS e SciELO, Internet, enciclopédias, livros científicos e leigos, literatura, arte e história. Foram consultados textos sobre os cuidados com lactentes em diferentes épocas, a história da Medicina, e artigos científicos recentes sobre nutrição infantil. SÍNTESE DOS DADOS: Durante o período pré-industrial, os costumes pouco variaram, e a chance de sobrevivência estava relacionada ao aleitamento materno ou à sua substituição pelo leite de uma ama. Caso isso não fosse possível, os lactentes recebiam leite animal, alimentos pré-mastigados ou papas pobres em nutrientes e contaminadas, que determinavam altos índices de mortalidade. Nada podia substituir a amamentação com sucesso, e dela dependia a sobrevivência da espécie. Com a Revolução Industrial, as mulheres, que costumavam amamentar, foram trabalhar nas fábricas, motivando a busca de alternativas para nutrir os lactentes. O consumo de leite animal e fórmulas (diluídas, farinhas, leite em pó, bem como a introdução precoce de alimentos comprometeram a saúde das crianças. O movimento feminista e a pílula anticoncepcional determinaram queda da natalidade. As fábricas, visando o lucro, desenvolveram fórmulas modificadas e investiram em propaganda. A sociedade reagiu com um movimento de incentivo ao aleitamento. CONCLUSÕES: Atualmente, reconhecem-se as vantagens do leite materno, e recomenda-se aleitamento exclusivo até os 6 meses, complementado com outros alimentos a partir dessa idade até pelo menos os 2 anos. A alimentação infantil, natural ou artificial, sempre foi determinada e condicionada pelo valor social atribuído à amamentação.OBJECTIVE: To retrace the history of infant nutrition with the objective of better understanding breastfeeding. SOURCES

  8. Complicação decorrente da presença de brônquio traqueal em lactente: relato de caso Complicación debida a la presencia de bronquiotraqueal en un lactante: relato de caso Complication related to tracheal bronchus in infant: case report

    OpenAIRE

    2006-01-01

    JUSTIFICATIVA E OBJETIVOS: O brônquio traqueal é uma anomalia congênita com incidência aproximada de 2% na população geral, habitualmente assintomática e de diagnóstico usualmente incidental. Esta anomalia caracteriza-se pela presença de brônquio para o lobo superior direito emergindo diretamente da traquéia, junto à carina. Em vigência de intubação traqueal, este brônquio pode ter sua luz obliterada pela cânula, levando a atelectasia isolada do lobo superior direito. O objetivo deste artigo ...

  9. Estudo audiológico e genético de lactentes de alto risco Audiological and genetics studies in high-risk infants

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    Maria Francisca Colella-Santos

    2011-12-01

    Full Text Available A audição é um dos principais meios de contato do indivíduo com o mundo externo, desempenhando papel fundamental na integração com a sociedade. OBJETIVO: Analisar os resultados obtidos na avaliação audiológica, otorrinolaringológica e genética de lactentes de alto risco que falharam na triagem auditiva neonatal. MATERIAL E MÉTODO: Estudo clínico e experimental. Foram avaliados 38 lactentes, entre 1 e 6 meses de idade cronológica. Os procedimentos utilizados foram: anamnese, imitanciometria, Potencial Evocado Auditivo de Tronco Encefálico, Emissões Otoacústicas por Transiente e avaliação otorrinolaringológica. O estudo genético foi realizado a partir da extração de DNA da mucosa bucal utilizando o método de protocolo adaptado no Laboratório de Genética Humana do CBMEG/UNICAMP. RESULTADO: Não houve diferença estatisticamente significante entre neonatos com audição normal e perda auditiva e as variáveis gênero e número de indicadores de risco. Quanto à idade gestacional, neonatos a termo foram mais afetados. A perda auditiva esteve presente em 58% da amostra, sendo do tipo condutiva em 31,5%, e neurossensorial em 28,9% dos casos. Não foram encontradas as mutações genéticas mais comumente observadas em casos com etiologia genética. CONCLUSÃO: A perda auditiva foi diagnosticada na maioria dos lactentes de risco com provável etiologia ambiental.Hearing is one of the main ways with which one person can contact the external world; it plays a key role in their integration with society. AIM: The objective of this study was to analyze the results of the hearing, medical and genetic evaluation of high-risk infants who failed the newborn hearing screening. MATERIALS AND METHODS: Clinical and experimental study. We assessed thirty-eight neonates, with ages between one and six months. The infants underwent the following procedures: medical interview; immittance testing; Brainstem Auditory Evoked Potential; Transient

  10. SeparaÃÃo materna prolongada induz desnutriÃÃo e inflamaÃÃo sistÃmica com deficiÃncia de igf-1 e leptina e alteraÃÃes hipocampais em camundongos lactentes

    OpenAIRE

    Ãtalo Leite Figueiredo

    2015-01-01

    A separaÃÃo materna prolongada (SMP) pode causar uma desnutriÃÃo energÃtico-proteica devido à restriÃÃo do leite materno, o que pode levar a alteraÃÃes no hipocampo, alÃm de afetar a barreira intestinal, induzindo translocaÃÃo bacteriana e inflamaÃÃo sistÃmica. Um estudo recente mostrou uma correlaÃÃo negativa entre marcadores inflamatÃrios sistÃmicos e nÃveis sÃricos do fator de crescimento insuliniforme 1 (IGF-1) em crianÃas desnutridas com baixa estatura. Contudo, ainda hà uma lacuna no co...

  11. Características clínicas da doença diarréica em lactentes na Zona da Mata Meridional do estado de Pernambuco Clinical characteristics of diarrheal disease in suckling children in the Zona da Mata Meridional in the State of Pernambuco

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    Giselia Alves Pontes da Silva

    2002-12-01

    Full Text Available OBJETIVOS: descrever as características clínicas dos episódios diarréicos apresentados por um grupo de crianças residentes na Zona da Mata Meridional do estado de Pernambuco nos primeiros seis meses de vida. MÉTODOS: o desenho do estudo é uma série de casos dele fazem parte todas as crianças acompanhadas dentro de um estudo de coorte realizado em quatro cidades da Zona da Mata Meridional do estado de Pernambuco e que durante o período de observação apresentaram pelo menos um episódio de doença diarréica. RESULTADOS: foram acompanhados 264 episódios de doença diarréica, que ocorreram em 239 crianças. A duração dos episódios variou entre um e 31 dias, sendo a mediana de dois dias e a moda de um dia. Um total de 93,5% dos episódios se auto-limitou em até sete dias. A maioria das crianças apresentou um episódio de diarréia durante o período de observação. Houve necessidade de hospitalização em 18 episódios (6,8%. Não foi observado nenhum óbito. CONCLUSÕES: a evolução clínica da doença diarréica quando estudada na comunidade é benigna, com episódios diarréicos de curta duração e levando a baixos índices de hospitalização.OBJECTIVES: to describe clinical characteristics of diarrhea episodes in a group of children residing in the Zona da Mata Meridional in the State of Pernambuco during the first six months of life. METHODS: the study's design is a case series comprising all children followed-up within a cohort study accomplished in four cities of the Zona da Mata Meridional of the State of Pernambuco who during observation had at least one episode of diarrheal disease. RESULTS: 264 episodes of diarrhea were followed-up in 239 children. The episodes lasted between one and 31 days, with the median of two days and the mode of one day. 93,5% of the episodes were self-limited to seven days. The majority of the children had one diarrhea episode during observation. Hospitalization was required in 18 episodes

  12. Dor abdominal aguda como manifestação de violência física em lactente: alerta aos pediatras Dolor abdominal agudo como manifestación de violencia física en lactante: alerta a los pediatras Acute abdominal pain as a manifestation of physical violence in an infant: alert to pediatricians

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    Patricia Gomes de Souza

    2012-12-01

    Full Text Available OBJETIVO: Alertar os pediatras e residentes de Pediatria quanto à possibilidade da ocorrência de violência contra a criança por meio do relato de um caso clínico. DESCRIÇÃO DO CASO: Paciente de 18 meses deu entrada à emergência com dor abdominal e vômitos há 48 horas. O exame abdominal revelou dois orifícios e massa pequena endurecida. O raio X de abdome mostrou imagem compatível com três objetos metálicos. Duas agulhas e um prego sem cabeça foram removidos da cavidade abdominal por meio de laparotomia. COMENTÁRIOS: O diagnóstico foi realizado no segundo atendimento médico, provavelmente por não ter sido aventada a possibilidade de lesão intencional no primeiro. A violência física é um diagnóstico diferencial a ser pensado nos quadros de dor abdominal em crianças. Ressalta-se a importância de aprimorar a formação do residente de Pediatria e dos pediatras em geral para a abordagem da violência contra a criança, de forma que estejam mais preparados para o acionamento da linha de cuidado em situações de violência.OBJETIVO: Alertar a los pediatras y médicos internos en Pediatría respecto a la posibilidad de ocurrencia de violencia contra el niño por medio del relato de un caso clínico. DESCRIPCIÓN DEL CASO: Paciente con 18 meses llevado a la emergencia por dolor abdominal y vómitos hace 48 horas. El examen abdominal reveló dos agujeros y masa pequeña endurecida. Rayo-X abdominal mostró imagen compatible con tres objetos metálicos. Dos agujas y un clavo sin cabeza fueron removidos de la cavidad abdominal mediante laparotomía. COMENTARIOS: El diagnóstico se realizó en la segunda atención médica, probablemente por no haber sido aventada la posibilidad de lesión intencional en la primera atención. La violencia física es un diagnóstico diferencial que se debe tener en cuenta en los cuadros de dolor abdominal en niños. Se subraya la importancia de perfeccionar la formación del médico interno en

  13. Efeitos da everminação de matrizes e de bezerros lactentes em sistema de produção de bovinos de corte na região de Cerrado Effects of deworming of cow-calf beef herds in brazilian savannas

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    João B. Catto

    2005-09-01

    Full Text Available Estudou-se o efeito da everminação de vacas no pré-parto e de bezerros antes do desmame, no número de ovos de nematódeos nas fezes (OPG e nos parâmetros produtivos em dois rebanhos de gado de corte na região do Brasil Central. Quatro lotes de vacas prenhes receberam os seguintes tratamentos: T1- vacas e bezerros controle, T2- somente bezerros tratados, T3- somente vacas tratadas antes do parto com ivermectina e T4- vacas e bezerros tratados. Os bezerros dos lotes T2 e T4 foram distribuídos nos seguintes grupos: A- tratados aos 3 a 5 meses de idade com ivermectina de ação prolongada, B- tratados com ivermectina e C- controle. Nas vacas a everminação não diminuiu o OPG durante a lactação, como também não teve efeito significativo na taxa de concepção, no ganho de peso e no peso dos bezerros aos 3 a 5 meses de idade. Os bezerros do Grupo A ganharam até o desmame, 84 a 108 dias após o tratamento, em média 4,2kg (P= 0,0003 e 7,1kg (PThe effect of deworming with ivermectin of cows before calving and of suckling calves on fecal egg counts (EPG and productive performance of two beef cattle herds in Central Brazil was studied. Four groups of pregnant cows received the following treatments: T1- cows and calves not treated, T2- only calves treated, T3- only cows treated, and T4- cows and calves treated. The calves of T2 and T4 were distributed in the following treatments: A- calves treated at 3 to 5 months of age with long action ivermectin, B- treated with ivermectin, and C- control. For the cows, the deworming did not diminish the EPG during lactation and also did not have significant effect on the conception rate, live weight gain and the body weight of their calves at 3 to 5 months of age. The calves of treatment A gained, from the time of treatment to weaning (84 to 108 days, an average of 4.2kg (P=0.0003 and 7.1kg (P<0.0001 more than those of treatment B and C, respectively. The average difference in live weight gain of 2.9kg

  14. Padrão e ritmo de aquisição das habilidades motoras de lactentes pré-termo nos quatro primeiros meses de idade corrigida Pattern and rate of motor skill acquisition among preterm infants during the first four months corrected age

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    Elaine P. Raniero

    2010-10-01

    Full Text Available OBJETIVOS: Este estudo objetivou caracterizar o padrão e o ritmo de aquisição das habilidades motoras de lactentes nascidos pré-termo nos quatro primeiros meses de idade corrigida, comparando-os com um grupo de lactentes a termo. MÉTODOS: Participaram do estudo 12 lactentes pré-termo saudáveis, (MD=33,6 semanas de idade gestacional, ± 1,25 e 10 lactentes a termo saudáveis (MD=39,1 semanas de idade gestacional, ± 0,73. Eles foram avaliados mensalmente (zero a quatro meses de idade com o Test of Infant Motor Performance (TIMP. RESULTADOS: O padrão de desempenho motor aumentou ao longo dos meses em ambos os grupos, constatando variabilidade nos escores totais em todas as idades. O grupo pré-termo apresentou escore médio mais elevado do que o a termo entre um e quatro meses de idade. Nesse grupo, o ritmo de aquisição motora foi maior de zero a um do que de três a quatro meses. Verificou-se também que os cuidadores desses lactentes iniciaram a estimulação com brinquedos anteriormente aos cuidadores do grupo a termo. Ambos os grupos apresentaram escores médios inferiores aos do TIMP. CONCLUSÕES: Os lactentes pré-termo apresentaram padrão de desenvolvimento motor semelhante aos típicos quanto à sequência de habilidades adquiridas e ritmo acelerado no período de recém-nascido (RN a um mês de idade. Sugere-se que lactentes pré-termo com essas características não necessitam de correção do grau de prematuridade e que programas de acompanhamento orientem os pais e cuidadores a estimulá-los, desde o primeiro mês, com brinquedos, propiciando a exploração precoce de diversos padrões motores.OBJECTIVES: This study aimed to characterize the pattern and rate of motor skill acquisition among preterm infants from newborn to four months corrected age, in comparison with a group of full-term infants. METHODS: Twelve healthy preterm infants (mean gestational age=33.6 weeks ± 1.25 and 10 healthy full-term infants (mean

  15. Fatores de risco relacionados com o desempenho de leitões lactentes em granjas de suínos da região norte do Paraná The relation of the risk factors on the suckling piglets performance in farms of north Parana state

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    Caio Abércio da Silva

    1998-12-01

    Full Text Available Foram avaliadas 18 granjas de suínos, sob sistema confinado, na região norte do estado do Paraná, no ano de 1994. Em cada criação, foram acompanhadas no mínimo seis matrizes e suas respectivas leitegadas do nascimento até o desmame. Foram estudadas 4 variáveis objetivas (presença de diarréia nos leitões, taxa de mortalidade, coeficiente de variação do peso ao desmame e o ganho de peso médio diário até o desmame e 16 variáveis explicativas: amplitude térmica diária na maternidade, vazio sanitário, condição nutricional das porcas, percentagem de abertura da maternidade, presença de forro na instalação, temperatura mínima interna, área da cela parideira, utilização de escamoteador, assistência ao parto, aleitamento coletivo, parasitismo intestinal, número de leitegadas por sala, número médio de leitões nascidos vivos, peso médio ao nascer, presença de onfalite e utilização de vacina contra colibacilose. As variáveis foram avaliadas através do programa ECOSUI desenvolvido pela EMBRAPA/CNPSA. Os principais fatores de risco encontrados, presentes em mais de 50% das granjas, foram: ausência de forro, elevada temperatura mínima interna com amplas variações térmicas diárias, reduzida área disponível por porca e sua leitegada, falta de vazio sanitário entre lotes, presença de parasitismo intestinal, salas de maternidade com número excessivo de celas pandeiros, alta freqüência de onfalite e não vacinação contra colibacilose nas porcas. Conseqüentemente, a freqüência de granjas que atingiram os objetivos de ganho de peso diário dos leitões (9/17, do coeficiente de variação de peso ao desmame (0/18, de ocorrência de diarréia (8/18 e de taxa de mortalidade de leitões (5/17 foi relativamente baixa. Estes dados indicam que no exercício da medicina veterinária preventiva esforços devem ser direcionados no sentido de corrigir os fatores de risco acima descritos, para possibilitar aos produtores

  16. Rotulagem de alimentos para lactentes e crianças de primeira infância Labeling food products for breastfeeding infants and toddlers

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    Sheylle Almeida da Silva

    2008-04-01

    Full Text Available OBJETIVO: Analisar a conformidade de rótulos de alimentos para lactentes e crianças de primeira infância, segundo os preceitos da ética e das legislações vigentes. MÉTODOS: Foram analisados 86 rótulos captados por livre acesso, amostragem intencional, distribuídos em: fórmulas infantis para lactentes (n=11, fórmulas de seguimento para lactentes (n=5; alimentos de transição (n=7; alimentos à base de cereais (n=11, leites e alimentos à base de vegetais (n=52 e alimentos comuns usualmente empregados na alimentação desse público (n=13. Foram preenchidos formulários estruturados com itens das Resoluções da Diretoria Colegiada 222/02, 977/98, 40/01, 40/02, 259/02, 23/00 e das Portarias 34/98 e 36/98 para cada alimento. Aplicaram-se os Testes Qui-Quadrado, Exato de Fisher e de Correlação. RESULTADOS: A freqüência de não conformidades na rotulagem específica foi muito maior que na rotulagem geral. A maior freqüência de não conformidades observada foi a apresentação de ilustrações inadequadas nos alimentos (imagens de lactentes ou crianças com figuras humanizadas. Outras inconformidades foram: a presença de expressões como leite humanizado, baby ou frases que dão falsa idéia de vantagem ou segurança; e a ausência de frases obrigatórias e não conformidade quanto à composição do produto. Alimentos que não tinham como designação de venda nenhuma das características de uso comum nesta faixa etária, ou seja, não eram comercializados como tal, como farinha láctea, flocos de cereais e mingaus, apresentavam frases de advertência não necessárias para aquele tipo de produto. CONCLUSÃO: A rotulagem de alimentos para lactentes e crianças de primeira infância apresenta muitas irregularidades, principalmente no que se refere à rotulagem específica do produto. Essa prática pode repercutir sobre a amamentação. A fiscalização deve ser intensificada, conjuntamente com maiores esclarecimentos às ind

  17. Estimulação ambiental e uso do andador infantil por lactentes com desenvolvimento normal Environmental stimulation and use of a children's baby walkers by infants with normal development

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    Karolina Alves de Albuquerque

    2011-06-01

    Full Text Available OBJETIVOS: avaliar a quantidade e qualidade de estímulos ambientais disponíveis para lactentes com desenvolvimento normal que fizeram uso do andador infantil anteriormente à aquisição da marcha independente. MÉTODOS: estudo transversal, com 24 lactentes distribuídos em dois grupos, sendo 12 do grupo exposto ao andador infantil (AI e 12 do grupo não-exposto (C, mantendo-se equivalência entre grupos em idade, sexo e nível sócio econômico da família. O teste Observation for Measurement of the Environment (HOME documentou os estímulos oferecidos pelo ambiente. Teste-t de Student para amostras independentes comparou os escores médios do teste HOME de ambos os grupos, considerando o nível de significância α=0,05. RESULTADOS: diferenças no teste HOME foram observadas, tendo o grupo AI obtido escores superiores ao grupo C (p=0,014, com efeito de magnitude fraca (d=0,24. CONCLUSÕES: o uso do voador infantil no período pré-aquisição da marcha por lactentes com desenvolvimento normal, pode estar associado a ambientes domiciliares mais estimuladores.OBJECTIVES: to evaluate the quantity and quality of environmental stimuli available to infants with normal development who use a baby walkers prior to learning to walk by themselves. METHODS: a cross-sectional study was carried out with 24 infants distributed into two groups of twelve: one group of children who had used a baby walkers (BW and 12 who had not (C, with the children in both groups being of equivalent ages, sex, and socio-economic background. The Home Observation for Measurement of the Environment (HOME test provided a documentary Record of the stimuli provided by the environment. Student's t-test for independent samples was used to compare the mean scores on the HOME test of both groups, considering the level of significance to be α=0.05. RESULTS: differences in the HOME scores, with the BW group obtaining higher scores than the control group (p=0.014, with a low magnitude

  18. Postural control of small for gestational age infants born at term Controle postural de lactentes nascidos a termo pequenos para a idade gestacional

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    D Campos

    2007-02-01

    Full Text Available OBJECTIVE: This study compared the postural control of small (SGA and appropriate (AGA for gestational age infants born at term, at the ages of 3, 6, 9 and 12 months. METHOD: This was a cohort study of infants born at term, with birth weight less than the 10th percentile for the SGA group and between the 10th and 90th percentiles for the AGA group. Infants with genetic syndromes, malformations, congenital infections and internment in neonatal intensive care unit were excluded. The evaluation instrument was the Alberta Infant Motor Scale. RESULTS: Comparison of the SGA and AGA groups did not show any significant differences (p>0.05 at the assessment times. However, the postural control of the SGA group was influenced by the gestational age (r=-0.83; p= 0.006 and 5th minute Apgar (r= 0.79; p= 0.01 in the 3rd month, and by maternal occupation (r= 0.67; p= 0.01 in the 6th month. CONCLUSION: It was concluded that the postural control was similar in the groups. However, the postural control of the SGA group was influenced by biological and environmental factors.OBJETIVO: Este estudo teve por objetivo comparar o controle postural de lactentes nascidos a termo, pequenos (PIG e adequados para a idade gestacional (AIG nos 3º, 6º, 9º e 12º meses. MÉTODO: Estudo longitudinal de lactentes nascidos a termo, com peso de nascimento menor que o percentil 10 para o grupo PIG e entre o percentil 10 e 90 para o grupo AIG. Síndromes genéticas, más-formações, infecções congênitas e internados em unidade de terapia intensiva neonatal foram excluídos. O instrumento de avaliação foi Alberta Infant Motor Scale. RESULTADOS: A comparação do grupo PIG e AIG não mostrou diferença significativa (p> 0,05 nos meses avaliados. Entretanto, o controle postural do grupo PIG foi influenciado pela idade gestacional (r= -0,83/p= 0,006 e Apgar de 5' (r= 0,79/p= 0,01 no 3º mês; e pela ocupação materna (r= 0,67/p= 0,01 no 6º mês. CONCLUSÃO: Concluiu-se que o

  19. Influência do tamanho e da rigidez dos objetos nos ajustes proximais e distais do alcance de lactentes Influence of object size and rigidity on proximal and distal adjustments to infant reaching

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    NACF Rocha

    2006-09-01

    Full Text Available CONTEXTUALIZAÇÃO: Estudos têm identificado que as propriedades dos objetos induzem os ajustes no alcance; no entanto, poucos investigaram a influência específica do tamanho e rigidez dos objetos em lactentes jovens. OBJETIVO: Verificar se lactentes de 4 a 6 meses realizam ajustes proximais e distais ao alcançarem objetos de diferentes tamanhos e rigidez. MÉTODOS: Nove lactentes saudáveis foram posicionados em uma cadeira inclinada a 50º. Quatro objetos foram apresentados, um rígido grande (RG, um rígido pequeno (RP, um maleável grande (MG e um maleável pequeno (MP, por um período de 1 minuto cada. Em um total de 384 alcances, foram analisados os ajustes proximais (alcance uni e bimanual e distais (orientação da mão horizontal, vertical e oblíqua; mão aberta, fechada e semi-aberta e o sucesso do alcance dos objetos. RESULTADOS: Constatou-se ajuste bimanual para o objeto RG e unimanual para os demais. A orientação da mão oblíqua foi predominante no toque dos objetos, enquanto para a preensão dos mesmos, a predominância foi a vertical, principalmente para o objeto RG. A orientação horizontal não foi observada na preensão do objeto RG. A mão semi-aberta foi mais freqüente no início do alcance para todos os objetos, enquanto no toque do objeto RG a mão aberta foi predominante. O sucesso do alcance foi maior para os objetos maleáveis (MG, MP do que para os rígidos (RG e RP. CONCLUSÃO: Lactentes jovens estudados são capazes de planejar e ajustar seus movimentos baseados na percepção das propriedades físicas dos objetos, o que sugere interação percepção-ação.BACKGROUND: Studies have identified that object properties lead to adjustments to reaching. However, few have investigated the specific influence of object size and rigidity among young infants. OBJECTIVE: To verify whether four to six-month-old infants make proximal and distal adjustments when reaching for objects of different sizes and rigidity. METHOD

  20. Contralateral Total Hip Arthroplasty After Hindquarter Amputation

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    Scott M. M. Sommerville

    2006-01-01

    Full Text Available We describe the management and outcome of a 62-year old lady who developed severe osteoarthritis of the hip, nine years after a hindquarter amputation for radiation-induced sarcoma of the contralateral pelvis. The difficulties of stabilising the pelvis intraoperatively and the problems of postoperative rehabilitation are outlined. The operation successfully relieved her pain and restored limited mobility.

  1. Contralateral Total Hip Arthroplasty After Hindquarter Amputation

    Science.gov (United States)

    Sommerville, Scott M. M.; Patton, James T.; Luscombe, Jonathan C.; Grimer, Robert J.

    2006-01-01

    We describe the management and outcome of a 62-year old lady who developed severe osteoarthritis of the hip, nine years after a hindquarter amputation for radiation-induced sarcoma of the contralateral pelvis. The difficulties of stabilising the pelvis intraoperatively and the problems of postoperative rehabilitation are outlined. The operation successfully relieved her pain and restored limited mobility. PMID:17496994

  2. Tuberculose associada a nefrocalcinose em um lactente = Tuberculosis associated with nephrocalcinosis in an infant

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    Afonso, Paula

    2014-01-01

    Conclusões: Este caso clínico destaca-se pela forma incomum de apresentação da tuberculose, com a presença de nefrocalcinose. As perturbações do metabolismo do cálcio associadas à tuberculose são raras, mas têm implicação no seguimento e no prognóstico

  3. Exigências nutricionais de bezerros nelores lactentes Nutritional requirements of nursing Nellore calves

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    Mozart Alves Fonseca

    2012-05-01

    Full Text Available Este trabalho foi conduzido com o objetivo de avaliar as exigências de proteína, energia e macrominerais de bezerros nelores do nascimento aos 180 dias. Foram utilizados 20 bezerros (10 machos e 10 fêmeas com peso corporal médio de 30±3 kg. Imediatamente após o nascimento, quatro bezerros, dois machos e duas fêmeas, foram abatidos para estimar a composição corporal inicial dos animais restantes no experimento. Aos 90 dias, foram abatidos oito bezerros (quatro machos e quatro fêmeas, o restante dos animais abatidos aos 180 dias. Além do leite, os bezerros foram alimentados com silagem de milho à vontade e concentrado comercial fixado em no máximo 0,5 kg/animal/dia. Foram conduzidos dois ensaios de digestibilidade, aos 30 e 90 dias para estimar os consumos de energia dos bezerros. Após o abate, todos os bezerros tiveram suas meias-carcaças direitas dissecadas. Os conteúdos corporais de proteína, energia e minerais foram estimados pela equação Y = a . PCVZb, sendo PCVZ o peso de corpo vazio. A relação PCVZ/PC dos bezerros foi de 0,9622 e a de ganho (G de PCVZ/GPC foi de 0,958. As exigências líquidas de proteína e energia aumentaram com o aumento do peso corporal, enquanto as de cálcio diminuíram. As exigências de proteína metabolizável para ganho de 1 kg de PC foram de 216,96 e 261,98 g para bezerros de 100 e 200 kg, respectivamente. Recomenda-se utilizar as seguintes equações para estimar os conteúdos corporais de bezerros Nelore lactentes: proteína (g/dia = 0,135 × PCVZ1,0351; energia (Mcal/dia = 1,1798 × PCVZ1,1805; cálcio (g/dia = 0,091 × PCVZ0,6019; fósforo (g/dia = 0,00894 × PCVZ0,9629; sódio (g/dia = 0,00126 × PCVZ0,9791; magnésio (g/dia = 0,000405 × PCVZ0,9827; potássio (g/dia = 0,00165 × PCVZ0,9364.This experiment was carried out to evaluate the nutritional requirements of protein, energy and macro minerals for Nellore calves from birth to 180 days. A total of 20 calves, 10 males (M and 10

  4. Resultados em curto prazo da reabilitação após cirurgia de reconstrução do ligamento cruzado anterior utilizando enxerto do tendão patelar contralateral - doi: 105102/ucs.v12i1.2667

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    Márcio de Paula e Oliveira

    2014-08-01

    Full Text Available As técnicas convencionais de cirurgia de reconstrução do LCA e os princípios que norteiam a reabilitação vêm surgindo como alternativas que proporcionam uma recuperação mais precoce e segura. O advento da utilização do enxerto do tendão patelar contralateral, têm se mostrado muito eficiente. Assim o objetivo desse estudo foi avaliar a condição clínica do joelho de pacientes submetidos a esse procedimento no momento da alta e comparar com os achados descritos na literatura para outras técnicas cirúrgicas. Participaram 23 indivíduos de ambos os gêneros, praticantes de esportes em nível recreacional. Para montagem dos protocolos foram utilizados o Questionário de Lysholm (QL, o Single Leg Hop Test (SLHT e a Avaliação Isocinética do Joelho (AIJ. A média de pontos encontrado no QL foi 93,30, com a classe excelente se destacando entre as demais. A diferença média encontrada entre os membros doador e receptor no SLHT foi de apenas 2,06cm. Os pacientes apresentaram evolução satisfatória ao tratamento, que pode ser verificada pela pontuação e simetria obtidas nos testes realizados. Para outras técnicas cirúrgicas de reconstrução do LCA, não foram encontrados níveis semelhantes de simetria entre os membros, dentro do mesmo tempo de recuperação.

  5. Hábitos de sono relacionados à síndrome da morte súbita do lactente: estudo populacional Sleeping habits related to sudden infant death syndrome: a population-based study

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    Lorena Teresinha Consalter Geib

    2006-02-01

    Full Text Available O estudo transversal, que descreve os hábitos de sono com risco potencial para a síndrome da morte súbita do lactente, incluiu todas as crianças nascidas vivas em 2003, em Passo Fundo, Rio Grande do Sul, Brasil, com coleta de dados nas Declarações de Nascidos Vivos e em entrevistas, analisados com estatística descritiva e teste de qui-quadrado. Dos 2.634 nascidos vivos, selecionaram-se 2.285 (86,75%, com exclusão de 8,4% e perda de 5,2%. Dentre os hábitos protetores, constatou-se, em 77% dos lactentes, uso de vestuário adequado, 90% envolvidos frouxamente, 69% com cobertas de espessura fina, 98% dormindo no quarto dos pais e 56%, no berço. Dos hábitos com potencial risco, observaram-se decúbito lateral (92%, uso de travesseiro (88% e os pés distanciados da borda inferior do berço (96%. Nas classes econômicas pobres, o hábito da criança de compartilhar a cama foi significativo (p = 0,00. Assim, num município com baixa prevalência de síndrome da morte súbita, os lactentes são expostos tanto a hábitos de sono protetores como de risco, sugerindo que, em populações desfavorecidas de países em desenvolvimento, outros fatores de risco dessa síndrome devam ser considerados.This cross-sectional study on sleeping habits with potential risk for sudden infant death syndrome included all live births in Passo Fundo, Rio Grande do Sul, Brazil, in 2003 with data collection from Certificates of Live Birth and interviews, analyzed with descriptive statistics and the qui-squared test. From the 2,634 live births, 2,285 children were selected (86.75%, with 8.4% exclusion and 5.2% losses. Protective habits included 77% of infants with appropriate clothing, 90% loosely wrapped, 69% with thin blankets, 98% sleeping in the parents' bedroom, and 56% in the crib. Potentially risky habits included lateral decubitus (92%, use of a pillow (88%, and feet far from the lower edge of the crib (96%. Among low-income families, bed-sharing with other

  6. Contralateral breast dose from partial breast brachytherapy.

    Science.gov (United States)

    Robinson, R Cole; Nelson, Christopher L; Bloom, Elizabeth S; Kisling, Kelly D; Mason, Bryan E; Fisher, Gary D; Kirsner, Steven M

    2015-11-08

    The purpose of this study was to determine the dose to the contralateral breast during accelerated partial breast irradiation (APBI) and to compare it to external beam-published values. Thermoluminescent dosimeter (TLD) packets were used to measure the dose to the most medial aspect of the contralateral breast during APBI simulation, daily quality assurance (QA), and treatment. All patients in this study were treated with a single-entry, multicatheter device for 10 fractions to a total dose of 34 Gy. A mark was placed on the patient's skin on the medial aspect of the opposite breast. Three TLD packets were taped to this mark during the pretreatment simulation. Simulations consisted of an AP and Lateral scout and a limited axial scan encompassing the lumpectomy cavity (miniscan), if rotation was a concern. After the simulation the TLD packets were removed and the patients were moved to the high-dose-rate (HDR) vault where three new TLD packets were taped onto the patients at the skin mark. Treatment was administered with a Nucletron HDR afterloader using Iridium-192 as the treatment source. Post-treatment, TLDs were read (along with the simulation and QA TLD and a set of standards exposed to a known dose of 6 MV photons). Measurements indicate an average total dose to the contralateral breast of 70 cGy for outer quadrant implants and 181 cGy for inner quadrant implants. Compared to external beam breast tangents, these results point to less dose being delivered to the contralateral breast when using APBI.

  7. Impacto da técnica de expiração lenta e prolongada na mecânica respiratória de lactentes sibilantes Impact of the prolonged slow expiratory maneuver on respiratory mechanics in wheezing infants

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    Fernanda de Cordoba Lanza

    2013-02-01

    Full Text Available OBJETIVO: Avaliar as alterações da mecânica respiratória e do volume corrente (VC em lactentes sibilantes em ventilação espontânea após a realização da técnica de expiração lenta e prolongada (ELPr. MÉTODOS: Foram incluídos no estudo lactentes com história de sibilância recorrente e sem exacerbações nos 15 dias anteriores. Para a avaliação da função pulmonar, os lactentes foram sedados e posicionados em decúbito dorsal com máscara facial acoplada a um pneumotacógrafo. As variáveis da respiração corrente - VC e FR - e da mecânica respiratória - complacência do sistema respiratório (Csr, resistência (Rsr e constante de tempo (psr - foram mensuradas antes e após a realização de três sequências consecutivas de ELPr. RESULTADOS: Foram avaliados 18 lactentes, com média de idade de 32 ± 11 semanas. Houve um aumento significante no VC após ELPr (79,3 ± 15,6 mL vs. 85,7 ± 17,2 mL; p = 0,009, assim como uma redução na FR (40,6 ± 6,9 ciclos/min vs. 38,8 ± 0,9 ciclos/min; p = 0,042. Entretanto, não houve alterações significantes nos valores da mecânica respiratória (Csr: 11,0 ± 3,1 mL/cmH2O vs. 11,3 ± 2,7 mL/cmH2O; Rsr: 29,9 ± 6,2 cmH2O • mL-1 • s-1 vs. 30,8 ± 7,1 cmH2O • mL-1 • s-1; e psr: 0,32 ± 0,11 s vs. 0,34 ± 0,12 s; p > 0,05 para todos. CONCLUSÕES: Essa técnica de fisioterapia respiratória é capaz de induzir alterações significativas no VC e na FR de lactentes com sibilância recorrente, mesmo na ausência de exacerbações. A manutenção das variáveis da mecânica respiratória indica que a técnica é segura para ser aplicada nesse grupo de pacientes. Estudos com lactentes sintomáticos são necessários para quantificar os efeitos funcionais da técnica.OBJECTIVE: To evaluate changes in respiratory mechanics and tidal volume (V T in wheezing infants in spontaneous ventilation after performing the technique known as the prolonged, slow expiratory (PSE maneuver. METHODS: We

  8. Efeitos do peso externo nos chutes espontâneos de lactentes nos primeiros dois meses de vida Effects of external load on spontaneous kicking by one and two-month-old infants

    Directory of Open Access Journals (Sweden)

    JF Landgraf

    2008-12-01

    Full Text Available OBJETIVO: Caracterizar o padrão de chutes espontâneos de lactentes nas idades de um e dois meses, bem como verificar se o peso externo modifica o padrão dos chutes nessas idades. MÉTODOS: Oito lactentes foram filmados nas idades de um e dois meses, estando em supino em uma cadeira infantil reclinada a 0º, na qual havia um móbile na extremidade superior e um painel na extremidade inferior. O experimento teve a duração de seis minutos e 20 segundos, durante os quais foram observados os movimentos de chutes nas situações sem e com peso de 1/10 e 1/3 da massa do membro inferior do lactente. Os pesos externos foram adicionados nos tornozelos do lactente. Pela análise das imagens coletadas por filmadoras digitais, foram verificados a freqüência de chutes e de contatos dos pés em um painel, os movimentos uni e bipodais, a preferência podal e o padrão de coordenação intramembro. RESULTADOS: O teste qui-quadrado revelou aumento significativo da freqüência de chutes nas idades de dois meses e nas situações de peso de 1/10 e pós-peso. Na situação de peso de 1/3 da massa do membro, verificaram-se diminuição do contato dos pés no painel e, na idade de dois meses, aumento da freqüência de contatos. Em todas as situações e idades, houve predomínio por chutes unipodais, não havendo preferência por um dos membros. Além disso, o padrão de coordenação intramembro dos chutes foi caracterizado como em-fase em ambas as idades. CONCLUSÕES: Fatores intrínsecos como a idade e extrínsecos como o peso externo referente a 1/10 da massa do membro inferior promoveram o aumento da freqüência dos chutes espontâneos em lactentes nas idades de um e dois meses.OBJECTIVE: To characterize the spontaneous kicking patterns among one and two-month-old infants, and find whether an external load can modify such patterns at this age. METHODS: Eight infants were filmed at the ages of one and two months, while in the supine position in a baby

  9. Avaliação da participação de mães em um programa de prevenção e controle de cáries e doenças periodontais para lactentes Evaluación de la participación de madres en un programa de prevención y control de las enfermedades caries y periodontal para lactantes Assessment of mothers' participation in a program of prevention and control of caries and periodontal diseases for infants

    Directory of Open Access Journals (Sweden)

    Rubenice Amaral da Silva

    2013-03-01

    Full Text Available OBJETIVO: Avaliar o conhecimento sobre saúde bucal de mães participantes de um programa educativo-preventivo para lactentes. MÉTODOS: Estudo de coorte com 112 mães e seus bebês de 0 a 18 meses, cadastrados no projeto "Promoção de Saúde Bucal na Primeira Infância", da Universidade Federal do Maranhão. Inicialmente, entrevistas semiestruturadas que contemplavam o nível de conhecimento das mães sobre a saúde bucal dos bebês foram realizadas. Também foi examinada a cavidade bucal dos bebês a fim de detectar o nível de placa bacteriana, sangramento gengival e presença de cárie. Em seguida, palestras educativo-preventivas foram ministradas e, após um ano de acompanhamento, novas entrevistas foram realizadas, bem como o exame clínico. Para analisar os dados, foram utilizados os testes de qui-quadrado e exato de Fisher com nível de significância de 5%. RESULTADOS: Antes das palestras educativas, 93% das mães executavam a higiene bucal de seus bebês e 57,3% a realizavam nos períodos diurno e noturno. Após as palestras, todas responderam executar os cuidados (p=0,02, sendo 74,7% nos períodos diurno e noturno (p=0,01. Não houve diferença quanto ao consumo de alimentos cariogênicos nos questionários inicial e final. Notou-se que, inicialmente, 5,6% das faces dentais apresentaram cárie; 29,7%, placa bacteriana; e 11,9%, sangramento gengival. Após as palestras, apenas 0,4% das faces dentais apresentaram cárie (pOBJETIVO: Evaluar el conocimiento sobre salud bucal de madres participantes de un programa educativo-preventivo para lactantes. MÉTODOS: Se realizó un estudio caso-control anidado a una cohorte. Se evaluaron a 112 madres y a sus bebés con edades de 0 a 18 meses, registrados en el proyecto «Promoción de Salud Bucal en la Primera Infancia», de la Universidad Federal de Maranhão. Inicialmente, se realizaron entrevistas semiestructuradas que contemplaban el nivel de conocimiento de las madres sobre la salud bucal

  10. Anterior septal deviation and contralateral alar collapse.

    Science.gov (United States)

    Schalek, P; Hahn, A

    2011-01-01

    Septal deviation is often found in conjunction with other pathological conditions that adversely affect nasal patency. Anterior septal deviation, together with contralateral alar collapse, is a relatively rare type of anatomical and functional incompetence. In our experience, it can often be resolved with septoplasty, without the necessity of surgery involving the external valve. The aim of this paper was to verify this hypothesis prospectively. Twelve patients with anterior septal deviation and simultaneous alar collapse on the opposite side were prospectively enrolled in the study. Subjective assessment of nasal patency was made on post-operative day 1, and again 6 months after surgery, using a subjective evaluation of nasal breathing. The width of the nostril (alar-columellar distance) on the side with the alar collapse was measured during inspiration pre-operatively, 1 day after surgery and again 6 months after surgery. Immediately after surgery, all patients reported improved or excellent nasal breathing on the side of the original septal deviation. On the collapsed side, one patient reported no change in condition. With the exception of one patient, all measurements showed some degree of improvement in the extension of the alar-columellar distance. The average benefit 6 months after surgery was an improvement of 4.54 mm. In our group of patients (anterior septal deviation and simultaneous contralateral alar collapse and no obvious structural changes of the alar cartilage) we found septoplasty to be entirely suitable and we recommend it as the treatment of choice in such cases.

  11. Presença de Candida spp. na cavidade bucal de lactentes durante os primeiros quatro meses de vida

    OpenAIRE

    Scherma, Alexandre Prado; Faculdade de Odontologia de São José dos Campos-UNESP; Santos, Daniel Valente de O.; Faculdade de Odontologia de São; Cardoso Jorge, Antonio Olavo; Faculdade de Odontologia de São José dos Campos – UNESP; Rocha, Rosilene Fernandes da; Faculdade de Odontologia de São José dos Campos – UNESP

    2010-01-01

    A candidose bucal é um dos processos infecciosos micóticos mais comuns da cavidade bucal e existe suscetibilidade aumentada para o mesmo durante o período neonatal principalmente devido à imaturidade dos mecanismos de defesa e a falta de um microbiota bucal balanceada. Para verificar a presença de Candida spp. na cavidade bucal de lactentes foram examinados inicialmente cem bebês, nos quais foi feita coleta de material do dorso da língua com swa...

  12. Lumbar disc cyst with contralateral radiculopathy

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    Kishore Tourani

    2012-08-01

    Full Text Available Disc cysts are uncommon intraspinal cystic lesions located in the ventrolateral epidural space. They communicate with the nucleus pulposus of the intervertebral disc and cause symptoms by radicular compression. We report a unique case of lumbar disc cyst that was associated with disc herniation and contralateral radiculopathy. A 22 year old male presented with one month history of back-ache radiating to the left leg. Magnetic Resonance Imaging (MRI showed L3-L4 disc herniation with annular tear and cystic lesion in the extradural space anterior to the thecal sac on right side, which increased in size over a period of 3 weeks. L3 laminectomy and bilateral discectomy and cyst excision was done with partial improvement of patients symptoms.

  13. Manifestações neurológicas na intoxicação de lactentes pela associação dimeticona e homatropina: relato de 6 casos

    Directory of Open Access Journals (Sweden)

    Assencio-Ferreira Vicente José

    2001-01-01

    Full Text Available OBJETIVO: alertar que o uso da associação dimeticona/homatropina (Espasmo Luftal® em recém-nascidos e lactentes de até dois meses, pode causar episódios disfuncionais transitórios extrapiramidais. MÉTODO: relato de 6 casos de crianças com menos de 2 meses, em uso diário da associação dimeticona/homatropina, que apresentaram sintomas agudos caracterizados por crises repetidas de curta duração com desvio tônico da cabeça para trás (opistótono, desvio do olhos para cima com olhar fixo e expressão de terror, postura mantida em hipertonia extensora dos 4 membros e emissão de choro e/ou sons guturais. RESULTADOS: os sintomas extrapiramidais desapareceram (e não retornaram após a suspensão da associação dimeticona/homatropina. Não foram constatadas anormalidades no exame neurológico, eletrencefalograma e provas sanguíneas. CONCLUSÕES: a associação dimeticona/homatropina pode determinar em crianças com menos de 2 meses, quadro disfuncional dos gânglios da base. É importante diferenciá-lo das crises epilépticas generalizadas, a fim de se evitar a utilização, errônea, de drogas antiepilépticas.

  14. Contralateral reinnervation of midline muscles in nonidiopathic facial palsy.

    NARCIS (Netherlands)

    Gilhuis, H.J.; Beurskens, C.H.G.; Vries, J. de; Marres, H.A.M.; Hartman, E.H.M.; Zwarts, M.J.

    2003-01-01

    The purpose of this study was to analyze contralateral reinnervation of the facial nerve in eight patients with complete facial palsy after surgery or trauma and seven healthy volunteers. All patients had contralateral reinnervation of facial muscles as demonstrated by electrical nerve stimulation v

  15. Vestibular schwannoma with contralateral facial pain – case report

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    Ghodsi Mohammad

    2003-03-01

    Full Text Available Abstract Background Vestibular schwannoma (acoustic neuroma most commonly presents with ipsilateral disturbances of acoustic, vestibular, trigeminal and facial nerves. Presentation of vestibular schwannoma with contralateral facial pain is quite uncommon. Case presentation Among 156 cases of operated vestibular schwannoma, we found one case with unusual presentation of contralateral hemifacial pain. Conclusion The presentation of contralateral facial pain in the vestibular schwannoma is rare. It seems that displacement and distortion of the brainstem and compression of the contralateral trigeminal nerve in Meckel's cave by the large mass lesion may lead to this atypical presentation. The best practice in these patients is removal of the tumour, although persistent contralateral pain after operation has been reported.

  16. Femoropopliteal artery centerline interpolation using contralateral shape.

    Science.gov (United States)

    Tran, David N; Fleischmann, Dominik; Rakshe, Tejas; Roos, Justus E; Rosenberg, Jarrett; Straka, Matus; Napel, Sandy

    2007-09-01

    Curved planar reformation allows comprehensive visualization of arterial flow channels, providing information about calcified and noncalcified plaques and degrees of stenoses. Existing semiautomated centerline-extraction algorithms for curved planar reformation generation fail in severely diseased and occluded arteries. We explored whether contralateral shape information could be used to reconstruct centerlines through femoropopliteal occlusions. We obtained CT angiography data sets of 29 subjects (16m/13f, 19-86yo) without peripheral arterial occlusive disease and five consecutive subjects (1m/4f, 54-85yo) with unilateral femoropopliteal arterial occlusions. A gradient-based method was used to extract the femoropopliteal centerlines in nondiseased segments. Centerlines of the five occluded segments were manually determined by four experts, two times each. We interpolated missing centerlines in 2475 simulated occlusions of various occlusion lengths in nondiseased subjects. We used different curve registration methods (reflection, similarity, affine, and global polynomial) to align the nonoccluded segments, matched the end points of the occluded segments to the corresponding patent end points, and recorded maximum Euclidean distances to the known centerlines. We also compared our algorithm to an existing knowledge-based PCA interpolation algorithm using the nondiseased subjects. In the five subjects with real femoropopliteal occlusions, we measured the maximum Euclidean distance and the percentage of the interpolation that remained within a typical 3 mm radius vessel. In the nondiseased subjects, we found that the rigid registration methods were not significantly (pinterpolation of centerlines through arterial occlusions.

  17. Carotid endarterectomy in patients with contralateral carotid artery occlusion.

    Science.gov (United States)

    Dalainas, Ilias; Nano, Giovanni; Bianchi, Paolo; Casana, Renato; Malacrida, Giovanni; Tealdi, Domenico G

    2007-01-01

    The aim of this study was to evaluate the 30-day outcome of carotid endarterectomy in patients with contralateral carotid artery occlusion and compare it to that in patients with patent contralateral carotid artery. We compared 2,959 carotid endarterectomies performed in patients with patent contralateral internal carotid artery to 373 carotid endarterectomies performed in patients with occlusion of the contralateral carotid artery in the same institute between 1988 and 2004. Patient demographics, surgical and anesthesiological strategy, perioperative neurological and cardiac events, and deaths were compared. The patients were grouped and analyzed according to the presence or absence of symptoms and to their gender. No significant difference was shown in perioperative cardiological and neurological events and deaths in patients with contralateral carotid occlusion versus patients without contralateral carotid occlusion. Females had significant more neurological events than males, in both the asymptomatic (P < 0.001) and symptomatic (P = 0.02) groups. Concomitant occlusion of the contralateral carotid artery was not associated with increased risk of perioperative cardiological or neurological adverse events. However, female gender was associated with higher risk for adverse neurological events.

  18. Changes in contralateral protein metabolism following unilateral sciatic nerve section

    Energy Technology Data Exchange (ETDEWEB)

    Menendez, J.A.; Cubas, S.C.

    1990-03-01

    Changes in nerve biochemistry, anatomy, and function following injuries to the contralateral nerve have been repeatedly reported, though their significance is unknown. The most likely mechanisms for their development are either substances carried by axoplasmic flow or electrically transmitted signals. This study analyzes which mechanism underlies the development of a contralateral change in protein metabolism. The incorporation of labelled amino acids (AA) into proteins of both sciatic nerves was assessed by liquid scintillation after an unilateral section. AA were offered locally for 30 min to the distal stump of the sectioned nerves and at homologous levels of the intact contralateral nerves. At various times, from 1 to 24 h, both sciatic nerves were removed and the proteins extracted with trichloroacetic acid (TCA). An increase in incorporation was found in both nerves 14-24 h after section. No difference existed between sectioned and intact nerves, which is consistent with the contralateral effect. Lidocaine, but not colchicine, when applied previously to the nerves midway between the sectioning site and the spinal cord, inhibited the contralateral increase in AA incorporation. It is concluded that electrical signals, crossing through the spinal cord, are responsible for the development of the contralateral effect. Both the nature of the proteins and the significance of the contralateral effect are matters for speculation.

  19. Crescimento de lactentes não-anêmicos suplementados com diferentes doses profiláticas de ferro Growth in non-anemic infants supplemented with different prophylactic iron doses

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    Danielle G. da Silva

    2008-08-01

    Full Text Available OBJETIVO: Comparar os efeitos de diferentes doses profiláticas de ferro sobre o crescimento e estado nutricional de lactentes não-anêmicos. MÉTODOS: Estudo do tipo prospectivo e randomizado. Lactentes de 5,0 a 6,9 meses de vida que atenderam aos critérios de inclusão e apresentaram hemoglobina capilar ≥ 11 g/dL foram alocados randomicamente em três grupos com doses profiláticas de suplemento de ferro (sulfato ferroso de 1 mg/kg/dia (n = 39, 2 mg/kg/dia (n = 36 e 25 mg/semana (n = 39. A suplementação durou 16 semanas. Foram avaliados peso e comprimento. O estado nutricional foi avaliado por meio dos escores z do peso/idade, comprimento/idade e peso/comprimento com base na referência da Organização Mundial da Saúde (2006. Os dados de morbidade foram obtidos durante as visitas mensais. RESULTADOS: Antes da suplementação, os grupos apresentaram similar estado nutricional. Não houve diferença entre os grupos na ingestão diária de nutrientes. Durante o estudo, o ganho de peso, o ganho de comprimento e os incrementos nos índices antropométricos não diferiram estatisticamente entre os grupos suplementados. A ocorrência e duração dos episódios de morbidade não diferiram estatisticamente entre os grupos. De modo geral, observaram-se melhorias nos índices peso/idade e peso/comprimento na população estudada, porém o comprimento/idade não apresentou diferenças antes e após a suplementação. CONCLUSÃO: As diferentes doses profiláticas de ferro não exerceram efeito diferenciado sobre o crescimento e estado nutricional dos lactentes não-anêmicos.OBJECTIVE: To compare the effects of different prophylactic iron doses on the growth and nutritional status of non-anemic infants. METHODS: Prospective randomized study. Infants aged 5.0 to 6.9 months who met the inclusion criteria and showed capillary hemoglobin ≥ 11 g/dL were randomly allocated into three groups who received the following prophylactic doses of iron

  20. Variabilidade do risco do tempo de permanência ajustado para lactentes de muito baixo peso ao nascer entre centros da Neocosur South American Network Center variability in risk of adjusted length of stay for very low birth weight infants in the Neocosur South American Network

    Directory of Open Access Journals (Sweden)

    Guillermo Marshall

    2012-12-01

    Full Text Available OBJETIVOS: Desenvolver um modelo de predição para o tempo de permanência hospitalar (TPH em lactentes de muito baixo peso ao nascer (MBPN e comparar esse resultado entre 20 centros de uma rede neonatal, visto que o TPH é utilizado como uma medida da qualidade da assistência em lactentes de MBPN. MÉTODOS: Utilizamos dados coletados prospectivamente de 7.599 lactentes com peso ao nascer entre 500 e 1.500 g no período entre os anos de 2001 a 2008. O modelo de regressão de Cox foi empregado para desenvolver dois modelos de predição: um modelo prévio com dados do nascimento e outro posterior, que acrescenta morbidades relevantes dos primeiros 30 dias de vida. RESULTADOS: A mediana do TPH estimado e ajustado a partir do nascimento foi de 59 dias; 28 dias depois do tempo de sobrevida de 30 dias. Houve uma alta correlação entre os modelos (r = 0,92. O TPH esperado e o TPH observado variaram bastante entre os centros, mesmo depois de correção para as morbidades relevantes após 30 dias. O TPH mediano (variação: 45-70 dias e a idade concepcional na alta hospitalar (variação: 36,4-39,9 semanas refletem uma variabilidade alta entre centros. CONCLUSÃO: Um modelo simples, com fatores apresentados no nascimento, pode predizer o TPH de um lactente de MBPN em uma rede neonatal. Observou-se uma variabilidade nos TPHs considerável entre unidades de terapia intensiva neonatal. Especulamos que os resultados sejam provenientes das diferenças entre as práticas dos centros.OBJECTIVES: To develop a prediction model for hospital length of stay (LOS in very low birth weight (VLBW infants and to compare this outcome among 20 centers within a neonatal network. METHODS: Data from 7,599 infants with birth weights of 500-1,500 g born between the years 2001-2008 were prospectively collected. The Cox regression model was employed to develop two prediction models: an early model based upon variables present at birth, and a late one that adds relevant

  1. Prognóstico de crianças portadoras de insuficiência renal aguda em unidade de terapia intensiva

    OpenAIRE

    Bresolin, Nilzete Liberato

    2004-01-01

    Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saude. Programa de Pós-graduação em Ciências Médicas Introdução: A insuficiência renal aguda (IRA) representa um fator importante de morbidade e mortalidade para lactentes e crianças gravemente enfermas. No entanto, há na literatura poucos estudos sobre fatores prognósticos nestes pacientes.

  2. Influência das avós na alimentação de lactentes: o que dizem suas filhas e noras Influencia de las abuelas en la alimentación de lactantes Influence of grandmothers on infant feeding: what they say to their daughters and granddaughters

    Directory of Open Access Journals (Sweden)

    Fabiana de Medeiros Gross

    2011-01-01

    Full Text Available OBJETIVO: Identificar as práticas de primíparas sobre a alimentação de crianças lactentes aprendidas com a mãe e/ou sogra. MÉTODOS: Trata-se de pesquisa qualitativa, do tipo descritiva. Os sujeitos foram 11 primíparas, usuárias do Sistema Único de Saúde de Palmeira das Missões/RS. Os dados foram coletados por entrevista semiestruturada e analisados por meio da análise temática. RESULTADOS: Emergiram três temas: práticas de alimentação transmitidas pelas avós; influência das avós na alimentação do lactente; sentimentos das primíparas em relação às ações das avós relativas à alimentação do lactente. CONCLUSÕES: As avós são importantes no que diz respeito à transmissão de conhecimentos, saberes e experiências relativas à alimentação do lactente. Para que a assistência de enfermagem priviligie a autonomia dos sujeitos que envolve corresponsabilidade e congruência cultural, o enfermeiro deve considerar as interações do grupo familiar que, em seu movimento dialético, modulam e são moduladas pela cultura.OBJETIVO: Identificar las prácticas de primigestas sobre la alimentación de niños lactantes aprendidas con la madre y/o suegra. MÉTODOS: Se trata de una investigación cualitativa, de tipo descriptiva. Los sujetos fueron 11 primigestas, usuarias del Sistema Único de Salud de Palmeira das Missões/RS. Los datos fueron recolectados por entrevista semiestructurada y analizados por medio del análisis temático. RESULTADOS: Emergieron tres temas: prácticas de alimentación transmitidas por las abuelas; influencia de las abuelas en la alimentación del lactante; sentimientos de las primigestas en relación a las acciones de las abuelas relativas a la alimentación del lactante. CONCLUSIONES: Las abuelas son importantes en lo referente a la transmisión de conocimientos, saberes y experiencias relativas a la alimentación del lactante. Para que la asistencia de enfermería privilegie la autonomía de los

  3. Fate of the contralateral limb after lower extremity amputation

    Science.gov (United States)

    Glaser, Julia D.; Bensley, Rodney P.; Hurks, Rob; Dahlberg, Suzanne; Hamdan, Allen D.; Wyers, Mark C.; Chaikof, Elliot L.; Schermerhorn, Marc L.

    2013-01-01

    Objective Lower extremity amputation is often performed in patients where both lower extremities are at risk due to peripheral arterial disease or diabetes, yet the proportion of patients who progress to amputation of their contralateral limb is not well defined. We sought to determine the rate of subsequent amputation on both the ipsilateral and contralateral lower extremities following initial amputation. Methods We conducted a retrospective review of all patients undergoing lower extremity amputation (exclusive of trauma or tumor) at our institution from 1998 to 2010. We used International Classification of Diseases-Ninth Revision codes to identify patients and procedures as well as comorbidities. Outcomes included the proportion of patients at 1 and 5 years undergoing contralateral and ipsilateral major and minor amputation stratified by initial major vs minor amputation. Cox proportional hazards regression analysis was performed to determine predictors of major contralateral amputation. Results We identified 1715 patients. Mean age was 67.2 years, 63% were male, 77% were diabetic, and 34% underwent an initial major amputation. After major amputation, 5.7% and 11.5% have a contralateral major amputation at 1 and 5 years, respectively. After minor amputation, 3.2% and 8.4% have a contralateral major amputation at 1 and 5 years while 10.5% and 14.2% have an ipsilateral major amputation at 1 and 5 years, respectively. Cox proportional hazards regression analysis revealed end-stage renal disease (hazard ratio [HR], 3.9; 95% confidence interval [CI], 2.3–6.5), chronic renal insufficiency (HR, 2.2; 95% CI, 1.5–3.3), atherosclerosis without diabetic neuropathy (HR, 2.9; 95% CI, 1.5–5.7), atherosclerosis with diabetic neuropathy (HR, 9.1; 95% CI, 3.7–22.5), and initial major amputation (HR, 1.8; 95% CI, 1.3–2.6) were independently predictive of subsequent contralateral major amputation. Conclusions Rates of contralateral limb amputation are high and predicted

  4. Longitudinal anthropometric assessment of infants born to HIV-1-infected mothers, Belo Horizonte, Southeastern Brazil Evaluación antropométrica longitudinal de lactantes nacidos de madres infectadas por VIH-1 Avaliação antropométrica longitudinal de lactentes nascidos de mães infectadas pelo HIV-1

    Directory of Open Access Journals (Sweden)

    Maria Arlene Fausto

    2011-08-01

    (variación: 6,8 a 18,0 meses y 14,3 meses (variación: 6,3 a 18,6 meses, respectivamente. Se utilizó el modelo de regresión linear de efectos mixtos ajustado por máxima verosimilitud restringida para construir las curvas de crecimiento. RESULTADOS: Los z-escores PI, EI y PE de los lactantes infectados con el VIH-1 presentaron decrecimiento. A los seis meses, la diferencia promedio en los z-escores PI, EI y PE entre lactantes infectados y no infectados con el VIH era, respectivamente, 1,02, 0,59 y 0,63 desviaciones-estándares. A los 12 meses, la diferencia promedio en los z-escores PI, EI y PE entre lactantes infectados y no infectados era, respectivamente, 1,15, 1,01 y 0,87 desviaciones-estándares. CONCLUSIONES: El comprometimiento precoz y creciente de los indicadores antropométricos de niños infectados con el VIH-1 muestra la importancia de identificar precozmente niños infectados con el VIH que están en riesgo nutricional y la necesidad de evaluarse continuamente las intervenciones nutricionales adoptadas.OBJETIVO: Avaliar os parâmetros de crescimento em lactentes nascidos de mães infectadas com o HIV-1. MÉTODOS: Avaliação longitudinal dos z-escores peso-idade (PI, estatura-idade (EI, peso-estatura (PE foi realizada em uma coorte. Foram estudados 97 lactentes não-infectados e 33 lactentes infectados nascidos de mães infectadas com o HIV-1 em Belo Horizonte, MG, de 1995 a 2003. O tempo mediano de seguimento para os lactentes infectados e não-infectados foi de 15,8 meses (variação: 6,8 a 18,0 meses e 14,3 meses (variação: 6,3 a 18,6 meses, respectivamente. Utilizou-se o modelo de regressão linear de efeitos mistos ajustado por máxima verossimilhança restrita para construir as curvas de crescimento. RESULTADOS: Os z-escores PI, EI e PE dos lactentes infectados com o HIV-1 apresentaram decréscimo. Aos seis meses, a diferença média nos z-escores PI, EI e PE entre lactentes infectados e não-infectados com o HIV era, respectivamente, 1,02, 0,59 e 0

  5. Contralateral risk reducing mastectomy in Non-BRCA-Mutated patients

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    Falco Giuseppe

    2016-01-01

    Full Text Available The use of contralateral risk reducing mastectomy (CRRM is indicated in women affected by breast cancer, who are at high risk of developing a contralateral breast cancer, particularly women with genetic mutation of BRCA1, BRCA2 and P53. However we should consider that the genes described above account for only 20-30% of the excess familiar risk. What is contralaterally indicated when genetic assessment results negative for mutation in a young patient with unilateral breast cancer? Is it ethically correct to remove a contralateral “healthy” breast? CRRM rates continue to rise all over the world although CRRM seems not to improve overall survival in women with unilateral sporadic breast cancer. The decision to pursue CRRM as part of treatment in women who have a low-to-moderate risk of developing a secondary cancer in the contralateral breast should consider both breast cancer individual-features and patients preferences, but should be not supported by the surgeon and avoided as first approach with the exception of women highly worried about cancer. Prospective studies are needed to identify cohorts of patients most likely to benefit from CRRM.

  6. Tinnitus intensity dependent gamma oscillations of the contralateral auditory cortex.

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    Elsa van der Loo

    Full Text Available BACKGROUND: Non-pulsatile tinnitus is considered a subjective auditory phantom phenomenon present in 10 to 15% of the population. Tinnitus as a phantom phenomenon is related to hyperactivity and reorganization of the auditory cortex. Magnetoencephalography studies demonstrate a correlation between gamma band activity in the contralateral auditory cortex and the presence of tinnitus. The present study aims to investigate the relation between objective gamma-band activity in the contralateral auditory cortex and subjective tinnitus loudness scores. METHODS AND FINDINGS: In unilateral tinnitus patients (N = 15; 10 right, 5 left source analysis of resting state electroencephalographic gamma band oscillations shows a strong positive correlation with Visual Analogue Scale loudness scores in the contralateral auditory cortex (max r = 0.73, p<0.05. CONCLUSION: Auditory phantom percepts thus show similar sound level dependent activation of the contralateral auditory cortex as observed in normal audition. In view of recent consciousness models and tinnitus network models these results suggest tinnitus loudness is coded by gamma band activity in the contralateral auditory cortex but might not, by itself, be responsible for tinnitus perception.

  7. The Manchester guidelines for contralateral risk-reducing mastectomy.

    Science.gov (United States)

    Basu, Narendra Nath; Ross, G L; Evans, D G; Barr, L

    2015-08-07

    Rates of contralateral risk-reducing mastectomy (CRRM) are rising, despite a decreasing global incidence of contralateral breast cancer. Reasons for requesting this procedure are complex, and we have previously shown a variable practice amongst breast and plastic surgeons in England. We propose a protocol, based on a published systematic review, a national UK survey and the Manchester experience of CRRM. We reviewed the literature for risk factors for contralateral breast cancer and have devised a 5-step process that includes history taking, calculating contralateral breast cancer risk, cooling off period/counselling, multi-disciplinary assessment and consent. Members of the multi-disciplinary team included the breast surgeon, plastic surgeon and geneticist, who formulated guidelines. A simple formula to calculate the life-time risk of contralateral breast cancer has been devised. This allows stratification of breast cancer patients into different risk-groups: low, above average, moderate and high risk. Recommendations vary according to different risk groups. These guidelines are a useful tool for clinicians counselling women requesting CRRM. Risk assessment is mandatory in this group of patients, and our formula allows evidence-based recommendations to be made.

  8. Hemifacial Spasm Associated with Contralateral Foramen Magnum Meningioma.

    Science.gov (United States)

    Matsuda, Masahide; Akutsu, Hiroyoshi; Yamamoto, Tetsuya; Ishikawa, Eiichi; Matsumura, Akira

    2016-05-01

    Hemifacial spasm (HFS) caused by a contralateral tumor is extremely rare, and all previously reported cases involved tumors at the cerebellopontine angle. We provide the first report to our knowledge of HFS caused by a contralateral foramen magnum meningioma, which improved after tumor removal without microvascular decompression. An 80-year-old woman presented with HFS caused by a contralateral foramen magnum meningioma. She had a 3-year history of gradual worsening of right-sided HFS. Magnetic resonance imaging showed a homogeneous gadolinium-enhancing tumor occupying the left ventrolateral portion of the foramen magnum. The loop of the right anterior inferior cerebellar artery extended into the right pontomedullary junction, compressing the root exit zone (REZ) of the right facial nerve. After tumor removal, with no attempt of confirmation of vascular compression of the right facial nerve REZ, facial spasm gradually decreased and eventually almost disappeared. Postoperative magnetic resonance imaging revealed that the loop of anterior inferior cerebellar artery had shifted away from the right facial nerve REZ. Dorsal shift of the anterior inferior cerebellar artery loop toward the facial nerve REZ along with dorsal shift of the vertebral and basilar arteries secondary to the huge contralateral mass located in the ventrolateral portion of the foramen magnum was suggested to represent the main cause of facial spasm. Although an extremely rare condition, facial spasm can develop as a result of contralateral tumors in locations other than the cerebellopontine angle. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Padrão alimentar de lactentes residentes em áreas periféricas de Fortaleza

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    SOARES Nadia Tavares

    2000-01-01

    Full Text Available Este estudo caracterizou o padrão alimentar de 96 crianças menores de um ano assistidas pelo Fundo Cristão para Crianças nos bairros Álvaro Weyne e Presidente Kennedy, na cidade de Fortaleza, Brasil. Os dados foram levantados por meio de entrevista domiciliar, utilizando o método recordatório 24h para conhecimento das quantidades dos alimentos consumidos, e um formulário contendo perguntas estruturadas sobre a prática do aleitamento materno e idade de introdução dos alimentos de desmame. Os resultados indicaram que o aleitamento materno misto predomina (68% sobre o aleitamento artificial (32% e exclusivo (10% e que 7% das crianças nunca receberam leite materno. Porém, até o final do décimo mês de vida, 53% das crianças ainda são amamentadas. Mingau lácteo, preparado com leite de vaca não modificado, constitui a alimentação básica de desmame. Do ponto de vista nutricional, as dietas são desbalanceadas, sendo o ferro o nutriente mais deficiente. Devem ser intensificados os esforços na promoção da alimentação infantil apropriada.

  10. Facial electroneurography on the contralateral side in unilateral Bell's palsy.

    Science.gov (United States)

    Psillas, G; Daniilidis, J

    2002-07-01

    In this study, ten patients who exhibited severe unilateral Bell's palsy of the House-Brackmann grade V underwent facial electroneurography (ENoG) on the contralateral, healthy side. Serial ENoG was conducted in seven consecutive sessions within 6 months at a given current intensity level of stimulation. According to our results, all the patients presented a rise in the maximum compound-action potential (MCAP) amplitude on the healthy side within 20 to 45 days from the onset of the palsy and shortly after the onset of the recovery of the facial function. This was attributed to the central contralateral compensatory process, which restores balanced facial function. Based on our data, a hypothetical model is shown, which demonstrates the clinical course of the contralateral MCAP values and reflects the plasticity effect of the central nervous system after the onset of Bell's palsy.

  11. Contralateral breast symmetrisation in unilateral DIEP flap breast reconstruction.

    Science.gov (United States)

    Wade, Ryckie G; Marongiu, Francesco; Sassoon, Elaine M; Haywood, Richard M; Ali, Rozina S; Figus, Andrea

    2016-10-01

    Women undergoing unilateral deep inferior epigastric artery perforator (DIEP) flap breast reconstruction may be offered a contralateral symmetrisation either at the time of reconstruction (simultaneous/immediate) or at a later stage (delayed). Simultaneous contralateral breast symmetrisation may be more beneficial to patients and healthcare institutions by avoiding staged surgery, although there is limited evidence on which to base practice. This deficit formed the rationale for our study. The primary outcome was the overall rate of revision surgery. Over a 6-year period, this prospective cohort study recorded the demographics, cancer treatments and operative outcomes of all consecutive unilateral DIEP flap breast reconstructions with or without contralateral symmetrising surgery. Patients were categorised into three groups: (1) simultaneous symmetrisation, 2) delayed symmetrisation and (3) no symmetrisation for comparative analysis. During the study period, 371 women underwent unilateral DIEP flap breast reconstruction 194 (52.3%) were not symmetrised, 155 (41.8%) were simultaneously symmetrised and 22 (5.9%) underwent delayed symmetrisation. Simultaneous symmetrisation of the contralateral breast and unilateral DIEP flap breast reconstruction increased the mean total operative time by 28 min. There were no differences in the rates of peri-operative complications. There were significantly higher rates of all-cause revision surgery (OR 3.97 [1.58, 9.94], p = 0.003) in women undergoing delayed symmetrisation, because of higher rates of revision lipomodelling, scar revision and revision contralateral symmetrisation. Simultaneous contralateral breast symmetrisation was associated with a lower risk of all-cause revision surgery. It is safe, beneficial and likely to be more cost-effective for women undergoing unilateral free DIEP flap breast reconstruction. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier

  12. Solitary Contralateral Adrenal Metastases after Nephrectomy for Renal Cell Carcinoma

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    Nikolaos Antoniou

    2004-01-01

    Full Text Available Two cases are reported of patients with a single metastasis in the contralateral adrenal, one and nine years respectively after nephrectomy for localized cancer in the opposite kidney. These types of metastases are usually asymptomatic they do not appear with signs of adrenal insufficiency, they are detected incidentally and the diagnosis is confirmed mainly with CT scan, which comprises the method of choice for the detection of such types of metastases. Many adrenal metastases probably have been overlooked in the past when advanced imaging techniques were not available. Both patients underwent adrenalectomy and replacement therapy with corticosteroids. Approximately 50% of all patients with renal cell carcinoma either present with metastases at diagnosis or will have metastatic disease after nephrectomy11. In order of decreasing frequency, the most common metastatic sites are the lungs, lymph nodes, liver, bone, contralateral kidney and ipsilateral adrenal glands. Adrenal involvement has been reported in 7 to 19% of autopsystudies. 1,3 Solitary metachronous metastatic involvement of the contralateral adrenal from renal cell carcinoma is rarely diagnosed during life and only 4 cases have been reported. 4,5 Recent advances in imaging techniques have allowed the diagnosis of adrenal involvement by renal cancer. Two cases of contralateral adrenal metastasis are reported 1 and 9 years after radical nephrectomy for localized renal cell carcinoma. Both patients underwent adrenalectomy and steroid replacement therapy.

  13. Comparação entre as curvas de crescimento do Centers for Disease Control and Prevention e da Organização Mundial da Saúde para lactentes com idade de seis a 12 meses Comparison between the Centers for Disease Control and Prevention and the World Health Organization growth curves for six to 12 months old infants

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    Bianca Sant'Anna Pires

    2010-12-01

    Full Text Available OBJETIVO: Comparar o estado nutricional de lactentes de ambos os sexos de acordo com a curva proposta pelo Centers for Disease Control and Prevention (CDC-2000 e com a nova curva de crescimento proposta pela Organização Mundial da Saúde (OMS-2006. MÉTODOS: Estudo longitudinal no qual foram acompanhadas crianças de ambos os sexos, nascidas a termo, com idade entre seis meses e um ano, em aleitamento materno predominante ou exclusivo. Os dados foram coletados por um único pesquisador por meio de ficha de atendimento nutricional composta por dados demográficos, antropométricos e sobre a alimentação da criança. Foram realizados testes de Wilcoxon e Friedman para comparar cada medida das curvas e analisar a variância, respectivamente. RESULTADOS: Da amostra final de 55 crianças, 51% (n=28 eram do sexo masculino. Os percentuais de eutrofia dos índices de peso por idade e de estatura adequada para idade de ambos os sexos apresentaram-se acima de 80%. Não houve diferença significante na classificação do estado nutricional, segundo as curvas utilizadas. A porcentagem de concordância das duas curvas em relação ao peso e à estatura foi de 98,2 e 96,4%, respectivamente. CONCLUSÕES: As curvas de crescimento da OMS-2006 e do CDC-2000 foram similares para classificar o estado nutricional de lactentes entre 6-12 meses em aleitamento materno.OBJECTIVE: Compare the nutritional status of male and female infants classified according to the growth curve proposed by the Center for Disease Control and Prevention (CDC-2000 and the new growth curve proposed by the World Health Organization (WHO-2006. METHODS: This longitudinal study enrolled children of 6-12 months old of both genders. They were born at term and exclusively or predominantly breastfed. A single researcher collected demographic, anthropometric and nutritional data. The Wilcoxon test was used to compare curves and the Friedman test was used to analyze the variance. RESULTS: Among the

  14. The routine of families with nursing infants Rutinas familiares con lactantes Rotinas das famílias com crianças lactentes

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    Astrid Eggert Boehs

    2007-10-01

    descritivo, de abordagem qualitativa, investigou-se as rotinas de famílias com filhos lactentes de 6 meses a 2 anos, cujas mães enfrentam o mercado de trabalho e se utilizam de Unidade Básica de Saúde em um município do Sul do Brasil. Como referencial teórico, utilizou-se a abordagem das rotinas familiares. Foram entrevistadas 25 mães, através de formulário semi-estruturado. A análise dos dados qualitativos seguiu as fases de organização, codificação, categorização e interpretação dos dados. Identificou-se que as rotinas familiares de cuidado variam com a periodicidade, horário e tipo de ocupação da mãe. Foram identificadas diferentes alternativas de cuidado da criança e, apesar de grande parte das entrevistadas se considerarem casadas, quase não houve menção aos maridos na rotina. A investigação, baseada nas rotinas da família, possibilita identificar os papéis familiares, as relações sociais e a organização de cuidados na saúde.

  15. Método para análise cinemática dos chutes de lactentes Método para el análisis cinemático de los pataleos de lactantes Method for the kinematic analysis of kicking movement in infants

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    Jocelene de Fátima Landgraf

    2013-03-01

    Full Text Available Os objetivos deste estudo foram descrever o método utilizado para a análise cinemática dos movimentos de chutes em lactentes e testar sua viabilidade de uso, empregando o sistema Dvideow. Para adequação do método, quatro lactentes foram filmados, longitudinalmente, nas idades de um a seis meses na posição supina. O experimento teve a duração de dois minutos, subdivididos em duas condições: treinamento e observação. O sistema Dvideow 6.3 foi utilizado para análise das imagens. Foi verificado que o uso de quatro câmeras de vídeo é mais apropriado para garantir a visibilidade de dois marcadores, simultaneamente, permitindo a reconstrução tridimensional do movimento. Além disso, utilizamos 6 fios de prumo para calibrar o sistema e garantir uma precisão de 2 mm. Portanto, concluímos que a utilização do sistema Dvideow para realizar a análise cinemática dos chutes de lactentes mostrou-se adequada e viável, uma vez que esse sistema é acessível, de baixo custo e de fácil utilização para os pesquisadores em geral.Los objetivos de este estudio fueron describir el método utilizado para el análisis cinemático de los movimientos de pataleo en lactantes y probar su factibilidad de uso, empleando el sistema Dvideow. Para la adecuación del método, cuatro lactantes fueron filmados, longitudinalmente, en las edades de uno a seis meses en la posición supina. El experimento tiene una duración de dos minutos, subdivididos en dos condiciones: entrenamiento y observación. El sistema Dvideow 6.3 fue utilizado para el análisis de las imágenes. Fue verificado que el uso de cuatro cámaras de video es más apropiado para garantizar la visibilidad de dos marcadores simultáneos, permitiendo la reconstrucción tridimensional del movimiento. Además, utilizamos seis alambres de plomo para calibrar el sistema y garantizar una precisión de 2 mm. Por lo tanto, concluimos que la utilización del sistema Dvideow para realizar el an

  16. Ultrasound screening of contralateral breast after surgery for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Ja [Department of Radiology, Seoul Metropolitan Government Seoul National University, Boramae Medical Center (Korea, Republic of); Chung, Se-Yeong; Chang, Jung Min; Cho, Nariya [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Han, Wonshik [Department of Surgery, Seoul National University Hospital (Korea, Republic of); Moon, Woo Kyung, E-mail: moonwk@snu.ac.kr [Department of Radiology, Seoul National University Hospital (Korea, Republic of)

    2015-01-15

    Highlights: • The addition of supplemental US to mammography depicted additional 5.0 cancers per 1000 postoperative women. • Positive biopsy rate of mammography-detected lesions was 66.7% (4 of 6) and that of US-detected lesions was 40.0% (6 of 15). • US can be helpful to detect mammographically occult breast cancer in the contralateral breast in women with previous history of cancer and dense breast. - Abstract: Objective: To determine whether supplemental screening ultrasound (US) to mammography could improve cancer detection rate of the contralateral breast in patients with a personal history of breast cancer and dense breasts. Materials and methods: During a one-year study period, 1314 screening patients with a personal history of breast cancer and dense breasts simultaneously underwent mammography and breast US. BI-RADS categories were given for mammography or US-detected lesions in the contralateral breast. The reference standard was histology and/or 1-year imaging follow-up, and the cancer rate according to BI-RADS categories and cancer detection rate and positive biopsy rate according to detection modality were analyzed. Results: Of 1314 patients, 84 patients (6.4%) were categorized as category 3 with one interval cancer and one cancer which was upgraded to category 4A after 6-month follow-up US (2.5% cancer rate, 95% CIs 1.5–9.1%). Fifteen patients (1.1%) had category 4A or 4B lesions in the contralateral breast. Four lesions were detected on mammography (two lesions were also visible on US) and 11 lesions were detected on US and 5 cancers were confirmed (33.3%, 95% CIs 15.0–58.5%). Six patients (0.5%) had category 4C lesions, 2 detected on mammography and 4 on US and 4 cancers were confirmed (66.7%, 95% CIs 29.6–90.8%). No lesions were categorized as category 5 in the contralateral breast. Cancer detection rate by mammography was 3.3 per 1000 patients and that by US was 5.0 per 1000 patients, therefore overall cancer detection rate by

  17. Predictors for contralateral prophylactic mastectomy in breast cancer patients

    OpenAIRE

    Fu, Yun; Zhuang, Zhigang; Dewing, Michelle; Apple, Sophia; Chang, Helena

    2015-01-01

    Background: In recent years, radical breast cancer surgery has been largely replaced by breast conservation treatment, due to early diagnosis and more effective adjuvant treatment. While breast conservation is mostly preferred, the trend of bilateral mastectomy has risen in the United States. The aim of this study is to determine factors influencing patients’ choice for having contralateral prophylactic mastectomy (CPM). Methods: This is a retrospective study of 373 patients diagnosed with pr...

  18. [Simultaneous rupture of a patellar tendon and contralateral quadriceps tendon].

    Science.gov (United States)

    Horas, U; Ernst, S; Meyer, C; Halbsguth, A; Herbst, U

    2006-09-01

    The simultaneous bilateral rupture of the quadriceps tendon is a rare injury; only occasional reports exist about the bilateral simultaneous rupture of the patellar tendon. Degenerative changes of the tendon due to drugs or diseases lead to the rupture. We describe two cases of simultaneous rupture of the patellar and contralateral quadriceps tendons; only one patient had special risks. We report the management of therapy and the functional results using the Lysholm score and Knee Rating Scale.

  19. Hearing outcome of recurrent sudden deafness: ipsilateral versus contralateral types.

    Science.gov (United States)

    Kuo, Yen-Lin; Young, Yi-Ho

    2012-03-01

    Patients with recurrent sudden deafness demonstrating normal vestibular-evoked myogenic potentials (VEMPs) in the lesion ear of the second episode may indicate a good hearing outcome. This study retrospectively reviewed our experience of patients with recurrent sudden deafness during the past 20 years. Sixteen (1.4 %) of 1156 patients with sudden deafness were diagnosed as having a recurrent episode, including ipsilateral type in 7 and contralateral type in 9. All patients underwent an audiovestibular test battery and blood and MRI examinations. After 2000, nine patients underwent the VEMP test. In the ipsilateral type, the mean interval between two episodes was 2 ± 2 years, which did not differ significantly from 3 ± 3 years in the contralateral type. There were no significant differences in relation to age at onset of the second episode, inter-episode interval, gender, presence of vertigo, and abnormal caloric results. However, abnormal rate of VEMP test in the contralateral type (five of five patients) was significantly higher than that in the ipsilateral type (none of four patients). At the second episode, all four patients with normal VEMPs on the lesion ear had improved hearing, while four of five patients with absent or delayed VEMPs showed unchanged hearing. Altogether, the hearing improvement rate in both types of recurrent sudden deafness was 50%.

  20. Demanda para intervenção fonoaudiológica em uma unidade neonatal de um hospital-escola

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    Mariana Miranda Fumelli Monti

    2013-12-01

    Full Text Available OBJETIVO: caracterizar a demanda e intervenção fonoaudiológicas realizadas em recém-nascidos e lactentes que apresentaram alterações no processo de alimentação por via oral, na Unidade Neonatal de um hospital-escola de caráter público. MÉTODOS: trata-se de um estudo retrospectivo, descritivo e de corte transversal. Foi realizada a coleta de dados por meio de consulta a todos os prontuários fonoaudiológicos de recém-nascidos e lactentes internados no período entre março de 2008 e fevereiro de 2010, que receberam ao menos uma avaliação/intervenção fonoaudiológica. RESULTADOS: foram atendidos nesse período 205 recém-nascidos e lactentes internados. Destes sujeitos, 104 atenderam aos critérios de inclusão na pesquisa. A população predominante foi do sexo masculino, composta de recém-nascidos pré-termo, adequados para idade gestacional, baixo peso ao nascimento, em média com 36 semanas de idade gestacional, com diagnósticos mais frequentes de distúrbio respiratório, síndrome ictérica e/ou distúrbio cardiovascular. Dentre os motivos de encaminhamento para avaliação fonoaudiológica predominaram: alteração no comportamento motor oral, avaliação da prontidão para alimentação por via oral e dificuldades no uso do copo. As avaliações foram solicitadas, em sua maioria, por médicos residentes quando os recém-nascidos estavam, em média, com 28 dias de vida. Verificou-se ampliação dos critérios de encaminhamento da equipe para avaliação fonoaudiológica, quando comparados aos critérios descritos na literatura. CONCLUSÕES: esse trabalho permitiu caracterizar a população, a demanda e a intervenção fonoaudiológicas em uma unidade neonatal. Verificou-se que a maioria dos recém-nascidos e lactentes ainda recebe alimentação por via oral sem avaliação fonoaudiológica prévia, o que pode gerar situações de risco para uma alimentação segura e eficiente.

  1. Contralateral Risk-Reducing Mastectomy: Review of Risk Factors and Risk-Reducing Strategies

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    N. N. Basu

    2015-01-01

    Full Text Available Rates of contralateral risk-reducing mastectomy have increased substantially over the last decade. Surgical oncologists are often in the frontline, dealing with requests for this procedure. This paper reviews the current evidence base regarding contralateral breast cancer, assesses the various risk-reducing strategies, and evaluates the cost-effectiveness of contralateral risk-reducing mastectomy.

  2. Perfil sérico da molécula de adesão intercelular-1 no pós-operatório cardíaco de lactentes submetidos à circulação extracorpórea Intercellular adhesion molecule-1 serum profile in cardiac postoperative period of infants undergoing cardiopulmonary bypass

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    Angela Hunsche

    2002-01-01

    Full Text Available Objetivos: mensurar os níveis séricos da molécula de adesão intercelular-1, solúvel em condições basais e após exposição ao circuito de circulação extracorpórea, em lactentes submetidos à cirurgia cardíaca para correção de defeitos cardíacos congênitos. Métodos: estudo de coorte contemporâneo envolvendo 21 lactentes submetidos à cirurgia cardíaca com uso de circulação extracorpórea. Foram medidos os níveis séricos da molécula de adesão intercelular-1, solúvel na indução anestésica, ao término e 8 e 26 horas após o término da circulação extracorpórea. As amostras foram dosadas através do método de ELISA. Resultados: as patologias cardíacas congênitas mais comuns foram defeito do septo atrioventricular e Tetralogia de Fallot. As médias de idade e de peso foram 6,6 meses e 5,8 quilos. As medianas dos tempos de circulação extracorpórea e de clampeamento da aorta foram, respectivamente, 87 e 53 minutos. Todos os lactentes utilizaram inotrópicos. As medianas dos tempos de intubação e de internação foram 72 horas e 21 dias. A taxa de mortalidade dos pacientes foi de 9,5%. Os níveis basais da molécula avaliada foram mais elevados do que aqueles considerados normais (pObjective: to measure the intercellular adhesion molecule-1 serum levels at baseline and after cardiopulmonary bypass exposure in infants undergoing surgery of congenital heart disease. Methods: contemporary cohort study, which consisted of 21 infants undergoing cardiac surgery with cardiopulmonary bypass. The intercellular adhesion molecule-1 serum levels were measured at induction of anesthesia, at the end of cardiopulmonary bypass, and 8 hours and 26 hours after cardiopulmonary bypass. The samples were measured using ELISA. Results: atrioventricular septal defects and tetralogy of Fallot were the most common congenital cardiac pathologies. The age and weight mean values were 6.6 months and 5.8 Kg. The median values of cardiopulmonary

  3. Análise do risco do escorregamento epifisário femoral proximal contralateral pelo escore de Oxford modificado

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    Jamil Faissal Soni

    2015-10-01

    Full Text Available r e s u m o Objetivo: Determinar a aplicacão do escore de Oxford modificado em pacientes com escorre gamento epifisário femoral proximal (EEFP no auxílio da indicacão do tratamento cirúrgico profilático dos quadris contralaterais. Métodos: Análise retrospectiva dos prontuários dos pacientes atendidos na instituicão na qual os autores trabalham. Foram selecionados aqueles com um tempo de seguimento mínimo de dois anos, atendidos de 2008 até 2011, que apresentaram EEPF unilateral. Os cri térios de exclusão foram pacientes com doenca endócrina ou metabólica, síndrome de Down e aqueles com radiografias inadequadas para determinar a pontuacão no escore de Oxford modificado. As radiografias iniciais receberam uma pontuacão que varia de 16 a 26. A aná lise estatística foi usada para determinar se a pontuacão foi preditiva do desenvolvimento futuro de deslizamento contralateral. Resultados: Dos 15 pacientes selecionados com EEFP unilateral, cinco (33,3% evoluíram para o escorregamento contralateral. Os pacientes foram divididos em dois grupos, qua tro pacientes foram considerados de risco e desses três desenvolveram o escorregamento contralateral. No grupo sem risco havia 11 pacientes, dois evoluíram para o escorregamento contralateral. Nota-se assim uma tendência de que pacientes do grupo que desenvolveu a doenca difiram do grupo que não desenvolveu em relacão à classificacão de risco. Conclusão: Apesar de na nossa amostra a aplicacão do escore de Oxford modificado não ter sido estatisticamente significativa, notamos uma tendência para o escorregamento contra lateral nos quadris com escore baixo.

  4. Meralgia paresthetica of the contralateral leg after total hip arthroplasty.

    Science.gov (United States)

    Weier, Chris A; Jones, Lynne C; Hungerford, Marc W

    2010-04-01

    In the United States, total hip arthroplasty (THA) is typically performed with the patient in the lateral decubitus position. Positioning of the morbidly obese patient can be technically challenging and may require special positioning equipment. Although the increased incidence of complications after THA in obese patients has been well documented, neurologic complications in the contralateral limb are rare. This article describes a case of a patient with impairment of the lateral femoral cutaneous nerve in the contralateral leg after THA.A 55-year-old woman with a body mass index of 34.24 kg/m(2) underwent THA in the right lateral decubitus position. Because of her body habitus, a bean-bag positioner was used. Total hip arthroplasty was performed using a direct lateral approach. Intraoperative surgical time was 2.5 hours, and total anesthesia time was 3.5 hours. A few days postoperatively, the patient began to experience "burning and shooting" pain in the contralateral hip, but she did not report this pain until 6 weeks postoperatively. She was treated initially with a single lidocaine injection. When this was ineffective, she was treated with topiramate (100 mg daily) and vitamin B6 (100 mg orally twice daily). The symptoms lessened markedly at 5 months and resolved completely at 9 months postoperatively.Meralgia paresthetica is an uncommon, but known, complication of THA. To our knowledge, it has been reported only in the operative limb. This report reinforces the need for careful positioning to avoid pressure over the anterior superior iliac spine intraoperatively. Copyright 2010, SLACK Incorporated.

  5. Disturbio adquirido de linguagem em crianças com doença cerebrovascular : aquisição de linguagem em lactentes e pre-escolares

    OpenAIRE

    2002-01-01

    Resumo: A Doença Cérebrovascular (DCV) é uma das causas do Distúrbio Adquirido de Linguagem (DAL), acometendo entre outras funções mentais superiores, a linguagem. A literatura especializada nos mostra quadros de DAL sem caracterizar os subsistemas lingüísticos alterados nos sujeitos avaliados. Assim, objetivou-se nesta pesquisa a avaliação de linguagem contendo subsistemas fonético-fonológicos, morfossintáticos, semântico lexicais, pragmáticos e discursivo narrativos, incluindo também as noç...

  6. Fatores associados à interrupção do aleitamento materno exclusivo de lactentes nascidos com baixo peso assistidos na atenção básica Factors associated with interruption of exclusive breastfeeding in low birth weight infants receiving primary care

    Directory of Open Access Journals (Sweden)

    Maria Teresa Cera Sanches

    2011-05-01

    Full Text Available Visou-se a identificar os fatores associados à interrupção do aleitamento materno exclusivo (AME de lactentes nascidos com baixo peso assistidos na Atenção Básica. Estudo transversal com 170 lactentes assistidos em unidades básicas de saúde (UBS da periferia do Município de São Paulo, Brasil. Incluíram-se nascidos com peso ≤ 2.500g (inclusive gemelares, Apgar (5' ≥ 7 e acompanhados até o terceiro mês. Excluíram-se bebê/mãe com alterações que impedissem o AME e óbitos. Coletaram-se os dados utilizando-se formulários preenchidos nas consultas e prontuários. As razões de prevalência foram obtidas por regressão de Poisson. Identificou-se associado à interrupção do AME no terceiro mês: idade materna This study aimed to identify factors associated with interruption of exclusive breastfeeding (EBF in low birth weight infants receiving primary care. This was a cross-sectional study of 170 infants treated at primary care units on the urban periphery of São Paulo, Brazil. The sample included infants with birth weight ≤ 2,500g (including twins and 5-minute Apgar ≥ 7, followed until the third month of life, and excluded infants/mothers with complications that would impede EBF, besides infant/maternal deaths. Data were collected from forms completed during consultations and patient records. Prevalence ratios were obtained by Poisson regression. The following factors were associated with interruption of EBF in the first three months of life: maternal age ≤ 18 years; informal employment (protective factor; alcohol intake during pregnancy; < 6 prenatal visits; multiple gestations; birth weight ≤ 2,000g; difficulty breastfeeding in the first month; complaints in breastfeeding during the first month; and use of pacifiers in the first two months. Prior knowledge of these factors can help plan measures and policies to increase EBF rates among low birth weight infants.

  7. Predictors for contralateral prophylactic mastectomy in breast cancer patients.

    Science.gov (United States)

    Fu, Yun; Zhuang, Zhigang; Dewing, Michelle; Apple, Sophia; Chang, Helena

    2015-01-01

    In recent years, radical breast cancer surgery has been largely replaced by breast conservation treatment, due to early diagnosis and more effective adjuvant treatment. While breast conservation is mostly preferred, the trend of bilateral mastectomy has risen in the United States. The aim of this study is to determine factors influencing patients' choice for having contralateral prophylactic mastectomy (CPM). This is a retrospective study of 373 patients diagnosed with primary invasive breast cancer who were treated by bilateral or unilateral mastectomy (BM or UM) at the Revlon/UCLA Breast Center between Jan. 2002 and Dec. 2010. In the BM group, only those with unilateral breast cancer who chose CPM were included in the analysis. When compared with the UM group, the following factors were found to be associated with BM: younger age, pre-menopausal, a family history of breast/ovarian cancer, BRCA mutation, more breast biopsies, history of breast augmentation, having MRI study within 6 months before the surgery, more likely to have reconstruction and sentinel lymph node biopsy (SLNB) and fewer had neoadjuvant/adjuvant chemotherapy/radiation. When patients with bilateral breast cancer were excluded, multivariate logistic regression analysis indicated younger patients with negative nodes, SLNB as the only nodal surgery and positive family history were significant factors predicting CPM and immediate reconstruction using tissue expanders or implants. Younger age, lower TN stage, requiring only SLNB and high risk family history predict contralateral prophylactic mastectomy. Tissue expander/implant-based reconstructions were more frequently chosen by patients with BM.

  8. Prediction of outcome after diagnosis of metachronous contralateral breast cancer

    Directory of Open Access Journals (Sweden)

    Fernö Mårten

    2011-03-01

    Full Text Available Abstract Background Although 2-20% of breast cancer patients develop a contralateral breast cancer (CBC, prognosis after CBC is still debated. Using a unique patient cohort, we have investigated whether time interval to second breast cancer (BC2 and mode of detection are associated to prognosis. Methods Information on patient-, tumour-, treatment-characteristics, and outcome was abstracted from patients' individual charts for all patients diagnosed with metachronous CBC in the Southern Healthcare Region of Sweden from 1977-2007. Distant disease-free survival (DDFS and risk of distant metastases were primary endpoints. Results The cohort included 723 patients with metachronous contralateral breast cancer as primary breast cancer event. Patients with less than three years to BC2 had a significantly impaired DDFS (p = 0.01, and in sub-group analysis, this effect was seen primarily in patients aged Conclusions In a large cohort of patients with CBC, we found the time interval to BC2 to be a strong prognostic factor for DDFS in young women and mode of detection to be related to risk of distant metastases. Future studies of tumour biology of BC2 in relation to prognostic factors found in the present study can hopefully provide biological explanations to these findings.

  9. A case of amblyopia with contralateral optic nerve hypoplasia.

    Science.gov (United States)

    Frantz, Kelly A; Pang, Yi

    2013-09-01

    We describe an unusual case of unilateral optic nerve hypoplasia (ONH) in a patient with contralateral anisometropic/strabismic amblyopia. A seven-year-old boy presented with visual acuities of 6/12 R and 6/18 L and eccentric fixation in the left eye. Cycloplegic retinoscopy was R +1.50/-0.50 × 180 and L +5.25 DS. Funduscopy revealed optic nerve hypoplasia of the right eye. The patient fixated with his better-seeing right eye, despite the optic nerve hypoplasia. His reduced vision may be attributed to optic nerve hypoplasia in the right eye and amblyopia in the left. Although optic nerve hypoplasia can occur with ipsilateral amblyopia, we believe this is the first reported case of unilateral optic nerve hypoplasia in the fellow eye of an amblyopic patient.

  10. MRI evaluation of the contralateral breast in patients with recently diagnosed breast cancer

    OpenAIRE

    Sangeeta Taneja; Amarnath Jena; Syed. Mohd. Shuaib Zaidi; Anuj Khurana

    2012-01-01

    Introduction: Contralateral breast cancer can be synchronous and/or metachronous in patients with cancer of one breast. Detection of a synchronous breast cancer may affect patient management. Dynamic contrast-enhanced MRI of the breast (DCE-MRI) is a sensitive technique for detecting contralateral lesions occult on the other imaging modalities in women already diagnosed with cancer of one breast. Aim: The aim was to assess the incidence of mammographically occult synchronous contralateral bre...

  11. Fatores associados ao envolvimento do pai nos cuidados do lactente Factores asociados al envolvimiento del papá en los cuidados del lactante Factors associated with father involvement in infant care

    Directory of Open Access Journals (Sweden)

    Olga G Falceto

    2008-12-01

    Full Text Available OBJETIVO: Identificar fatores associados à falta de envolvimento ativo do pai nos cuidados de crianças aos quatro meses. MÉTODOS: Estudo transversal envolvendo famílias de 153 crianças aos quatro meses de vida, entrevistadas em suas casas por dois terapeutas de famílias. Além do envolvimento do pai nos cuidados do lactente foram examinadas características sociodemográficas, saúde mental dos pais (utilizando a escala Self Report Questionnaire-20 e avaliação com os critérios do Diagnostic and Statistical Manual of Mental Disorders-IV e qualidade do relacionamento conjugal (usando a escala Global Assessment of Relational Functioning do Diagnostic and Statistical Manual of Mental Disorders-IV. Utilizou-se regressão de Poisson para avaliar a associação entre falta de envolvimento do pai nos cuidados do filho e variáveis selecionadas. A magnitude das associações foi estimada pela razão de prevalências. RESULTADOS: Os pais de 13% dos lactentes não tinham qualquer contato com seus filhos. Entre as famílias em que os pais coabitavam (78% do total, 33% dos pais relataram não participar ativamente nos cuidados de seus filhos. Relação conjugal problemática e mãe ser "do lar" mostraram-se associadas à falta de envolvimento dos pais nos cuidados do filho. CONCLUSÕES: É alta a prevalência de famílias nas quais o pai não tem envolvimento ativo no cuidado de seu filho, ocorrendo em especial quando a relação conjugal é problemática e a mãe não tem trabalho remuneradoOBJETIVO: Identificar factores asociados a la falta del envolvimiento activo del papá en los cuidados de niños a los cuatro meses. MÉTODOS: Se realizó estudio transversal involucrando familias de 153 niños de cuatro meses de edad, y se entrevistaron en sus casas por dos terapeutas de familias en Porto Alegre (Sureste de Brasil, 1998-2000. Además de involucrar al padre en los cuidados del lactante se examinaron características sociodemográficas, salud

  12. Multicystic dysplastic kidney and contralateral vesicoureteral reflux. Renal growth.

    Science.gov (United States)

    Fanos, V; Sinaguglia, G; Vino, L; Pizzini, C; Portuese, A

    2001-04-01

    To evaluate if vesicoureteral reflux (VUR) contralateral to the multicystic dysplastic kidney can interfere with the compensatory renal hypertrophy. Twenty-seven patients (17 males, 10 females) with multicystic dysplastic kidney (MDK) (14 on the right, 13 on the left) have been treated at the Nephrology Unit of the Pediatric Department of the University of Verona from birth up to the second year of life. All these patients were diagnosed as having MDK by prenatal ultrasonography. Seven children (4 males and 3 females) had VUR (5 monolateral, 2 bilateral), diagnosed at the end of the first month of life. After diagnosis children underwent antibiotic prophylaxis with beta-lactam compounds at low doses. Four patients underwent a surgical correction of VUR associated with nephrectomy within the second year of life. The remaining 3 patients were treated with antibiotic prophylaxis; a progressive resolution or downgrading of reflux grade took place respectively in 1 and in 2 of them. Only 6 children with MDK underwent nephrectomy. Renal growth was studied by serial echographic measurements of the longitudinal renal lenght (performed at birth, at 6 months, and at 2 years of life). Renal length was 5.68+/-1.24 cm, 6.72+/-0.88 cm, 8.56+/-1.27 cm in children without VUR, respectively at birth, 6 months and 2 years of life. Renal length was 4.65+/-0.63 cm, 6.70+/-0.64 cm, 7.07+/-1.14 cm in children with VUR, respectively at birth, 6 months and 2 years of life. A statistically significant difference was observed between the two groups at birth (p<0.05) and at 2 years of life (p<0.01). The conclusion is that VUR contralateral to the MDK is associated with small kidneys and reduced renal growth both at birth and at 2 years of life.

  13. Evolução histórica dos utensílios empregados para alimentar lactentes não amamentados Historical evolution of utensils used to feed non breastfed infants

    Directory of Open Access Journals (Sweden)

    Silvia Diez Castilho

    2010-06-01

    Full Text Available O objetivo desse artigo de revisão é descrever os utensílios empregados ao longo da história para alimentar lactentes não amamentados. O levantamento bibliográfico foi realizado nas bases de dados MEDLINE, LILACS e SciELO, de 1966 a 2007. Para a análise documental, foram processadas buscas na Internet, em enciclopédias, livros de arte, história e museus. Utensílios manufaturados com materiais e formas variadas, dependendo da disponibilidade, poder aquisitivo e cultura, foram empregados desde os primórdios da história para alimentar bebês que, por diferentes motivos, deixaram de ser amamentados. Muitos objetos coexistiram na mesma época e local, outros em tempos e pontos geográficos distantes. A aceitação de uma nova alternativa ocorria sem evidência que comprovasse ou apontasse para os benefícios da mudança. Alguns utensílios voltaram a ser empregados embora a mortalidade infantil fosse elevada à época em que foram utilizados. No início do século XX, as mamadeiras assumiram a forma cilíndrica cônica. A tecnologia trouxe avanços no sentido de melhorar a higienização e possibilitar o controle da contaminação. O vidro deu lugar ao plástico e os bicos de borracha, aos de silicone, mas a mamadeira, como a conhecemos hoje, é a mesma de cem anos atrás.The objective of this article is to describe the utensils used throughout history to feed non breastfed infants. The method used was article review, reference search on the MEDLINE, LILACS and SciELO databases from 1966 to 2007 and documental analysis based on data from the internet, encyclopedias, art and history books, and museums. Utensils manufactured in a variety of materials and shapes, depending on availability, purchasing power and culture have been used since early history to feed babies who for different reasons were not breastfed. Many objects coexisted at the same time and place, others at distant sites and times. New alternatives have been accepted without

  14. Tamoxifen and Risk of Contralateral Breast Cancer for BRCA1 and BRCA2 Mutation Carriers

    DEFF Research Database (Denmark)

    Phillips, Kelly-Anne; Milne, Roger L; Rookus, Matti A;

    2013-01-01

    To determine whether adjuvant tamoxifen treatment for breast cancer (BC) is associated with reduced contralateral breast cancer (CBC) risk for BRCA1 and/or BRCA2 mutation carriers.......To determine whether adjuvant tamoxifen treatment for breast cancer (BC) is associated with reduced contralateral breast cancer (CBC) risk for BRCA1 and/or BRCA2 mutation carriers....

  15. Contralateral neck dissection in oral squamous cell carcinoma:when it should be done?

    Institute of Scientific and Technical Information of China (English)

    Laura Villanueva-Alcojol

    2016-01-01

    Oral cavity squamous cell carcinoma (OSCC) has a high incidence of cervical micrometastases and sometimes metastasizes bilaterally because of the rich lymphatics in the submucosal plexus, which freely communicate across the midline. The presence of contralateral pathologic lymph nodes has been reported previously as a critical factor influencing the survival of patients. There are a few reports in the literature with regard to the rates of contralateral neck disease and the factors that may be involved in the risk with them. An elective ipsilateral neck treatment is generally recommended for initial treatment in all OSCC. However, no consensus exists whether or not to perform an elective contralateral neck dissection or radiation. In this study, a systematic review has been performed in order to evaluate the predictive value of clinical-histopathologic factors potentially related to contralateral occult lymph node metastasis in squamous cell carcinomas of the oral cavity to form a rational basis for elective contralateral neck management.

  16. Choroidal Melanoma Causing Contralateral Amaurosis via Orbital Invasion

    Directory of Open Access Journals (Sweden)

    Melis Palamar Onay

    2011-06-01

    Full Text Available To report a case of tumor invasion into the ipsilateral orbit/optic chiasm and into the contralateral optic nerve. A 51- year-old male who declared removal of his left eye ten years ago elsewhere, attended to our clinic for swelling of the left eyelids and pain. He was ophthalmologically and radiologically evaluated. A hyperpigmented mass was detected at the socket conjunctiva of the patient whose eyelids were swollen and hyperemic. Anterior and posterior segments of the right eye were normal, and the best corrected visual acuity was 10/10. On orbital computed tomography, the left orbit was found to be filled with mass. No intracranial invasion was detected. Exenteration was performed to the patient who had no systemic metastasis. Histopathological examination revealed malignant melanoma. Ten months later, the patient presented with sudden visual loss. Light perception was absent in the right eye. Optic nerve head was pale at fundus examination. No p100 wave was obtained from the right eye with visual evoked potentials. On orbital magnetic resonance imaging, a mass invading the optic chiasm and the right optic nerve was evident. When treated with appropriate methods, choroidal malignant melanoma with no extraocular extension has pretty good prognosis. When performing enucleation in patients with intraocular tumor suspicion, extra care should be spent not to make any unnecessary maneuver leading to extraocular spread. In the presence of extraocular dissemination, exenteration should be performed. (Turk J Ophthalmol 2011; 41: 194-6

  17. Cisto broncogênico complicado por mediastinite e empiema contra-lateral Bronchogenic cyst complicated by mediastinitis and contralateral empyema

    OpenAIRE

    Nuno Ferreira de Lima; Gisele Moreira Dias; André de Aquino Carvalho

    2004-01-01

    O cisto broncogênico, apesar da aparência pouco ominosa como opacidade de contornos precisos no mediastino, tem potencial não desprezível para complicar. Relatamos um caso de complicação grave em um paciente de 28 anos com queixa de dor epigástrica irradiada para o dorso, e radiografia de tórax demonstrando massa bem delimitada no mediastino posterior e inferior à direita. Em cinco dias evoluiu para sepse decorrente de mediastinite e empiema pleural à esquerda. O paciente necessitou ser subme...

  18. Outcome of contralateral C7 nerve transferring to median nerve

    Institute of Scientific and Technical Information of China (English)

    GAO Kai-ming; LAO Jie; ZHAO Xin; GU Yu-dong

    2013-01-01

    Background Contralateral C7 (cC7) transfer had been widely used in many organizations in the world,but the outcomes were significantly different.So the purpose of the study was to evaluate the outcome of patients treated with cC7 transferring to median nerve and to determine the factors affecting the outcome of this procedure.Methods A retrospective review of 51 patients with total root avulsion brachial plexus injuries who underwent cC7 transfer was conducted.All of the surgeries were performed with two surgery stages and median nerve was the recipient nerve.The cC7 nerve was used in three different ways.The entire C7 root was used in 11 patients; the posterior division together with the lateral part of the anterior division was used in 15 patients; the anterior or the posterior division alone was used in 25 patients.The mean follow-up period was 6.9 years.Results The efficiency of the surgery in these 51 patients was 49.02% in motor and 62.75% in sensory function.The patients with entire C7 root transfer obtained significantly better recovery in both motor and sensory function than the patients with partial C7 transfer.The best function recovery could be induced if the interval between the two surgery stages was 4-8 months.Conclusions cC7 transfer is an effective procedure in repairing median nerve.But using the entire C7 root transfer can obtain better recovery; so we emphasize using the entire root as the donor.The optimal interval between two surgery stages is 4-8 months.

  19. The origin of activity in the biceps brachii muscle during voluntary contractions of the contralateral elbow flexor muscles

    NARCIS (Netherlands)

    Zijdewind, Inge; Butler, Jane E.; Gandevia, Simon C.; Taylor, Janet L.

    2006-01-01

    During strong voluntary contractions, activity is not restricted to the target muscles. Other muscles, including contralateral muscles, often contract. We used transcranial magnetic stimulation (TMS) to analyse the origin of these unintended contralateral contractions (termed "associated" contractio

  20. The origin of activity in the biceps brachii muscle during voluntary contractions of the contralateral elbow flexor muscles

    NARCIS (Netherlands)

    Zijdewind, Inge; Butler, Jane E.; Gandevia, Simon C.; Taylor, Janet L.

    2006-01-01

    During strong voluntary contractions, activity is not restricted to the target muscles. Other muscles, including contralateral muscles, often contract. We used transcranial magnetic stimulation (TMS) to analyse the origin of these unintended contralateral contractions (termed "associated"

  1. Prediction of contralateral inguinal hernias in children: a prospective study of 357 unilateral inguinal hernias.

    Science.gov (United States)

    Hoshino, M; Sugito, K; Kawashima, H; Goto, S; Kaneda, H; Furuya, T; Hosoda, T; Masuko, T; Ohashi, K; Inoue, M; Ikeda, T; Tomita, R; Koshinaga, T

    2014-06-01

    Previously, we established a pre-operative risk scoring system to predict contralateral inguinal hernia in children with unilateral inguinal hernias. The current study aimed to verify the usefulness of our pre-operative scoring system. This was a prospective study of patients undergoing unilateral inguinal hernia repair from 2006 to 2009 at a single institution. Gender, age at initial operation, birth weight, initial operation side, and the pre-operative risk score were recorded. We analyzed the incidence of contralateral inguinal hernia, risk factors, and the usefulness of our pre-operative risk scoring system. The follow-up period was 36 months. We used forward multiple logistic regression analysis to predict contralateral hernia. Of the 372 patients who underwent unilateral hernia repair, 357 (96.0 %) were completely followed-up for 36 months, and 23 patients (6.4 %) developed a contralateral hernia. Left-sided hernia (OR = 5.5, 95 %, CI = 1.3-24.3, p = 0.023) was associated with an increased risk of contralateral hernia. The following covariates were not associated with contralateral hernia development: gender (p = 0.702), age (p = 0.215), and birth weight (p = 0.301). The pre-operative risk score (cut-off point = 4.5) of the patients with a contralateral hernia was significantly higher, compared with the patients without a contralateral hernia using the area under the receiver operating characteristic curve (p = 0.024). Using multivariate analysis, we confirmed usefulness of our pre-operative scoring system and initial side of the inguinal hernia, together, for the prediction of contralateral inguinal hernia in children.

  2. Trigeminal-Rostral Ventromedial Medulla circuitry is involved in orofacial hyperalgesia contralateral to tissue injury

    Directory of Open Access Journals (Sweden)

    Chai Bryan

    2012-10-01

    Full Text Available Abstract Background Our previous studies have shown that complete Freund’s adjuvant (CFA-induced masseter inflammation and microinjection of the pro-inflammatory cytokine interleukin-1β (IL-1β into the subnucleus interpolaris/subnucleus caudalis transition zone of the spinal trigeminal nucleus (Vi/Vc can induce contralateral orofacial hyperalgesia in rat models. We have also shown that contralateral hyperalgesia is attenuated with a lesion of the rostral ventromedial medulla (RVM, a critical site of descending pain modulation. Here we investigated the involvement of the RVM-Vi/Vc circuitry in mediating contralateral orofacial hyperalgesia after an injection of CFA into the masseter muscle. Results Microinjection of the IL-1 receptor antagonist (5 nmol, n=6 into the ipsilateral Vi/Vc attenuated the CFA-induced contralateral hyperalgesia but not the ipsilateral hyperalgesia. Intra-RVM post-treatment injection of the NK1 receptor antagonists, RP67580 (0.5-11.4 nmol and L-733,060 (0.5-11.4 nmol, attenuated CFA-induced bilateral hyperalgesia and IL-1β induced bilateral hyperalgesia. Serotonin depletion in RVM neurons prior to intra-masseter CFA injection prevented the development of contralateral hyperalgesia 1–3 days after CFA injection. Inhibition of 5-HT3 receptors in the contralateral Vi/Vc with direct microinjection of the select 5-HT3 receptor antagonist, Y-25130 (2.6-12.9 nmol, attenuated CFA-induced contralateral hyperalgesia. Lesions to the ipsilateral Vc prevented the development of ipsilateral hyperalgesia but did not prevent the development of contralateral hyperalgesia. Conclusions These results suggest that the development of CFA-induced contralateral orofacial hyperalgesia is mediated through descending facilitatory mechanisms of the RVM-Vi/Vc circuitry.

  3. Screening for carcinoma in situ of the contralateral testis in patients with germinal testicular cancer

    DEFF Research Database (Denmark)

    Berthelsen, J G; Skakkebaek, N E; von der Maase, H

    1982-01-01

    Two hundred and fifty biopsy specimens from the contralateral testis in patients with unilateral germinal testicular cancer were analysed by light microscopy for carcinoma-in-situ changes. Changes were found in 13 (5.2%) patients. One-third of patients with an atrophic contralateral testis (volume...... of cryptorchidism or both had been screened. Since the natural course of carcinoma in situ in the contralateral testis of patients with germinal testicular cancer has not been established, the patients are being re-evaluated frequently. To date two patients with carcinoma in situ have developed a second cancer....

  4. Perfil epidemiológico e estratégias para o diagnóstico de SMSL em um país em desenvolvimento

    Directory of Open Access Journals (Sweden)

    Ana Paula Silveira Pinho

    2011-04-01

    Full Text Available OBJETIVO: Descrever o perfil epidemiológico, os fatores de risco e as melhores estratégias para diagnosticar a síndrome da morte súbita do lactente (SMSL em um país em desenvolvimento. MÉTODOS: Estudo caso-controle populacional com crianças nascidas entre 01/01/2001 e 31/12/2003 em Porto Alegre (RS, divididas em três grupos: casos de SMSL (33 e controles - óbitos esclarecidos (192 e crianças vivas (192 -, que foram pareados por idade e sexo aos casos. As famílias com casos de lactentes menores de 1 ano que faleceram em casa foram identificadas, e as informações das certidões de óbito e autópsias foram comparadas para confirmar a SMSL. Os óbitos esclarecidos foram os ocorridos em hospitais, e os controles vivos foram selecionados na vizinhança dos casos de SMSL. Os pais foram entrevistados para obter informações sobre a saúde e os hábitos de sono da criança. Realizou-se uma análise multivariada para identificar fatores de risco na população estudada. RESULTADOS: A incidência da SMSL na população avaliada foi de 0,55/1.000 nascidos vivos. A análise revelou os seguintes fatores de risco: etnia (autorreferida como negra, prematuridade, baixo peso ao nascer, mãe adolescente, tabagismo na gravidez e renda familiar abaixo de um salário mínimo. Além disso, 94% dos casos de SMSL foram mal-diagnosticados na certidão de óbito. CONCLUSÕES: Embora a SMSL tenha sido mal-diagnosticada, seu perfil epidemiológico é semelhante ao da literatura, assim como os fatores de risco, que poderiam ser reduzidos com campanhas preventivas. Investigar a SMSL em países em desenvolvimento requer estratégias especiais para evitar erros de diagnóstico.

  5. Contralateral acoustic suppression of transient evoked otoacoustic emissions: Activation of the medial olivocochlear system

    Directory of Open Access Journals (Sweden)

    Komazec Zoran

    2003-01-01

    Full Text Available Medial olivocochlear pathway represents the final part of efferent acoustic pathway which comes from the superior olivary complex ending at outer hair cells. Activation of medial olivocochlear system (MOCS alters the cochlear output decreasing the travelling wave within cochlea. Stimulation of MOCS provides protection against moderate levels of noise, encoding noise signals as well as selecting hearing attention. Activation of MOCS can be performed using contralateral acoustic stimulation. The principal result of presentation of contralateral acoustic stimulation during screening of transient evoked otoacoustic emission (TEOAE is an attenuation of the TEOAE amplitude. Thirty-eight ears were examined in this study: twenty-eight ears from 14 normal-hearing adults and 10 patients with unilateral deafness. Healthy subjects were exposed to contralateral broad-band noise of various intensities (40, 30, 20 and 10 dB SL, as well as 30 dB SL pure tone stimulation (1 kHz and 4 kHz. A decrease of TEOAE amplitudes during contralateral stimulation with 40 and 30 dB SL broad-band noise and pure tones was established. This effect was a result of MOCS activation. A greater intensity of contralateral stimulation evoked greater decrease of TEOAE amplitude; stimulation with broad-band noise caused greater attenuation than with pure tone stimulation. Contralateral stimulation of deaf ears in the group with unilateral deafness was also performed. Statistically significant difference between TEOAE amplitude before and during contralateral stimulation was not established. This circumstance explains that activation of MOCS and consequent reduction of outer hair cells motility is very possibly caused by contralateral acoustic stimulation. Apart from studying physiological significance of efferent auditory system, results of this and similar studies can be used for production of hearing aids improving speech discrimination in noisy environment.

  6. Contralateral hyperinflation: Computed tomography demonstration of an unusual complication of unrecognized endobronchial intubation

    Directory of Open Access Journals (Sweden)

    Jyotindu Debnath

    2011-01-01

    Full Text Available Endobronchial intubation (EBI is an important complication of endotracheal intubation. In a case of unrecognized EBI, usually, the intubated lung gets hyperinflated while the contralateral lung collapses. We report a case of unrecognized right main stem EBI with ipsilateral normal aeration and contralateral hyperinflation detected during computed tomography scan of the chest for trauma work up in a case of severe head injury.

  7. Carotid endarterectomy in patients with occlusion of the contralateral carotid artery. Perioperative risk and late results

    DEFF Research Database (Denmark)

    Sillesen, H; Schroeder, T; Rasmussen, L;

    1987-01-01

    Recent reports on the outcome of carotid endarterectomy in patients with contralateral occlusion have been conflicting. Therefore, we reviewed 51 cases identified, among 675 consecutive carotid endarterectomies. A perioperative mortality of 2% and a permanent morbidity rate of 16% was observed....... Compared with a complication rate of about 5% previously reported from this institution, this clearly indicates contralateral carotid occlusion as a major risk factor in carotid surgery. Though not statistically significant, patients with severely reduced cerebral perfusion pressure (CPP) had suffered more...

  8. Perceived listening effort for a tonal task with contralateral competing signals

    OpenAIRE

    2013-01-01

    Perceived listening effort was assessed for a monaural irregular-rhythm detection task while competing signals were presented to the contralateral ear. When speech was the competing signal, listeners reported greater listening effort compared to either contralateral steady-state noise or no competing signal. Behavioral thresholds for irregular-rhythm detection were unaffected by competing speech, indicating that listeners compensated for this competing signal with effortful listening. These r...

  9. Contralateral approach to iliac artery recanalization with kissing nitinol stents present in the aortic bifurcation.

    Science.gov (United States)

    Joseph, George; Hooda, Amit; Thomson, Viji Samuel

    2015-01-01

    A 69-year-old man, who had earlier undergone reconstruction of the aortic bifurcation with kissing nitinol stents, presented with occlusion of the left external iliac artery. The occlusion was successfully and safely recanalized using contralateral femoral approach with passage of interventional hardware through the struts of the stents in the aortic bifurcation. Presence of contemporary flexible nitinol stents with open-cell design in the aortic bifurcation is not a contraindication to the use of the contralateral femoral approach.

  10. The Influence of Language Experience on Contralateral Suppression of Click-Evoked Otoacoustic Emissions in Young Adults

    Science.gov (United States)

    Bhagat, Shaum P.; Xu, Jingjing

    2009-02-01

    Click-evoked otoacoustic emissions (CEOAEs) were recorded from the right ear of eight native Mandarin speakers and eight native English speakers in conditions with and without a contralateral suppressor. The CEOAE stimuli consisted of linear clicks presented at 65 dB peSPL. Two types of 70 dB SPL contralateral suppressors (white noise and synthesized Mandarin tone) were utilized. The amount of contralateral suppression was quantified in nine 2-ms time bands. No significant differences in contralateral suppression occurred between language groups for the white noise suppressor. Notably, significantly more contralateral suppression was evoked by the synthesized Mandarin tone in native Mandarin speakers compared to native English speakers.

  11. Maximal intermittent contractions of the first dorsal interosseous inhibits voluntary activation of the contralateral homologous muscle.

    Science.gov (United States)

    Kavanagh, Justin J; Feldman, Matthew R; Simmonds, Michael J

    2016-09-07

    The aim of this study was to investigate how maximal intermittent contractions for a hand muscle influence cortical and reflex activity, as well as the ability to voluntarily activate, the homologous muscle in the opposite limb. Twelve healthy subjects (age: 24 ± 3 years, all right hand dominant) performed maximal contractions of the dominant limb first dorsal interosseous (FDI), and activity of the contralateral FDI was examined in a series of experiments. Index finger abduction force, FDI EMG, motor evoked potentials and heteronomous reflexes were obtained from the contralateral limb during brief non-fatiguing contractions. The same measures, as well as the ability to voluntarily activate the contralateral FDI, were then assessed in an extended intermittent contraction protocol that elicited fatigue. Brief contractions under non-fatigued conditions increased index finger abduction force, FDI EMG, and motor evoked potential amplitude of the contralateral limb. However, when intermittent maximal contractions were continued until fatigue, there was an inability to produce maximal force with the contralateral limb (~30%) which was coupled to a decrease in the level of voluntary activation (~20%). These declines were present without changes in reflex activity, and regardless of whether cortical or motor point stimulation was used to assess voluntary activation. It is concluded that performing maximal intermittent contractions with a single limb causes an inability of the CNS to maximally drive the homologous muscle of the contralateral limb. This was, in part, mediated by mechanisms that involve the motor cortex ipsilateral to the contracting limb.

  12. Disturbance of contralateral unipedal postural control after stimulated and voluntary contractions of the ipsilateral limb.

    Science.gov (United States)

    Paillard, Thierry; Chaubet, Vincent; Maitre, Julien; Dumitrescu, Michel; Borel, Liliane

    2010-12-01

    One session of sustained unilateral voluntary muscular contractions increases central fatigue and induces a cross-over of fatigue of homologous contralateral muscles. It is not known, however, how this cross-transfer affects contralateral unipedal postural control. Moreover, contralateral neurophysiological effects differ between voluntary muscular contractions and electrically stimulated contractions. The aims of this study were thus to examine the effects of muscle fatigue on contralateral unipedal postural control and to compare the effects of stimulated and voluntary contractions. Fifteen subjects took part in the protocol. Fatigue of the ipsilateral quadriceps femoris was generated either by neuromuscular electrical stimulation (NMES) or by isometric voluntary muscular contraction (VOL). Postural control on the contralateral limb was measured before (PRE condition) and after the completion of the two fatiguing exercises (POST condition) using a force platform. We analyzed body sway area and the spectral power density given by the wavelet transform. In POST condition, postural control recorded in the unipedal stance on the contralateral limb was disturbed after NMES and VOL fatiguing exercises. In addition, postural control was similarly disturbed for both exercises. These results suggest that cross-over fatigue is able to disturb postural control after both stimulated and voluntary contractions.

  13. The impact of adjuvant therapy on contralateral breast cancer risk and the prognostic significance of contralateral breast cancer: a population based study in the Netherlands.

    NARCIS (Netherlands)

    Schaapveld, M.; Visser, O.; Louwman, W.J.; Willemse, P.H.; Vries, EG de; Graaf, W.T.A. van der; Otter, R.; Coebergh, J.W.; Leeuwen, F.E. van

    2008-01-01

    BACKGROUND: The impact of age and adjuvant therapy on contralateral breast cancer (CBC) risk and prognostic significance of CBC were evaluated. PATIENTS AND METHODS: In 45,229 surgically treated stage I-IIIA patients diagnosed in the Netherlands between 1989 and 2002 CBC risk was quantified using st

  14. The impact of adjuvant therapy on contralateral breast cancer risk and the prognostic significance of contralateral breast cancer: A population based study in the Netherlands

    NARCIS (Netherlands)

    M. Schaapveld (Michael); O.J. Visser (Otto); W.J. Louwman; P.H.B. Willemse (Pax); E.G.E. de Vries (Elisabeth); W.T.A. van der Graaf (Winette); R. Otter (Renée); J.W.W. Coebergh (Jan Willem); F.E. van Leeuwen (Flora)

    2008-01-01

    textabstractBackground: The impact of age and adjuvant therapy on contralateral breast cancer (CBC) risk and prognostic significance of CBC were evaluated. Patients and Methods: In 45,229 surgically treated stage I-IIIA patients diagnosed in the Netherlands between 1989 and 2002 CBC risk was quantif

  15. Comportamento da anemia e eosinofilia nas infestações por nematelmintos em crianças internadas na 5.ª Enfermaria do Instituto Fernandes Figueira

    Directory of Open Access Journals (Sweden)

    Márta Maria Bozóti

    1969-12-01

    Full Text Available 1 A incidência de exames coprológicos positivos para helmintos foi de 64.6% em crianças de baixo nível sócio-econômico procedentes do Estado da Guanabara e vizinhanças e internados no Instituto Fernandes Figueira devido a diversas entidades nosológicas. 2 Das crianças com exames positivos, 50,77% eram infestados por áscaris, 45% por tricuris, 13,84% por ancilóstoma e/ou necator, 18,56% por estrongilóides e 0,77% por esquistossoma. Não foram computados as infestações por oxiuros. 3 A ausência de casos de teníase provavelmente deve-se à alimentação carente em carnes. 4 As parasitoses mais freqüentes eram a ascaridíase e a tricuríase, isto é, as adquiridos por via digestiva. 5 O componente melanodérmico da amostra mostrou-se mais susceptível ao parasitismo que o leucodérmico, sendo o faiodérmico de susceptibilidade intermediária. 6 Os lactentes apresentam menor incidência de parasitismo que os grupos etários mais avançados (diferença estatisticamente significante, embora haja presença a de helmintíases graves em lactentes do grupo. 7 Mesmo em se tratando de crianças de nível sócio-econômico baixo e de precárias condições nutritivas, que predispõem à anemia, o grupo com exames de fezes positivos para nematelmintos apresenta uma incidência de diversos tipos de anemia maior que o grupo com exames de fezes negativos para helmintos (diferença estatisticamente significativa. 8 Alta incidência de estrongiloidíase na amostra. 9 Foi estudado o comportamento da eosinofilia em crianças com exames de fezes negativos, com exames positivos para nematelmintos e especial atenção foi dada à eosinofilia em lactentes de 0 a 1 ano.

  16. Aleitamento materno e cárie do lactente e do pré-escolar: uma revisão crítica Breastfeeding and early childhood caries: a critical review

    Directory of Open Access Journals (Sweden)

    Nilza M. E. Ribeiro

    2004-11-01

    Full Text Available OBJETIVO: Buscar evidências científicas que comprovem ou refutem a afirmação de que o aleitamento materno noturno e em livre demanda está associado com cárie do lactente e do pré-escolar. FONTES DOS DADOS: Foi realizada busca de artigos científicos utilizando-se as bases de dados MEDLINE, Lilacs e SciELO, páginas de internet relevantes, livros técnicos e publicações de consenso de organismos nacionais e internacionais. As palavras-chave utilizadas foram: early childhood caries, dental caries, dental decay e breastfeeding. Percebida a relevância, também se buscou diretamente as referências indicadas nos artigos encontrados. SÍNTESE DOS DADOS: Os estudos que relacionam a cárie com o aleitamento materno invariavelmente só observam os fatores inter-relacionados com o surgimento dessa doença, deixando de lado aqueles associados à amamentação. Muitos desses fatores atuam como variáveis de confusão porque, do mesmo modo que interferem no aleitamento materno, também têm influência no surgimento da cárie. Além disso, estudos atuais têm demonstrado a cariogenicidade de vários alimentos dados às crianças e a não-cariogenicidade do leite materno. CONCLUSÕES: Não há evidências científicas que comprovem que o leite materno possa estar associado com o surgimento de cárie, sendo essa relação complexa e confundida por muitas variáveis.OBJECTIVE: To find scientific evidences that can prove or refute the assumption that nocturnal and on demand breastfeeding are associated with caries in infants and preschool children. SOURCES OF DATA: MEDLINE, Lilacs, and SciELO articles were searched, as well as important internet sites, technical books and consensus publications of national and international organisms. The following keywords were used: "early childhood caries", "dental caries", "dental decay" and "breastfeeding". References cited in the articles selected were also included. SUMMARY OF THE FINDINGS: Studies associating

  17. Excreção urinária de iodo em lactentes segundo as características pós parto

    Directory of Open Access Journals (Sweden)

    Livia Fernandes de LIMA

    2013-12-01

    Full Text Available To evaluate the concentration of iodine in the urine of infants (ioduria and its possible relation to the postpartum characteristics of the newborn infant, and to assess the concentration of iodine in table salt, since this is the food with the highest content of this micronutrient ingested by the population, Methods: 32 infants under 6 months of age participated, The analysis of iodine in urine was based on the Sandell-Kolthoff reaction (1937 and that in salt on the titration method recommended by the National Health Foundation (Funasa, Postpartum infant characteristics were collected by means of a questionnaire answered by the nursing mothers, A descriptive statistical analysis was carried out, To compare the average ioduria of the infants in terms of the variables: type of delivery, breastfeeding, pregnancy and use of supplement, the Student t-test was applied, Associations of interest were examined by Fisher's exact test, The criterion of significance was p0.05, Results: The mean height and weight of the infants at birth were 47.5 cm and 3.2 kg, respectively, Most infants received exclusive breastfeeding, took no supplement, were born at term and by cesarean section, The median urinary iodine found in the infants was 190.78 mg /L and the average concentration of iodine in the salt was 75.59 mg I /kg salt, There was no correlation between the iodine content in salt and ioduria in infants, Conclusion: The median urinary iodine was found to be adequate, but the concentration of iodine in salt was excessive, There were no significant relationships between the postpartum characteristics of the infant and urinary iodine.

  18. Alimentação de recém-nascidos e lactentes a termo e prematuros atendidos em um hospital escola

    OpenAIRE

    Yagi, Rosicler Garcia Rodrigues

    2005-01-01

    O Brasil adota uma política de saúde voltada para a promoção, proteção e apoio ao aleitamento materno, como forma de reduzir a mortalidade infantil e melhorar a qualidade de vida das crianças. Os objetivos deste estudo foram; a) caracterizar a amostra e verificar a alimentação de bebês com idade inferior a dois anos, prematuros e a termo, avaliando os indicadores de aleitamento materno propostos pela Organização Mundial de Saúde (OMS): amamentação exclusiva, amamentação predominante, alimenta...

  19. Comportamento de lactentes nascidos a termo pequenos para a idade gestacional no primeiro trimestre da vida Behavior of full term infants small for gestational age in the first three months of life

    Directory of Open Access Journals (Sweden)

    Bernadete Balanin A. Mello

    2004-12-01

    Full Text Available O objetivo foi comparar o comportamento de lactentes nascidos a termo com peso adequado (AIG a lactantes pequenos para a idade gestacional (PIG, no primeiro trimestre de vida. A amostra foi de 20 lactentes, avaliados no 1º, 2º e 3º meses. Foram utilizadas as Escalas Bayley de Desenvolvimento Infantil - II, com ênfase na Escala de Classificação do Comportamento (ECC. Houve diferença significativa entre os grupos no 2º mês, com maior número de lactentes PIG classificados como alterados na ECC. O Fator Qualidade Motora demonstrou valores da mediana significativamente menores no grupo PIG, nos itens Motricidade Axial, Controle de Movimentos e Hipertonia Muscular. O Fator Atenção/Vigília não mostrou diferença entre os grupos. Entretanto, quando analisados os itens Exploração de Objetos e de Ambiente e Interação com o Examinador, houve diferença significativa no 2º mês, com valores da mediana menores no grupo PIG.The objective was to compare the behavior of full-term infants small-for-gestational age (SGA with full-term appropriate-for-gestational age (AGA. The sample considered 20 infants in the 1st, 2nd and in the 3rd months of life. The Bayley Scales of Infant Development-II were used, with attention to items related to Behavior Rate Scale (BRS. It was found that SGA infants showed lower average values in the BRS in the 2nd month. The Motor Quality Factor displayed significantly lower average values in SGA group, in the items Gross-motor Movement Required by Tasks, Control of Movements and Hypertonicity. The Attention/Arousal Factor in the items Exploration of Objects/Surroundings and Orientation to Examiner displayed significantly lower average values in the SGA group.

  20. Calcinose enzoótica em ruminantes no Brasil Central

    Directory of Open Access Journals (Sweden)

    Karla M.R. Guedes

    2011-08-01

    Full Text Available A calcinose enzoótica é uma enfermidade caracterizada por mineralização de artérias e tecidos moles, osteopetrose, hipercalcemia e hiperfosfatemia. Neste trabalho descreve-se uma calcinose enzoótica em ruminantes no Mato Grosso, Goiás, Minas Gerais, Tocantins e no Distrito Federal, em campos onde não foi encontrada nenhuma das plantas calcinogênicas conhecidas. Os primeiros casos foram diagnosticados em 2004, e até 2010 foram necropsiados 86 casos da doença provenientes de 42 propriedades. Trinta e três propriedades foram visitadas, e em 32 os pastos eram caracterizados por moderada a acentuada degradação e invasão por plantas daninhas. A doença foi diagnosticada em ovinos em 19 fazendas, em bovinos em 17, em caprinos em 5 e em uma fazenda foram afetados tanto caprinos quanto ovinos. Animais adultos foram mais acometidos, mas a doença foi observada, também, em animais lactentes. A enfermidade foi observada durante todo o ano, mas a maioria dos surtos ocorreu nos meses de maior índice pluviométrico. Em duas fazendas foram determinados, mensalmente, os níveis séricos de Ca e P observando-se uma elevação significativa dos mesmos durante o período de chuvas. Os principais sinais clínicos observados foram de emagrecimento progressivo, caquexia e flexão de membros anteriores, com andar rígido. As principais lesões macroscópicas e histológicas foram de mineralização das artérias, valvas cardíacas, pulmões e rins. Sugere-se que a doença é provocada por uma planta calcinogênica ainda desconhecida. Mesmo sem conhecer a causa da calcinose recomenda-se evitar o pastejo de ruminantes em áreas degradadas e reformar pastagens degradadas.

  1. Restoration of contralateral representation in the mouse somatosensory cortex after crossing nerve transfer.

    Directory of Open Access Journals (Sweden)

    Haruyoshi Yamashita

    Full Text Available Avulsion of spinal nerve roots in the brachial plexus (BP can be repaired by crossing nerve transfer via a nerve graft to connect injured nerve ends to the BP contralateral to the lesioned side. Sensory recovery in these patients suggests that the contralateral primary somatosensory cortex (S1 is activated by afferent inputs that bypassed to the contralateral BP. To confirm this hypothesis, the present study visualized cortical activity after crossing nerve transfer in mice through the use of transcranial flavoprotein fluorescence imaging. In naïve mice, vibratory stimuli applied to the forepaw elicited localized fluorescence responses in the S1 contralateral to the stimulated side, with almost no activity in the ipsilateral S1. Four weeks after crossing nerve transfer, forepaw stimulation in the injured and repaired side resulted in cortical responses only in the S1 ipsilateral to the stimulated side. At eight weeks after crossing nerve transfer, forepaw stimulation resulted in S1 cortical responses of both hemispheres. These cortical responses were abolished by cutting the nerve graft used for repair. Exposure of the ipsilateral S1 to blue laser light suppressed cortical responses in the ipsilateral S1, as well as in the contralateral S1, suggesting that ipsilateral responses propagated to the contralateral S1 via cortico-cortical pathways. Direct high-frequency stimulation of the ipsilateral S1 in combination with forepaw stimulation acutely induced S1 bilateral cortical representation of the forepaw area in naïve mice. Cortical responses in the contralateral S1 after crossing nerve transfer were reduced in cortex-restricted heterotypic GluN1 (NMDAR1 knockout mice. Functional bilateral cortical representation was not clearly observed in genetically manipulated mice with impaired cortico-cortical pathways between S1 of both hemispheres. Taken together, these findings strongly suggest that activity-dependent potentiation of cortico

  2. Contralateral needling at unblocked collaterals for hemiplegia following acute ischemic stroke

    Institute of Scientific and Technical Information of China (English)

    Huanmin Gao; Xugang Li; Xia Gao; Benxu Ma

    2013-01-01

    Hemiplegia caused by stroke indicates dysfunction of the network between the brain and limbs, namely col ateral shock in the brain. Contralateral needling is the insertion of needles into acupoints on the relative healthy side of the body to treat diseases such as apoplexy. However, there is little wel-designed and control ed clinical evidence for this practice. This study investigated whether contralateral needling could treat hemiplegia after acute ischemic stroke in 106 randomly selected patients with acute ischemic stroke. These patients were randomly assigned to three groups:45 in the contralateral needling group, receiving acupuncture on the unaffected limbs; 45 in the tional acupuncture group, receiving acupuncture on the hemiplegic limbs; and 16 in the control group, receiving routine treatments without acupuncture. Acupuncture at acupoints Chize (LU5) in the upper limb and Jianliao (TE14) in the lower limb was performed for 45 minutes daily for 30 consecutive days. The therapeutic effective rate, Neurological Deficit Score, Modified Barthel Index and Fugl-Meyer Assessment were evaluated. The therapeutic effective rate of contralateral needl-ing was higher than that of conventional acupuncture (46.67% vs. 31.11%, P < 0.05). The neuro-logical deficit score of contralateral needling was significantly decreased compared with conven-tional acupuncture (P < 0.01). The Modified Barthel Index and Fugl-Meyer Assessment score of contralateral needling increased more significantly than those of conventional acupuncture (both P<0.01). The present findings suggest that contralateral needling unblocks col aterals and might be more effective than conventional acupuncture in the treatment of hemiplegia fol owing acute ischemic stroke.

  3. Effects of contralateral noise on the 20-Hz auditory steady state response--magnetoencephalography study.

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    Hajime Usubuchi

    Full Text Available The auditory steady state response (ASSR is an oscillatory brain response, which is phase locked to the rhythm of an auditory stimulus. ASSRs have been recorded in response to a wide frequency range of modulation and/or repetition, but the physiological features of the ASSRs are somewhat different depending on the modulation frequency. Recently, the 20-Hz ASSR has been emphasized in clinical examinations, especially in the area of psychiatry. However, little is known about the physiological properties of the 20-Hz ASSR, compared to those of the 40-Hz and 80-Hz ASSRs. The effects of contralateral noise on the ASSR are known to depend on the modulation frequency to evoke ASSR. However, the effects of contralateral noise on the 20-Hz ASSR are not known. Here we assessed the effects of contralateral white noise at a level of 70 dB SPL on the 20-Hz and 40-Hz ASSRs using a helmet-shaped magnetoencephalography system in 9 healthy volunteers (8 males and 1 female, mean age 31.2 years. The ASSRs were elicited by monaural 1000-Hz 5-s tone bursts amplitude-modulated at 20 and 39 Hz and presented at 80 dB SPL. Contralateral noise caused significant suppression of both the 20-Hz and 40-Hz ASSRs, although suppression was significantly smaller for the 20-Hz ASSRs than the 40-Hz ASSRs. Moreover, the greatest suppression of both 20-Hz and 40-Hz ASSRs occurred in the right hemisphere when stimuli were presented to the right ear with contralateral noise. The present study newly showed that 20-Hz ASSRs are suppressed by contralateral noise, which may be important both for characterization of the 20-Hz ASSR and for interpretation in clinical situations. Physicians must be aware that the 20-Hz ASSR is significantly suppressed by sound (e.g. masking noise or binaural stimulation applied to the contralateral ear.

  4. Effects of contralateral noise on the 20-Hz auditory steady state response--magnetoencephalography study.

    Science.gov (United States)

    Usubuchi, Hajime; Kawase, Tetsuaki; Kanno, Akitake; Yahata, Izumi; Miyazaki, Hiromitsu; Nakasato, Nobukazu; Kawashima, Ryuta; Katori, Yukio

    2014-01-01

    The auditory steady state response (ASSR) is an oscillatory brain response, which is phase locked to the rhythm of an auditory stimulus. ASSRs have been recorded in response to a wide frequency range of modulation and/or repetition, but the physiological features of the ASSRs are somewhat different depending on the modulation frequency. Recently, the 20-Hz ASSR has been emphasized in clinical examinations, especially in the area of psychiatry. However, little is known about the physiological properties of the 20-Hz ASSR, compared to those of the 40-Hz and 80-Hz ASSRs. The effects of contralateral noise on the ASSR are known to depend on the modulation frequency to evoke ASSR. However, the effects of contralateral noise on the 20-Hz ASSR are not known. Here we assessed the effects of contralateral white noise at a level of 70 dB SPL on the 20-Hz and 40-Hz ASSRs using a helmet-shaped magnetoencephalography system in 9 healthy volunteers (8 males and 1 female, mean age 31.2 years). The ASSRs were elicited by monaural 1000-Hz 5-s tone bursts amplitude-modulated at 20 and 39 Hz and presented at 80 dB SPL. Contralateral noise caused significant suppression of both the 20-Hz and 40-Hz ASSRs, although suppression was significantly smaller for the 20-Hz ASSRs than the 40-Hz ASSRs. Moreover, the greatest suppression of both 20-Hz and 40-Hz ASSRs occurred in the right hemisphere when stimuli were presented to the right ear with contralateral noise. The present study newly showed that 20-Hz ASSRs are suppressed by contralateral noise, which may be important both for characterization of the 20-Hz ASSR and for interpretation in clinical situations. Physicians must be aware that the 20-Hz ASSR is significantly suppressed by sound (e.g. masking noise or binaural stimulation) applied to the contralateral ear.

  5. Cisto broncogênico complicado por mediastinite e empiema contra-lateral Bronchogenic cyst complicated by mediastinitis and contralateral empyema

    Directory of Open Access Journals (Sweden)

    Nuno Ferreira de Lima

    2004-02-01

    Full Text Available O cisto broncogênico, apesar da aparência pouco ominosa como opacidade de contornos precisos no mediastino, tem potencial não desprezível para complicar. Relatamos um caso de complicação grave em um paciente de 28 anos com queixa de dor epigástrica irradiada para o dorso, e radiografia de tórax demonstrando massa bem delimitada no mediastino posterior e inferior à direita. Em cinco dias evoluiu para sepse decorrente de mediastinite e empiema pleural à esquerda. O paciente necessitou ser submetido a toracotomia esquerda para descorticação pulmonar precoce e desbridamento do mediastino e, num segundo tempo com intervalo de uma semana, a toracotomia direita para ressecção do cisto mediastinal infectado. Este caso enfatiza a indicação sensata de ressecção dos cistos mediastinais mesmo na apresentação assintomática, face ao risco inerente de complicações.Notwithstanding its hardly ominous appearance as a mediastinal opaque mass with precise contours, the bronchogenic cyst has a significant potential for complications. We report a case of severe complication in a 28-year-old male presenting with epigastric pain irradiating to the back and at chest X-ray disclosing a well delimited mass in the posterior-inferior right side of the mediastinum. On the fifth day after onset of the symptoms, the patient developed sepsis resulting from mediastinitis and left pleural empyema. The patient was submitted to a left thoracotomy for lung decortication and mediastinal drainage and, after one week interval at a second stage, to a right thoracotomy for resection of the infected mediastinal cyst. In view of the inherent risk of omplications, mediastinal cyst resection is strongly recommended, even in cases of asymptomatic presentation.

  6. Estudo da orelha contralateral na otite média crônica: "Efeito Orloff ®"

    Directory of Open Access Journals (Sweden)

    Scheibe Ana Bárbara

    2002-01-01

    Full Text Available Introdução: A otite média crônica (OMC representa entidade de alta prevalência e distribuição mundial. Apesar da grande quantidade de estudos publicados a respeito, ainda não há, na literatura pertinente, consenso sobre a patogênese da OMC. Uma das hipóteses é a do continuum, que apresenta a otite média crônica como uma série de eventos contínuos, onde insultos iniciais desencadeiam uma cascata de alterações. Partindo então da idéia de continuum, pesquisamos a orelha contralateral (OCL de indivíduos com diagnóstico de OMC, descrevendo as alterações encontradas. Forma de estudo: Clínico prospectivo randomizado. Material e Métodos: Foram selecionados 108 pacientes com diagnóstico de OMC não-colesteatomatosa (OMC NC ou colesteatomatosa (OMC C acompanhados no ambulatório do Grupo de Pesquisa em Patologia da Orelha Média do Hospital de Clínicas de Porto Alegre. Nestes, foi realizada otoendoscopia com fibra óptica bilateral. A orelha mais estável foi considerada contralateral (OCL, sendo classificada como normal ou alterada (e as alterações descritas. Resultados: Dentre os pacientes avaliados, 59,2% portavam OMC NC e 40,8% OMC C. 46,3% de todos os pacientes apresentaram alterações significativas na OCL. Dos pacientes com OMC C, 57% apresentavam alteração na OCL, sendo que 39% dos pacientes com OMC NC tinham OCL alterada. A alteração mais freqüentemente encontrada foi retração de MT, em ambos os grupos. Conclusões: Os dados encontrados sugerem que pacientes que apresentam OMC tem maior probabilidade de apresentarem patologia na OCL, o que corrobora a idéia que a OMC se trata de um evento constitucional e não isolado da orelha média.

  7. Mutability of bifunctional thigh muscle activity in pedaling due to contralateral leg force generation.

    Science.gov (United States)

    Kautz, S A; Brown, D A; Van der Loos, H F M; Zajac, F E

    2002-09-01

    Locomotion requires uninterrupted transitions between limb extension and flexion. The role of contralateral sensorimotor signals in executing smooth transitions is little understood even though their participation is crucial to bipedal walking. However, elucidating neural interlimb coordinating mechanisms in human walking is difficult because changes to contralateral sensorimotor activity also affect the ipsilateral mechanics. Pedaling, conversely, is ideal for studying bilateral coordination because ipsilateral mechanics can be independently controlled. In pedaling, the anterior and posterior bifunctional thigh muscles develop needed anterior and posterior crank forces, respectively, to dominate the flexion-to-extension and extension-to-flexion transitions. We hypothesized that contralateral sensorimotor activity substantially contributes to the appropriate activation of these bifunctional muscles during the limb transitions. Bilateral pedal forces and surface electromyograms (EMGs) from four thigh muscles were collected from 15 subjects who pedaled with their right leg against a right-crank servomotor, which emulated the mechanical load experienced in conventional two-legged coupled-crank pedaling. In one pedaling session, the contralateral (left) leg pseudo-pedaled (i.e., EMG activity and pedal forces were pedaling-like, but pedal force was not allowed to affect crank rotation). In other sessions, the mechanically decoupled contralateral leg was first relaxed and then produced rhythmic isometric force trajectories during either leg flexion or one of the two limb transitions of the pedaling leg. With contralateral force production in the extension-to-flexion transition (predominantly by the hamstrings), rectus femoris activity and work output increased in the pedaling leg during its flexion-to-extension transition, which occurs simultaneously with contralateral extension-to-flexion in conventional pedaling. Similarly, with contralateral force production in the

  8. Miniopen Transforaminal Lumbar Interbody Fusion with Unilateral Fixation: A Comparison between Ipsilateral and Contralateral Reherniation

    Directory of Open Access Journals (Sweden)

    Zheng Li

    2016-01-01

    Full Text Available The aim of this study was to evaluate the risk factors between ipsilateral and contralateral reherniation and to compare the effectiveness of miniopen transforaminal lumbar interbody fusion (TLIF with unilateral fixation for each group. From November 2007 to December 2014, clinical and radiographic data of each group (ipsilateral or contralateral reherniation were collected and compared. Functional assessment (Visual Analog Scale (VAS score and Japanese Orthopaedic Association (JOA and radiographic evaluation (fusion status, disc height, lumbar lordosis (LL, and functional spine unit (FSU angle were applied to compare surgical effect for each group preoperatively and at final followup. MacNab questionnaire was applied to further evaluate the satisfactory rate after the discectomy and fusion. No difference except pain-free interval was found between ipsilateral and contralateral groups. There was a significant difference in operative time between two groups. No differences were found in clinical and radiographic data for assessment of surgical effect between two groups. The satisfactory rate was decreasing in both groups with time passing after discectomy. Difference in pain-free interval may be a distinction for ipsilateral and contralateral reherniation. Miniopen TLIF with unilateral pedicle screw fixation can be a recommendable way for single level reherniation regardless of ipsilateral or contralateral reherniation.

  9. Carotid stenting for unilateral stenosis can increase contralateral hemispheric cerebral blood flow.

    Science.gov (United States)

    Sadato, Akiyo; Maeda, Shingo; Hayakawa, Motoharu; Adachi, Kazuhide; Toyama, Hiroshi; Nakahara, Ichiro; Hirose, Yuichi

    2017-07-12

    The revascularization of carotid stenosis can increase ipsilateral cerebral blood flow (CBF). Occasionally, elevated CBF is also evident on the contralateral side, but this phenomenon is poorly understood. To analyze retrospectively the relationship between a contralateral CBF increase and several clinical and radiologic features. We retrospectively analyzed 40 patients with unilateral cervical carotid stenosis treated by carotid artery stenting (CAS). Using (123)I-iodamphetamine single-photon emission computed tomography (SPECT); we compared pre- and postoperative hemispheric CBF on both sides. We investigated the influence of the following five factors on the increase of the contralateral hemispheric CBF: stenosis grade (≥50% or increased significantly on both sides: from 33.4±5.6 (mean ± SD) to 38.7±7.8 mL/min on the operated side (paired t test, pincrease of the CBF on the contralateral side (p=0.03). Revascularization by CAS for unilateral carotid stenosis can increase hemispheric CBF on both sides. Increase of the contralateral CBF is correlated with stenosis grade (≥50%). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. MRI evaluation of the contralateral breast in patients with recently diagnosed breast cancer

    Directory of Open Access Journals (Sweden)

    Sangeeta Taneja

    2012-01-01

    Full Text Available Introduction: Contralateral breast cancer can be synchronous and/or metachronous in patients with cancer of one breast. Detection of a synchronous breast cancer may affect patient management. Dynamic contrast-enhanced MRI of the breast (DCE-MRI is a sensitive technique for detecting contralateral lesions occult on the other imaging modalities in women already diagnosed with cancer of one breast. Aim: The aim was to assess the incidence of mammographically occult synchronous contralateral breast cancer in patients undergoing MRI mammography for the evaluation of a malignant breast lesion. Materials and Methods: A total of 294 patients with recently diagnosed breast cancer who underwent MRI of the breast were evaluated for lesions in the opposite breast. Results: The incidence of synchronous contralateral malignancy detected by preoperative MRI mammography done for evaluation of extent of disease was 4.1%. Conclusion: Preoperative breast MRI may detect clinically and mammographically occult synchronous contralateral cancer, and can help the patient avoid an additional second surgery or a second course of chemotherapy later; also, as theoretically these lesions are smaller, there may be a survival benefit as well.

  11. Unilateral arm strength training improves contralateral peak force and rate of force development.

    Science.gov (United States)

    Adamson, Michael; Macquaide, Niall; Helgerud, Jan; Hoff, Jan; Kemi, Ole Johan

    2008-07-01

    Neural adaptation following maximal strength training improves the ability to rapidly develop force. Unilateral strength training also leads to contralateral strength improvement, due to cross-over effects. However, adaptations in the rate of force development and peak force in the contralateral untrained arm after one-arm training have not been determined. Therefore, we aimed to detect contralateral effects of unilateral maximal strength training on rate of force development and peak force. Ten adult females enrolled in a 2-month strength training program focusing of maximal mobilization of force against near-maximal load in one arm, by attempting to move the given load as fast as possible. The other arm remained untrained. The training program did not induce any observable hypertrophy of any arms, as measured by anthropometry. Nevertheless, rate of force development improved in the trained arm during contractions against both submaximal and maximal loads by 40-60%. The untrained arm also improved rate of force development by the same magnitude. Peak force only improved during a maximal isometric contraction by 37% in the trained arm and 35% in the untrained arm. One repetition maximum improved by 79% in the trained arm and 9% in the untrained arm. Therefore, one-arm maximal strength training focusing on maximal mobilization of force increased rapid force development and one repetition maximal strength in the contralateral untrained arm. This suggests an increased central drive that also crosses over to the contralateral side.

  12. Space representation for eye movements is more contralateral in monkeys than in humans.

    Science.gov (United States)

    Kagan, Igor; Iyer, Asha; Lindner, Axel; Andersen, Richard A

    2010-04-27

    Contralateral hemispheric representation of sensory inputs (the right visual hemifield in the left hemisphere and vice versa) is a fundamental feature of primate sensorimotor organization, in particular the visuomotor system. However, many higher-order cognitive functions in humans show an asymmetric hemispheric lateralization--e.g., right brain specialization for spatial processing--necessitating a convergence of information from both hemifields. Electrophysiological studies in monkeys and functional imaging in humans have investigated space and action representations at different stages of visuospatial processing, but the transition from contralateral to unified global spatial encoding and the relationship between these encoding schemes and functional lateralization are not fully understood. Moreover, the integration of data across monkeys and humans and elucidation of interspecies homologies is hindered, because divergent findings may reflect actual species differences or arise from discrepancies in techniques and measured signals (electrophysiology vs. imaging). Here, we directly compared spatial cue and memory representations for action planning in monkeys and humans using event-related functional MRI during a working-memory oculomotor task. In monkeys, cue and memory-delay period activity in the frontal, parietal, and temporal regions was strongly contralateral. In putative human functional homologs, the contralaterality was significantly weaker, and the asymmetry between the hemispheres was stronger. These results suggest an inverse relationship between contralaterality and lateralization and elucidate similarities and differences in human and macaque cortical circuits subserving spatial awareness and oculomotor goal-directed actions.

  13. Preoperative ultrasonographic evaluation of the contralateral patent processus vaginalis at the level of the internal inguinal ring is useful for predicting contralateral inguinal hernias in children: a prospective analysis.

    Science.gov (United States)

    Kaneda, H; Furuya, T; Sugito, K; Goto, S; Kawashima, H; Inoue, M; Hosoda, T; Masuko, T; Ohashi, K; Ikeda, T; Koshinaga, T; Hoshino, M; Goto, H

    2015-08-01

    The current study aimed to verify the usefulness of preoperative ultrasonographic evaluation of contralateral patent processus vaginalis (PPV) at the level of the internal inguinal ring. This was a prospective study of patients undergoing unilateral inguinal hernia repair at two institutions during 2010-2011. The sex, age at initial operation, birth weight, initial operation side, and the preoperative diameter of the contralateral PPV as determined using ultrasonography (US) were recorded. We analyzed the incidence of contralateral inguinal hernia, risk factors, and the usefulness of the preoperative major diameter of the contralateral PPV. The follow-up period was 36 months. All 105 patients who underwent unilateral hernia repair completed 36 months of follow-up, during which 11 patients (10.5 %) developed a contralateral hernia. The following covariates were not associated with contralateral hernia development: sex (p = 0.350), age (p = 0.185), birth weight (p = 0.939), and initial operation side (p = 0.350). The preoperative major diameter of the contralateral PPV determined using US was significantly wider among patients with a contralateral hernia than those without a contralateral hernia (p = 0.001). When the 105 patients were divided into two groups according to cut-off values of the preoperative major diameter of the contralateral PPV (wide group, >2.0 mm; narrow group, ≤2.0 mm), a significant association was observed between the preoperative major diameter of the contralateral PPV and patient outcomes (p = 0.001). We used US and confirmed the usefulness of a preoperative evaluation of the major diameter of the contralateral PPV at the level of the internal inguinal ring in pediatric patients with unilateral inguinal hernias.

  14. Quantification of Contralateral Breast Dose and Risk Estimate of Radiation-Induced Contralateral Breast Cancer Among Young Women Using Tangential Fields and Different Modes of Breathing

    Energy Technology Data Exchange (ETDEWEB)

    Zurl, Brigitte, E-mail: brigitte.zurl@klinikum-graz.at [Department of Therapeutic Radiology and Oncology, Medical University of Graz (Austria); Stranzl, Heidi; Winkler, Peter; Kapp, Karin Sigrid [Department of Therapeutic Radiology and Oncology, Medical University of Graz (Austria)

    2013-02-01

    Purpose: Whole breast irradiation with deep-inspiration breath-hold (DIBH) technique among left-sided breast cancer patients significantly reduces cardiac irradiation; however, a potential disadvantage is increased incidental irradiation of the contralateral breast. Methods and Materials: Contralateral breast dose (CBD) was calculated by comparing 400 treatment plans of 200 left-sided breast cancer patients whose tangential fields had been planned on gated and nongated CT data sets. Various anatomic and field parameters were analyzed for their impact on CBD. For a subgroup of patients (aged {<=}45 years) second cancer risk in the contralateral breast (CB) was modeled by applying the linear quadratic model, compound models, and compound models considering dose-volume information (DVH). Results: The mean CBD was significantly higher in DIBH with 0.69 Gy compared with 0.65 Gy in normal breathing (P=.01). The greatest impact on CBD was due to a shift of the inner field margin toward the CB in DIBH (mean 0.4 cm; range, 0-2), followed by field size in magnitude. Calculation with different risk models for CBC revealed values of excess relative risk/Gy ranging from 0.48-0.65 vs 0.46-0.61 for DIBH vs normal breathing, respectively. Conclusion: Contralateral breast dose, although within a low dose range, was mildly but significantly increased in 200 treatment plans generated under gated conditions, predominately due to a shift in the medial field margin. Risk modeling for CBC among women aged {<=}45 years also pointed to a higher risk when comparing DIBH with normal breathing. This risk, however, was substantially lower in the model considering DVH information. We think that clinical decisions should not be affected by this small increase in CBD with DIBH because DIBH is effective in reducing the dose to the heart in all patients.

  15. Histological evidence of testicular dysgenesis in contralateral biopsies from 218 patients with testicular germ cell cancer

    DEFF Research Database (Denmark)

    Hoei-Hansen, Christina E; Holm, Mette; Rajpert-De Meyts, Ewa

    2003-01-01

    patients, areas with immature and morphologically distorted tubules were also noted. Spermatogenesis was qualitatively normal in 51.4%, whereas 11.5% had very poor or absent spermatogenesis. It is concluded that microscopic testicular dysgenesis is a frequent feature in contralateral biopsies from patients...... dysgenesis, microscopic dysgenetic features were quantified in contralateral testicular biopsies in patients with a testicular germ cell tumour. Two hundred and eighty consecutive contralateral testicular biopsies from Danish patients with testicular cancer diagnosed in 1998-2001 were evaluated...... of other dysgenetic features was immature tubules with undifferentiated Sertoli cells, 4.6%; microcalcifications (microliths), 6.0%; and the presence of a Sertoli-cell-only pattern in at least a few tubules, 13.8%. The cumulative incidence of one or more signs of testicular dysgenesis was 25.2%. In a few...

  16. Recurrent, symptomatic, late-onset, contralateral subdural effusion following decompressive craniectomy treated by cranial strapping.

    Science.gov (United States)

    Krishnan, Prasad; Roy Chowdhury, Siddhartha

    2015-01-01

    Subdural effusions following decompressive craniotomy for trauma are usually benign, ipsilateral to the craniotomy and resolve spontaneously. Far less common and more dangerous are contralateral subdural effusions causing external cerebral herniation. We report a case of recurrent contralateral effusion and highlight the management dilemmas. Arachnoid tear is probably the cause of these collections. Contralateral subdural effusions should be suspected in patients who have delayed neurological deterioration after an initial improvement particularly in the setting of increased "flap bulge" though they may also be found in patients who remain moribund after initial surgery. There are no clear-cut guidelines on their management due to their rarity. A variety of options like subduro-peritoneal shunt and drainage with simultaneous cranioplasty may be tried. In situations where resources or patient compliance is an issue, tapping the effusion followed by cranial strapping may be tried as was done in our case.

  17. Screening for carcinoma in situ in the contralateral testicle in patients with testicular cancer

    DEFF Research Database (Denmark)

    Kier, M G G; Lauritsen, Jakob; Almstrup, Kristian

    2015-01-01

    population-based screening programme for contralateral CIS in patients with testicular cancer showed no significant difference in the risk for metachronous GCC between a screened and an unscreened cohort. Single-site biopsy including modern immunohistochemistry does not identify all cases of CIS.......BACKGROUND: Screening programmes for contralateral carcinoma in situ (CIS) testis in patients with unilateral germ-cell cancer (GCC) have never been evaluated. We investigated the effect of screening for contralateral CIS in a large nation-wide, population-based study. PATIENTS AND METHODS...... years was 1.9% in the screened cohort and 3.1% in the unscreened cohort (P = 0.097), hazard ratio (HR) for the unscreened cohort: 1.59 (P = 0.144). Expert revision with contemporary methodology of CIS-negative biopsy samples from patients with metachronous cancer revealed CIS in 17 out of 45 (38%) cases...

  18. Histological evidence of testicular dysgenesis in contralateral biopsies from 218 patients with testicular germ cell cancer

    DEFF Research Database (Denmark)

    Hoei-Hansen, Christina E; Holm, Mette; Rajpert-De Meyts, Ewa

    2003-01-01

    This study was prompted by a hypothesis that testicular germ cell cancer may be aetiologically linked to other male reproductive abnormalities as a part of the so-called 'testicular dysgenesis syndrome' (TDS). To corroborate the hypothesis of a common association of germ cell cancer with testicular...... dysgenesis, microscopic dysgenetic features were quantified in contralateral testicular biopsies in patients with a testicular germ cell tumour. Two hundred and eighty consecutive contralateral testicular biopsies from Danish patients with testicular cancer diagnosed in 1998-2001 were evaluated...... presenting with testicular germ cell neoplasms of the adolescent and young type. The findings therefore support the hypothesis that this cancer is part of a testicular dysgenesis syndrome. The presence of contralateral carcinoma in situ was higher in the present study than previously reported....

  19. Unilateral hypoplasia with contralateral hypertrophy of anterior belly of digastric muscle: a case report.

    Science.gov (United States)

    Ochoa-Escudero, Martin; Juliano, Amy F

    2016-10-01

    Anomalies of the anterior belly of the digastric muscle (DM) are uncommon. We present a case of hypoplasia of the anterior belly of the left DM with hypertrophy of the anterior belly of the contralateral DM. The importance of recognizing this finding is to differentiate hypoplasia of the anterior belly of the DM from denervation atrophy, and not to confuse contralateral hypertrophy with a submental mass or lymphadenopathy. In denervation atrophy of the anterior belly of the DM, associated atrophy of the ipsilateral mylohyoid muscle is present. Hypertrophy of the anterior belly of the contralateral DM can be differentiated from a submental mass or lymphadenopathy by recognizing its isodensity on computed tomography and isointensity on magnetic resonance imaging to other muscles, without abnormal contrast enhancement.

  20. Percepções de educadores de creches acerca de práticas cotidianas na alimentação de lactentes: impacto de um treinamento Perceptions of day care center teachers about daily practices of infant feeding: the impact of training

    Directory of Open Access Journals (Sweden)

    Giovana Longo-Silva

    2013-02-01

    Full Text Available O artigo apresenta a importância da capacitação dos profissionais envolvidos com alimentação das crianças em creches, para que estes ofereçam alimentos adequados e promovam ações para que os lactentes incorporem práticas alimentares saudáveis desde o nascimento. Desta forma, o objetivo do presente trabalho foi avaliar o impacto de um treinamento de educadores de creches nas percepções e práticas acerca da alimentação infantil. Para avaliação do impacto do treinamento foi utilizada abordagem qualitativa, com aplicação da técnica do grupo focal. Foram realizados 16 grupos, sendo oito com as creches expostas ao treinamento e oito com as não-expostas, tendo em média de seis a 11 participantes por instituição, os quais apresentavam idades entre 19 e 66 anos. O discurso das educadoras que participaram do treinamento está pontuado de indícios de pequenas mudanças, ou pelo menos, de reconhecimento de que é preciso e possível mudar. Destaca-se a relevância de elaborar e executar programas de treinamento e educação nutricional para educadores de creches com supervisão contínua dos efeitos da capacitação como estratégia de saúde infantil.This article stresses the importance of the qualification of professionals involved in thefeeding of children in daycare centers, such that they offeradequate food and programs are developed in order to fosterhealthy food habits in infantsfrom birth. Thus, the scope of this paper was to evaluate the impact of a training program for these daycare teachers in their perceptions and practicesin infant feeding. A qualitative approach was used to evaluate the impact of training, with the application of the focus grouptechnique. Sixteen groups were created, eight of whichwere daycare centerswith training and eight without training, the average number of participants being 6 to 11 per institution agedbetween 19 and 66. The discourse of the teachers who took part in the training program is

  1. L-Arginina facilita a depressão alastrante cortical, de forma dependente da dose, em ratos nutridos e precocemente desnutridos

    OpenAIRE

    Maria Silva de Seixas Maia, Luciana

    2008-01-01

    A L-Arginina atua como precursor do óxido nítrico, que possui várias funções no sistema nervoso, e cuja síntese pode ser modulada pela ingestão de L-Arginina. Em trabalho anterior deste laboratório (Frazão, 2004), demonstrou-se que a administração de 300mg/kg/dia de L-Arginina durante o aleitamento facilita, em animais bem nutridos adultos (90-120 dias), a propagação do fenômeno da depressão alastrante cortical (DAC). Neste trabalho, ratos lactentes, nutridos e desnutridos, foram tratados por...

  2. Response of SII cortex to ipsilateral, contralateral and bilateral flutter stimulation in the cat

    Directory of Open Access Journals (Sweden)

    Favorov Oleg

    2005-02-01

    Full Text Available Abstract Background A distinctive property of SII is that it is the first cortical stage of the somatosensory projection pathway that integrates information arising from both sides of the body. However, there is very little known about how inputs across the body mid-line are processed within SII. Results Optical intrinsic signal imaging was used to evaluate the response of primary somatosensory cortex (SI and SII in the same hemisphere to 25 Hz sinusoidal vertical skin displacement stimulation ("skin flutter" applied contralaterally, ipsilaterally, and bilaterally to the central pads of the forepaws. A localized increase in absorbance in both SI and SII was evoked by both contralateral and bilateral flutter stimulation. Ipsilateral flutter stimulation evoked a localized increase in absorbance in SII, but not in SI. The SII region that responded with an increase in absorbance to ipsilateral stimulation was posterior to the region in which absorbance increased maximally in response to stimulation of the contralateral central pad. Additionally, in the posterior SII region that responded maximally to ipsilateral stimulation of the central pad, bilateral central pad stimulation approximated a linear summation of the SII responses to independent stimulation of the contralateral and ipsilateral central pads. Conversely, in anterior SII (the region that responded maximally to contralateral stimulation, bilateral stimulation was consistently less than the response evoked from the contralateral central pad. Conclusions The results indicate that two regions located at neighboring, but distinctly different A-P levels of the anterior ectosylvian gyrus process input from opposite sides of the body midline in very different ways. The results suggest that the SII cortex, in the cat, can be subdivided into at least two functionally distinct regions and that these functionally distinct regions demonstrate a laterality preference within SII.

  3. Response of SI cortex to ipsilateral, contralateral and bilateral flutter stimulation in the cat

    Directory of Open Access Journals (Sweden)

    Favorov Oleg

    2005-04-01

    Full Text Available Abstract Background While SII cortex is considered to be the first cortical stage of the pathway that integrates tactile information arising from both sides of the body, SI cortex is generally not considered as a region in which neuronal response is modulated by simultaneous stimulation of bilateral (and mirror-image skin sites. Results Optical intrinsic signal imaging was used to evaluate the response of SI and SII in the same hemisphere to 25 Hz sinusoidal vertical skin displacement stimulation ("skin flutter" applied contralaterally, ipsilaterally, and bilaterally (simultaneously to the central pads of the forepaws. A localized increase in absorbance in both SI and SII occurred in response to both contralateral and bilateral flutter stimulation. Ipsilateral flutter stimulation evoked a localized increase in absorbance in SII, but little or no change in SI absorbance. In the forepaw representational region of SI, however, bilateral stimulation of the central pads evoked a response substantially smaller (approximately 30–35% smaller than the response to flutter stimulation of the contralateral central pad. Conclusion The finding that the response of SI cortex to bilateral central pad flutter stimulation is substantially smaller than the response evoked by a contralateral flutter stimulus, together with the recently published observation that a region located posteriorly in SII responds with a substantially larger response to a bilateral flutter stimulus than the response evoked from the contralateral central pad, lead us to propose that the SI activity evoked by contralateral skin stimulation is suppressed/inhibited (via corticocortical connections between SII and SI in the same hemisphere by the activity a simultaneous ipsilateral skin stimulus evokes in posterior SII.

  4. Response of the contralateral hippocampus to lateral fluid percussion brain injury.

    Science.gov (United States)

    Tran, Lorriann D; Lifshitz, Jonathan; Witgen, Brent M; Schwarzbach, Elizabeth; Cohen, Akiva S; Grady, M Sean

    2006-09-01

    Traumatic brain injury is a leading cause of death and disability in the United States. Pathological examinations of humans and animal models after brain injury demonstrate hippocampal neuronal damage, which may contribute to cognitive impairments. Data from our laboratories have shown that, at 1 week after brain injury, mice possess significantly fewer neurons in all ipsilateral hippocampal subregions and a cognitive impairment. Since cognitive function is distributed across both cerebral hemispheres, the present paper explores the morphological and physiological response of the contralateral hippocampus to lateral brain injury. We analyzed the contralateral hippocampus using design-based stereology, Fluoro-Jade (FJ) histochemistry, and extracellular field recordings in mice at 7 and 30 days after lateral fluid percussion injury (FPI). At 7 days, all contralateral hippocampal subregions possess significantly fewer healthy neurons compared to sham-injured animals and demonstrate FJ-positive neuronal damage, but not at 30 days. Both the ipsilateral and contralateral dentate gyri demonstrate significantly increased excitability at 7 days post-injury, but only ipsilateral dentate gyrus hyperexcitability persists at 30 days compared to sham. In the contralateral hippocampus, the transient decrease in the number of healthy neurons, concomitant with FJ damage, and electrophysiological alterations establish a stunned period of cellular and circuit dysfunction. The return of healthy neuron number, absence of FJ damage, and sham level of excitability in the contralateral hippocampus suggest recovery of structure and function by 30 days after injury. The cognitive recovery observed after human traumatic brain injury may stem from a differential injury exposure and time course of recovery between homologous regions of the two hemispheres.

  5. Contralateral Obturator Hernia Immediately after a Right Obturator Herniorrhaphy: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Soo Jin [Soonchunhyang University Cheonan Hospital College of Medicine, Cheonan (Korea, Republic of); Choi, Gyo Chang; Kim, Hyeong Soo [Soonchunhyang University Gumi Hospital College of Medicine, Gumi (Korea, Republic of)

    2010-11-15

    An obturator hernia is a very rare condition that occurs in elderly debilitated women and its nonspecific symptoms delay the diagnosis. Computed tomography is a useful tool for the early diagnosis of an obturator hernia. Previous studies report that bilateral obturator hernias comprise approximately 6% of all obturator hernias is 6%. To the best of our knowledge, there is no reported case of a contralateral obturator hernia immediately after a herniorrhaphy. We report a case of contralateral obturator hernia that occurred immediately after a right obturator herniorrhaphy

  6. Perceived listening effort for a tonal task with contralateral competing signals.

    Science.gov (United States)

    Bologna, William J; Chatterjee, Monita; Dubno, Judy R

    2013-10-01

    Perceived listening effort was assessed for a monaural irregular-rhythm detection task while competing signals were presented to the contralateral ear. When speech was the competing signal, listeners reported greater listening effort compared to either contralateral steady-state noise or no competing signal. Behavioral thresholds for irregular-rhythm detection were unaffected by competing speech, indicating that listeners compensated for this competing signal with effortful listening. These results suggest that perceived listening effort may be associated with suppression of task-irrelevant information, even for conditions where informational masking and competition for linguistic processing resources would not be expected.

  7. Unilateral Optic Nerve Hypoplasia with Contralateral Optic Pathway Hypoplasia: A Case Report.

    Science.gov (United States)

    Nishi, Tomo; Yukawa, Eiichi; Taoka, Toshiaki; Ogata, Nahoko

    2013-01-01

    Optic nerve hypoplasia is diagnosed by the ophthalmoscopic appearance of the fundus of the eye and by standard magnetic resonance imaging of the brain. The ability to study eyes with optic nerve hypoplasia by magnetic resonance diffusion tensor imaging has improved the evaluation of the optic pathways. The authors report a case of unilateral optic nerve hypoplasia with hypoplasia of the contralateral optic pathway. The entire visual pathway of this patient was examined by magnetic resonance and magnetic resonance diffusion tensor imaging. The images show a decrease of the volume of the optic radiation contralateral to the optic nerve abnormality and also pre- and post-chiasmal abnormalities.

  8. Transição alimentar em recém-nascidos com displasia broncopulmonar Transition time for full oral feeding in newborns with bronchopulmonary dysplasia

    Directory of Open Access Journals (Sweden)

    Daiana Evangelista

    2009-03-01

    Full Text Available OBJETIVO: verificar o tempo de transição da sonda para a via oral plena nos lactentes com Displasia Broncopulmonar (DBP e descrever as intercorrências observadas durante os períodos de alimentação. MÉTODOS: revisão de prontuários do setor de Fonoaudiologia de 32 lactentes nascidos no Hospital Universitário Pedro Ernesto (HUPE/UERJ divididos em 2 grupos. Grupo 1: 18 lactentes com diagnóstico de DBP; grupo 2: 18 lactentes com idade gestacional entre 29 e 32 semanas sem complicações clínicas relevantes que foram utilizados como grupo controle. Foram registrados o tempo de transição alimentar, as intercorrências durante a alimentação e via oral na alta hospitalar de ambos os grupos. RESULTADOS: média e desvio padrão do tempo de transição alimentar dos grupos 1 e 2 respectivamente: 18,22 dias e 14,79; 6,50 dias e 3,68, com p=0,002. Nos broncodisplásicos foram comuns intercorrências respiratórias, dificuldade de coordenação sucçãoXrespiraçãoXdeglutição, dificuldades no padrão oral, além de sinais de retraimento e rebaixamento do estado de consciência durante a alimentação. Apesar disso, 10 lactentes (52,63% tiveram alta em aleitamento materno exclusivo e 3 (15,78% em aleitamento misto. CONCLUSÃO: pacientes com DBP precisaram de um período maior de treino de VO (18 dias, além de serem passíveis de intercorrências durante a alimentação. No entanto, constata-se que foi possível o aleitamento materno exclusivo.PURPOSE: to check the time of transition from the feeding tube to oral feeding in newborns with Bronchopulmonar Dysplasia (BPD; observe the difficulties occurred during the oral feeding./ METHODS: the speech pathology department reviewed thirty-two past cases of newborns born in the Pedro Ernesto Hospital of Rio de Janeiro State University. The first group was composed of eighteen newborns with BPD, while a second group was composed of eighteen healthy newborns born between 29 and 32 weeks used as a

  9. Simple shielding reduces dose to the contralateral breast during prone breast cancer radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Goyal, Uma, E-mail: uma.goyal@gmail.com; Locke, Angela; Smith-Raymond, Lexie; Georgiev, Georgi N.

    2016-07-01

    Our goal was to design a prone breast shield for the contralateral breast and study its efficacy in decreasing scatter radiation to the contralateral breast in a prone breast phantom setup receiving radiation therapy designed for breast cancer. We constructed a prone breast phantom setup consisting of (1) A thermoplastic mask with a left-sided depression created by a water balloon for a breast shape; (2) 2 plastic bags to hold water in the thermoplastic mask depression; (3) 2000 mL of water to fill the thermoplastic mask depression to create a water-based false breast; (4) 1-cm thick bolus placed in the contralateral breast holder; (5) 2 lead (Pb) sheets, each 0.1-cm thick for blocking scatter radiation in the contralateral bolus-based false breast; (6) a prone breast board to hold the thermoplastic mask, water, bolus, and lead; (7) 9 cm solid water on top of the breast board to simulate body; (8) a diode was used to verify dose for each treatment field of the treated water-based breast; (9) metal–oxide–semiconductor-field effect transistor (MOSFET) dosimeters to measure dose to the contralateral bolus-based breast. The phantom prone breast setup was CT simulated and treatment was designed with 95% isodose line covering the treated breast. The maximum dose was 107.1%. Megavoltage (MV) port images ensured accurate setup. Measurements were done using diodes on the treated water-based breast and MOSFET dosimeters at the medial and lateral sides of the contralateral bolus-based breast without and with the Pb shield. Five treatments were done for each of the 3 data sets and recorded individually for statistical purposes. All treatments were completed with 6 MV photons at 200 cGy per treatment. The dose contributions from each of the 3 data sets including 15 treatments total without and with the prone lead shield to the medial and lateral portions of contralateral bolus-based breast were averaged individually. Unshielded dose means were 37.11 and 2.94 cGy, and

  10. Cuidado do lactente no primeiro ano de vida conhecimentos desejados por um grupo de mães

    Directory of Open Access Journals (Sweden)

    Rosemary Ribeiro Lindholm

    1984-03-01

    Full Text Available O objetivo principal deste estudo foi verificar os conhecimentos que as mães de crianças de zero a um ano de idade gostariam de receber para cuidar de seus filhos. Foram entrevistadas 110 mães primíparas, matriculadas num centro de saúde, na cidade de São Paulo. Os conhecimentos requeridos pelas mães por ordem decrescente foram alimentação, manifestações orgânicas ou afecções comuns da infância, desenvolvimento, higiene corporal, crescimento, sono. Imunização, necessidades afetivas e higiene do ambiente. Constatou-se, ainda, que quanto mais baixa a idade da criança maior o número de solicitações apresentadas pelas mães. Os resultados desta pesquisa podem ser aplicados eventualmente em centros de saúde, mas de maneira criteriosa, para evitar generalizações que, provavelmente, iriam contrariar as necessidades individuais de aprendizagem das mães.

  11. Contralateral Hypoplastic Venous Draining Sinuses Are Associated with Elevated Intracranial Pressure in Unilateral Cerebral Sinovenous Thrombosis.

    Science.gov (United States)

    Farias-Moeller, R; Avery, R; Diab, Y; Carpenter, J; Murnick, J

    2016-12-01

    Variations in cerebral venous development can influence the ability to regulate drainage. In cerebral sinovenous thrombosis, these variations can be associated with elevated intracranial pressure. We present a series of pediatric patients with unilateral cerebral sinovenous thrombosis and investigate whether the contralateral venous sinus size increases the risk of developing elevated intracranial pressure. Patients diagnosed with a unilateral cerebral sinovenous thrombosis were identified by querying our institutional radiology data base. The difference in the occurrence of elevated intracranial pressure in patients with cerebral sinovenous thrombosis with and without hypoplastic venous sinuses was studied. Twelve cases of unilateral cerebral sinovenous thrombosis met the inclusion criteria and had sufficient images. Six patients had hypoplastic contralateral venous sinuses. The presence of hypoplastic contralateral venous sinus in the setting of thrombosis of a dominant sinus was associated with elevation of intracranial pressure (83% versus 0%, P = .015). Patients with cerebral sinovenous thrombosis and contralateral hypoplastic venous sinuses are at higher risk of developing elevated ICP and may benefit from screening with an ophthalmologic examination.

  12. Contralateral breast cancer after radiotherapy among BRCA1 and BRCA2 mutation carriers

    DEFF Research Database (Denmark)

    Bernstein, Jonine L; Thomas, Duncan C; Shore, Roy E

    2013-01-01

    Women with germline BRCA1 or BRCA2 (BRCA1/BRCA2) mutations are at very high risk of developing breast cancer, including asynchronous contralateral breast cancer (CBC). BRCA1/BRCA2 genes help maintain genome stability and assist in DNA repair. We examined whether the risk of CBC associated with ra...

  13. Foveational Complexity in Single Word Identification: Contralateral Visual Pathways Are Advantaged over Ipsilateral Pathways

    Science.gov (United States)

    Obregon, Mateo; Shillcock, Richard

    2012-01-01

    Recognition of a single word is an elemental task in innumerable cognitive psychology experiments, but involves unexpected complexity. We test a controversial claim that the human fovea is vertically divided, with each half projecting to either the contralateral or ipsilateral hemisphere, thereby influencing foveal word recognition. We report a…

  14. Women's preferences for contralateral prophylactic mastectomy: An investigation using protection motivation theory.

    Science.gov (United States)

    Tesson, Stephanie; Richards, Imogen; Porter, David; Phillips, Kelly-Anne; Rankin, Nicole; Musiello, Toni; Marven, Michelle; Butow, Phyllis

    2016-05-01

    Most women diagnosed with unilateral breast cancer without BRCA1 or BRCA2 mutations are at low risk of contralateral breast cancer. Contralateral Prophylactic Mastectomy (CPM) decreases the relative risk of contralateral breast cancer, but may not increase life expectancy; yet international uptake is increasing. This study applied protection motivation theory (PMT) to determine factors associated with women's intentions to undergo CPM. Three hundred eighty-eight women previously diagnosed with unilateral breast cancer and of negative or unknown BRCA1 or BRCA2 status were recruited from an advocacy group's research database. Participants completed measures of PMT constructs based on a common hypothetical CPM decision-making scenario. PMT constructs explained 16% of variance in intentions to undergo CPM. Response efficacy (CPM's advantages) and response costs (CPM's disadvantages) were unique individual predictors of intentions. Decision-making appears driven by considerations of the psychological, cosmetic and emotional advantages and disadvantages of CPM. Overestimations of threat to life from contralateral breast cancer and survival benefit from CPM also appear influential factors. Patients require balanced and medically accurate information regarding the pros and cons of CPM, survival rates, and recurrence risks to ensure realistic and informed decision-making.

  15. Coexistence of Granular Cell Tumor and Invasive Ductal Breast Cancer in Contralateral Breasts: A Case Report

    Directory of Open Access Journals (Sweden)

    Maurizio Di Bonito

    2014-07-01

    Full Text Available Granular cell tumor (GCT is a benign tumor of the breast that can mimic, on breast imaging, invasive carcinomas. Biological evolution of mammary GCT is unknown, especially if it is associated with an invasive carcinoma in the same or contralateral breast. This report details the morphological features of these synchronous lesions highlighting their biological characteristics and suggesting an appropriate follow up.

  16. Review: Bone conduction devices and contralateral routing of sound systems in single-sided deafness

    NARCIS (Netherlands)

    Peters, Jeroen P M; Smit, Adriana L; Stegeman, Inge; Grolman, Wilko

    2015-01-01

    OBJECTIVES/HYPOTHESIS: Systematically review the literature on the clinical outcome of bone conduction devices (BCD) and contralateral routing of sound systems (CROSS) for patients with single-sided deafness (SSD). DATA SOURCES: PubMed, Embase, Cochrane Library, and CINAHL databases were searched up

  17. Wavelet analysis demonstrates no abnormality in contralateral suppression of otoacoustic emissions in tinnitus patients

    NARCIS (Netherlands)

    Geven, Leontien I.; Wit, Hero P.; de Kleine, Emile; van Dijk, Pim

    2012-01-01

    The efferent auditory system is thought to play a role in the origin of tinnitus. Part of this system can be tested in humans with contralateral suppression of otoacoustic emissions. Stimulation of the medial olivocochlear efferent system is responsible for this reduction of otoacoustic emissions af

  18. Functionality of the contralateral biceps femoris reflex response during human walking

    DEFF Research Database (Denmark)

    Stevenson, Andrew James Thomas; Geertsen, Svend S.; Sinkjær, Thomas

    2014-01-01

    In this study we examined the functionality of the contralateral biceps femoris (cBF) reflex response following ipsilateral knee extension joint rotations during the late stance phase of the gait cycle [1]. Stevenson et al. [1] proposed that the cBF reflex acts to slow the forward progression...

  19. Characterization of a novel scale maille contralateral breast shield: SMART Armor.

    Science.gov (United States)

    Butson, Macinley; Carroll, Susan; Butson, Martin; Hill, Robin

    2017-09-01

    During breast radiotherapy treatment, the contralateral breast receives radiation doses to the skin and subcutaneous tissue caused mainly from incident electron contamination and low energy photon scatter radiation. Measurements have shown that for a typical hybrid tangential treatment, these dose levels can be up to 17% of maximum applied prescription dose if no shielding is used during the treatment process. This work examined the use of different shielding metals, aluminum, copper, and lead to reduce peripheral radiation dose to evaluate the optimal metal to form the basis of a contralateral breast radiation shield. This work also shows a simple but novel method to substantially reduce this unwanted radiation dose with the use of a copper scale maille sheet which can be easily and accurately draped over a patient's contralateral breast during treatment. The copper scale maille is flexible and can thus conform around typical breast shapes. It can also form irregular shaped edges to match those outlined by typical tangential treatment fields. As the shield is made from copper, it is nontoxic and can potentially be used directly on patients for treatment. The designed copper scale maille has shown to reduce contralateral breast skin and subcutaneous dose by up to 80% for typical radiation fields used in breast radiotherapy. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  20. [Glomerular changes in the contralateral kidney in the rat with experimental hydronephrosis].

    Science.gov (United States)

    Castillo Bernabéu, R; Gázquez Ortiz, A; Bonillo Morales, A; Sierra Planas, M A; Ocaña Losa, J M; Romanos Lezcano, A

    1985-10-31

    We have studied under optic and electronmicroscopes the alterations of glomeruli in contralateral kidneys of rats with experimental hydronephrosis. Forty-eight Wistar rats, divided into two groups (control and experimental) were used. They were sacrificed 3, 6, 9 and 12 days after ureteral obstruction. There was a slight hypertrophy of glomeruli and hiperplasia of other components accompanied by a increased development of podocytes.

  1. Long-term glial reactivity in rat retinas ipsilateral and contralateral to experimental glaucoma.

    Science.gov (United States)

    Kanamori, Akiyasu; Nakamura, Makoto; Nakanishi, Yoriko; Yamada, Yuko; Negi, Akira

    2005-07-01

    Although glaucoma is known to alter glial reactivity, the long-term effect of elevated intraocular pressure (IOP) on glial change has not been fully elucidated. This study aimed to examine how chronically elevated IOP induced by episcleral vein cauterization (EVC) in unilateral eyes affect reactivities of astrocytes and Müller cells of rats in the treated as well as contralateral eyes over time. EVC in unilateral eyes of Sprague-Dawley rats were performed to produce chronically elevated IOP. Flat mounted retina preparations were made at several points until 6 months, which were subjected to immunostaining for glial fibrillary acidic protein (GFAP). Retinal homogenates were one- or two-dimensionally electrophoresed, followed by GFAP immunoblotting. EVC significantly increased IOPs up to 27.8 from 13.1 mmHg, which gradually decreased over time. In flat mounted retinas, astrocytes lost but Müller cells gained GFAP immunoreactivity at 3 days after cauterization. The glial changes were partially reversed over time but last even after IOP normalization. In the contralateral eyes, similar glial changes gradually appeared at 1 month after EVC and thereafter. Immunoblotting demonstrated not only molecular size shifts but also alteration of isoelectric focusing of GFAP both in treated and contralateral retina as compared with age-matched control retina. EVC led to opposite reactions in astrocytes and Müller cells in terms of GFAP immunoreactivity. Late-onset glial reactivity also occurred in the contralateral retina.

  2. Serious neonatal airway obstruction with massive congenital sublingual ranula and contralateral occurrence

    Directory of Open Access Journals (Sweden)

    Manish M. George

    2015-06-01

    Conclusions: The prenatal diagnosis of congenital ranulas have been seldom reported, with no reported cases of contralateral occurrence and airway obstruction from an intraoral ranula. This rare case highlights the need for a well considered contingency plan when surgery is required for a neonatal airway at risk.

  3. TREATMENT OF 36 CASES OF SCAPULOHUMERAL PERIARTHRITIS MAINLY BY CONTRALATERAL NEEDLING

    Institute of Scientific and Technical Information of China (English)

    吴家萍; 韩臣子

    2004-01-01

    Objective: To analyze the therapeutic effect of contralateral needling in the treatment of scapulohumeral periarthritis.Methods: A total of 68 cases of scapulohumeral periarthritis were outpatients and were randomized into treatment group (n=36) and control group (n=32).In treatment group, Zhiyin (BL67), Jinmen (BL63) and Yanglao (SI6) on the contralateral side of the affected shoulder and local tenderpoints (Ashi-points) were punctured once every other day, with 7 days being a therapeutic course; while in control group, local Ashi-points were used for injection of Procaine and Prednisolone Acetate, once every 7 days and with 3~4 sessions being a therapeutic course.Results: Following 2 courses of treatment, of the 32 cases in control group, 8 (25.0%) were cured, 17 (53.1%) experienced improvement and 7 failed in the treatment, with a total of effective rate of 78.1%; of the 36 cases in treatment group, 18 (50.0%) were cured, 16 (44.4%) experienced improvement and 2 (5.6%) failed in the treatment, with a total effective rate of 94.4%.The therapeutic effect of contralateral needling is significantly higher than that of Ashi-point blocking method (P<0.05).Conclusion: Contralateral needling is superior to Ashi-point in the treatment of scapulohumeral periarthritis.

  4. Effect of differing intensities of fatiguing dynamic contractions on contralateral homologous muscle performance.

    Science.gov (United States)

    Kawamoto, Jon-Erik; Aboodarda, Saied Jalal; Behm, David George

    2014-12-01

    The purpose of this study was to investigate different intensities of unilateral fatiguing dynamic quadriceps contractions on non-exercised, contralateral quadriceps performance. In a randomized crossover study design with 12 recreationally trained male (1.78 ± 0.05 m, 84.5 ± 7.6 kg, 30.0 ± 8.5 yrs) participants, maximal voluntary contraction (MVC) force, force developed in the first 100 ms (F100), and electromyography of the non-exercised contralateral knee extensors were measured before and after fatiguing protocols performed by ipsilateral knee extensors. Non-exercised knee extensors' endurance was also measured post-intervention. The fatigue protocols consisted of four sets of dynamic knee extensions each to task failure with 40% and 70% MVC on separate days. Both the 40% (p = 0.009, Effect Size [ES] = 0.72) and 70% (p = 0.001, ES = 2.03) conditions exhibited 23.7% and 34.6% decreases in F100 respectively with the non-exercised contralateral knee extensors. A significant time effect (p = 0.002) demonstrated that both the 40% (and 70% (conditions exhibited 4.4% (ES = 0.29) and 7.1% (ES = 0.53) force decreases from pre- to post-intervention, respectively. However, the condition * time interaction only showed a trend (p = 0.09) with moderate (40%: ES = 0.62) to large (70%: ES = 0.82) effect sizes for decreased contralateral limb force compared with control session. The 40% (p = 0.09, ES = 0.65) and 70% (p = 0.07, ES = 0.79) protocols had a tendency to induce greater contralateral force variation during sustained submaximal isometric contraction compared with control. In conclusion, this study highlighted that unilateral lower limb fatigue induced by low intensity as well as high intensity dynamic knee extensions provided some evidence of crossover fatigue with the contralateral non-exercised limb. Key PointsThere was a pattern of crossover fatigue effects with significant impairments in F100, near significant, moderate to large magnitude decrements in MVC force

  5. Immunohistopathology of the contralateral testis of rats undergoing experimental torsion of the spermatic cord

    Institute of Scientific and Technical Information of China (English)

    Marcelo G. Rodriguez; Claudia Rival; María S. Theas; Livia Lustig

    2006-01-01

    Aim: To evaluate the immunohistopathological changes in the contralateral testis of rats after an experimental spermatic cord torsion. Methods: Male Sprague-Dawley rats of 45-50 days old were subjected to a 720° unilateral spermatic cord torsion for 10, 30 and 80 days (experimental group, E), respectively or sham operation (control group, C). Histopathology of the contralateral testis as well as germ cell apoptosis were studied using the Terminal Deoxynucleotidyl Transferase Biotin-dUTP Nick End Labeling (TUNEL) technique. The number of testicular lymphocytes, mast cells and macrophages, and the expression of tumor necrosis factor-α (TNF-α) and its receptor (TNFR 1) in testicular cells of the contralateral testis were quantified by histochemistry and immunohistochemistry.TNF-o concentration in testicular fluid was determined by ELISA. Results: In the contralateral testis of rats from the E group, the maximal degree of damage of the germinal epithelium was seen 30 days after torsion. At this time we observed in the E group vs. The C group increases: (I) the number of testicular T-lymphocytes; (ii) the number of testicular mast cells and macrophages; (iii) the percentage of macrophages expressing TNF-α; (iv) TNF-α concentration in testicular fluid; (v) the number of apoptotic germ cells; and (vi) the number of TNFR1 + germ cells. Conclusion:Experimental spermatic cord torsion induces, in the contralateral testis, a focal damage of seminiferous tubules characterized by apoptosis and sloughing of germ cells. Results suggest humoral and cellular immune mediated testicular cell damage in which macrophages and mast cells seem to be involved in the induction of germ cell apoptosis through the TNF-α/TNFR1 system and in the modulation of the inflammatory process.

  6. The Effect of Learning Disability on Contralateral Suppression of Otoacoustic Emissions in Primary Students

    Directory of Open Access Journals (Sweden)

    Saeid Sarough Farahani

    2006-06-01

    Full Text Available Background and Aim: One of the most significant complaints of children with learning disability (LD is difficulty in understanding speech in the presence of background noise. Different studies have shown that the medial olivocochlear bundle(MOCB may play a role in hearing in noise. The MOCB function can be evaluated by the contralateral suppression of tone burst evoked otoacoustic emissions (TBEOAEs.The aim of the present study was to evaluate frequency specifications of MOCB by the contralateral suppression of TBEOAEs at 1,2,3 and 4 KHz in response to contralateral white noise in LD students. Materials and Methods: This case-control study was conducted on 34 LD students aged 7-11 years and 31 normal students matched for age.The contralateral suppression of TBEOAEs was evaluated by comparing TBEOAEs amplitudes with and without contralateral white noise. Results: In the absence of noise there was no significant difference between TBEOAEs amplitudes of two groups. In the presence of noise significant decrease was seen in TBEOAEs amplitudes at 1,2,3 and 4 KHz in both groups. In LD students the amount of this decrement at 1,2 and 4 KHz was lower than in the normal students. Conclusion: A significant diminished suppression effect at 1,2 and 4 KHz in LD students indicates that at these frequency regions MOCB function was reduced. Therefore it suggests that the assessment of MOCB by evaluating the suppression effect of TBEOAEs included in the test battery approach used in the diagnostic of LD students.

  7. Testicular hypertrophy as a predictor for contralateral monorchism: Retrospective review of prospectively recorded data.

    Science.gov (United States)

    Hodhod, A; Capolicchio, J P; Jednak, R; El-Sherbiny, M

    2016-02-01

    Testicular hypertrophy has previously been evaluated as a predictor of monorchism. However, its implication in clinical practice is not well evaluated. The aim of the present study was to examine its value in planning the operative time. Medical charts of prospectively recorded data of 76 consecutive patients with unilateral impalpable testis from 2011 to 2014 were reviewed at the present institute. Inclusion criteria included prepubertal patients with non-palpable testes by examination under anesthesia. Contralateral testes were prospectively measured using a Takihara orchidometer. Orchiectomy or orchiopexy was performed according to the viability of the undescended testis (UDT). Collected data included age of surgery, contralateral testicular size, surgical time and laparoscopic findings. A ROC curve was used to define the best cut-off volume of the contralateral testis that can predict ipsilateral testicular viability. The Student's t-test was used to examine if this cut-off volume would be useful in allocating the operative time. Of 76 patients, four palpable testes by examination under anesthesia were excluded. The remaining 72 patients were included in the study. Ipsilateral normal viable testes were found in 26 (36.1%) patients, while 46 (63.9%) had non-viable testes (testicular nubbins or vanishing testes) (Figure). A contralateral testicular volume > 2 ml was significantly predictive for monorchism with 71.7% sensitivity and 100% specificity (P 2 ml was 50 min, which was significantly shorter than that for UDT with a contralateral size ≤ 2 ml, which was 88 min (P 2 ml as a predictor for monorchism can reduce the allocated operative time by approximately one third. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  8. Endothelin receptor blockade improves oxygenation in contralateral TRAM flap tissue in pigs.

    Science.gov (United States)

    Erni, D; Wessendorf, R; Wettstein, R; Schilling, M K; Banic, A

    2001-07-01

    Partial skin and fat necrosis is the most common complication occurring in TRAM flaps. It is related to disturbances of the microcirculation and oxygenation in the contralateral part of the flap. It may be hypothesised that the development of necrosis is promoted by the vasoconstrictor endothelin, the production of which is enhanced in ischaemic flap tissues. The purpose of this study was to evaluate the effect of tezosentan, a new endothelin receptor blocker, on microcirculation and oxygenation in experimental TRAM flaps. The administration of tezosentan began preoperatively (3 mg/kg body weight) and then continued at a rate of 1.5 mg/kg/h. A TRAM flap with a skin island measuring 16 x 8 cm was raised in the middle of the epigastrium in minipigs. The flap was pedicled on the right superior epigastric vessels. Microcirculatory blood flow was measured with laser Doppler flowmetry and tissue oxygen tension was measured with a Clark-type microprobe. Dominant subcutaneous veins were cannulated in both the ipsilateral and the contralateral parts of the flap. Subdermal tissue oxygen tension in the contralateral part of the flap was significantly reduced 4h after surgery to 5 mmHg (ca. 48 mmHg in normal tissue) in the control group, but to only 12 mmHg in the group that had been administered tezosentan (Peffluent of the contralateral part of the flap, although microcirculatory blood flow remained virtually unchanged. Our findings suggest that tezosentan improves oxygenation and metabolism in the jeopardised contralateral flap tissue, probably as a result of a decrease in venous vascular resistance and fluid extravasation.

  9. Unilateral partial limbal stem cell deficiency: contralateral versus ipsilateral autologous cultivated limbal epithelial transplantation.

    Science.gov (United States)

    Vazirani, Jayesh; Basu, Sayan; Kenia, Hemal; Ali, Md Hasnat; Kacham, Santhosh; Mariappan, Indumathi; Sangwan, Virender

    2014-03-01

    To report the outcomes of autologous cultivated limbal epithelial transplantation using the healthy part of the affected eye or the fellow eye as a source of limbal stem cells in patients with unilateral, partial limbal stem cell deficiency (LSCD). Retrospective, nonrandomized, interventional case series. setting: L. V. Prasad Eye Institute, Hyderabad, India. study population: Patients with unilateral, partial LSCD who underwent autologous cultivated limbal epithelial transplantation between 2001 and 2011. intervention: The limbal biopsy was taken either from the healthy part of the limbus of the same eye (ipsilateral group) or from the healthy fellow eye (contralateral group). Cells were cultivated using a xeno-free explant culture technique, and cultivated cells were transplanted onto the affected surface. primary outcome measure: Success of cultivated limbal epithelial transplantation, defined as a completely epithelialized, avascular, and clinically stable corneal surface. Seventy eyes of 70 patients were studied. The mean follow up was 17.5 ± 7 months. In 34 eyes the limbal biopsy was taken from the ipsilateral eye and in the remaining 36 eyes from the contralateral eye. Clinical success was achieved in 70.59% of eyes in the ipsilateral group and 75% of eyes in the contralateral group (P = .79). Limbal transplant survival rates at the final follow-up visit were 65.1% ± 0.09% in the ipsilateral group and 53.6% ± 0.12% in the contralateral group (P = .74). Ocular surface restoration in partial LSCD is possible with cell-based therapy. Outcomes are similar irrespective of whether the limbal biopsy is taken from the healthy part of the ipsilateral eye or the contralateral eye. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Unilateral static and dynamic hamstrings stretching increases contralateral hip flexion range of motion.

    Science.gov (United States)

    Chaouachi, Anis; Padulo, Johnny; Kasmi, Sofien; Othmen, Aymen Ben; Chatra, Moktar; Behm, David G

    2017-01-01

    Static (SS) and dynamic stretching (DS) can lead to subsequent performance impairments or enhancement with the stretched limb. Crossover or non-local muscle fatigue (NLMF) refers to unilateral fatigue-induced impairments in a contralateral or non-exercised muscle. Whereas there are conflicting findings in the NLMF literature, there are few studies examining the effect of an acute bout of SS or DS on contralateral flexibility, torque or power. Fourteen highly trained subjects (means ± standard deviations: 18 ± 2 years; 179·4 ± 4·6 cm; 70·5 ± 6·3 kg; %body fat: 10·7 ± 2·5%) were tested before and following separate sessions of eight repetitions of 30 s of unilateral hip flexion SS or DS. Pre- and postintervention testing at 1 and 10 min included hip flexor range of motion (ROM), isokinetic leg flexion torque and power at 60°.s(-1) and 300°.s(-1) of the stretched and contralateral limbs. The stretched limb had a 6·3% (P = 0·01; ES: 0·91) ROM increase with DS at 10 min. The contralateral non-stretched hip flexors experienced ROM increases with SS of 5·7% (P = 0·02; ES: 0·68) from pretest to 1 min post-test, whereas DS showed 7·1% (P<0·0001; ES: 1·09) and 8·4% (P = 0·005; ES: 0·89) increases, respectively. There were no relative differences in ROM changes between conditions or limbs nor any stretch-induced changes in isokinetic torque or power. In conclusion, unilateral SS and DS augment contralateral limb ROM likely through an increased stretch tolerance.

  11. Contentment with quality of life among breast cancer survivors with and without contralateral prophylactic mastectomy.

    Science.gov (United States)

    Geiger, Ann M; West, Carmen N; Nekhlyudov, Larissa; Herrinton, Lisa J; Liu, In-Liu A; Altschuler, Andrea; Rolnick, Sharon J; Harris, Emily L; Greene, Sarah M; Elmore, Joann G; Emmons, Karen M; Fletcher, Suzanne W

    2006-03-20

    To understand psychosocial outcomes after prophylactic removal of the contralateral breast in women with unilateral breast cancer. We mailed surveys to women with contralateral prophylactic mastectomy after breast cancer diagnosis between 1979 and 1999 at six health care delivery systems, and to a smaller random sample of women with breast cancer without the procedure. Measures were modeled on instruments developed to assess contentment with quality of life, body image, sexual satisfaction, breast cancer concern, depression, and health perception. We examined associations between quality of life and the other domains using logistic regression. The response rate was 72.6%. Among 519 women who underwent contralateral prophylactic mastectomy, 86.5% were satisfied with their decision; 76.3% reported high contentment with quality of life compared with 75.4% of 61 women who did not undergo the procedure (P = .88). Among all case subjects, less contentment with quality of life was not associated with contralateral prophylactic mastectomy or demographic characteristics, but was associated with poor or fair general health perception (odds ratio [OR], 7.0; 95% CI, 3.4 to 14.1); possible depression (OR, 5.4; 95% CI, 3.1 to 9.2); dissatisfaction with appearance when dressed (OR, 3.5; 95% CI, 2.0 to 6.0); self-consciousness about appearance (OR, 2.0; 95% CI, 1.1 to 3.7); and avoiding thoughts about breast cancer (modest: OR, 2.2; 95% CI, 1.1 to 4.5; highest: OR, 1.7; 95% CI, 0.9 to 3.2). Most women undergoing contralateral prophylactic mastectomy report satisfaction with their decision and experience psychosocial outcomes similar to breast cancer survivors without the procedure.

  12. Sentinel Lymph Node Detection in Contralateral Axilla at Initial Presentation of a Breast Cancer Patient: Case Report

    Directory of Open Access Journals (Sweden)

    Gülin Uçmak Vural

    2010-06-01

    Full Text Available The main basin for breast lymphatic drainage is ipsilateral axilla. However, extra-axillary drainage may be seen in some patients. The most common extra-axillary site is internal mammary chain, while contralateral axillary drainage is an extremely rare situation in previously untreated patients. We describe a case of untreated right breast retroareolar carcinoma with contralateral axillary drainage detected on preoperative lymphoscintigraphy. Contralateral axillary dissection was performed based on the result of frozen section examination of the sentinel lymph node (SLN which turned out to burden micrometastasis. Postoperative histopathological examination revealed invasive ductal carcinoma metastasis in 17 out of 22 lymph nodes from the ipsilateral axillary dissection, whereas 14 lymph nodes from contralateral axillary dissection other than the SLN were nonmetastatic. In our opinion, determination of contralateral axillary metastasis in primary staging process had a major contribution to the management of the patient

  13. The impact of contralateral mastectomy on mortality in BRCA1 and BRCA2 mutation carriers with breast cancer.

    Science.gov (United States)

    Narod, Steven A

    2011-07-01

    Among women with breast cancer and a BRCA1 or BRCA2 mutation, the lifetime risk of breast cancer may be as high as 40%. Many physicians recommend prophylactic contralateral mastectomy, which is an effective measure of minimising the risk of contralateral cancer. The benefits of preventive contralateral mastectomy are apparent within 10 years, in terms of preventing cancer, but a much longer time period is required in order to demonstrate a reduction in mortality. Under the simple model presented here, among women who retain the contralateral breast, 0.4% of women are expected to die of contralateral breast cancer within 5 years, but 6.8% are expected to die at 20 years from diagnosis. These unnecessary deaths can be prevented by bilateral mastectomy.

  14. Infecções do trato respiratório inferior pelo vírus sincicial respiratório em crianças hospitalizadas menores de um ano de idade Respiratory syncytial vírus - associated lower respiratory tract infections in hospitalized infants

    Directory of Open Access Journals (Sweden)

    Cláudio D'Elia

    2005-02-01

    Full Text Available Analisou-se características clínicas e evolutivas em crianças menores de um ano internadas com infecção do trato respiratório inferior por vírus sincicial respiratório (VSR. Feito estudo transversal com 89 lactentes hospitalizados durante as épocas de maior incidência do VSR, em 1997 e 1998, na cidade do Rio de Janeiro. Foram pesquisados antígenos virais, nas secreções de nasofaringe, com anticorpos monoclonais anti-VSR, antiinfluenza A e B e antiparainfluenza tipo 3, por ensaio de imunofluorescência indireta. Formaram-se três grupos: bronquiolite ou bronquite sibilante (n=44, pneumonia (n=26 e bronquiolite e pneumonia (n=19. Houve positividade para o VSR em 42 (47,1% pacientes. Em 1997 a média de dias de oxigenoterapia foi de 5,2 e em 1998, de 2,5 dias (p> 0,05. Não houve diferença de apresentação clínica entre os lactentes que apresentaram positividade para o VSR e aqueles cujo resultado foi negativo. A sensibilidade e especificidade da sibilância em relação ao isolamento de VSR foram 85% e 65%, respectivamente. O VSR foi o principal causador de infeções do trato respiratório inferior em lactentes que necessitaram de hospitalização.For analysis of clinical features and outcome of hospitalized infants with respiratory syncytial virus lower respiratory tract infection, was carried out. Cross-sectional study with 89 infants, hospitalized in two public hospitals during the 1997 and 1998 RSV seasons, in Rio de Janeiro city. Nasopharyngeal secretions were obtained and specimens processed for viral antigens detection by indirect immunofluorescence assay with the use of anti RSV, antiinfluenza A and B and anti parainfluenza type 3 monoclonal antibodies. Patients were allocated into three diagnostic groups: bronchiolitis or wheeze bronchitis (n = 44; Pneumonia (n = 26 and bronchiolitis or wheeze bronchitis and pneumonia (n = 19. Positivity for RSV was found in 42 (47.1% patients. More days of hospitalization were seen in

  15. Efeito da cisaprida e da fisioterapia respiratória sobre o refluxo gastroesofágico de lactentes chiadores segundo avaliação cintilográfica Effects of cisapride and chest physical therapy on the gastroesophageal reflux of wheezing babies based on scintigraphy

    Directory of Open Access Journals (Sweden)

    Maria Angela G.O. Ribeiro

    2001-10-01

    Full Text Available OBJETIVO: analisar o efeito da cisaprida e da fisioterapia respiratória em lactentes chiadores (LC, com doença do refluxo gastroesofágico (DRGE. MÉTODOS: avaliamos, prospectivamente, em 13 LC com DRGE e 12 sem DRGE, a densidade nuclear de tecnécio (99Tc em 3 topografias esofágicas. Os 2 grupos foram submetidos à investigação clínica, exames laboratoriais, radiológicos e cintilográficos para investigação etiológica da síndrome do LC e DRGE. A técnica fisioterápica denominada aceleração de fluxo expiratório (AFE foi realizada antes e após tratamento com cisaprida. O tempos totais de RGE(TTRGE, primeiramente durante a cintilografia basal, e em seguida, durante a AFE, foram analisados e somados, para cada topografia esofágica. RESULTADOS: a cisaprida diminuiu o TTRGE, com significância estatística somente no terço superior do esôfago (p OBJECTIVE: to evaluate the effect of cisapride and chest physical therapy on the gastroesophageal reflux of wheezing babies. METHODS: we prospectively assessed the presence of technetium (99Tc in the upper, middle, and lower esophagus of 25 wheezing babies (13 with GERD and 12 without GERD using scintigraphy. Both groups underwent clinical investigation, including laboratory, X-ray and scintigraphy tests, for the etiology of the wheezing baby syndrome (WBS and GERD. Expiratory Flow Acceleration (EFA was performed before and after treatment with cisapride. The total time of GER episodes was accounted for each portion of the esophagus during scintigraphy and during EFA. RESULTS: cisapride significantly reduced the total reflux time in the upper esophagus (P < 0.05, but showed no influence during EFA. After cisapride therapy, EFA increased the total reflux time in the upper and medium esophagus; however, no statistical significance was found. Infants with GERD presented a shorter total reflux time in the distal esophagus (P<0.05 during EFA. After cisapride treatment, no statistical

  16. Acolhimento e características maternas associados à oferta de líquidos a lactentes Acogimiento y características maternas asociadas a la oferta de líquidos a lactantes User embracement and maternal characteristics associated with liquid offer to infants

    Directory of Open Access Journals (Sweden)

    Roberta Pereira Niquini

    2010-08-01

    Full Text Available OBJETIVO: Identificar características maternas e ações de acolhimento às mães de crianças menores de seis meses associadas à oferta precoce de líquidos. MÉTODOS: Estudo transversal realizado em 2007 com amostra representativa de mães de crianças menores de seis meses (n = 1.057 usuárias de unidades básicas de saúde (UBS na cidade do Rio de Janeiro, RJ. Para estimar a associação entre as variáveis explicativas e a oferta de líquidos utilizou-se um modelo de regressão logística multivariado com ponderação, efeito de desenho e controlado pela idade da criança. RESULTADOS: Das mães, 32% não recebeu o cartão de acolhimento na maternidade, 47% não recebeu orientação sobre amamentação na primeira ida à UBS após o parto e 55% relatou a oferta de líquidos aos lactentes. Mulheres sem experiência pregressa em amamentar por pelo menos seis meses apresentaram chance de oferta de líquidos maior que aquelas com experiência (OR = 1,57; IC 95%: 1,16;2,13. As que não receberam orientação sobre amamentação na primeira ida à UBS após o parto tiveram chance 58% maior de oferecer líquidos que aquelas que receberam orientação. A oferta de líquidos mostrou-se positivamente associada com a adolescência entre mulheres com companheiro (OR = 2,17; IC 95%: 1,10;4,30 e negativamente associada com a adolescência entre aquelas sem companheiro (OR = 0,31; IC95%: 0,11;0,85. Entre mulheres com menos de oito anos de estudo, as que não receberam orientação sobre amamentação após o nascimento da criança apresentaram chance de oferta de líquidos 1,8 vez maior que aquelas que receberam orientação. CONCLUSÕES: Idade, situação conjugal e experiência pregressa em amamentar são características maternas associadas à oferta de líquidos para crianças menores de seis meses. O recebimento de orientação precoce sobre aleitamento materno pode reduzir o oferecimento de líquidos aos lactentes.OBJETIVO: Identificar caracter

  17. Pure ipsilateral central facial palsy and contralateral hemiparesis secondary to ventro-medial medullary stroke.

    Science.gov (United States)

    Ahdab, R; Saade, H S; Kikano, R; Ferzli, J; Tarcha, W; Riachi, N

    2013-09-15

    Medullary infarcts are occasionally associated with facial palsy of the central type (C-FP). This finding can be explained by the course of the facial corticobulbar (F-CB) fibers. It is believed that fibers that project to the upper facial muscles decussate at the level of the facial nucleus, whereas those destined to the lower facial muscles decussate more caudally, at the level of the mid or upper medulla. It has been proposed that the lower F-CB fibers descend ventromedially near the corticospinal tract to the upper medulla where they cross midline and ascend dorsolaterally. Accordingly, ventromedial medullary infarcts are expected to result in contralateral facial and limb weakness. We report a patient with a medial medullary infarct restricted to the right pyramid and associated with ipsilateral C-FP and contralateral hemiparesis. The neurological findings are discussed in light of the hypothetical course of the F-CB fibers in the medulla.

  18. Acanthamoeba and Stenotrophomonas maltophilia keratitis with fungal keratitis in the contralateral eye

    Directory of Open Access Journals (Sweden)

    Thomas F Mauger

    2010-10-01

    Full Text Available Thomas F Mauger, Rebecca Ann Kuennen, Reynell Harder Smith, William SawyerDepartment of Ophthalmology, The Ohio State University, Columbus, OH, USAPurpose: The purpose of this study is to describe the diagnosis, course, and outcome of a case of Acanthamoeba and Stenotrophomonas keratitis with a fungal keratitis in the contralateral eye.Methods: A case of Acanthamoeba and Stenotrophomonas keratitis was diagnosed with confocal microscopy and cultures with confocal diagnosis of fungal keratitis in the fellow eye.Results: During the initial treatment of the Acanthamoeba and Stenotrophomonas keratitis, the contralateral eye developed a keratitis that demonstrated hyphae in the corneal stroma with confocal microscopy consistent with fungal keratitis.Conclusions: Bilateral chronic keratitis cannot be assumed to be caused by the same organism and independent cultures, and confocal microscopy needs to be performed to direct appropriate therapy.Keywords: Acanthamoeba, Stenotrophomonas, confocal, fungus, keratitis

  19. Incidence of metachronous contralateral breast cancer in Denmark 1978–2009

    DEFF Research Database (Denmark)

    Rasmussen, Christina Bording; Kjaer, Susanne K.; Ejlertsen, Bent;

    2014-01-01

    adjustments were made by use of Poisson regression models. RESULTS: The incidence of CBC decreased with increasing age at first breast cancer. Before 1998, incidence rates of CBC showed little variation. The rates decreased by period of first primary from 546 per 10(5) person-years in 1993-97 to 328 per 10......(5) person-years in 2003-09. After adjustment for age and calendar period, no clear trend was observed in the overall incidence according to time since first breast cancer. CONCLUSIONS: Occurrence of cancer in the contralateral breast seems to be rather independent of time passed since the first primary......BACKGROUND: Incidence of contralateral breast cancer (CBC) is much less studied than primary breast cancer. We aimed to assess incidence rates of CBC in relation to age, calendar period and time since first breast cancer. METHODS: Using the nationwide Danish Cancer Registry, we identified 85 863...

  20. Combined Ipsilateral Oculomotor Nerve Palsy and Contralateral Downbeat Nystagmus in a Case of Cerebral Infarction

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    Kosuke Matsuzono

    2014-04-01

    Full Text Available We report a patient with acute cerebral infarction of the left paramedian thalamus, upper mesencephalon and cerebellum who exhibited ipsilateral oculomotor nerve palsy and contralateral downbeat nystagmus. The site of the infarction was considered to be the paramedian thalamopeduncular and cerebellar regions, which are supplied by the superior cerebellar artery containing direct perforating branches or both the superior cerebellar artery and the superior mesencephalic and posterior thalamosubthalamic arteries. Contralateral and monocular downbeat nystagmus is very rare. Our case suggests that the present downbeat nystagmus was due to dysfunction of cerebellar-modulated crossed oculovestibular fibers of the superior cerebellar peduncle or bilateral downbeat nystagmus with one-sided oculomotor nerve palsy.

  1. Postoperative epidural hematoma. Five cases of epidural hematomas developed after supratentorial craniotomy on the contralateral side

    Energy Technology Data Exchange (ETDEWEB)

    Sato, M. (Shiga Univ. of Medical Science, Ohtsu (Japan)); Mori, K.; Handa, H.

    1981-10-01

    Postoperative epidural hematomas developed far from the operative field are generally recognized as a complication of ventriculo-peritoneal shunt, ventricular drainage or suboccipital craniotomy. It is very rare but may occur after supratentorial craniotomy on the contralateral side. Five such cases are presented with a review of the relevant literature. The mechanism of this complication is not clearly understood. In hydrocephalus, these massive epidural hematomas are probably caused by dura-skull detachment when the brain volume is strikingly reduced by a decompressive procedure. On rare occasions, pins of head rest may detach the dura and cause epidural hematomas. When sudden brain swelling during craniotomy is encountered, attention should be directed not only to intracerebral hemorrhage but also epidural hematoma developed on the contralateral side.

  2. Horner's syndrome and contralateral abducens nerve palsy associated with zoster meningitis.

    Science.gov (United States)

    Cho, Bum-Joo; Kim, Ji-Soo; Hwang, Jeong-Min

    2013-12-01

    A 55-year-old woman presented with diplopia following painful skin eruptions on the right upper extremity. On presentation, she was found to have 35 prism diopters of esotropia and an abduction limitation in the left eye. Two weeks later, she developed blepharoptosis and anisocoria with a smaller pupil in the right eye, which increased in the darkness. Cerebrospinal fluid analysis showed pleocytosis and a positive result for immunoglobulin G antibody to varicella zoster virus. She was diagnosed to have zoster meningitis with Horner's syndrome and contralateral abducens nerve palsy. After intravenous antiviral and steroid treatments, the vesicular eruptions and abducens nerve palsy improved. Horner's syndrome and diplopia resolved after six months. Here we present the first report of Horner's syndrome and contralateral abducens nerve palsy associated with zoster meningitis.

  3. Contralateral Noise Stimulation Delays P300 Latency in School-Aged Children.

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    Thalita Ubiali

    Full Text Available The auditory cortex modulates auditory afferents through the olivocochlear system, which innervates the outer hair cells and the afferent neurons under the inner hair cells in the cochlea. Most of the studies that investigated the efferent activity in humans focused on evaluating the suppression of the otoacoustic emissions by stimulating the contralateral ear with noise, which assesses the activation of the medial olivocochlear bundle. The neurophysiology and the mechanisms involving efferent activity on higher regions of the auditory pathway, however, are still unknown. Also, the lack of studies investigating the effects of noise on human auditory cortex, especially in peadiatric population, points to the need for recording the late auditory potentials in noise conditions. Assessing the auditory efferents in schoolaged children is highly important due to some of its attributed functions such as selective attention and signal detection in noise, which are important abilities related to the development of language and academic skills. For this reason, the aim of the present study was to evaluate the effects of noise on P300 responses of children with normal hearing.P300 was recorded in 27 children aged from 8 to 14 years with normal hearing in two conditions: with and whitout contralateral white noise stimulation.P300 latencies were significantly longer at the presence of contralateral noise. No significant changes were observed for the amplitude values.Contralateral white noise stimulation delayed P300 latency in a group of school-aged children with normal hearing. These results suggest a possible influence of the medial olivocochlear activation on P300 responses under noise condition.

  4. Protective effect of sildenafil citrate on contralateral testis injury after unilateral testicular torsion/detorsion

    OpenAIRE

    Yíldíz,Hamit; Durmus, Ali Said; Şimşek,Halil; Yaman, Mine

    2011-01-01

    OBJECTIVES: This study was designed to investigate prevention of contralateral testicular injury with sildenafil citrate after unilateral testicular torsion/detorsion. METHODS: Thirty-seven adult male rats were divided into four groups: sham operated (group 1, n = 7), torsion/detorsion + saline (group 2, n = 10), torsion/detorsion + 0.7 mg of sildenafil citrate (group 3, n = 10) and torsion/detorsion + 1.4 mg of sildenafil citrate (group 4, n = 10). Unilateral testicular torsion was created b...

  5. Case of Chronic Otitis Media with Intracranial Complication and Contralateral Extracranial Presentation

    Science.gov (United States)

    Lim, P. S.; Pua, K. C.

    2016-01-01

    Intracranial complications of chronic otitis media have been on the decline with advent of antibiotics. Septic thrombosis of the sigmoid sinus is rarer compared to commoner complications such as otogenic brain abscesses and meningitis. This patient presented with recurrent infection after left mastoidectomy secondary to cholesteatoma and a contralateral internal jugular vein thrombosis with parapharyngeal abscess, which was drained. He recovered well postoperatively with antibiotics. PMID:27668115

  6. The impact of contralateral cooling on skin capillary blood cell velocity in patients with diabetes mellitus.

    Science.gov (United States)

    Haak, E; Haak, T; Grözinger, Y; Krebs, G; Usadel, K H; Kusterer, K

    1998-01-01

    In healthy volunteers, cooling of the contralateral hand leads to a rapid decrease in the ipsilateral capillary perfusion via a nerval reflex arc. The aim of this study was to investigate whether this reflex arc after contralateral cooling might be altered in patients with diabetes mellitus with and without peripheral neuropathy. Therefore, 12 patients with diabetic neuropathy (4 IDDM, diabetes duration 17.2 +/- 2.9 (SD) years, age 60.8 +/- 4.0 years, HbA1c 6.5 +/- 0.3%) and 12 patients with diabetes mellitus but without neuropathy (6 IDDM, diabetes duration 15.1 +/- 2.7 years, age 55.9 +/- 4.5 years, HbA1c 5.4 +/- 0.1%) were investigated by nailfold capillaroscopy. Twelve healthy volunteers (age 56.8 +/- 3.1 years, HbA1c 4.8 +/- 0.2%) served as controls. Contralateral skin capillary blood cell velocity was determined at rest and during the following 20 min after cooling of the hand (3 min at 15 degreesC). Blood pressure, heart rate and local skin temperature were examined regularly during the investigation. Resting capillary blood cell velocity did not differ between patients and controls. While contralateral cooling resulted in a decrease in capillary blood cell velocity (CBV) in controls (0.29 +/- 0.05 vs. 0.42 +/- 0.05 mm/s, p nerval reflex arcs are impaired. A long-term follow-up in a larger number of patients is required to evaluate whether these findings might serve as a very early diagnostic tool for the diagnosis of developing diabetic neuropathy.

  7. Acanthamoeba and Stenotrophomonas maltophilia keratitis with fungal keratitis in the contralateral eye

    OpenAIRE

    2010-01-01

    Thomas F Mauger, Rebecca Ann Kuennen, Reynell Harder Smith, William SawyerDepartment of Ophthalmology, The Ohio State University, Columbus, OH, USAPurpose: The purpose of this study is to describe the diagnosis, course, and outcome of a case of Acanthamoeba and Stenotrophomonas keratitis with a fungal keratitis in the contralateral eye.Methods: A case of Acanthamoeba and Stenotrophomonas keratitis was diagnosed with confocal microscopy and cultures with confocal diagnosis of fungal keratitis ...

  8. Space representation for eye movements is more contralateral in monkeys than in humans

    OpenAIRE

    Kagan, Igor; Iyer, Asha; Lindner, Axel; Andersen, Richard A.

    2010-01-01

    Contralateral hemispheric representation of sensory inputs (the right visual hemifield in the left hemisphere and vice versa) is a fundamental feature of primate sensorimotor organization, in particular the visuomotor system. However, many higher-order cognitive functions in humans show an asymmetric hemispheric lateralization—e.g., right brain specialization for spatial processing—necessitating a convergence of information from both hemifields. Electrophysiological studies in monkeys and fun...

  9. Intraoperative contralateral extradural hematoma during evacuation of traumatic acute extradural hematoma

    Directory of Open Access Journals (Sweden)

    Sharma Anand

    2015-09-01

    Full Text Available Introduction: Extradural hematomas (EDHs accounts for approximately 2% of patients following head trauma and 5-15% of patients with fatal head injuries. When indicated, the standard surgical management consists of evacuation of the hematoma via craniotomy. Intraoperative development of acute extradural hematoma (AEDH on the contralateral side following evacuation of acute extradural hematoma is uncommon and very few cases have been reported.

  10. Generalized dysplasia epiphysealis hemimelica with contralateral sacro-iliac joint involvement

    Energy Technology Data Exchange (ETDEWEB)

    Karam, Adib R.; Birjawi, Ghina A.; Khoury, Nabil J. [American University of Beirut Medical Center, Department of Diagnostic Radiology, Beirut (Lebanon); Saghieh, Said [American University of Beirut Medical Center, Department of Orthopedic Surgery, Beirut (Lebanon); Tawil, Ayman [American University of Beirut Medical Center, Department of Pathology, Beirut (Lebanon)

    2008-12-15

    Dysplasia epiphysealis hemimelica (or Trevor's disease) is a rare developmental bone dysplasia characterized by benign osteocartilaginous overgrowth involving one or multiple epiphyses, usually of a single lower extremity. It is classified as localized form, classical form (most common), and generalized form. In this report we describe a case of generalized form of dysplasia epiphysealis hemimelica with involvement of the contralateral sacroiliac joint, which is an extremely rare presentation. (orig.)

  11. Treatment of phantom pain with contralateral injection into tender points: a new method of treatment

    Directory of Open Access Journals (Sweden)

    Alaa A El Aziz Labeeb

    2015-01-01

    Conclusion Contralateral injections of 1 ml of 0.25% bupivacaine in the myofascial hyperalgesic areas attenuated phantom limb pain and affected phantom limb sensation. Our study gives a basis of a new method of management of that kind of severe pain to improve the method of rehabilitation of amputee. However, further longitudinal studies with larger number of patients are needed to confirm our study.

  12. Impact of contra-lateral breast reshaping on mammographic surveillance in women undergoing breast reconstruction following mastectomy for breast cancer.

    Science.gov (United States)

    Nava, Maurizio B; Rocco, Nicola; Catanuto, Giuseppe; Falco, Giuseppe; Capalbo, Emanuela; Marano, Luigi; Bordoni, Daniele; Spano, Andrea; Scaperrotta, Gianfranco

    2015-08-01

    The ultimate goal of breast reconstruction is to achieve symmetry with the contra-lateral breast. Contra-lateral procedures with wide parenchymal rearrangements are suspected to impair mammographic surveillance. This study aims to evaluate the impact on mammographic detection of mastopexies and breast reductions for contralateral adjustment in breast reconstruction. We retrospectively evaluated 105 women affected by uni-lateral breast cancer who underwent mastectomy and immediate two-stage reconstruction between 2002 and 2007. We considered three groups according to the contra-lateral reshaping technique: mastopexy or breast reduction with inferior dermoglandular flap (group 1); mastopexy or breast reduction without inferior dermoglandular flap (group 2); no contra-lateral reshaping (group 3). We assessed qualitative mammographic variations and breast density in the three groups. Statistically significant differences have been found when comparing reshaped groups with non reshaped groups regarding parenchymal distortions, skin thickening and stromal edema, but these differences did not affect cancer surveillance. The surveillance mammography diagnostic accuracy in contra-lateral cancer detection was not significantly different between the three groups (p = 0.56), such as the need for MRI for equivocal findings at mammographic contra-lateral breast (p = 0.77) and the need for core-biopsies to confirm mammographic suspect of contra-lateral breast cancer (p = 0.90). This study confirms previous reports regarding the safety of mastopexies and breast reductions when performed in the setting of contra-lateral breast reshaping after breast reconstruction. Mammographic accuracy, sensitivity and specificity are not affected by the glandular re-arrangement. These results provide a further validation of the safety of current reconstructive paradigms. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. CONTRALATERAL SUPPRESSION OF DISTORTION PRODUCT OTOACOUSTIC EMISSION IN CHILDREN WITH AUDITORY PROCESSING DISORDERS

    Institute of Scientific and Technical Information of China (English)

    Jessica Oppee; SUN Wei; Nancy Stecker

    2014-01-01

    Previous research has demonstrated that the amplitude of evoked emissions decreases in human sub-jects when the contralateral ear is stimulated by noise. The medial olivocochlear bundle (MOCB) is be-lieved to control this phenomenon. Recent research has examined this effect in individuals with auditory pro-cessing disorders (APD), specifically with difficulty understanding speech in noise. Results showed tran-sient evoked otoacoustic emissions (TEOAEs) were not affected by contralateral stimulation in these sub-jects. Much clinical research has measured the function of the MOCB through TEOAEs.This study will use an alternative technique, distortion product otoacoustic emissions (DPOAEs), to examine this phenomenon and evaluate the function of the MOCB. DPOAEs of individuals in a control group with normal hearing and no significant auditory processing difficulties were compared to the DPOAEs of children with signifi-cant auditory processing difficulties.Results showed that the suppression effect was observed in the control group at 2 kHz with 3 kHz of narrowband noise. For the auditory processing disorders group, no significant suppression was observed.Overall, DPOAEs showed suppression with contralateral noise, while the APD group levels increased overall.These results provide further evidence that the MOCB may have reduced function in children with APD.

  14. Contralateral Cochlear Labyrinthine Concussion without Temporal Bone Fracture: Unusual Posttraumatic Consequence

    Science.gov (United States)

    Méndez, D.; Silva, J. M. Duque; del Álamo, P. Ortega

    2016-01-01

    Introduction. Labyrinthine concussion is a term used to describe a rare cause of sensorineural hearing loss with or without vestibular symptoms occurring after head trauma. Isolated damage to the inner ear without involving the vestibular organ would be designated as a cochlear labyrinthine concussion. Hearing loss is not a rare finding in head trauma that involves petrous bone fractures. Nevertheless it generally occurs ipsilateral to the side of the head injury and extraordinarily in the contralateral side and moreover without the presence of a fracture. Case Report. The present case describes a 37-year-old patient with sensorineural hearing loss and tinnitus in his right ear after a blunt head trauma of the left-sided temporal bone (contralateral). Otoscopy and radiological images showed no fractures or any abnormalities. A severe sensorineural hearing loss was found in his right ear with a normal hearing of the left side. Conclusion. The temporal bone trauma requires a complete diagnostic battery which includes a neurotologic examination and a high resolution computed tomography scan in the first place. Hearing loss after a head injury extraordinarily occurs in the contralateral side of the trauma as what happened in our case. In addition, the absence of fractures makes this phenomenon even more unusual.

  15. Ipsilateral Cerebral and Contralateral Cerebellar Hyperperfusion in Patients with Unilateral Cerebral Infarction; SPM Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Sun Pyo; Yoon, Joon Kee; Choi, Bong Hoi; Joo, In Soo; Yoon, Seok Nam [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2008-10-15

    Cortical reorganization has an important role in the recovery of stroke. We analyzed the compensatory cerebral and cerebellar perfusion change in patients with unilateral cerebral infarction using statistical parametric mapping (SPM). Fifty seven {sup 99m}Tc-Ethylene Cystein Diethylester (ECD) cerebral perfusion SPECT images of 57 patients (male/female=38/19, mean age=56{+-}17 years) with unilateral cerebral infarction were evaluated retrospectively. Patients were divided into subgroups according to the location (left, right) and the onset (acute, chronic) of infarction. Each subgroup was compared with normal controls (male/female=11/1, mean age =36{+-}10 years) in a voxel-by-voxel manner (two sample t-test, p<0.001) using SPM. All 4 subgroups showed hyperperfusion in the ipsilateral cerebral cortex, but not in the contralateral cerebral cortex. Chronic left and right infarction groups revealed hyperperfusion in the ipsilateral primary sensorimotor cortex, meanwhile, acute subgroups did not. Contralateral cerebellar hyperperfusion was also demonstrated in the chronic left infarction group. Using {sup 99m}Tc-ECD SPECT, we observed ipsilateral cerebral and contralateral cerebeller hyperperfusion in patients with cerebral infarction. However, whether these findings are related to the recovery of cerebral functions should be further evaluated.

  16. The benefit of image guidance for the contralateral interhemispheric approach to the lateral ventricle.

    Science.gov (United States)

    Fronda, Chiara; Miller, Dorothea; Kappus, Christoph; Bertalanffy, Helmut; Sure, Ulrich

    2008-06-01

    Recently, neurosurgeons have increasingly faced small intracerebral lesions in asymptomatic or minimally symptomatic patients. Here, we evaluated a series of four patients with nearly asymptomatic intraventricular tumors close to the corpus callosum that had been treated with the aid of an image-guided transcallosal approach. Four consecutive patients suffering from left intra- and paraventricular tumors were operated on via a contralateral interhemispheric transcallosal approach with the aid of neuronavigation. Our image-guided system directed: (1) the skin incision, (2) the interhemispheric dissection, and (3) the incision of the corpus callosum. Using the image-guided contralateral interhemispheric transcallosal approach to the left ventricle all lesions have been completely resected without the risk of damage to the dominant hemisphere. The callosal incision was kept as limited as possible (1.2-2.1cm) depending on the size of the tumor. No postoperative neurological or neuropsychological deficit was observed in our series. Neuronavigation facilitates a safe and targeted contralateral interhemispheric transcallosal approach to the dominant hemisphere's lateral ventricle. Our technique minimizes the risk of damage to the dominant hemisphere and requires only a limited opening of the corpus callosum, which might decrease the risk of neuropsychological morbidity.

  17. Automated contralateral subtraction of dental panoramic radiographs for detecting abnormalities in paranasal sinus

    Science.gov (United States)

    Hara, Takeshi; Mori, Shintaro; Kaneda, Takashi; Hayashi, Tatsuro; Katsumata, Akitoshi; Fujita, Hiroshi

    2011-03-01

    Inflammation in the paranasal sinus is often observed in seasonal allergic rhinitis or with colds, but is also an indication for odontogenic tumors, carcinoma of the maxillary sinus or a maxillary cyst. The detection of those findings in dental panoramic radiographs is not difficult for radiologists, but general dentists may miss the findings since they focus on treatments of teeth. The purpose of this work is to develop a contralateral subtraction method for detecting the odontogenic sinusitis region on dental panoramic radiographs. We developed a contralateral subtraction technique in paranasal sinus region, consisting of 1) image filtering of the smoothing and sobel operation for noise reduction and edge extraction, 2) image registration of mirrored image by using mutual information, and 3) image display method of subtracted pixel data. We employed 56 cases (24 normal and 32 abnormal). The abnormal regions and the normal cases were verified by a board-certified radiologist using CT scans. Observer studies with and without subtraction images were performed for 9 readers. The true-positive rate at a 50% confidence level in 7 out of 9 readers was improved, but there was no statistical significance in the difference of area-under-curve (AUC) in each radiologist. In conclusion, the contralateral subtraction images of dental panoramic radiographs may improve the detection rate of abnormal regions in paranasal sinus.

  18. Population-based study of contralateral prophylactic mastectomy and survival outcomes of breast cancer patients.

    Science.gov (United States)

    Bedrosian, Isabelle; Hu, Chung-Yuan; Chang, George J

    2010-03-17

    Despite increased demand for contralateral prophylactic mastectomy (CPM), the survival benefit of this procedure remains uncertain. We used the Surveillance, Epidemiology, and End Results database to identify 107 106 women with breast cancer who had undergone mastectomy for treatment between 1998 and 2003 and a subset of 8902 women who also underwent CPM during the same period. Associations between predictor variables and the likelihood of undergoing CPM were evaluated by use of chi(2) analyses. Risk-stratified (estrogen receptor [ER] status, stage, and age) adjusted survival analyses were performed by using Cox regression. Statistical tests were two-sided. In a univariate analysis, CPM was associated with improved disease-specific survival (hazard ratio [HR] of death = 0.63, 95% confidence interval [CI] = 0.57 to 0.69; P mastectomy also had a lower overall risk for contralateral breast cancer than women with ER-negative tumors (0.46% vs 0.90%, difference = 0.44%; P < .001). CPM is associated with a small improvement in 5-year breast cancer-specific survival mainly in young women with early-stage ER-negative breast cancer. This effect is related to a higher baseline risk of contralateral breast cancer.

  19. Fatores que influenciam na interrupção do aleitamento materno exclusivo em nutrizes

    Directory of Open Access Journals (Sweden)

    Luna Jamile Xavier Amaral

    Full Text Available RESUMO Objetivo Identificar os fatores que podem influenciar as nutrizes na interrupção do aleitamento materno exclusivo durante os primeiros seis meses de vida do lactente. Método Pesquisa descritiva, exploratória, qualitativa. As informações foram coletadas por meio de entrevista semiestruturada com 14 mulheres que estavam em aleitamento materno e realizaram pré-natal em Unidades Básicas de Saúde da Família no município de Campina Grande-PB, no período de abril a maio de 2013. Os dados foram tratados pela técnica de Análise de Conteúdo de Bardin. Resultados Pouco conhecimento das nutrizes em relação ao vínculo afetivo do binômio, à redução dos gastos da família com a alimentação da criança e ao risco de hemorragias no pós-parto; crença na produção insuficiente de leite; dificuldade de pega da mama; e diversas intercorrências mamárias no pós-parto. Conclusões É necessário expandir as orientações e o apoio ao AM com vistas principalmente ao apoio às nutrizes nas primeiras semanas pós-parto.

  20. Incidence of occult contralateral carcinomas of the breast following mastoplasty aimed at symmetrization.

    Science.gov (United States)

    Sorin, T; Fyad, J-P; Pujo, J; Colson, T; Bordes, V; Leroux, A; Marchal, F; Brix, M; Simon, E; Verhaeghe, J-L; Classe, J-M; Dolivet, G

    2014-04-01

    Breast carcinomas are the most frequent form of cancer in French women. Following a total mastectomy, only an estimated 25% of patients wish to undergo breast reconstruction. After mammary volume reconstitution, the plastic surgeon often attempts to harmonize the two breasts by carrying out contralateral reduction mammaplasty (CRM). In the literature, the incidence of occult contralateral carcinomas incidentally discovered in surgical specimens ranges from 1.12 to 4.5%. The main objective of this study was to evaluate occurrence of carcinoma in the CRM specimens in the framework of a breast reconstruction operation. The secondary objective was to determine the consequences of the incidentally discovered carcinoma in the contralateral breast. This was a 6-year, bicentric, retrospective study involving women having undergone breast cancer surgery who later underwent contralateral reduction mammaplasty (CRM), that is to say reconstruction aimed at harmonization of the two breasts. Three hundred and nineteen patients were included in the study. Mean age during the CRM was 55years (29-79). Mean weight of the surgical specimens was 323grams (12-2500). Incidence of occult carcinomas found in the specimens was 0.94% (3 patients). The mean age for these 3 cases was 58years (47-64). All 3 patients had superior pedicle mammaplasty. One of the patients benefited from monobloc resection with orientation of the surgical specimen. In the other 2 cases, there existed 3 surgical resection specimens; in one case, they were oriented; in the other, they were not. In all 3 cases, the histological findings were unifocal ductal carcinomas in situ (DCIS). Mean tumor size was 5.7mm (3-9). Only the patient having had monobloc resection with orientation of the specimen underwent salvage surgery, which consisted in partial mastectomy, otherwise known as secondary lumpectomy. Adjuvant radiotherapy was administered to all of the patients. After 17months of mean follow-up (12-22), no recurrence

  1. Prior contralateral amputation predicts worse outcomes for lower extremity bypasses performed in the intact limb

    Science.gov (United States)

    Baril, Donald T.; Goodney, Philip P.; Robinson, William P.; Nolan, Brian W.; Stone, David H.; Li, YouFu; Cronenwett, Jack L.; Schanzer, Andres

    2013-01-01

    Introduction To date, history of a contralateral amputation as a potential predictor of outcomes after lower extremity bypass (LEB) for critical limb ischemia (CLI) has not been studied. We sought to determine if a prior contralateral lower extremity amputation predicts worse outcomes in patients undergoing LEB in the remaining intact limb. Methods A retrospective analysis of all patients undergoing infrainguinal LEB for CLI between 2003 and 2010 within hospitals comprising the Vascular Study Group of New England was performed. Patients were stratified according to whether or not they had previously undergone a contralateral major or minor amputation before LEB. Primary end points included major amputation and graft occlusion at 1 year postoperatively. Secondary end points included in-hospital major adverse events, discharge status, and mortality at 1 year. Results Of 2636 LEB procedures, 228 (8.6%) were performed in the setting of a prior contralateral amputation. Patients with a prior amputation compared to those without were younger (66.5 vs 68.7; P = .034), more like to have congestive heart failure (CHF; 25% vs 16%; P = .002), hypertension (94% vs 85%; P = .015), renal insufficiency (26% vs 14%; P = .0002), and hemodialysis-dependent renal failure (14% vs 6%; P = .0002). They were also more likely to be nursing home residents (8.0% vs 3.6%; P = .036), less likely to ambulate without assistance (41% vs 80%; P amputation experienced increased rates of graft occlusion (38% vs 17%; P amputation (16% vs 7%; P amputation was an independent predictor of both major amputation (odds ratio, 1.73; confidence interval, 1.06–2.83; P = .027) and graft occlusion (odds ratio, 1.93; confidence interval, 1.39–2.68; P amputations who present with CLI in the intact limb represent a high-risk population, even among patients with advanced peripheral arterial disease. When considering LEB in this setting, both physicians and patients should expect increased rates of

  2. Realidades e controvérsias em relação ao conceito psicanalítico de autismo normal

    Directory of Open Access Journals (Sweden)

    Maria Izabel Tafuri

    2003-12-01

    Full Text Available Neste trabalho discute-se a evolução do pensamento psicanalítico a partir da noção de autismo normal e sua posterior refutação, feita por Tustin, em 1991. A proposta de refutação pode ser vista como perpetuação de outro erro: a imprecisão conceitual criada por Mahler desde a definição original do termo. Tustin restringiu, à moda de Mahler, a noção de satisfação autística do lactente na “casca do ovo” à de autismo normal.Dessa forma, a refutação do autismo normal recai na mesma problemáticagerada por Bleuler e Kanner: a subtração de Eros do conceito de auto-erotismo.

  3. Carcinoma in situ of contralateral testis in patients with testicular germ cell cancer: study of 27 cases in 500 patients

    DEFF Research Database (Denmark)

    von der Maase, H; Rørth, M; Walbom-Jørgensen, S

    1986-01-01

    Carcinoma in situ in the contralateral testis was diagnosed in 27 of 500 patients (5.4%) with unilateral testicular germ cell cancer. Eight of the 27 patients received intensive chemotherapy for spread of their initial testicular cancer. Follow up biopsy studies did not detect changes of carcinoma...... in situ in any of these patients, and none developed a contralateral testicular tumour (observation time 12-88 months). Of the remaining 19 patients with carcinoma in situ, seven developed contralateral testicular cancer. The estimated risk of developing invasive growth was 40% within three years and 50......% within five years. None of the 473 patients without carcinoma in situ detected by screening biopsy developed contralateral testicular cancer (observation time 12-96 months). No serious complications arose from the biopsy procedures. All patients with unilateral testicular germ cell cancer should...

  4. Problematic parent-infant relationships in two-parent families: prevalence and risk factors in a Brazilian neighborhood Relações problemáticas entre pais e criança em famílias com pai e mãe: prevalência e fatores de risco em um bairro brasileiro

    Directory of Open Access Journals (Sweden)

    Olga Garcia Falceto

    2012-09-01

    investigar a prevalência e os fatores de risco de diferentes tipos de relações entre pais e lactentes em um bairro brasileiro. Métodos: Durante 1 ano, todas as famílias (n = 230 residentes em uma comunidade urbana de Porto Alegre, sul do Brasil, com filhos de 4 meses de idade nascidos em hospitais públicos foram identificadas, e 148 foram investigadas em detalhe por dois terapeutas familiares. Este estudo descreve os dados dos 116 lactentes com famílias formadas por pai e mãe. Variáveis demográficas, obstétricas e relacionais foram coletadas através de questionários e escalas (Parent-Infant Relationship Global Assessment Scale, Global Assessment of Relational Functioning e Self-Report Questionnaire. Razões de prevalência foram calculadas, e a regressão de Poisson com variância robusta foi utilizada para ajuste de covariáveis. Resultados: Quase 10% das mães e 12% dos pais mostraram pelo menos uma relação significativamente perturbada com seus lactentes de 4 meses de idade. Vínculo inadequado entre mãe e lactente coincidiu com evidências de transtorno mental paterno, uma rede social de apoio insatisfatória por parte da mãe e interrupção do aleitamento materno aos 4 meses. Relação problemática entre o pai e o lactente associou-se com relação disfuncional do casal e com baixo peso do lactente ao nascimento. Conclusões: Há uma alta prevalência de problemas nas relações precoces entre pais e filho, sugerindo a necessidade de intervenções do sistema de saúde. Problemas relacionais pais-filho são altamente prevalentes logo no início na vida do lactente e são mais associados a outros problemas relacionais do que a sobrecarga socioeconômica.

  5. Increased risk of carcinoma in situ in patients with testicular germ cell cancer with ultrasonic microlithiasis in the contralateral testicle

    DEFF Research Database (Denmark)

    Holm, Mette; Hoei-Hansen, Christina E; Rajpert-De Meyts, Ewa

    2003-01-01

    We compared clinical and histological data regarding the contralateral testicle in a population of men diagnosed with testicular germ cell cancer to find features associated with an increased risk of bilateral neoplasia.......We compared clinical and histological data regarding the contralateral testicle in a population of men diagnosed with testicular germ cell cancer to find features associated with an increased risk of bilateral neoplasia....

  6. Bulectomia bilateral por cirurgia torácica vídeo-assistida uniportal combinada com acesso contralateral ao mediastino anterior Bilateral bullectomy through uniportal video-assisted thoracoscopic surgery combined with contralateral access to the anterior mediastinum

    Directory of Open Access Journals (Sweden)

    Nan Song

    2013-02-01

    Full Text Available OBJETIVO: A cirurgia torácica vídeo-assistida (CTVA tem sido uma intervenção de escolha para o tratamento de pneumotórax espontâneo (PS com bolha pulmonar. Nosso objetivo foi apresentar uma abordagem de CTVA uniportal unilateral para bulectomia bilateral e avaliar sua eficácia terapêutica. MÉTODOS: Entre maio de 2011 e janeiro de 2012, cinco pacientes foram submetidos a bulectomia bilateral por essa abordagem. Todos apresentavam PS bilateral. A TCAR pré-operatória mostrou que todos os pacientes tinham bolhas bilaterais no pulmão apical. As indicações cirúrgicas, os procedimentos de operação e os desfechos foram revisados. RESULTADOS: Todos os pacientes foram submetidos com sucesso a essa abordagem para bulectomia bilateral, sem complicações intraoperatórias. A mediana de tempo para a retirada do dreno torácico foi de 4,2 dias, e a mediana do tempo de hospitalização no pós-operatório foi de 5,2 dias. A mediana de seguimento pós-operatório foi de 11,2 meses. Um paciente teve recidiva de PE do lado esquerdo três semanas após a cirurgia e foi submetido a abrasão pleural. CONCLUSÕES: A bulectomia bilateral utilizando CTVA uniportal combinada com acesso contralateral ao mediastino anterior é tecnicamente confiável e promove desfechos favoráveis para pacientes com PS que desenvolvem bolhas bilaterais no pulmão apical. Entretanto, para a realização desse procedimento cirúrgico, são necessários cirurgiões com experiência em CTVA, instrumentos toracoscópicos longos, entre outras exigências.OBJECTIVE: Video-assisted thoracoscopic surgery (VATS has been a surgical intervention of choice for the treatment of spontaneous pneumothorax (SP with lung bulla. Our objective was to introduce a uniportal VATS approach for simultaneous bilateral bullectomy and to evaluate its therapeutic efficacy. METHODS: Between May of 2011 and January of 2012, five patients underwent bilateral bullectomy conducted using this approach. All

  7. Cardiac tamponade in an infant during contrast infusion through central venous catheter for chest computed tomography; Tamponamento cardiaco durante infusao de contraste em acesso venoso central para realizacao de tomografia computadorizada do torax em lactente

    Energy Technology Data Exchange (ETDEWEB)

    Daud, Danilo Felix; Campos, Marcos Menezes Freitas de; Fleury Neto, Augusto de Padua [Hospital Geral de Palmas, TO (Brazil)

    2013-11-15

    Complications from central venous catheterization include infectious conditions, pneumothorax, hemothorax and venous thrombosis. Pericardial effusion with cardiac tamponade hardly occurs, and in infants is generally caused by umbilical catheterization. The authors describe the case of cardiac tamponade occurred in an infant during chest computed tomography with contrast infusion through a central venous catheter inserted into the right internal jugular vein. (author)

  8. Hip dislocation in cerebral palsy: evolution of the contralateral side after reconstructive surgery

    Directory of Open Access Journals (Sweden)

    João Caetano Munhoz Abdo

    2016-06-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the progression of the contralateral hip after unilateral reconstruction of hip dislocation in patients classified as GMFCS IV-V; and to identify potential prognostic factors for their evolution. METHODS: This was a retrospective study on 17 patients with spastic cerebral palsy, who were classified on the GMFCS scale (Gross Motor Functional Classification System as degrees IV and V, and who underwent unilateral reconstruction surgery to treat hip dislocation (adductor release, femoral varus osteotomy and acetabuloplasty. The minimum postoperative follow-up was 30 months. The clinical parameters evaluated were sex, age at time of surgery, length of follow-up after surgery and range of abduction. The treatment parameters were use/nonuse of femoral shortening, application of botulinum toxin and any previous muscle releases. The radiographic parameters were Reimer's extrusion index (REI, acetabular angle (AA and the continuity of Shenton's line. RESULTS: Among the 17 patients evaluated, eight presented dislocation (group I and nine did not (group II. Group I comprised three males and five females; group II comprised one male and eight females. The mean age at the time of surgery among the group I patients was 62 months and the mean follow-up was 62 months. In group II, these were 98 and 83 months, respectively. There was a trend in which patients of greater age did not evolve with contralateral dislocation. Among the nine patients with the combination of REI < 30% and AA < 25°, only one presented dislocation during the follow-up. Contralateral subluxation occurred within the first two years after the surgery. CONCLUSION: Hips presenting REI < 30° and AA < 25° do not tend to evolve to subluxation and can be kept under observation. Preoperative clinical and radiographic measurements alone are not useful for indicating the natural evolution of non- operated hips. The critical period for subluxation is the first two

  9. Contralateral reversed distal femoral locking plate for fixation of subtrochanteric femoral fractures

    Institute of Scientific and Technical Information of China (English)

    Paritosh Gogna; Reetadyuti Mukhopadhyay; Amanpreet Singh; Ashish Devgan; Sahil Arora; Amit Batra; Sushil Kumar Yadav

    2015-01-01

    Purpose:Subtrochanteric fractures of the femur are being managed successfully with various intramedullary and extramedulary implants with reasonable success.However,these implants require precise placement under image intensifier guidance,which exposes the surgeon to substantial amount of radiation.It also restricts the management of these fractures at peripheral centers where facility of image intensifiers is not available.Keeping this in mind we designed this study to identify if contralateral reversed distal femoral locking plate can be used successfully without the use of image intensifier.Methods:Twenty-four consecutive patients (18 men and 6 women) with a mean age of 28 years (range 19-47 years) suffering subtrochanteric fractures of the femur underwent open reduction and internal fixation with reversed contralateral distal femoral locking plate.The outcome was assessed at the mean follow-up period of 3.2 years (range 2-4.6 years) using the Harris hip score.Results:Twenty-one fractures united with the primary procedure,with a mean time of consolidation being 11 weeks (range,9-16 weeks).One patient developed superficial suture line infection,which resolved with oral antibiotics.Another patient had a fall 3 weeks after surgery and broke the plate.Repeat surgery with reversed distal femoral locking compression plate was performed along with bone grafting and the fracture united.Two cases had nonunion,which went in for union after bone grafting.The mean Harris hip score at the time of final follow-up was 90.63 (range 82-97).Conclusion:The reversed contralateral distal femoral plate is a biomechanically sound implant,which when used for fixation of the subtrochanteric fractures with minimal soft tissue stripping shows results comparable to those achieved by using other extramedullary implants as well as intramedullary devices.The added advantage of this implant is its usability in the absence of an image intensifier.

  10. Contralateral adrenal suppression on adrenocortical scintigraphy provides good evidence showing subclinical cortisol overproduction from unilateral adenomas.

    Science.gov (United States)

    Katabami, Takuyuki; Ishii, Satoshi; Obi, Ryusei; Asai, Shiko; Tanaka, Yasushi

    2016-12-30

    Unilateral and/or predominant uptake on adrenocortical scintigraphy (ACS) may be related to autonomous cortisol overproduction in patients with subclinical Cushing's syndrome (SCS). However, there is no information regarding whether increased tracer uptake on the tumor side or decreased uptake on the contralateral side on ACS is more greatly associated with inappropriate cortisol production. Therefore, we evaluated the relationship between quantitative (131)I-6β-iodomethyl-norcholesterol ((131)I-NP-59) uptake in both adrenal glands and parameters of autonomic cortisol secretion and attempted to set a cut off for SCS detection. The study included 90 patients with unilateral adrenal adenoma who fulfilled strict criteria. The diagnosis of SCS was based on serum cortisol ≥3.0 μg/dL after 1-mg dexamethasone suppression test (DST) with at least 1 other hypothalamus-pituitary-adrenal axis function abnormality. Twenty-two (27.7%) subjects were diagnosed with SCS. The uptake rate on the affected side in the SCS group was comparable to that in the non-functioning adenoma group. In contrast, the uptake rate on the contralateral side was lower and the laterality ratio significantly higher in the SCS group. The two ACS indices were correlated with serum cortisol levels after a 1-mg DST, but uptake on the tumor side was not. Tumor size was also important for the functional statuses of adrenal tumors and NP-59 imaging patterns. The best cut-off point for the laterality ratio to detect SCS was 3.07. These results clearly indicate that contralateral adrenal suppression in ACS is good evidence showing subclinical cortisol overproduction.

  11. [Contralateral aneurysm-like adrenal gland metastasis of a renal adenocarcinoma].

    Science.gov (United States)

    Joual, A; Patard, J J; Chopin, D; Abbou, C C

    1998-02-01

    The authors report a case of adrenal metastasis contralateral to a renal cell carcinoma in a 74-year-old patient who had undergone right radical nephrectomy for renal cell carcinoma. Nine months later, computed tomography revealed a hypervascular mass considered to be an aneurysm of the splenic artery. Arteriography led to the diagnosis of hypervascular adrenal tumour. Left adrenalectomy was performed. Histological examination showed a metastasis from renal cell carcinoma. This is an unusual form of renal cancer metastasis. Its treatment and prognosis are discussed.

  12. Ipsilateral hemiparesis and contralateral lower limb paresis caused by anterior cerebral artery territory infarct.

    Science.gov (United States)

    Xu, Yongfeng; Liu, Lan

    2016-07-01

    Ipsilateral hemiparesis is rare after a supratentorial stroke, and the role of reorganization in the motor areas of unaffected hemisphere is important for the rehabilitation of the stroke patients. In this study, we present a patient who had a subclinical remote infarct in the right pons developed ipsilateral hemiparesis and contralateral lower limb paresis caused by a new infarct in the left anterior cerebral artery territory. Our case suggests that the motor areas of the unaffected hemisphere might be reorganized after stroke, which is important for the rehabilitation of stroke patients.

  13. Simultaneous traumatic rupture of the patellar tendon and the contralateral quadriceps tendon in a healthy individual.

    Science.gov (United States)

    Kumar, S; Rachakatla, N; Kerin, C; Kumar, R

    2010-11-05

    A simultaneous traumatic complete rupture of the patellar tendon and the contralateral quadriceps tendon is reported to occur in patients with renal failure and other inflammatory diseases, but is extremely rare in a healthy individual because of the different contributory factors and mechanisms of injury. We present a rare case report of such a combination of injuries in a 48-year-old healthy man. To our knowledge only three such cases have been reported in the English literature. This is an unusual combination and hence there is potential for missed diagnosis leading to suboptimal treatment.

  14. Changes in the contralateral eye in uncomplicated persistent hyperplastic primary vitreous in adults.

    Science.gov (United States)

    Awan, K J; Humayun, M

    1985-02-15

    In two adults (a 62-year-old man and a 71-year-old woman) uncomplicated full-blown unilateral persistent hyperplastic primary vitreous was diagnosed on the basis of characteristic clinical features and ultrasonography. In the contralateral uninvolved eyes, we found open-angle glaucoma, anomalous blood vessels along the entire circumference of the anterior chamber angle, band keratopathy, and heterochromia iridis. The axial length of one involved eye was about 0.85 mm larger than that of the uninvolved eye.

  15. Functionality of the contralateral biceps femoris reflex response during human walking

    DEFF Research Database (Denmark)

    Stevenson, Andrew James Thomas; Geertsen, Svend Sparre; Sinkjaer, Thomas

    2014-01-01

    In this study we examined the functionality of the contralateral biceps femoris (cBF) reflex response following ipsilateral knee extension joint rotations during the late stance phase of the gait cycle [1]. Stevenson et al. [1] proposed that the cBF reflex acts to slow the forward progression...... the treadmill velocity was altered concurrently or 50 ms after knee perturbation onset. These results, together with the finding that the cBF reflex response is under some cortical control [1], strongly suggest a functional role for the cBF reflex during walking that is adaptable to the environmental situation....

  16. Implante uretero-vesical em ratos

    OpenAIRE

    Tucci Jr. Silvio; Cologna Adauto José; Suaid Haylton Jorge; Martins Sandra L. Balero Penharvel; Mazzetto Sebastião Assis; Martins Antonio Carlos Pereira

    2000-01-01

    Apresentar os resultados obtidos com técnica de implante ureterovesical em ratos após obstrução ureteral ipsilateral. Treze ratos foram submetidos à obstrução ureteral distal à direita e, após uma semana, realizou-se o implante desse ureter na bexiga seguido da nefrectomia contralateral. No período de observação de 4 semanas foram estudados os níveis séricos semanais de uréia e creatinina e, na quarta semana, foi realizada cistografia para pesquisa de refluxo vésico-ureteral. Nove animais sob...

  17. Contralateral breast doses depending on treatment set-up positions for left-sided breast tangential irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Chan Seong; Park, Su Yeon; Kim, Jong Sik; Choi, Byeong Gi; Chung, Yoon Sun; Park, Won [Dept. of Radiation Oncology, Samsung Seoul Hospital, Seoul (Korea, Republic of)

    2015-12-15

    To evaluate Contralateral Breast Doses with Supine and Prone Positions for tangential Irradiation techniques for left-sided breast Cancer We performed measurements for contralateral doses using Human Phantom at each other three plans (conventional technique, Field-in-Field, IMRT, with prescription of 50 Gy/25fx). For the measurement of contralateral doses we used Glass dosimeters on the 4 points of Human Phantom surface (0 mm, 10 mm, 30 mm, 50 mm). For the position check at every measurements, we had taken portal images using EPID and denoted the incident points on the human phantom for checking the constancy of incident points. The contralateral doses in supine position showed a little higher doses than those in prone position. In the planning study, contralateral doses in the prone position increased mean doses of 1.2% to 1.8% at each positions while those in the supine positions showed mean dose decreases of 0.8% to 0.9%. The measurements using glass dosimeters resulted in dose increases (mean: 2.7%, maximum: 4% of the prescribed dose) in the prone position. In addition, the delivery techniques of Field-in-field and IMRT showed mean doses of 3% higher than conventional technique. We evaluated contralateral breast doses depending on different positions of supine and prone for tangential irradiations. For the phantom simulation of set-up variation effects on contralateral dose evaluation, although we used humanoid phantom for planning and measurements comparisons, it would be more or less worse set-up constancy in a real patient. Therefore, more careful selection of determination of patient set-up for the breast tangential irradiation, especially in the left-sided breast, should be considered for unwanted dose increases to left lung and heart. In conclusion, intensive patient monitoring and improved patient set-up verification efforts should be necessary for the application of prone position for tangential irradiation of left-sided breast cancer.

  18. Shrinkage of ipsilateral taste buds and hyperplasia of contralateral taste buds following chorda tympani nerve transection

    Directory of Open Access Journals (Sweden)

    Yi-ke Li

    2015-01-01

    Full Text Available The morphological changes that occur in the taste buds after denervation are not well understood in rats, especially in the contralateral tongue epithelium. In this study, we investigated the time course of morphological changes in the taste buds following unilateral nerve transection. The role of the trigeminal component of the lingual nerve in maintaining the structural integrity of the taste buds was also examined. Twenty-four Sprague-Dawley rats were randomly divided into three groups: control, unilateral chorda tympani nerve transection and unilateral chorda tympani nerve transection + lingual nerve transection. Rats were allowed up to 42 days of recovery before being euthanized. The taste buds were visualized using a cytokeratin 8 antibody. Taste bud counts, volumes and taste receptor cell numbers were quantified and compared among groups. No significant difference was detected between the chorda tympani nerve transection and chorda tympani nerve transection + lingual nerve transection groups. Taste bud counts, volumes and taste receptor cell numbers on the ipsilateral side all decreased significantly compared with control. On the contralateral side, the number of taste buds remained unchanged over time, but they were larger, and taste receptor cells were more numerous postoperatively. There was no evidence for a role of the trigeminal branch of the lingual nerve in maintaining the structural integrity of the anterior taste buds.

  19. Protective effect of sildenafil citrate on contralateral testis injury after unilateral testicular torsion/detorsion

    Directory of Open Access Journals (Sweden)

    Hamit Yíldíz

    2011-01-01

    Full Text Available OBJECTIVES: This study was designed to investigate prevention of contralateral testicular injury with sildenafil citrate after unilateral testicular torsion/detorsion. METHODS: Thirty-seven adult male rats were divided into four groups: sham operated (group 1, n = 7, torsion/detorsion + saline (group 2, n = 10, torsion/detorsion + 0.7 mg of sildenafil citrate (group 3, n = 10 and torsion/detorsion + 1.4 mg of sildenafil citrate (group 4, n = 10. Unilateral testicular torsion was created by rotating the right testis 720º in a clockwise direction for 2 h in other groups, except for group 1, which was served as sham group. After torsion (2 h and detorsion (2 h periods, rats were killed. RESULTS: The level of reduced glutathion (GSH (p0.05. Histopathological changes were detected in groups 2, 3 and 4. CONCLUSION: These results suggest that biochemically and histologically torsion/detorsion injury occurs in the contralateral testis following 2-h torsion and 2-h detorsion and that administration of low-dose sildenafil citrate before detorsion prevents ischemia/reperfusion cellular damage in testicular tissue.

  20. System identification algorithm analysis of acupuncture effect on mean blood flux of contralateral hegu acupoint.

    Science.gov (United States)

    Wang, Guangjun; Han, Jianguo; Litscher, Gerhard; Zhang, Weibo

    2012-01-01

    Background. Acupoints (belonging to 12 meridians) which have the same names are symmetrically distributed on the body. It has been proved that acupoints have certain biological specificities different from the normal parts of the body. However, there is little evidence that acupoints which have the same name and are located bilaterally and symmetrically have lateralized specificity. Thus, researching the lateralized specificity and the relationship between left-side and right-side acupuncture is of special importance. Methodology and Principal Findings. The mean blood flux (MBF) in both Hegu acupoints was measured by Moor full-field laser perfusion imager. With the method of system identification algorithm, the output distribution in different groups was acquired, based on different acupoint stimulation and standard signal input. It is demonstrated that after stimulation of the right Hegu acupoint by needle, the output value of MBF in contralateral Hegu acupoint was strongly amplified, while after acupuncturing the left Hegu acupoint, the output value of MBF in either side Hegu acupoint was amplified moderately. Conclusions and Significance. This paper indicates that the Hegu acupoint has lateralized specificity. After stimulating the ipsilateral Hegu acupoint, symmetry breaking will be produced in contrast to contralateral Hegu acupoint stimulation.

  1. Generalized seizures and transient contralateral hemiparesis following retrobulbar anesthesia: a case report.

    Science.gov (United States)

    Dettoraki, Maria; Dimitropoulou, Chrisafoula; Nomikarios, Nikolaos; Moschos, Marilita M; Brοuzas, Dimitrios

    2015-07-28

    Retrobulbar block is a local anesthetic technique widely used for intraocular surgery. Although retrobulbar anesthesia is considered to be relatively safe, a number of serious adverse events have been reported. To our knowledge, immediate onset of generalized seizures with contralateral hemiparesis after retrobulbar anesthesia has not been reported. A 62-year-old Caucasian healthy male with a right eye retinal detachment was admitted for pars plana vitrectomy. During retrobulbar anesthesia with ropivacaine and before needle withdrawal, the patient developed twitching of the face which rapidly progressed to generalized tonic-clonic seizures. Arterial oxygen saturation decreased to 75 %. Chin lift was performed and 100 % oxygen was administrated via face mask, which increased saturation to 99 %. Midazolam 2 mg was administrated intravenously to control seizures. After cessation of seizures, left-sided hemiparesis was evident. Brain computed tomography and electroencephalogram were normal 3 h later. The patient underwent pars plana vitrectomy under general anesthesia 4 days later. Serious complications of local anesthesia for ophthalmic surgery are uncommon. We present a case in which generalized tonic-clonic seizures developed during retrobulbar anesthesia, followed by transient contralateral hemiparesis. The early onset of seizures indicated intra-arterial injection of the anesthetic. Our case suggested the need for close monitoring during the performance of retrobulbar anesthesia and the presence of well-trained personnel for early recognition and immediate management of the complications.

  2. Contralateral breast cancer adjacent to a fibroadenoma: report of a case.

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    Iwamoto, Miki; Takei, Hiroyuki; Iida, Shinya; Yamashita, Kouji; Yanagihara, Keiko; Kurita, Tomoko; Tsuchiya, Shinichi; Kanazawa, Yoshikazu; Uchida, Eiji

    2014-01-01

    A 64-year-old woman noticed a lump of the right breast and consulted our outpatient clinic. She had undergone multiple excisional biopsies of fibroadenomas in both breasts and mastectomy for invasive ductal carcinoma (IDC) of the left breast. After completing 5 years of treatment with adjuvant tamoxifen, she had undergone screening with annual physical examinations and occasional computed tomography. She was declared recurrence-free 13 years after breast cancer surgery, although lumps were detected in the right breast, probably due to fibroadenomas. Mammography, ultrasonography, and magnetic resonance imaging revealed that the lump was irregularly shaped, 2 cm in diameter, and adjacent to a fibroadenoma with macrocalcification. Two axillary lymph nodes were enlarged and suggestive of metastasis. A core needle biopsy revealed IDC of the right breast. She underwent a right partial mastectomy with axillary lymph node dissection. The IDC was 2 cm in diameter, of nuclear grade 2, and adjacent to a 0.7-cm fibroadenoma with a macrocalcification. The margins of the IDC close to the fibroadenoma were clearly demarcated by the fibrous capsule of the fibroadenoma. Four axillary lymph nodes were positive for metastasis. In the present case the presence of fibroadenoma might have interfered with the early detection of the contralateral IDC. The history of multiple excisions of fibroadenomas and mastectomy for breast cancer suggests an increased risk of contralateral breast cancer for the patient's entire life; therefore, regular annual follow-up, such as physical examinations and mammography, is recommended.

  3. Varicella-Zoster Virus Keratitis with Asymptomatic Conjunctival Viral Shedding in the Contralateral Eye

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    Akio Miyakoshi

    2012-10-01

    Full Text Available Purpose: To report a case of varicella-zoster virus (VZV keratitis with detection of VZV DNA in the tear fluid of not only the symptomatic eye but also the contralateral asymptomatic eye by polymerase chain reaction (PCR. Methods: This is a case report. A 63-year-old otherwise healthy woman presented with circular corneal ulcer and stromal opacity with infiltration accompanied by mild conjunctival and ciliary injections in the left eye. Bacterial cultures of the corneal scrapings and virus PCR analyses of tear fluid from both eyes were performed. Results: No pathogen was found by bacterial cultures. PCR was negative for Acanthamoeba, herpes simplex virus and cytomegalovirus, but positive for VZV. VZV DNA was also detected in the unaffected eye. Based on the diagnosis of VZV keratitis, oral valacyclovir and acyclovir eye ointment were administered to the corneal infected eye. The infected eye was healed and VZV DNA turned negative in the tear fluid of the treated eye after 6 months of treatment; however, VZV DNA was still positive in the tear fluid of the contralateral eye. Conclusions: To our knowledge, this is the first case report of the detection of VZV DNA in the tear fluid of both affected and unaffected eyes in a patient with VZV keratitis. Asymptomatic conjunctival shedding of VZV may continue in the healthy unaffected eye in VZV keratitis patients.

  4. [Lower limb salvage with a free fillet fibula flap harvested from the contralateral amputated leg].

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    Bouyer, M; Corcella, D; Forli, A; Mesquida, V; Semere, A; Moutet, F

    2015-06-01

    We report a unusual case of "fillet flap" to reconstruct the lower limb with the amputated contralateral leg. This kind of procedure was first described by Foucher et al. in 1980 for traumatic hand surgery as the "bank finger". A 34-year-old man suffered a microlight accident with bilateral open legs fractures. A large skin defect of the left leg exposed the ankle, the calcaneus and a non-vascularized part of the tibial nerve (10 cm). The patient came to the OR for surgical debridement and had massive bone resection of the left calcaneus. The right leg showed limited skin defect at the lower part, exposing the medial side of the ankle and a tibial bone defect, measuring 10 cm. Salvage the left leg was impossible due to complex nerve, bones and skin associated injuries, so this leg was sacrificed and used as a donor limb, to harvest a free fibula flap for contralateral tibial reconstruction. At 18 months of follow-up, the patient was very satisfied, the clinical result was very good on both lower limbs and X-rays showed excellent integration of the free fibula flap. The patient had normal dailies occupations, can run and have bicycle sport practice with a functional left leg fit prosthesis. This case showed an original application of the "fillet flap concept" to resolve complex and rare traumatic situations interesting the both lower limbs. In our opinion, this strategy must be a part of the plastic surgeon skills in uncommon situations.

  5. Intravaginal testicular torsion in newborns. To fix or not to fix the contralateral testis?

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    G. Bordin

    2013-10-01

    Full Text Available Scrotal swelling suggesting testicular torsion is a rare urological emergency which requires a clinical urgent evaluation and most of the times must be managed surgically. In newborns it can occur in the postnatal period, usually within the twenty-eighth day of life, or more frequently in utero, during the descent of the testis into the scrotum. Usually its poor fixedness allows the testis an abnormal mobility inside the scrotum, configuring the framework of extravaginal torsion. On the contrary during the perinatal period a twist that takes place inside the tunica vaginalis, known as intravaginal torsion, is extremely uncommon and only few cases are well documented in the literature. Authors present a rare case of intravaginal testicular torsion occurred in perinatal period. In this situation only the early surgical exploration of the scrotum may allow the rescue of the gonad, although in rare cases. Timing of surgical treatment and need for contralateral testicular fixation remain controversial. However since the anatomical defect of the tunica vaginalis can be bilateral the surgical fixation even of the contralateral testis is important, now or later, in order to prevent any future torsion of this gonad. The authors also present a brief review of recent literature on the subject.

  6. Cervical disc herniation presenting with neck pain and contralateral symptoms: a case report

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    Yeung Jacky T

    2012-06-01

    Full Text Available Abstract Introduction Cervical disc herniation often results in neck and arm pain in patients as a result of direct impingement of nerve roots and associated inflammatory processes. The clinical presentation usually corresponds with the side of herniation and ipsilateral symptoms predominate the clinical picture. Case presentation A 35-year-old Caucasian man presented to our facility with neck pain and left-sided upper and lower extremity pain. A magnetic resonance imaging scan revealed a right paramedian herniated disc at the C5 to C6 level. All other cervical levels were normal without central canal stenosis or neural foraminal stenosis. Results from magnetic reasonance imaging scans of the brain and lumbar spine were negative. An anterior cervical discectomy was performed at the C5 to C6 level, and an inter-body graft and plate were placed. Our patient had complete resolution of his neck and left arm pain. Conclusions Anterior discectomy and fusion of the cervical spine resulted in complete resolution of our patient’s neck and left arm symptoms and improvement of his contralateral left leg pain. Cervical disc herniation may present with contralateral symptoms that are different from the current perception of this disease.

  7. Shrinkage of ipsilateral taste buds and hyperplasia of contralateral taste buds following chorda tympani nerve transection

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    Yi-ke Li; Juan-mei Yang; Yi-bo Huang; Dong-dong Ren; Fang-lu Chi

    2015-01-01

    The morphological changes that occur in the taste buds after denervation are not well under-stood in rats, especially in the contralateral tongue epithelium. In this study, we investigated the time course of morphological changes in the taste buds following unilateral nerve transection. The role of the trigeminal component of the lingual nerve in maintaining the structural integrity of the taste buds was also examined. Twenty-four Sprague-Dawley rats were randomly divided into three groups:control, unilateral chorda tympani nerve transection and unilateral chorda tympani nerve transection+lingual nerve transection. Rats were allowed up to 42 days of re-covery before being euthanized. The taste buds were visualized using a cytokeratin 8 antibody. Taste bud counts, volumes and taste receptor cell numbers were quantiifed and compared among groups. No signiifcant difference was detected between the chorda tympani nerve transection and chorda tympani nerve transection+lingual nerve transection groups. Taste bud counts, vol-umes and taste receptor cell numbers on the ipsilateral side all decreased signiifcantly compared with control. On the contralateral side, the number of taste buds remained unchanged over time, but they were larger, and taste receptor cells were more numerous postoperatively. There was no evidence for a role of the trigeminal branch of the lingual nerve in maintaining the structural integrity of the anterior taste buds.

  8. Resilience to the contralateral visual field bias as a window into object representations.

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    Garcea, Frank E; Kristensen, Stephanie; Almeida, Jorge; Mahon, Bradford Z

    2016-08-01

    Viewing images of manipulable objects elicits differential blood oxygen level-dependent (BOLD) contrast across parietal and dorsal occipital areas of the human brain that support object-directed reaching, grasping, and complex object manipulation. However, it is unknown which object-selective regions of parietal cortex receive their principal inputs from the ventral object-processing pathway and which receive their inputs from the dorsal object-processing pathway. Parietal areas that receive their inputs from the ventral visual pathway, rather than from the dorsal stream, will have inputs that are already filtered through object categorization and identification processes. This predicts that parietal regions that receive inputs from the ventral visual pathway should exhibit object-selective responses that are resilient to contralateral visual field biases. To test this hypothesis, adult participants viewed images of tools and animals that were presented to the left or right visual fields during functional magnetic resonance imaging (fMRI). We found that the left inferior parietal lobule showed robust tool preferences independently of the visual field in which tool stimuli were presented. In contrast, a region in posterior parietal/dorsal occipital cortex in the right hemisphere exhibited an interaction between visual field and category: tool-preferences were strongest contralateral to the stimulus. These findings suggest that action knowledge accessed in the left inferior parietal lobule operates over inputs that are abstracted from the visual input and is contingent on analysis by the ventral visual pathway, consistent with its putative role in supporting object manipulation knowledge.

  9. Sustained posterior contralateral activity indicates re-entrant target processing in visual change detection: An EEG study

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    Daniel eSchneider

    2014-05-01

    Full Text Available The present study investigated the neural mechanisms that contribute to the detection of visual feature changes between stimulus displays by means of event-related lateralizations of the electroencephalogram (EEG. Participants were instructed to respond to a luminance change in either of two lateralized stimuli that could randomly occur alone or together with an irrelevant orientation change of the same or contralateral stimulus. Task performance based on response times and accuracy was decreased compared to the remaining stimulus conditions when relevant and irrelevant feature changes were presented contralateral to each other (lateral distractor condition. The sensory response to the feature changes was reflected in a posterior contralateral positivity at around 100ms after change presentation and a posterior contralateral negativity in the N1 time window (N1pc. N2pc reflected a subsequent attentional bias in favor of the relevant luminance change. The continuation of the sustained posterior contralateral negativity (SPCN following N2pc covaried with response times within feature change conditions and revealed a posterior topography comparable to the earlier components associated with sensory and attentional mechanisms. Therefore, this component might reflect the re-processing of information based on sustained short-term memory representations in the visual system until a stable target percept is created that can serve as the perceptual basis for response selection and the initiation of goal-directed behavior.

  10. Activity of superior head of human lateral pterygoid increases with increases in contralateral and protrusive jaw displacement.

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    Bhutada, Manish K; Phanachet, Intira; Whittle, Terry; Peck, Chris C; Murray, Greg M

    2007-08-01

    The hypothesis was that the superior head of human lateral pterygoid muscle (SHLP) plays a similar role in jaw movement as the inferior head of human lateral pterygoid muscle (IHLP). The aims were to determine the functional properties of SHLP single motor units (SMUs) and root mean square activity (RMS) of the SHLP during contralateral and protrusive jaw movement tasks and to compare these features with those identified previously for the IHLP. In 22 human subjects, SMUs were recorded intramuscularly from computer tomography-verified sites within the SHLP during standardized contralateral and protrusive jaw movement tasks recorded by a jaw-tracking device. Of the 50 SMUs discriminated, 39 were active during contralateral and 29 during protrusive jaw movements. The firing rates and RMS of the SHLP motor units increased with an increase in jaw displacement. The RMS activity across the entire trial during contralateral jaw movement was significantly greater than that during protrusion. Similarly to conclusions previously identified for the IHLP, the data are consistent with an important role for the SHLP in the control of contralateral and protrusive jaw movements. The similarities in SHLP and IHLP functional properties support the proposal that both heads should be regarded as a system of fibers acting as one muscle.

  11. Chronic stress effects in contralateral medial pterygoid muscle of rats with occlusion alteration.

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    Loyola, Bruno Melo; Nascimento, Glauce Crivelaro; Fernández, Rodrigo Alberto Restrepo; Iyomasa, Daniela Mizusaki; Pereira, Yamba Carla Lara; Leite-Panissi, Christie Ramos Andrade; Issa, João Paulo Mardegan; Iyomasa, Mamie Mizusaki

    2016-10-01

    Temporomandibular disorder (TMD) has a high prevalence in our society, characterized by a severe pain condition of the masticatory muscles and temporomandibular joint. Despite the indication of multiple factor initiators of TMD, there is still controversy about its etiology and its pathophysiology is poorly understood. Using rats as experimental animals we investigated the effect of unpredictable chronic stress with or without unilateral molar extraction on the contralateral medial pterygoid muscle. Our hypothesis is that these two factors induce changes in morphology, oxidative metabolism and oxidative stress of muscle fibers. Young adult male Wistar rats (±200g) were divided into four groups: a group with extraction and unpredictable chronic stress (E+US); with extraction and without stress (E+C); without extraction and with unpredictable chronic stress (NO+US); and a control group without either extraction or stress (NO+C). The animals were subjected to unilateral extraction of the upper left molars, under intraperitoneal anesthesia with 4% Xylazine (10mg/kg) and 10% Ketamine (80mg/kg) on day zero. The rats of groups E+US and NO+US were submitted to different protocols of stress, from the 14th day after the extraction. The protocols were different every day for five consecutive days, which were repeated from the 6th day for five days more. Contralateral medial pterygoid muscles were obtained on the 24th day after the start of the experiment for morphological, metabolic, capillary density, and oxidative stress analysis. The data from capillary density showed a decrease of capillaries in animals subjected to dental extraction, compared with those without extraction and an increase of laminin expression in the group submitted to the unpredictable chronic stress when compared to the unexposed to stress. SDH test revealed a decrease of light fibers in the group submitted to unilateral extraction of molars, compared with this area in the control group. In E+US and NO

  12. Contralateral adrenal metastasis from renal cell carcinoma with tumor thrombus in the adrenal vein: a case report

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    Sebastian Piotrowicz

    2015-12-01

    Full Text Available A 64-year-old woman presented with contralateral right adrenal metastasis with adrenal vein thrombus, which was diagnosed many years after left nephrectomy with adrenalectomy due to renal cell cancer. The patient underwent right adrenalectomy with adrenal vein tumor thrombectomy for treatment. The pathologic examination confi rmed metastatic clear cell carcinoma. The remote but existing risk of developing contralateral adrenal metastasis (CAM after primary radical nephrectomy supports the idea of sparing the adrenal gland in suitable patients who undergo radical nephrectomy. Contralateral adrenal metastasis from RCC is a rare fi nding with the potential benefi t of cure after resection. Care must be taken in preoperative diagnostics, as this metastasis is capable of causing inferior vena cava tumor thrombus via the suprarenal venous route. According to our knowledge, our case is the second similar entity described in literature so far.

  13. [Reconstruction of tracheal defect using the contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum].

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    Lin, Huang; Tang, Ping-zhang; Li, Sen-kai

    2005-05-01

    To reconstruct tracheal defect after tumor excision, we used the contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum. The contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum was used to reconstruct the tracheal defect when the blood supply to the ipsilateral sternocleidomastoideus was destroyed because of lymphonode clearing or radiotherapy. The pedicle of the musculo-periosteum flap was dissected adequately and the blood supply was protected carefully. All flaps survived with epithelization and osteogenesis. The endotracheal tubes were pulled out safely without trachea stenosis in all the patients. The contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum could reconstruct the tracheal defect when the ipsilateral blood supply was damaged. This method extends the application of the musculo-periosteum flap.

  14. Contralateral Breast Symmetrisation in Immediate Prosthetic Breast Reconstruction after Unilateral Nipple-Sparing Mastectomy: The Tailored Reduction/Augmentation Mammaplasty

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    Marzia Salgarello

    2015-05-01

    Full Text Available BackgroundIn the literature on nipple-sparing mastectomy (NSM with one-stage immediate implant reconstruction, contralateral symmetrisation has drawn little attention, with many surgeons still performing standard cosmetic mammaplasty procedures. However, standard implant-based mammaplasty usually does not result in proper symmetry with the mastectomy side, especially regarding breast projection, overall shape, and volume distribution.MethodsWe retrospectively reviewed 19 consecutive patients undergoing unilateral NSM with immediate prosthetic reconstruction and contralateral simultaneous symmetrisation by using the tailored reduction/augmentation mammaplasty technique between June 2012 and August 2013.ResultsThe average follow-up time was 13 months (range, 10-24 months. No major complications, such as infection, haematoma, and nipple-areola complex necrosis, were experienced.ConclusionsOur experience suggests that simultaneous contralateral symmetrisation with tailored reduction/augmentation mammaplasty after unilateral immediate implant reconstruction after NSM facilitates durable and pleasant symmetric outcomes.

  15. Effects of joint contracture on the contralateral unoperated limb in a rabbit knee contracture model: a biomechanical and genetic study.

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    Abdel, Matthew P; Morrey, Mark E; Grill, Diane E; Kolbert, Christopher P; An, Kai-Nan; Steinmann, Scott P; Sanchez-Sotelo, Joaquin; Morrey, Bernard F

    2012-10-01

    In most animal models, unoperated contralateral limbs are used as controls. However, in some experimental circumstances, the contralateral limb may represent a skewed control. The main purpose of this study was to determine if the unoperated contralateral limb could be used as a control, or if a different unoperated animal's limb should be used instead. Seventeen rabbits were divided into two groups. Group 1 rabbits (n = 12) underwent surgery on their right limbs to induce a contracture. Group 2 rabbits (n = 5) underwent no surgery. The left non-operated limbs of rabbits in group 1 were biomechanically and genetically compared to the limbs of unoperated rabbits in group 2 with the use of a validated joint measuring device and custom microarray, respectively. After 8 weeks of immobilization, there was a statistically greater flexion contracture in the unoperated contralateral limbs compared to the limbs of animals that received no surgery(8.4 ± 8.9° vs. 0 ± 0°; p-value = 0.03). When animals were remobilized for an additional 16 weeks, the significance between groups was lost (11.9 ± 21.4° vs. 8.9 ± 9.5°; p = 0.38). Similarly, there was a statistically significant increase in nine genes at 8 weeks (p contracture at 8 weeks. After 16 weeks of remobilization, there is no biomechanical or genetic difference between contralateral non-operated limbs and limbs of animals not undergoing any surgical intervention. Given the biomechanical and genetic findings, the contralateral non-operated limb can be used as a valid control. Copyright © 2012 Orthopaedic Research Society.

  16. Compensatory hypertrophy of the contralateral inferior turbinate in patients with unilateral nasal septal deviation. A computed tomography study.

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    Chiesa Estomba, Carlos; Rivera Schmitz, Teresa; Ossa Echeverri, Carla C; Betances Reinoso, Frank A; Osorio Velasquez, Alejandra; Santidrian Hidalgo, Carmelo

    2015-01-01

    The compensatory hypertrophy of the inferior turbinate in patients with septal deviation to one of the nostrils is considered to protect the airways from the excess of air that could enter through the nostril and its potential negative effects such as dryness, alteration of air filtration, mucociliary flow, or lung involvement. A prospective, longitudinal, non-randomized study. Patients were divided in two groups: 10 consecutive patients, with nasal septal deviation and compensatory hypertrophy of the inferior turbinate in the contralateral nasal cavity (10 non-hypertrophied turbinates as control and 10 contralateral hypertrophied turbinates as study cases), and the second group with 5 patients without any nasal pathology (10 turbinates without any obvious pathology). In both groups CT scans of the nasal region were performed. A comparison of patients with nasal septal deviation with compensatory hypertrophy of the inferior turbinate in the contralateral nasal cavity and with non-pathological inferior turbinate was carried out. When analyzing the groups of patients with septal deviation, the contralateral hypertrophied turbinate and the non-hypertrophied turbinate side, we found a significant hypertrophy in the anterior portion of the inferior turbinate, at the level of the medial mucosa (P = 0.002) and bone (P = 0.001) in the group of patients with contralateral hypertrophied turbinate. However, when we compared the contralateral hypertrophic turbinate with the turbinate of patients without septal deviation, we found a significant difference in all volumes of the medial and lateral mucosa and the bone portion (P = 0.001, P = 0.005). Surgical correction of the nasal septum and lateralization or reduction of the volume of the inferior turbinate (which may include the medial mucosa, head or part of the bone) is necessary in order to improve air passage into the nasal valve.

  17. SU-E-T-373: Evaluation and Reduction of Contralateral Skin /subcutaneous Dose for Tangential Breast Irradiation

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    Butson, M; Carroll, S; Whitaker, M; Odgers, D; Martin, D; Hinds, S; Kader, J; Ho, K; Amos, S; Toohey, J [Chris O’Brien LifeHouse, Sydney, NSW (Australia)

    2015-06-15

    Purpose: Tangential breast irradiation is a standard treatment technique for breast cancer therapy. One aspect of dose delivery includes dose delivered to the skin caused by electron contamination. This effect is especially important for highly oblique beams used on the medical tangent where the electron contamination deposits dose on the contralateral breast side. This work aims to investigate and predict as well as define a method to reduce this dose during tangential breast radiotherapy. Methods: Analysis and calculation of breast skin and subcutaneous dose is performed using a Varian Eclipse planning system, AAA algorithm for 6MV x-ray treatments. Measurements were made using EBT3 Gafchromic film to verify the accuracy of planning data. Various materials were tested to assess their ability to remove electron contamination on the contralateral breast. Results: Results showed that the Varian Eclipse AAA algorithm could accurately estimate contralateral breast dose in the build-up region at depths of 2mm or deeper. Surface dose was underestimated by the AAA algorithm. Doses up to 12% of applied dose were seen on the contralateral breast surface and up to 9 % at 2mm depth. Due to the nature of this radiation, being mainly low energy electron contamination, a bolus material could be used to reduce this dose to less than 3%. This is accomplished by 10 mm of superflab bolus or by 1 mm of lead. Conclusion: Contralateral breast skin and subcutaneous dose is present for tangential breast treatment and has been measured to be up to 12% of applied dose from the medial tangent beam. This dose is deposited at shallow depths and is accurately calculated by the Eclipse AAA algorithm at depths of 2mm or greater. Bolus material placed over the contralateral can be used to effectively reduce this skin dose.

  18. Influence of contralateral acoustic stimulation on distortion-product and spontaneous otoacoustic emissions in the barn owl.

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    Manley, G A; Taschenberger, G; Oeckinghaus, H

    1999-12-01

    The avian auditory papilla provides an interesting object on which to study efferent influences, because whereas a significant population of hair cells in birds is not afferently innervated, all hair cells are efferently innervated (Fischer, 1992, 1994a, b). Previous studies in mammals using contralateral sound to stimulate the efferent system demonstrated a general suppressive effect on spontaneous and click-evoked, as well as on distortion-product otoacoustic emissions (DPOAE). As little is known about the effects of contralateral stimulation on hearing in birds, we studied the effect of such stimuli (broadband noise, pure tones) on the amplitude of the DPOAE 2f(1)-f(2) and on spontaneous otoacoustic emissions (SOAE) in the barn owl, Tyto alba. For the DPOAE measurements, fixed primary-tone pairs [f(1)=8.875 kHz (ratio=1.2), f(1)=8.353 kHz (ratio=1.15) and f(1)=7.889 kHz (ratio=1.1)] were presented and the DPOAE measured in the presence and absence of continuous contralateral stimulation. The DPOAE often declined in amplitude but in some cases we observed DPOAE enhancement. The changes in amplitude were as large as 9 dB. The influence of the contralateral noise changed over time, however, and the effects of contralateral tones were frequency-dependent. SOAE were suppressed in amplitude and shifted in frequency by contralateral broadband noise. Control measurements in animals after middle-ear muscle resection showed that these phenomena were not attributable to the acoustic middle-ear reflex. The finding of DPOAE enhancement is interesting, because a type of efferent fiber that suppressed its discharge rate during stimulation has been described in birds (Kaiser and Manley, 1994).

  19. Age-related declines in distortion product otoacoustic emissions utilizing pure tone contralateral stimulation in CBA/CaJ mice.

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    Varghese, George I; Zhu, Xiaoxia; Frisina, Robert D

    2005-11-01

    One role of the medial olivocochlear (MOC) auditory efferent system is to suppress cochlear outer hair cell (OHC) responses when presented with a contralateral sound. Using distortion product otoacoustic emissions (DPOAEs), the effects of active changes in OHC responses due to the MOC as a function of age can be observed when contralateral stimulation with a pure tone is applied. Previous studies have shown that there are age-related declines of the MOC when broad band noise is presented to the contralateral ear. In this study, we measured age-related changes in CBA/CaJ mice by comparing DPOAE generation with and without a contralateral pure tone at three different frequencies (12, 22, and 37 kHz). Young (n = 16), middle (n = 10) and old-aged (n = 10) CBA mice were tested. DPOAE-grams were obtained using L1 = 65 and L2 = 50 dB SPL, F1/F2 = 1.25, using eight points per octave covering a frequency range from 5.6-44.8 kHz. The pure tone was presented contralaterally at 55 dB SPL. DPOAE-grams and ABR levels indicated age-related hearing loss in the old mice. In addition, there was an overall change in DPOAEs in the middle-aged and old groups relative to the young. Pure tone stimulation was not as effective as a suppressor compared to broadband noise. An increase in pure tone frequency from 12 to 22 kHz induced greater suppression of DPOAEs, but the 37 kHz was least effective. These results indicate that as the mouse ages, there are significant changes in the efficiency of the suppression mechanism as elicited by contralateral narrowband stimuli. These findings reinforce the idea that age-related changes in the MOC or the operating points of OHCs play a role in the progression of presbycusis - age-related hearing loss in mammals.

  20. Redefining Risk and Benefit: Understanding the Decision to Undergo Contralateral Prophylactic Mastectomy.

    Science.gov (United States)

    Rendle, Katharine A S; Halley, Meghan C; May, Suepattra G; Frosch, Dominick L

    2015-09-01

    Rates of contralateral prophylactic mastectomy (CPM) among unilateral breast cancer patients are rapidly increasing; however, there are little data documenting the decision-making process of patients with no known BRCA mutations, who elect this more aggressive treatment. We conducted semistructured interviews with nine newly diagnosed patients who elected CPM over other surgical options. Using grounded theory, we analyzed interview data to identify influential decision-making factors by prevalence and intensity across participants. Decision-making factors included subjective evaluations of risk and benefit, avoidance of future breast cancer surveillance and accompanying worry, and desire to maintain (or improve) breast appearance. Based solely on survival benefit, the decision to undergo CPM might be viewed as unnecessary or even misguided. However, our findings show the importance of psychosocial factors in patients' assessments of risk and benefit, and support the need for additional patient-provider communication regarding these factors.

  1. BILATERAL TUMORS AND TUMORS IN A SOLITARY FUNCTIONING KIDNEY IN COMBINATION WITH CONTRALATERAL NEO-CANCER

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    R. Kh. Galeev

    2011-01-01

    Full Text Available The incidence of kidney cancer is 2–3 % of all malignancies and tends to rise. If the problems of treatment in patients with a renal tumor and a normally functioning contralateral kidney have mainly been solved, how to treat patients with bilateral tumors and a tumor in a solitary functioning kidney continues to be discussed. In particular, the limited decrease in renal function of the remaining kidney in a patient after nephrectomy, whose achievement does not require renal replacement therapy, has not been conclusively defined; what part of a solitary kidney with tumors will be able to maintain a good quality of life in the patient, without doing hemodyalisis, has not been elucidated either.

  2. Ipsilateral and contralateral sensory changes in healthy subjects after experimentally induced concomitant sensitization and hypoesthesia.

    Science.gov (United States)

    Enax-Krumova, Elena K; Pohl, Stephanie; Westermann, Andrea; Maier, Christoph

    2017-03-23

    In unilateral neuropathic pain. e.g. after peripheral nerve injury, both positive and negative sensory signs occur often, accompanied by minor but equally directed contralateral sensory changes. To mimic this feature, we experimentally aimed to induce concomitant c-fibre sensitization and block in healthy subjects and analyzed the bilateral sensory changes by quantitative sensory testing (QST) using the protocol of the German Research Network on Neuropathic Pain. Twenty eight healthy subjects were firstly randomized in 2 groups to receive either topical capsaicin (0.6%, 12 cm(2), application duration: 15 min.) or a lidocaine/prilocaine patch (25/25 mg, 10 cm(2), application duration: 60 min.) on the right volar forearm. Secondly, 7-14 days later in the same area either at first capsaicin (for 15 min.) and immediately afterwards local anesthetics (for 60 min.) was applied (Cap/LA), or in inversed order with the same application duration (LA/Cap). Before, after each application and 7-14 days later a QST was performed bilaterally. Wilcoxon-test, ANOVA, p sensory changes occurred only after the co-application with concomitant sensitization and hypoesthesia and comprised increased cold (Cap/LA, LA/Cap) and mechanical detection as well as cold pain threshold (LA/Cap). The present experimental model using combined application of capsaicin and LA imitates partly the complex sensory changes observed in patients with unilateral neuropathic pain and might be used as an additional surrogate model. Only the concomitant use both agents in the same area induces both positive and negative sensory signs ipsilaterally as well as parallel contralateral sensory changes (to a lesser extent). ClinicalTrials.gov Identifier NCT01540877 , registered on 23 February 2012.

  3. Correlation of Respiratory Activity of Contralateral Diaphragm Muscles for Evaluation of Recovery Following Hemiparesis

    Science.gov (United States)

    Dow, Douglas E.; Zhan, Wen-Zhi; Sieck, Gary C.; Mantilla, Carlos B.

    2014-01-01

    Respiration is impaired by disruption of the central drive for inspiration to the diaphragm muscle (DIAm). Some function may recover involving nerve regeneration, reinnervation or neuroplasticity. A research animal model involves inducing hemiparesis of the DIAm and monitoring any recovery under different conditions. Methods to accurately track the level of functional recovery are needed. In this study, an algorithm was developed and tested to quantify the relative amount of electromyogram (EMG) activity that temporally correlated for an experimental (EXP) hemi-DIAm with its intact contralateral hemi-DIAm. An average rectified value (ARV) trace was calculated. A template was formed of the ARV trace of the intact hemi-DIAm, with higher positive values corresponding with periods of inspirations and lower negative values corresponding with quiet periods. This template was multiplied by the EXP ARV trace to reward (more positive) periods of correlating activity, and punish (more negative) periods of high activity on the EXP side that corresponded with quiet periods on the intact side. The average integrated value was the index of correlating contralateral activity (ICCA). A negative ICCA value indicated no net correlation of activity, and a positive value indicated a net correlation of activity. The algorithm was tested on rats having the conditions of control or hemi-paresis induced by denervatation (DNV), tetrodotoxin administration (TTX) or cervical spinal hemi-section (SH). Control had high positive ICCA values, and DNV had negative values. TTX maintained negative ICCA values at 3, 7 and 14 days, indicating a lack of functional recovery. SH maintained negative values at 3 and 7 days, but a subset had positive values at 14 days indicating some functional recovery. PMID:19965125

  4. Predicting women's intentions for contralateral prophylactic mastectomy: An application of an extended theory of planned behaviour.

    Science.gov (United States)

    Richards, Imogen; Tesson, Stephanie; Porter, David; Phillips, Kelly-Anne; Rankin, Nicole; Musiello, Toni; Marven, Michelle; Butow, Phyllis

    2016-04-01

    Most women with unilateral breast cancer (BC) without BRCA1/2 gene mutations are at low risk of contralateral breast cancer (CBC). One CBC risk-management option is contralateral prophylactic mastectomy (CPM). While there is no evidence that CPM increases life-expectancy, its uptake is increasing. This study aimed to assess the validity of an extended social-cognition model, the Theory of Planned Behaviour (TPB), in predicting women's intentions to undergo CPM. Four hundred women previously treated for BC completed an online survey exploring demographic and disease factors, attitude, subjective norm, perceived behavioural control, anticipated regret, uncertainty avoidance, self-efficacy to not have CPM and intentions to undergo CPM in a common hypothetical decision-making scenario. The TPB uniquely explained 25.7% of intention variance. Greater anticipated regret, uncertainty avoidance and lower self-efficacy to cope with not having CPM were associated with stronger CPM intentions, explaining an additional 7.7%, 10.6% and 2.9% respectively, of variance over and above the TPB. Women who had undergone CPM, had not attended university, and had children reported stronger CPM intentions. A holistic understanding of CPM decision-making appears to require consideration beyond CBC risk, demographics and disease characteristics, exploring women's expectations about CPM outcomes, others' opinions, and avoidance of emotionality and difficulties associated with not undergoing surgery. This study provides a theoretical basis from which the complexity of CPM decision-making may be understood, and from which resources for patients and treating staff may be developed to support women's informed decision-making aligning with their personal values. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Contralaterally Controlled Functional Electrical Stimulation for Recovery of Elbow Extension and Hand Opening After Stroke

    Science.gov (United States)

    Knutson, Jayme S.; Harley, Mary Y.; Hisel, Terri Z.; Makowski, Nathaniel S.; Chae, John

    2014-01-01

    Objective The aims of this study were to determine whether patients with moderate-to-severe upper limb hemiplegia could use contralaterally controlled functional electrical stimulation at the arm and the hand (Arm+Hand CCFES) at home and to evaluate the feasibility of the Arm+Hand CCFES to reduce arm and hand motor impairment. Design With the Arm+Hand CCFES, the paretic elbow and hand extensors were stimulated with intensities proportional to the degree of elbow extension and hand opening, respectively, of the contralateral unimpaired side. For 1 2 wks, four participants with chronic (≥6 mos) upper limb hemiplegia received ∼7 hrs per week of self-administered home-based stimulation-mediated elbow extension and hand opening exercise plus ∼2.5 hrs per week of therapist-supervised laboratory-based stimulation-assisted functional task practice. Assessments of upper limb impairment were made at pretreatment, posttreatment, and 1 mo after treatment. Results All four participants were able to use the Arm+Hand CCFES system at home either independently or with very minimal assistance from a caregiver. All four participants had increases in the Fugl-Meyer score (1–9 points) and the Wolf Motor Function Test (0.2–0.8 points) and varying degrees of improvement in maximum hand opening, maximum elbow extension, and simultaneous elbow extension and hand opening. Conclusions The Arm+Hand CCFES can be successfully administered in stroke patients with moderate-to-severe impairment and can reduce various aspects of upper limb impairment. A larger efficacy study is warranted. PMID:24508938

  6. Prevalence of Contralateral Hearing Aid Use in Adults with Cochlear Implants

    Directory of Open Access Journals (Sweden)

    Yamaguchi, Cintia Tizue

    2013-09-01

    Full Text Available Introduction: The exclusive use of a cochlear implant (CI in one ear allows patients to effectively hear speech in a quiet environment. However, in environments with competing noise, the processing of multiple sounds becomes complex. In an attempt to promote binaural hearing in a noninvasive manner, the use of a hearing aid in the nonimplanted ear is suggested for patients with a unilateral CI. Aims: To identify the prevalence of hearing aid use in the contralateral ear in adults who already have a CI; to determine the reasons why some patients do not use contralateral hearing aids (CHAs; and to analyze the effects of residual hearing in CHA users. Materials and Methods: This is a clinical study in 82 adult patients with CI implants who responded to a questionnaire designed to determine current use of CHA. Results: In our patient sample, 70 CHA nonusers were identified. The prevalence of CHA users was determined to be 12% with a 95% confidence interval of 11 to 13%. About 58.2% of the CHA nonusers reported a lack of noticeable benefit even after wearing hearing aids, and 23.6% reported not having received the option to use a CHA. CHA users had a pure tone average of 107-dB hearing level, whereas CHA nonusers had a pure tone average of 117-dB hearing level. Conclusion: The prevalence of the use of a CHA is low in our study. We attribute the low use of a CHA to either a lack of residual hearing or to a lack of benefit from the amplification.

  7. Attitudes to contralateral risk reducing mastectomy among breast and plastic surgeons in England

    Science.gov (United States)

    Basu, NN; Littlechild, S; Barr, L; Ross, GL; Evans, DG

    2016-01-01

    Introduction Rates of contralateral risk reducing mastectomy (CRRM) are rising despite a paucity of data to support this practice. Surgeons work as part of the multidisciplinary team (MDT). They may counsel women on these requests without the benefit of established guidelines or agreed protocol. This study assessed the practices and perceptions of breast and plastic surgeons in England on CRRM. Methods A postal questionnaire was sent to 455 breast and 364 plastic surgeons practising in England. Basic demographics, trends in CRRM, risk assessment, role of the MDT and knowledge base were assessed. Results The response rate among breast surgeons was 48.3% (220/455) and 12.6% (46/364) among plastic surgeons. Nearly half (44%) of the respondents felt there had been an increase in rates of CRRM over the last three years. Seventy-one per cent of those surveyed performed 1–5 CRRMs annually while sixteen per cent did not perform this procedure at all. A third (32%) of respondents correctly quoted their patients an annual risk of 0.5–0.7%. Funding was refused in 4% of cases and 43% of the surgeons felt that in the future they would have to apply to relevant clinical commissioning groups. Over half (58%) of all respondents reported that decisions for CRRM are always discussed in the MDT meeting but 6% stated that these cases are never discussed by the MDT. BRCA mutation was perceived as the main risk factor for contralateral breast cancer by 81% of respondents. Surgeons felt that women requested CRRM mainly to alleviate anxiety. The next most common reasons were carriage of BRCA mutation and a desire to have reconstructions match. Conclusions A wide variation of surgical practices and perceptions exist in assessing women for CRRM. Guidelines to standardise practices are required. PMID:26741657

  8. Interhemispheric interaction between human dorsal premotor and contralateral primary motor cortex.

    Science.gov (United States)

    Mochizuki, Hitoshi; Huang, Ying-Zu; Rothwell, John C

    2004-11-15

    We used transcranial magnetic stimulation (TMS) in a paired pulse protocol to investigate interhemispheric interactions between the right dorsal premotor (dPM) and left primary motor cortex (M1) using interstimulus intervals of 4, 6, 8, 10, 12, 16 and 20 ms in ten healthy subjects. A conditioning stimulus over right dPM at an intensity of either 90 or 110% resting motor threshold (RMT) suppressed motor-evoked potentials (MEPs) evoked in the first dorsal interosseous (FDI) muscle by stimulation of left M1. Maximum effects occurred for interstimulus intervals (ISIs) of 8-10 ms. There was no effect if the conditioning stimulus was applied 2.5 cm lateral, anterior or medial to dPM. The effect differed from previously described M1 interhemispheric inhibition in that the threshold for the latter was greater than 90% RMT, whereas stimulation of the dPM at the same intensity led to significant inhibition. In addition, voluntary contraction of the left FDI (i.e. contralateral to the conditioning TMS) enhanced interhemispheric inhibition from right M1 but had no effect on the inhibition from right dPM. Finally, conditioning to right dPM at 90% RMT reduced short-interval intracortical inhibition (SICI; at ISI = 2 ms) in left M1 whilst there was no effect if the conditioning stimulus was applied to right M1. We conclude that conditioning TMS over dPM has effects that differ from the previous pattern of interhemispheric inhibition described between bilateral M1s. This may reflect the existence of commissural fibres between dPM and contralateral M1 that may play a role in bimanual coordination.

  9. Delayed cell death in the contralateral hippocampus following kainate injection into the CA3 subfield.

    Science.gov (United States)

    Maglóczky, Z; Freund, T F

    1995-06-01

    A model of epileptic cell death has been developed employing unilateral injections of kainic acid, a glutamate agonist, into the CA3 subfield of the hippocampus. The contralateral hippocampus, where neuronal damage is induced by hyperactivity in afferent pathways, served as the model structure. The pattern of cell death in this model was shown earlier to correspond to the vulnerable regions in human temporal lobe epilepsy. In the present time-course study we demonstrated that the different subpopulations of vulnerable cells in the contralateral hippocampus of the rat degenerate at different times following kainate injection. Spiny calretinin-containing cells in the hilus and CA3 stratum lucidum disappear at 12-24 h, other types of hilar neurons and CA3c pyramidal cells show shrinkage and argyrophilia at two days, whereas CA1 pyramidal cells degenerate at three days postinjection. The majority of cells destined to die showed a transient expression of the heatshock protein 72, approximately one day (for hilar-CA3c) or two days (for CA1) before degeneration. Parvalbumin-immunoreactivity transiently disappeared from the soma and dendrites of interneurons between the first and the fourth day. The results suggest that seizure-induced cell death is delayed, therefore acute oedema, even if it occurs, is insufficient to kill neurons. The only exception is the population of calretinin-containing interneurons degenerating at 12-24 h. The further one day delay between hilar-CA3c and CA1 cell death is likely to be due to differences in the relative density of glutamate receptor types (kainate versus NMDA) and the source of afferent input of these subfields. Thus, simple pharmacotherapy targeting only one of the excitotoxic mechanisms (i.e. acute oedema of calretinin cells versus delayed death of hilar-CA3c and CA1 cells at different time points) is likely to fail.

  10. Cost-Effectiveness of Contralateral Prophylactic Mastectomy Versus Routine Surveillance in Patients With Unilateral Breast Cancer

    Science.gov (United States)

    Zendejas, Benjamin; Moriarty, James P.; O'Byrne, Jamie; Degnim, Amy C.; Farley, David R.; Boughey, Judy C.

    2011-01-01

    Purpose Contralateral prophylactic mastectomy (CPM) rates in women with unilateral breast cancer are increasing despite controversy regarding survival advantage. Current scrutiny of the medical costs led us to evaluate the cost-effectiveness of CPM versus routine surveillance as an alternative contralateral breast cancer (CBC) risk management strategy. Methods Using a Markov model, we simulated patients with breast cancer from mastectomy to death. Model parameters were gathered from published literature or national databases. Base-case analysis focused on patients with average-risk breast cancer, 45 years of age at treatment. Outcomes were valued in quality-adjusted life-years (QALYs). Patients' age, risk level of breast cancer, and quality of life (QOL) were varied to assess their impact on results. Results Mean costs of treatment for women age 45 years are comparable: $36,594 for the CPM and $35,182 for surveillance. CPM provides 21.22 mean QALYs compared with 20.93 for surveillance, resulting in an incremental cost-effectiveness ratio (ICER) of $4,869/QALY gained for CPM. To prevent one CBC, six CPMs would be needed. CPM is no longer cost-effective for patients older than 70 years (ICER $62,750/QALY). For BRCA-positive patients, CPM is clearly cost-effective, providing more QALYs while being less costly. In non-BRCA patients, cost-effectiveness of CPM is highly dependent on assumptions regarding QOL for CPM versus surveillance strategy. Conclusion CPM is cost-effective compared with surveillance for patients with breast cancer who are younger than 70 years. Results are sensitive to BRCA-positive status and assumptions of QOL differences between CPM and surveillance patients. This highlights the importance of tailoring treatment for individual patients. PMID:21690472

  11. PROPAGATION OF EPILEPTIFORM ACTIVITY DURING DEVELOPMENT OF AMYGDALA KINDLING IN RATS - LINEAR AND NONLINEAR ASSOCIATION BETWEEN IPSILATERAL AND CONTRALATERAL SITES

    NARCIS (Netherlands)

    BELDHUIS, HJA; SUZUKI, T; PIJN, JPM; TEISMAN, A; DASILVA, FHL; BOHUS, B

    1993-01-01

    The relationship between ipsi- and contralateral epileptiform electroencephalographic (EEG) activity was investigated in rats that were kindled daily in the amygdala. Two types of relationship-linear and non-linear associations-were studied and used to estimate time delays of EEG activity between ho

  12. Dose to the contralateral breast from radiotherapy and risk of second primary breast cancer in the WECARE study

    DEFF Research Database (Denmark)

    Stovall, M.; Smith, S.A.; Langholz, B.M.

    2008-01-01

    PURPOSE: To quantify the risk of second primary breast cancer in the contralateral breast (CB) after radiotherapy (RT) for first breast cancer. METHODS AND MATERIALS: The study population included participants in the Women's Environmental, Cancer, and Radiation Epidemiology study: 708 cases (wome...

  13. Alcohol intake and cigarette smoking and risk of a contralateral breast cancer: The Women's Environmental Cancer and Radiation Epidemiology Study

    DEFF Research Database (Denmark)

    Knight, J.A.; Bernstein, L.; Largent, J.

    2009-01-01

    Women with primary breast cancer are at increased risk of developing second primary breast cancer. Few studies have evaluated risk factors for the development of asynchronous contralateral breast cancer in women with breast cancer. In the Women's Environmental Cancer and Radiation Epidemiology St...

  14. Contralateral development of acute subdural hematoma (SDH immediately following a burr-hole craniostomy for chronic SDH

    Directory of Open Access Journals (Sweden)

    Jae Sung Park, MD

    2016-12-01

    Conclusion: This report represents a contralateral ASDH that occurred less than an hour after a burr-hole trephination for CSDH. Several hypotheses concerning the etiology of this rare complication, albeit inconclusive, are worth contemplation. Excessive drain of CSDH must be refrained from in order not to encounter any unexpected complications.

  15. Lateral visual field stimulation reveals extrastriate cortical activation in the contralateral hemisphere: an fMRI study.

    Science.gov (United States)

    Schiffer, Fredric; Mottaghy, Felix M; Pandey Vimal, Ram Lakhan; Renshaw, Perry F; Cowan, Ronald; Pascual-Leone, Alvaro; Teicher, Martin; Valente, Elizabeth; Rohan, Michael

    2004-05-30

    We examined whether lateral visual field stimulation (LSTM) could activate contralateral extrastriate cortical areas as predicted by a large experimental literature. We asked seven unscreened, control subjects to wear glasses designed to allow vision out of either the left (LVF) or right lateral visual field (RVF) depending upon which side the subject looked toward. Each subject participated in a block design functional magnetic resonance imaging (fMRI) study with alternating 30-s epochs in which he was asked to look to one side and then the other for a total of five epochs. On each side of the bore of the scanner, we taped a photograph for the subject to view in the LVF and RVF. The data were analyzed with SPM99 using a fixed effect, box-car design with contrasts for the LVF and the RVF conditions. Both LVF and RVF conditions produced the strongest fMRI activation in the contralateral occipitotemporal and posterior parietal areas as well as the contralateral dorsolateral prefrontal cortex. LSTM appears to increase contralateral fMRI activation in striate and extrastriate cortical areas as predicted by earlier studies reporting differential cognitive and/or emotional effects from unilateral sensory or motor stimulation.

  16. The value of surveillance mammography of the contralateral breast in patients with a history of breast cancer

    NARCIS (Netherlands)

    Lu, W.L.; Schaapveld, M.; Jansen, L.; Bagherzadegan, E.; Sahinovic, M.M.; Baas, P.C.; Hanssen, L.M.H.C.; van der Mijle, H.C.J.; Brandenburg, J.D.; Wiggers, T.; de Bock, G.H.

    2009-01-01

    Purpose: To determine the contribution of surveillance mammography to the early detection of metachronous contralateral. breast cancer (MCBC) and to assess its impact on the survival of breast cancer patients with relation to compliance. Method: Breast cancer patients (5589) were identified using fi

  17. Contribution of a Contralateral Hearing Aid to Perception of Consonant Voicing, Intonation, and Emotional State in Adult Cochlear Implantees

    Science.gov (United States)

    Most, Tova; Gaon-Sivan, Gal; Shpak, Talma; Luntz, Michal

    2012-01-01

    Binaural hearing in cochlear implant (CI) users can be achieved either by bilateral implantation or bimodally with a contralateral hearing aid (HA). Binaural-bimodal hearing has the advantage of complementing the high-frequency electric information from the CI by low-frequency acoustic information from the HA. We examined the contribution of a…

  18. The contralateral synchronous breast carcinoma: a comparison of histology, localization, and magnetic resonance imaging characteristics with the primary index cancer.

    Science.gov (United States)

    Renz, Diane M; Böttcher, Joachim; Baltzer, Pascal A T; Dietzel, Matthias; Vag, Tibor; Gajda, Mieczyslaw; Camara, Oumar; Runnebaum, Ingo B; Kaiser, Werner A

    2010-04-01

    Women with unilateral breast carcinoma reveal an increased risk of suffering from malignancies in the contralateral breast. There is a controversy about the existence of bilateral phenotypic similarities. The aim of this investigation was to compare histologic findings, magnetic resonance imaging (MRI) parameters, and tumor localizations of synchronous bilateral carcinomas. MRI revealed in 42 of 875 women (4.8%) with primary index carcinomas a contralateral malignancy. Twenty-two of the 42 contralateral carcinomas could only be detected by MRI, not by clinical examination, X-ray mammography, or ultrasonography. In 875 patients, MRI therefore identified 22 (2.5%) otherwise occult contralateral cancers. To evaluate bilateral MRI similarities, multiple dynamic and morphologic parameters were evaluated. Of 42 bilateral cancer pairs, histologic tumor type was identical in 54.8% (correlation analysis, P types were bilaterally congruent on MRI (P analogies of tumor neoangiogenesis, histopathologic components, and infiltration in the surrounding stroma. Bilateral synchronous carcinomas may represent on each site distinct, but similar biologic entities, due to analogous influences of tumor developments.

  19. A systematic review of contralateral liver lobe hypertrophy after unilobar selective internal radiation therapy with Y90.

    Science.gov (United States)

    Teo, Jin-Yao; Allen, John C; Ng, David C; Choo, Su-Pin; Tai, David W M; Chang, Jason P E; Cheah, Foong-Khoon; Chow, Pierce K H; Goh, Brian K P

    2016-01-01

    Curative liver resection is the treatment of choice for both primary and secondary liver malignancies. However, an inadequate future liver remnant (FLR) frequently precludes successful surgery. Portal vein embolization is the gold-standard modality for inducing hypertrophy of the FLR. In recent times, unilobar Yttrium-90 selective internal radiation therapy (SIRT) has been reported to induce hypertrophy of the contralateral, untreated liver lobe. The aim of this study is to review the current literature reporting on contralateral liver hypertrophy induced by unilobar SIRT. A systematic review of the English-language literature between 2000 and 2014 was performed using the search terms "Yttrium 90" OR "selective internal radiation therapy" OR "radioembolization" AND "hypertrophy". Seven studies, reporting on 312 patients, were included. Two hundred and eighty four patients (91.0%) received treatment to the right lobe. Two hundred and fifteen patients had hepatocellular carcinoma (HCC), 12 had intrahepatic cholangiocarcinoma, and 85 had liver metastases from mixed primaries. Y90 SIRT resulted in contralateral liver hypertrophy which ranged from 26 to 47% at 44 days-9 months. All studies were retrospective in nature, and heterogeneous, with substantial variations relative to pathology treated, underlying liver disease, dosage and delivery of Y90, number of treatment sessions and time to measurement of hypertrophy. Unilobar Y90 SIRT results in significant hypertrophy of the contralateral liver lobe. The rate of hypertrophy seems to be slower than that achieved by other methods. Copyright © 2015 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

  20. A Binaural Cochlear Implant Sound Coding Strategy Inspired by the Contralateral Medial Olivocochlear Reflex.

    Science.gov (United States)

    Lopez-Poveda, Enrique A; Eustaquio-Martín, Almudena; Stohl, Joshua S; Wolford, Robert D; Schatzer, Reinhold; Wilson, Blake S

    2016-01-01

    In natural hearing, cochlear mechanical compression is dynamically adjusted via the efferent medial olivocochlear reflex (MOCR). These adjustments probably help understanding speech in noisy environments and are not available to the users of current cochlear implants (CIs). The aims of the present study are to: (1) present a binaural CI sound processing strategy inspired by the control of cochlear compression provided by the contralateral MOCR in natural hearing; and (2) assess the benefits of the new strategy for understanding speech presented in competition with steady noise with a speech-like spectrum in various spatial configurations of the speech and noise sources. Pairs of CI sound processors (one per ear) were constructed to mimic or not mimic the effects of the contralateral MOCR on compression. For the nonmimicking condition (standard strategy or STD), the two processors in a pair functioned similarly to standard clinical processors (i.e., with fixed back-end compression and independently of each other). When configured to mimic the effects of the MOCR (MOC strategy), the two processors communicated with each other and the amount of back-end compression in a given frequency channel of each processor in the pair decreased/increased dynamically (so that output levels dropped/increased) with increases/decreases in the output energy from the corresponding frequency channel in the contralateral processor. Speech reception thresholds in speech-shaped noise were measured for 3 bilateral CI users and 2 single-sided deaf unilateral CI users. Thresholds were compared for the STD and MOC strategies in unilateral and bilateral listening conditions and for three spatial configurations of the speech and noise sources in simulated free-field conditions: speech and noise sources colocated in front of the listener, speech on the left ear with noise in front of the listener, and speech on the left ear with noise on the right ear. In both bilateral and unilateral listening

  1. Cisto broncogênico complicado por mediastinite e empiema contra-lateral

    OpenAIRE

    Lima,Nuno Ferreira de; Dias,Gisele Moreira; Carvalho,André de Aquino

    2004-01-01

    O cisto broncogênico, apesar da aparência pouco ominosa como opacidade de contornos precisos no mediastino, tem potencial não desprezível para complicar. Relatamos um caso de complicação grave em um paciente de 28 anos com queixa de dor epigástrica irradiada para o dorso, e radiografia de tórax demonstrando massa bem delimitada no mediastino posterior e inferior à direita. Em cinco dias evoluiu para sepse decorrente de mediastinite e empiema pleural à esquerda. O paciente necessitou ser subme...

  2. Esvaziamento cervical no carcinoma epidermoide de laringe: indicação de esvaziamento eletivo contralateral Neck dissection in squamous cell carcinoma of the larynx: indication of elective contralateral neck dissection

    Directory of Open Access Journals (Sweden)

    Ali Amar

    2012-04-01

    Full Text Available O planejamento terapêutico dos tumores da laringe inclui a possibilidade de esvaziamento cervical uni ou bilateral. OBJETIVO: Avaliar a prevalência e localização de metástases linfonodais bilaterais ou contralaterais nos tumores de laringe. CASUÍSTICA E MÉTODO: Estudo longitudinal retrospectivo de 272 prontuários de pacientes com carcinoma epidermoide de laringe tratados entre 1996 e 2004, selecionados 104 submetidos à cirurgia com esvaziamento cervical. Avaliada a incidência de metástases bilaterais ou contralaterais, de acordo com a localização e extensão do tumor primário, considerando os subsítios anatômicos e a linha mediana. RESULTADOS: A prevalência de metástases contralaterais nos tumores lateralizados foi de 3,5% nas lesões glóticas e 26% nas lesões supraglóticas. As metástases contralaterais foram infrequentes nos casos N0. Tanto no esvaziamento eletivo como no terapêutico, os níveis linfonodais IIa e III foram os mais acometidos. CONCLUSÃO: Nas lesões glóticas lateralizadas, mesmo nos tumores transglóticos, não há necessidade de esvaziamento contralateral eletivo. Nas lesões da supraglote sem metástases ipsilaterais, a incidência de metástases ocultas não justifica o esvaziamento eletivo contralateral. A linha mediana não é um indicador fidedigno do risco de metástases contralaterais nos tumores da laringe.Unilateral or bilateral neck dissection must be considered in the treatment of laryngeal cancer AIM: To evaluate the prevalence of contralateral metastases in larynx cancer and distribution of these metastases according to lymph node levels in the neck. METHOD: Retrospective longitudinal study of 272 charts from patients with squamous cell cancer of the larynx treated between 1996 and 2004; and we selected 104 surgical cases submitted to neck dissection. We evaluated the incidence of bilateral or contralateral metastases, according to the location and extension of the primary tumor

  3. Sperm Concentration, Testicular Volume and Age Predict Risk of Carcinoma In Situ in Contralateral Testis of Men with Testicular Germ Cell Cancer

    DEFF Research Database (Denmark)

    Rud, Camilla Nymann; Daugaard, Gedske; Rajpert-De Meyts, Ewa

    2013-01-01

    We investigated whether semen quality or some easily attainable clinical parameters might be used to estimate the risk of contralateral carcinoma in situ in patients with unilateral testicular germ cell tumors.......We investigated whether semen quality or some easily attainable clinical parameters might be used to estimate the risk of contralateral carcinoma in situ in patients with unilateral testicular germ cell tumors....

  4. Avaliação dos níveis de resposta das emissões otoacústicas em neonatos com asfixia perinatal

    Directory of Open Access Journals (Sweden)

    Georgea Espindola Ribeiro

    2014-09-01

    Full Text Available Objetivo: Avaliar os efeitos da asfixia perinatal sobre os níveis de resposta das emissões otoacústicas por estímulo transiente em lactentes. Métodos: Foi realizado, para comparação, o registro das emissões otoacústicas transientes em 154 neonatos: 54 bebês que sofreram asfixia perinatal, medida pela escala de Apgar e diagnóstico médico ao nascimento, e 100 bebês sem risco. Escores abaixo de 4 no primeiro minuto e/ou menores que 6 no quinto minuto foram considerados "Apgar baixo". A análise estatística do conjunto de dados foi efetuada utilizando-se os testes não paramétricos de Kruskal, Wilcoxon e Mann-Whitney. Resultados: Foram observados menores níveis de resposta nas emissões otoacústicas transientes para o grupo que sofreu asfixia perinatal, com valores estatisticamente significantes para as frequências de 2000, 3000 e 4000Hz na orelha direita e 2000 e 4000Hz na orelha esquerda. Conclusão: A análise das características intrínsecas do exame de emissões otoacústicas transientes mostrou baixo desempenho das células ciliadas externas em neonatos que tiveram asfixia perinatal, o que pode afetar o desenvolvimento das habilidades auditivas nessa população.

  5. Efeito da estimulação acústica contralateral nas medidas temporais das emissões otoacústicas Effect of contralateral acoustic stimulation in temporal measures of otoacoustic emissions

    Directory of Open Access Journals (Sweden)

    Vanessa Nogueira Leme

    2009-01-01

    Full Text Available OBJETIVO: comparar o nível de resposta e o tempo de latência das emissões otoacústicas sem e com apresentação de ruído contralateral. MÉTODOS: foram avaliados 30 indivíduos, com idade entre 18 e 30 anos, sem queixas auditivas e com presença de emissões otoacústicas por produto de distorção. Analisou-se o nível de resposta e latência das emissões otoacústicas por meio do programa Latencygram, com e sem apresentação de ruído contralateral tipo "White noise". RESULTADOS: houve diminuição significante nos níveis de resposta das emissões otoacústicas com apresentação de ruído contralateral, confirmando o efeito de supressão relacionado com a ação do sistema eferente; contudo, não houve diferença significante nos valores de latência das emissões otoacústicas. CONCLUSÃO: o sistema eferente atua apenas na modulação dos níveis de resposta das emissões otoacústicas, contudo não interfere nas medidas temporais das mesmas.PURPOSE: compare the otoacoustic emissions response level and latency in two situations: with and without contralateral competitive noise. METHODS: thirty individuals between eighteen and thirty-year-old, with no auditory complaints and presence of otoacoustic distortion product emissions were evaluated. The latency and the response level of otoacoustic emissions was evaluated using the Latencygram program. The test was performed in two different situations: with and without contralateral competitive white noise. RESULTS: the results demonstrated a significant reduction in otoacoustic emissions response levels with contralateral noise, proving the otoacoustic suppression effect associated with olivocochlear efferent system action. However, there was no significant difference in otoacoustic emissions latency. CONCLUSION: the efferent system may act only in otoacoustic emissions response level modulation but it does not interfere in otoacoustic emissions latency.

  6. [Strategy for revascularization of chronic carotid occlusion with contralateral carotid stenosis].

    Science.gov (United States)

    Fukumitsu, Ryu; Yoshida, Kazumichi; Sadamasa, Nobutake; Narumi, Osamu; Chin, Masaki; Yamagata, Sen

    2010-02-01

    The optimal therapeutic approach for chronic carotid occlusion with contralateral carotid stenosis (ICO-ICS) remains uncertain. The aim of this study was to elucidate the safety and efficacy of initial vascular reconstruction for ICS in patients with ICO-ICS. Eleven patients with ICO-ICS who demonstrated severe cerebral hypoperfusion in the hemisphere ipsilateral to ICO were treated in our institution between February 2003 and November 2007. Revascularization for ICS after measuring cerebral blood flow (CBF) by single photon emission computed tomography (SPECT) was performed either by carotid endarterectomy or carotid stenting. External carotid artery-internal carotid artery (EC-IC) bypass for ICO was also performed when SPECT after revascularization for ICS still demonstrated marked hypoperfusion. In 6 patients with collateral flow via the anterior communicating artery and/or who had high-grade ICS (>70%), sufficient improvement of CBF solely by revascularization for ICS was confirmed. With regard to perioperative complications, 2 patients suffered bradycardia and hypotension and another 2 showed asymptomatic cerebral infarction on diffusion-weighted magnetic resonance imaging. Overall results for revascularization of ICS prior to that for ICO in patients with ICO-ICS were acceptable. CBF of bilateral hemispheres was sufficiently improved in more than half of the patients solely by revascularization for ICS. This strategy might be both efficient and effective for ICO-ICS.

  7. Metachronous adrenal metastasis from operated contralateral renal cell carcinoma with adrenalectomy and iatrogenic Addison's disease.

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    Ozturk, Hakan; Karaaslan, Serap

    2014-09-01

    Metachronous adrenal metastasis from contralateral renal cell carcinoma (RCC) surgery is an extremely rare condition. Iatrogenic Addison's disease occurring after metastasectomy (adrenalectomy) is an even rarer clinical entity. We present a case of a 68-year-old male with hematuria and left flank pain 9 years prior. The patient underwent left transperitoneal radical nephrectomy involving the ipsilateral adrenal glands due to a centrally-located, 75-mm in diameter solid mass lesion in the upper pole of the left kidney. The tumour lesion was confined within the renal capsule, and the histo-pathological examination revealed a Fuhrman nuclear grade II clear cell carcinoma. The patient underwent transperitoneal right adrenalectomy. The histopathological examination revealed metastasis of clear cell carcinoma. The patient was diagnosed with iatrogenic Addison's disease based on the measurement of serum cortisol levels and the adrenocorticotropic hormone (ACTH) stimulation test, after which glucocorticoid and mineralocorticoid replacement was initiated. The patient did not have local recurrence or new metastasis in the first year of the follow-up. The decision to perform ipsilateral adrenalectomy during radical nephrectomy constitutes a challenge, and the operating surgeon must consider all these rare factors.

  8. [Contralateral replantation after bilateral traumatic lower leg amputation. Case report with 6 year follow-up].

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    Betz, A; Stock, W; Hierner, R; Sebisch, E; Schweiberer, L

    1995-05-01

    A 66-year-old patient attempted suicide by jumping in front of a train. The lower extremities were amputated at different levels. On the right side, there was a complete amputation within the distal third of the lower leg. Proximal to the amputation site, there was an extensive soft-tissue and bone defect. On the left side, there was a crush injury of the tarsal and mid-tarsal bones. The left lower leg showed only few injuries. An ipsilateral (anatomical) replantation was not possible. In order to save one lower extremity, we decided to carry out a cross-over (contralateral) replantation of the right foot to the left lower leg. After a follow-up of six years, the patient is able to walk well with her prosthesis on the right side and the right foot hooked up to the left lower leg. Functionally, this treatment (cross-over replantation-one-side prosthesis of the lower leg) is much better than the prosthesis on both extremities, as the result has shown. Also from a psychological point of view, it seems to be better for the patient to preserve one extremity even with a cross-over replanted foot.

  9. A pilot study of contralateral homonymous muscle activity simulated electrical stimulation in chronic hemiplegia.

    Science.gov (United States)

    Osu, Rieko; Otaka, Yohei; Ushiba, Junichi; Sakata, Sachiko; Yamaguchi, Tomofumi; Fujiwara, Toshiyuki; Kondo, Kunitsugu; Liu, Meigen

    2012-01-01

    For the recovery of hemiparetic hand function, a therapy was developed called contralateral homonymous muscle activity stimulated electrical stimulation (CHASE), which combines electrical stimulation and bilateral movements, and its feasibility was studied in three chronic stroke patients with severe hand hemiparesis. Patients with a subcortical lesion were asked to extend their wrist and fingers bilaterally while an electromyogram (EMG) was recorded from the extensor carpi radialis (ECR) muscle in the unaffected hand. Electric stimulation was applied to the homonymous wrist and finger extensors of the affected side. The intensity of the electrical stimulation was computed based on the EMG and scaled so that the movements of the paretic hand looked similar to those of the unaffected side. The patients received 30-minutes of therapy per day for 2 weeks. Improvement in the active range of motion of wrist extension was observed for all patients. There was a decrease in the scores of modified Ashworth scale in the flexors. Fugl-Meyer assessment scores of motor function of the upper extremities improved in two of the patients. The results suggest a positive outcome can be obtained using the CHASE system for upper extremity rehabilitation of patients with severe hemiplegia.

  10. Clinical value of ipsi- and contralateral sacral reflex latency measurement: a normative data study in man.

    Science.gov (United States)

    Amarenco, G; Kerdraon, J

    2000-01-01

    The latency of the bulbocavernosus reflex (BCR) evoked by electrical stimulation of the penis provides a measure of the conduction velocity over the sacral reflex arc at the S2-4 level but does not allow evaluation of the side affected since it results from the simultaneous excitation of both dorsal nerves of the penis (DNP) at the penile root. To evaluate the reliability of the side-to-side BCR latency measurement, this study compared the reflex characteristics of the response elicited by both DNP stimulation and unilateral DNP block. After a unilateral selective DNP anesthesic block, we found that the early response of the contralateral BCR is strictly ipsilateral with no differences in terms of latency, morphology, and reflex threshold from controls. This result may indicate that the side-to-side BCR latency measurement allows a comparative study of the respective right and left sacral reflex arcs in men. We found a mean inter-latency difference of 1.8 +/- 0.4 millisecond of the early BCR response after simultaneous recording of the right and left sides in 10 normal men. We established that an inter-latency difference >3 milliseconds may be indicative of a significant alteration in the conduction over the sacral reflex arc.

  11. Effects of rosiglitazone on contralateral iliac artery after vascular injury in hypercholesterolemic rabbits

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    Baroncini Liz

    2008-05-01

    Full Text Available Abstract Background The objective was to evaluate the effects of rosiglitazone on iliac arteries of hypercholesterolemic rabbits undergoing balloon catheter injury in the contralateral iliac arteries. Methods White male rabbits were fed a hypercholesterolemic diet for 6 weeks and divided into two groups as follows: rosiglitazone group, 14 rabbits treated with rosiglitazone (3 mg/Kg body weight/day during 6 weeks; and control group, 18 rabbits without rosiglitazone treatment. All animals underwent balloon catheter injury of the right iliac artery on the fourteenth day of the experiment. Results There was no significant difference in intima/media layer area ratio between the control group and the rosiglitazone group. Rosiglitazone did not reduce the probability of lesions types I, II, or III (72.73% vs. 92.31%; p = 0.30 and types IV or V (27.27% vs. 7.69%; p = 0.30. There were no differences in the extent of collagen type I and III deposition or in the percentage of animals with macrophages in the intima layer. The percentage of rabbits with smooth muscle cells in the intima layer was higher in rosiglitazone group (p = 0.011. Conclusion These findings demonstrate that rosiglitazone given for 6 weeks did not prevent atherogenesis at a vessel distant from the injury site.

  12. Prognostic factors of second primary contralateral breast cancer in early-stage breast cancer

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    LI, ZHENG; SERGENT, FABRICE; BOLLA, MICHEL; ZHOU, YUNFENG; GABELLE-FLANDIN, ISABELLE

    2015-01-01

    The aim of the present study was to investigate the therapeutic outcome of early-stage breast cancer (pT1aN0M0) and to identify prognostic factors for secondary primary contralateral breast cancer (CBC). A total of 85 patients with mammary carcinomas were included. All patients had undergone breast surgery and adjuvant treatment between January 2001 and December 2008 at the Central Hospital of Grenoble University (Grenoble, France). The primary end-points were disease-free survival and secondary CBC, and the potential prognostic factors were investigated. During a median follow-up of 60 months, 10 of the 85 patients presented with secondary primary cancer, of which six suffered with CBC. No patient mortalities were reported. The rates of CBC were 2.35, 3.53 and 7.06% at one, two and five years, respectively. The cumulative univariate analysis showed that microinvasion and family history are potential risk factors for newly CBC. The current study also demonstrated that secondary CBC was more likely to occur in patients with microinvasion or a family history of hte dise. In addition, the systematic treatment of secondary CBC should include hormone therapy. PMID:25435968

  13. The contralateral delay activity as a neural measure of visual working memory.

    Science.gov (United States)

    Luria, Roy; Balaban, Halely; Awh, Edward; Vogel, Edward K

    2016-03-01

    The contralateral delay activity (CDA) is a negative slow wave sensitive to the number of objects maintained in visual working memory (VWM). In recent years, a growing number of labs started to use the CDA in order to investigate VWM, leading to many fascinating discoveries. Here, we discuss the recent developments and contribution of the CDA in various research fields. Importantly, we report two meta-analyses that unequivocally validate the relationship between the set-size increase in the CDA amplitude and the individual VWM capacity, and between the CDA and filtering efficiency. We further discuss how the CDA was used to study the role of VWM in visual search, multiple object tracking, grouping, binding, and whether VWM capacity allocation is determined by the items' resolution or instead by the number of objects regardless of their complexity. In addition, we report how the CDA has been used to characterize specific VWM deficits in special populations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Unilateral renal hypoplasia and contralateral renal agenesis: a new association with 45,X/46,XY mosaicism.

    Science.gov (United States)

    Wax, J R; Prabhakar, G; Giraldez, R A; Hutchins, G M; Stetten, G; Blakemore, K J

    1994-05-01

    The association of urinary anomalies with Turner's syndrome is well established. This report describes an unusual antenatal presentation of this cytogenetic disorder and the first reported case of unilateral renal hypoplasia and contralateral renal agenesis in a 45,X/46,XY fetus. The fetus presented with severe third trimester oligohydramnios and symmetrical intrauterine growth retardation at 29 weeks and 2 days' gestation. Chorionic villus cultures revealed a 45,X karyotype. A phenotypically male infant weighing 1833 g was delivered at 35 weeks and 2 days. Chromosomal analysis of the newborn showed a 45,X/46,XY mosaicism, and surgical exploration revealed absence of the left kidney and a hypoplastic right kidney. The infant died at 11 months of age from renal failure and peritonitis. This case demonstrates that monosomy X may be encountered in fetuses with marked growth delay and oligohydramnios. The etiology of the oligohydramnios in this case was a fetal renal malformation not previously described in Turner's syndrome. Antenatal cytogenetic findings should be confirmed postnatally, with a search for mosaicism, when monosomy X is encountered.

  15. Acute-Onset Tinnitus Is Associated with Contralateral Hearing in Sudden Deafness.

    Science.gov (United States)

    Lee, Ho Yun; Choi, Myoung Su; Chang, Dong Sik; Kim, Ah-Young; Cho, Chin Saeng

    2015-01-01

    We aimed to evaluate the prognostic factors for acute-onset tinnitus associated with unilateral idiopathic sudden sensorineural hearing loss (ISSNHL) and to assess the relationship between these factors and the final recovery. A total of 770 patients with unilateral ISSNHL were enrolled retrospectively and their medical records reviewed. Patients were classified into two groups according to the presence of acute-onset tinnitus at the initial examination. Patient characteristics and the results of pure-tone audiometry were compared between the two groups initially and 3 months later. A total of 70.9% (n = 546) of patients had tinnitus initially. There was no significant difference in the mean hearing thresholds of the affected ear irrespective of accompanying tinnitus. In contrast, patients with tinnitus in the affected ear tended to have significantly better mean hearing thresholds in the nonaffected ear (p < 0.05). The logistic regression analysis revealed that better mean hearing thresholds in the nonaffected ear were associated with tinnitus occurrence (p < 0.05). Better hearing thresholds in the nonaffected ear, younger age, absence of dizziness, low-tone hearing loss, and combined intratympanic dexamethasone injection were associated with full recovery (p < 0.05). However, tinnitus was not an independent risk factor for full recovery. Better contralateral hearing was associated with both an increased incidence of concurrent tinnitus and a better final recovery. However, tinnitus was not related to full recovery. © 2015 S. Karger AG, Basel.

  16. Arteriovenous Malformation in Temporal Lobe Presenting as Contralateral Ocular Symptoms Mimicking Carotid-Cavernous Fistula

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    Fadzillah Mohd-Tahir

    2013-01-01

    Full Text Available Aim. To report a rare case of arteriovenous malformation in temporal lobe presenting as contralateral orbital symptoms mimicking carotid-cavernous fistula. Method. Interventional case report. Results. A 31-year-old Malay gentleman presented with 2-month history of painful progressive exophthalmos of his left eye associated with recurrent headache, diplopia, and reduced vision. Ocular examination revealed congestive nonpulsating 7 mm exophthalmos of the left eye with no restriction of movements in all direction. There was diplopia in left lateral gaze. Left IOP was elevated at 29 mmHg. Left eye retinal vessels were slightly dilated and tortuous. CT scan was performed and showed right temporal arteriovenous malformation with a nidus of 3.8 cm × 2.5 cm with right middle cerebral artery as feeding artery. There was dilated left superior ophthalmic vein of 0.9 mm in diameter with enlarged left cavernous sinus. MRA and carotid angiogram confirmed right temporal arteriovenous malformation with no carotid-cavernous fistula. Most of the intracranial drainage was via left cavernous sinus. His signs and symptoms dramatically improved following successful embolisation, completely resolved after one year. Conclusion. Intracranial arteriovenous malformation is rarely presented with primary ocular presentation. Early intervention would salvage the eyes and prevent patients from more disaster morbidity or fatality commonly due to intracranial haemorrhage.

  17. MEP Latencies Predict the Neuromodulatory Effect of cTBS Delivered to the Ipsilateral and Contralateral Sensorimotor Cortex.

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    Gan Huang

    Full Text Available Recently, it was shown that the highly variable after-effect of continuous theta-burst stimulation (cTBS of the primary motor cortex (M1 can be predicted by the latency of motor-evoked potentials (MEPs recorded before cTBS. This suggests that at least part of this inter-individual variability is driven by differences in the neuronal populations preferentially activated by transcranial magnetic stimulation (TMS.Here, we recorded MEPs, TMS-evoked brain potentials (TEPs and somatosensory-evoked potentials (SEPs to investigate the effects of cTBS delivered over the primary sensorimotor cortex on both the ipsilateral and contralateral M1, and the ipsilateral and contralateral primary somatosensory cortex (S1.We confirm that the after-effects of cTBS can be predicted by the latency of MEPs recorded before cTBS. Over the hemisphere onto which cTBS was delivered, short-latency MEPs at baseline were associated with an increase of MEP magnitude (i.e. an excitatory effect of cTBS whereas late-latency MEPs were associated with reduced MEPs (i.e. an inhibitory effect of cTBS. This relationship was reversed over the contralateral hemisphere, indicating opposite effects of cTBS on the responsiveness of the ipsilateral and contralateral M1. Baseline MEP latencies also predicted changes in the magnitude of the N100 wave of TEPs elicited by stimulation of the ipsilateral and contralateral hemisphere, indicating that this TEP component is specifically dependent on the state of M1. Finally, there was a reverse relationship between MEP latency and the effects of cTBS on the SEP waveforms (50-130 ms, indicating that after-effects of cTBS on S1 are opposite to those on M1.Taken together, our results confirm that the variable after-effects of cTBS can be explained by differences in the neuronal populations activated by TMS. Furthermore, our results show that this variability also determines remote effects of cTBS in S1 and the contralateral hemisphere, compatible with

  18. Consumo precoce de alimentos não recomendados por lactentes do sul do Brasil = Early consumption of non-recommended foods among southern Brazilian infants

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    Vitolo, Márcia Regina

    2013-01-01

    Full Text Available Objetivo: Avaliar o consumo de alimentos não recomendados em crianças assistidas no âmbito da Atenção Primária à Saúde no município de Porto Alegre, RS. Materiais e Métodos: A amostra compreendeu crianças residentes no território de cobertura de vinte Unidades de Saúde. As mães das crianças de 6 a 9 meses de idade responderam a um questionário fechado, em que ela confirmava ou não se a criança já tinha consumido determinados alimentos. Posteriormente, na idade de 12 a 15 meses, foi realizada nova investigação quanto ao consumo dos mesmos alimentos no último mês. Resultados: Refrigerante, bala ou pirulito e biscoito recheado foram consumidos por, aproximadamente, 40% das crianças na idade de 6 a 9 meses e 80% na idade de 12 a 15 meses. A prevalência de consumo de açúcar de adição, queijo petit suisse e gelatina foi superior a 70% nos dois momentos. Alimentos fritos e chocolate foram consumidos por mais de 80% na idade de 12 a 15 meses. Conclusão: Os resultados mostram elevada prevalência de consumo de alimentos não recomendados para crianças menores de dois anos, enfatizando a necessidade de sensibilização, formação e preparo dos profissionais da Atenção Primária à Saúde para a realização de aconselhamento dietético

  19. Altered Contralateral Auditory Cortical Morphology in Unilateral Sudden Sensorineural Hearing Loss.

    Science.gov (United States)

    Fan, Wenliang; Zhang, Wenjuan; Li, Jing; Zhao, Xueyan; Mella, Grace; Lei, Ping; Liu, Yuan; Wang, Haha; Cheng, Huamao; Shi, Hong; Xu, Haibo

    2015-12-01

    To investigate the cerebral gray matter volume alterations in unilateral sudden sensorineural hearing loss patients within the acute period by the voxel-based morphometry method, and to determine if hearing impairment is associated with regional gray matter alterations in unilateral sudden sensorineural hearing loss patients. Prospective case study. Tertiary class A teaching hospital. Thirty-nine patients with left-side unilateral sudden sensorineural hearing loss and 47 patients with right-side unilateral sudden sensorineural hearing loss. Diagnostic. To compare the regional gray matter of unilateral sudden sensorineural hearing loss patients and healthy control participants. Compared with control groups, patients with left side unilateral sudden sensorineural hearing loss had significant gray matter reductions in the right middle temporal gyrus and right superior temporal gyrus, whereas patients with right side unilateral sudden sensorineural hearing loss showed gray matter decreases in the left superior temporal gyrus and left middle temporal gyrus. A significant negative correlation with the duration of the sudden sensorineural hearing loss (R = -0.427, p = 0.012 for left-side unilateral SSNHL and R = -0.412, p = 0.013 for right-side unilateral SSNHL) was also found in these brain areas. There was no region with increased gray matter found in both groups of unilateral sudden sensorineural hearing loss patients. This study confirms that detectable decreased contralateral auditory cortical morphological changes have occurred in unilateral SSNHL patients within the acute period by voxel-based morphometry methods. The gray matter volumes of these brain areas also perform a negative correlation with the duration of the disease, which suggests a gradual brain structural impairment after the progression of the disease.

  20. Posterior SMA Syndrome following subcortical stroke: contralateral akinesia reversed by visual feedback.

    Science.gov (United States)

    Radman, Narges; Cacioppo, Stephanie; Spierer, Lucas; Schmidlin, Eric; Mayer, Eugène; Annoni, Jean-Marie

    2013-11-01

    The supplementary motor area (SMA) plays a key role in motor programming and production and is involved in internally-cued movements. In neurological populations, SMA syndrome following a lesion to the "SMA proper" is characterized by transient impairment of voluntary movements and motor sequences. This syndrome is assumed to follow on from an interruption of the motor cortico-subcortical loop, and some case reports indicate that such a syndrome could occur after a brain lesion isolating the SMA from subcortical structures. To characterize the pattern of motor impairments in a patient whose stroke disconnects the SMA from the subcortical motor loop. A patient developed a moderate transient left hemiparesis following a subcortical stroke in the right anterior cerebral artery area, which disconnected the SMA from basal ganglia. Eight days after the stroke, when the hemiparesis had regressed, the patient presented a specific SMA motor disorder of the left hand which manifested as an akinesia and was exacerbated when his visual attention was not directed towards his hand. We assessed finger tapping with left and right hands, eyes closed and open, in the left and right hemispace. We indexed movement speed as the number of taps filmed over 5-s periods. Left motor weakness (grasping strength of right hand: 49 kg and left hand: 41 kg) was resolved in a week. Ideomotor and ideational gestures and motor sequences were preserved. On the tapping task, left-hand tapping was slower than right-hand tapping. Critically, visual feedback improved tapping speed for the left, but not for the right, hand. The hemispace of the task execution had no effect on tapping performance. Our results suggest that SMA-basal ganglia disconnection decreases contralateral movement initiation and maintenance and this effect is partly compensated by visual cues. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Contralaterally Controlled Functional Electrical Stimulation Improves Hand Dexterity in Chronic Hemiparesis: A Randomized Trial.

    Science.gov (United States)

    Knutson, Jayme S; Gunzler, Douglas D; Wilson, Richard D; Chae, John

    2016-10-01

    It is unknown whether one method of neuromuscular electrical stimulation for poststroke upper limb rehabilitation is more effective than another. Our aim was to compare the effects of contralaterally controlled functional electrical stimulation (CCFES) with cyclic neuromuscular electrical stimulation (cNMES). Stroke patients with chronic (>6 months) moderate to severe upper extremity hemiparesis (n=80) were randomized to receive 10 sessions/wk of CCFES- or cNMES-assisted hand opening exercise at home plus 20 sessions of functional task practice in the laboratory for 12 weeks. The task practice for the CCFES group was stimulation assisted. The primary outcome was change in Box and Block Test (BBT) score at 6 months post treatment. Upper extremity Fugl-Meyer and Arm Motor Abilities Test were also measured. At 6 months post treatment, the CCFES group had greater improvement on the BBT, 4.6 (95% confidence interval [CI], 2.2-7.0), than the cNMES group, 1.8 (95% CI, 0.6-3.0), between-group difference of 2.8 (95% CI, 0.1-5.5), P=0.045. No significant between-group difference was found for the upper extremity Fugl-Meyer (P=0.888) or Arm Motor Abilities Test (P=0.096). Participants who had the largest improvements on BBT were <2 years post stroke with moderate (ie, not severe) hand impairment at baseline. Among these, the 6-month post-treatment BBT gains of the CCFES group, 9.6 (95% CI, 5.6-13.6), were greater than those of the cNMES group, 4.1 (95% CI, 1.7-6.5), between-group difference of 5.5 (95% CI, 0.8-10.2), P=0.023. CCFES improved hand dexterity more than cNMES in chronic stroke survivors. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00891319. © 2016 American Heart Association, Inc.

  2. Triple negative status and BRCA mutations in contralateral breast cancer: a population-based study.

    Science.gov (United States)

    Pellegrino, Benedetta; Bella, Mariangela; Michiara, Maria; Zanelli, Paola; Naldi, Nadia; Porzio, Rosa; Bortesi, Beatrice; Boggiani, Daniela; Zanoni, Daniele; Camisa, Roberta; Neri, Tauro Maria; Pinto, Carmine; Musolino, Antonino

    2016-05-06

    BRCA1/2 mutation carriers diagnosed with breast cancer have a strong life-time risk of developing contralateral breast cancer (CBC). We performed a population-based study with the aim of estimating the proportion of CBC associated with BRCA1/BRCA2 mutations, and the contribution of germline mutations to both molecular and clinical features of these tumors. Fifty-five women with invasive CBC consecutively seen at the at the Genetic Oncology Service of the University Hospital of Parma from 2000 to 2011 were subjected to BRCA1/2 testing. Fifty-five case-matched, unilateral breast cancer (UBC)  patients (pts), which tested negative for BRCA1/2 mutations, were selected as control group. BRCA mutations were detected in 13 (24%) of 55 CBC pts. Women with BRCA1 mutations, and to a lesser extent BRCA2 mutations, were significantly more likely to present with high histologic grade, negative hormone receptor status and high proliferation rate in both first and second primary breast cancers than BRCA-negative, CBC tumors. A diagnosis of triple-negative breast cancer (TNBC) was significantly more frequent in women with BRCA mutations in comparison with BRCA-negative, UBC controls. There were no survival differences between BRCA-positive and non-BRCA tumors. Results of the present study indicate that both first primary and second primary breast cancers in BRCA carriers are qualitatively distinct from BRCA negative CBC, and from sporadic UBC controls. These findings highlight relevant clinical considerations about the potential value of BRCA testing in women with CBC as well as therapeutic, preventive, and surveillance implications for patients carrying a mutation.

  3. Unilateral Plantar Flexors Static-Stretching Effects on Ipsilateral and Contralateral Jump Measures

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    Josinaldo Jarbas da Silva, David George Behm, Willy Andrade Gomes, Fernando Henrique Domingues de Oliveira Silva, Enrico Gori Soares, Érica Paes Serpa, Guanis de Barros Vilela Junior, Charles Ricardo Lopes, Paulo Henrique Marchetti

    2015-06-01

    Full Text Available The aim of this study was to evaluate the acute effects of unilateral ankle plantar flexors static-stretching (SS on the passive range of movement (ROM of the stretched limb, surface electromyography (sEMG and single-leg bounce drop jump (SBDJ performance measures of the ipsilateral stretched and contralateral non-stretched lower limbs. Seventeen young men (24 ± 5 years performed SBDJ before and after (stretched limb: immediately post-stretch, 10 and 20 minutes and non-stretched limb: immediately post-stretch unilateral ankle plantar flexor SS (6 sets of 45s/15s, 70-90% point of discomfort. SBDJ performance measures included jump height, impulse, time to reach peak force, contact time as well as the sEMG integral (IEMG and pre-activation (IEMGpre-activation of the gastrocnemius lateralis. Ankle dorsiflexion passive ROM increased in the stretched limb after the SS (pre-test: 21 ± 4° and post-test: 26.5 ± 5°, p < 0.001. Post-stretching decreases were observed with peak force (p = 0.029, IEMG (P<0.001, and IEMGpre-activation (p = 0.015 in the stretched limb; as well as impulse (p = 0.03, and jump height (p = 0.032 in the non-stretched limb. In conclusion, SS effectively increased passive ankle ROM of the stretched limb, and transiently (less than 10 minutes decreased muscle peak force and pre-activation. The decrease of jump height and impulse for the non-stretched limb suggests a SS-induced central nervous system inhibitory effect.

  4. Social Network, Surgeon, and Media Influence on the Decision to Undergo Contralateral Prophylactic Mastectomy.

    Science.gov (United States)

    Venetis, Maria K; MacGeorge, Erina L; Baptiste, Dadrie F; Mouton, Ashton; Friley, Lorin B; Pastor, Rebekah; Hatten, Kristen; Lagoo, Janaka; Bowling, Monet W; Clare, Susan E

    2016-07-26

    The rate of contralateral prophylactic mastectomy (CPM) has risen sharply in the past decade. The current study was designed to examine social network, surgeon, and media influence on patients' CPM decision-making, examining not only who influenced the decision, and to what extent, but also the type of influence exerted. Patients (N=113) who underwent CPM at 4 Indiana University-affiliated hospitals between 2008 and 2012 completed structured telephone interviews in 2013. Questions addressed the involvement and influence of the social network (family, friends, and nonsurgeon health professionals), surgeon, and media on the CPM decision. Spouses, children, family, friends, and health professionals were reported as exerting a meaningful degree of influence on patients' decisions, largely in ways that were positive or neutral toward CPM. Most surgeons were regarded as providing options rather than encouraging or discouraging CPM. Media influence was present, but limited. Patients who choose CPM do so with influence and support from members of their social networks. Reversing the increasing choice of CPM will require educating these influential others, which can be accomplished by encouraging patients to include them in clinical consultations, and by providing patients with educational materials that can be shared with their social networks. Surgeons need to be perceived as having an opinion, specifically that CPM should be reserved for those patients for whom it is medically indicated.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0/.

  5. False amblyopia prediction in strabismic patients by fixation preference testing correlates with contralateral ocular dominance.

    Science.gov (United States)

    AlHarkan, Dora H; Khan, Arif O

    2014-10-01

    Binocular fixation preference testing is commonly used to predict strabismic amblyopia in preverbal children. However, false positives can occur and can lead to unnecessary patching treatment. We explored potential causes for this phenomenon. In this prospective cohort study (2013-2014) of consecutive verbal strabismic patients without incomitance or decreased vision other than strabismic amblyopia, binocular fixation preference testing was graded from 1 (strong preference) to 4 (free alteration), with grade 1 or 2 considered predictive of amblyopia and the examiner masked to visual acuity. These results were compared to the presence/absence of true strabismic amblyopia. Ocular dominance and hand dominance were assessed, and previous patching history was documented. Of 114 enrolled subjects (mean age, 7.9 years; range, 3.4-22.4; 63 males), 98 (86%) had esotropia and 16 (14%) had exotropia (mean primary position horizontal strabismus, 27.9(Δ); range, 8(Δ)-70(Δ), with only one eye correlated with ipsilateral ocular dominance (79.5%; P hand dominance or recent patching history. Positive predictive value was poor (45.8%; 95% CI, 34.0%-58.0%), but negative predictive value was high (97.6%; 95% CI, 87.4%-99.6%). Subgroup analysis revealed no significant correlations with degree or type of strabismus. False positives during binocular fixation preference testing of strabismic patients are common and likely due to contralateral ocular dominance. The test is more useful for predicting the absence rather than the presence of strabismic amblyopia. Copyright © 2014 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  6. Contralateral delay activity tracks the influence of Gestalt grouping principles on active visual working memory representations.

    Science.gov (United States)

    Peterson, Dwight J; Gözenman, Filiz; Arciniega, Hector; Berryhill, Marian E

    2015-10-01

    Recent studies have demonstrated that factors influencing perception, such as Gestalt grouping cues, can influence the storage of information in visual working memory (VWM). In some cases, stationary cues, such as stimulus similarity, lead to superior VWM performance. However, the neural correlates underlying these benefits to VWM performance remain unclear. One neural index, the contralateral delay activity (CDA), is an event-related potential that shows increased amplitude according to the number of items held in VWM and asymptotes at an individual's VWM capacity limit. Here, we applied the CDA to determine whether previously reported behavioral benefits supplied by similarity, proximity, and uniform connectedness were reflected as a neural savings such that the CDA amplitude was reduced when these cues were present. We implemented VWM change-detection tasks with arrays including similarity and proximity (Experiment 1); uniform connectedness (Experiments 2a and 2b); and similarity/proximity and uniform connectedness (Experiment 3). The results indicated that when there was a behavioral benefit to VWM, this was echoed by a reduction in CDA amplitude, which suggests more efficient processing. However, not all perceptual grouping cues provided a VWM benefit in the same measure (e.g., accuracy) or of the same magnitude. We also found unexpected interactions between cues. We observed a mixed bag of effects, suggesting that these powerful perceptual grouping benefits are not as predictable in VWM. The current findings indicate that when grouping cues produce behavioral benefits, there is a parallel reduction in the neural resources required to maintain grouped items within VWM.

  7. Steal phenomenon in Sturge-Weber syndrome imitating an ictal electroencephalography change in the contralateral hemisphere: report of 2 cases.

    Science.gov (United States)

    Limotai, Chusak; Go, Cristina Y; Baba, Shiro; Okanari, Kazuo; Ochi, Ayako; Rutka, James T; Snead, O Carter; Otsubo, Hiroshi

    2015-08-01

    Infants with Sturge-Weber syndrome (SWS) are considered for surgery if they develop seizures and the seizures prove medically refractory. The authors report on 2 infants (15 and 19 months old) with SWS who underwent scalp video electroencephalography (EEG) and subsequent functional hemispherotomy for intractable partial motor seizures due to extensive left hemispheric angiomatosis. They presented with similar interictal and ictal EEG findings. Ictal EEG showed abrupt high-amplitude delta slow waves, without evolution on the contralateral hemisphere before the build-up of ictal EEG changes on the lesional hemisphere. The patients became seizure free after hemispherotomy. The ictal contralateral slow waves were not a sign of an ictal hemisphere and may indicate prominent ischemic changes resulting from a steal phenomenon of hemispheric angiomatosis during seizure.

  8. Metastasis of Ciliary Body Melanoma to the Contralateral Eye: A Case Report and Review of Uveal Melanoma Literature

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    Nouritza M. Torossian

    2015-01-01

    Full Text Available Many types of cancers metastasize to the eye. However, uveal melanoma metastasizing to the contralateral choroid is very rare. We report the case of a 68-year-old man with history of treated uveal melanoma of the right eye that developed metastasis to the liver and the choroid of the left eye. Ten years earlier, he was diagnosed to have uveal melanoma of the right eye and was initially treated with plaque radiotherapy. Two years later, upon progression of the disease in the right eye he had enucleation of the eye. We describe the patient’s clinical history, the diagnosis of recurrent disease in the contralateral eye, therapy of the left eye, and systemic metastasis. In addition, we reviewed the published medical literature and described the recent advances in the management of uveal melanoma.

  9. Role of movement velocity on the magnitude of grip force while lifting an object with touch from the contralateral finger.

    Science.gov (United States)

    Iyengar, Veena; Santos, Marcio J; Aruin, Alexander S

    2009-04-01

    We investigated whether slower velocity of arm movement affects grip-force generation in conditions with the finger touch provided to the wrist of the target arm. Nine subjects performed the task of lifting and transporting an object at slow, intermediate, and fast velocities with a light finger touch from the contralateral arm and without it. There was an effect of velocity of arm movement on grip-force generation in both conditions. However, when the no touch and touch trials performed with similar velocity were matched, the effect of touch on grip-force reduction was statistically significant (p touch conditions and underlines the importance of using a contralateral touch in the performance of activities of daily living. It also points to a possibility of the development of therapeutic advances for the enhancement of grip-force control in patients with neurological impairments.

  10. Oftalmoplegia internuclear achado clínico inicial e único em endocardite bacteriana

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    Antonio L. dos Santos Werneck

    1990-03-01

    Full Text Available Oftalmoplegia internuclear unilateral traduz-se por paralisia homolateral da adução ocular e nistagmo contralateral. As principais causas são a esclerose múltipla e a insuficiência vértebro-basilar. Apresentamos um caso secundário a endocardite bacteriana, em que este sinal iniciou o quadro e foi o único achado neurológico.

  11. Unilateral lesion of dorsal hippocampus in adult rats impairs contralateral long-term potentiation in vivo and spatial memory in the early postoperative phase.

    Science.gov (United States)

    Li, Hongjie; Wu, Xiaoyan; Bai, Yanrui; Huang, Yan; He, Wenting; Dong, Zhifang

    2012-05-01

    It is well documented that bilateral hippocampal lesions or unilateral hippocampal lesion at birth causes impairment of contralateral LTP and long-term memory. However, effects of unilateral hippocampal lesion in adults on contralateral in vivo LTP and memory are not clear. We here examined the influence of unilateral electrolytic dorsal hippocampal lesion in adult rats on contralateral LTP in vivo and spatial memory during different postoperative phases. We found that acute unilateral hippocampal lesion had no effect on contralateral LTP. However, contralateral LTP was impaired at 1 week after lesion, and was restored to the control level at postoperative week 4. Similarly, spatial memory was also impaired at postoperative week 1, and was restored at postoperative week 4. In addition, the rats at postoperative week 1 showed stronger spatial exploratory behavior in a novel open-field environment. The sham operation had no effects on contralateral LTP, spatial memory and exploration at either postoperative week 1 or week 4. These results suggest that unilateral dorsal hippocampal lesion in adult rats causes transient contralateral LTP impairment and spatial memory deficit. Copyright © 2012 Elsevier B.V. All rights reserved.

  12. Spontaneous Rupture of the Patellar Tendon and the Contralateral Quadriceps Tendon, Associated with Lupus Erythematosus: Analysis of the Literature

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    Efthimios J. Karadimas

    2011-01-01

    Full Text Available Bilateral rupture of the patellar tendon is a rare injury. A case of a 67-year-old man with systemic lupus erythematosus under corticosteroid treatment for the last 10 years, who sustained spontaneous rupture of the patellar tendon and the contralateral quadriceps tendon, is herein presented. The patient was operated bilaterally, had an optimal outcome considering his age and the comorbidities, and was followed up for 24 months.

  13. Screening for carcinoma in situ in the contralateral testicle in patients with testicular cancer: a population-based study.

    Science.gov (United States)

    Kier, M G G; Lauritsen, J; Almstrup, K; Mortensen, M S; Toft, B G; Rajpert-De Meyts, E; Skakkebaek, N E; Rørth, M; von der Maase, H; Agerbaek, M; Holm, N V; Andersen, K K; Dalton, S O; Johansen, C; Daugaard, G

    2015-04-01

    Screening programmes for contralateral carcinoma in situ (CIS) testis in patients with unilateral germ-cell cancer (GCC) have never been evaluated. We investigated the effect of screening for contralateral CIS in a large nation-wide, population-based study. A contralateral single-site biopsy was offered to 4130 patients in whom GCC had been diagnosed in 1984-2007 (screened cohort); 462 patients in whom GCC was diagnosed in 1984-1988 comprised the unscreened cohort. Cases with CIS were offered radiotherapy. Initially CIS-negative biopsies in patients with metachronous GCC were revised according to today's standards. Risk for metachronous GCC was estimated using cumulative incidence and the Cox proportional hazards model. In the screened cohort, contralateral CIS was found in 181 (4.4%) patients. The cumulative incidence of metachronous GCC after 20 years was 1.9% in the screened cohort and 3.1% in the unscreened cohort (P = 0.097), hazard ratio (HR) for the unscreened cohort: 1.59 (P = 0.144). Expert revision with contemporary methodology of CIS-negative biopsy samples from patients with metachronous cancer revealed CIS in 17 out of 45 (38%) cases. Decreased risks for metachronous GCC were related to older age at diagnosis (HR 0.52 per 10 years, P testicular cancer showed no significant difference in the risk for metachronous GCC between a screened and an unscreened cohort. Single-site biopsy including modern immunohistochemistry does not identify all cases of CIS. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  14. The activity in the contralateral primary motor cortex, dorsal premotor and supplementary motor area is modulated by performance gains

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    Ronen eSosnik

    2014-04-01

    Full Text Available There is growing experimental evidence that the engagement of different brain areas in a given motor task may change with practice, although the specific brain activity patterns underlying different stages of learning, as defined by kinematic or dynamic performance indices, are not well understood. Here we studied the change in activation in motor areas during practice on sequences of handwriting-like trajectories, connecting four target points on a digitizing table 'as rapidly and as accurately as possible' while lying inside an fMRI scanner. Analysis of the subjects' pooled kinematic and imaging data, acquired at the beginning, middle and end of the training period, revealed no correlation between the amount of activation in the contralateral M1, PM (dorsal and ventral, SMA, preSMA and PPC and the amount of practice per-se. Single trial analysis has revealed that the correlation between the amount of activation in the contralateral M1 and trial mean velocity was partially modulated by performance gains related effects, such as increased hand motion smoothness. Furthermore, it was found that the amount of activation in the contralateral preSMA increased when subjects shifted from generating straight point-to-point trajectories to their spatiotemporal concatenation into a smooth, curved trajectory. Altogether, our results indicate that the amount of activation in the contralateral M1, PMd and preSMA during the learning of movement sequences is correlated with performance gains and that high level motion features (e.g., motion smoothness may modulate, or even mask correlations between activity changes and low-level motion attributes (e.g., trial mean velocity.

  15. Balancing bilateral sensory activity: callosal processing modulates sensory transmission through the contralateral thalamus by altering the response threshold.

    Science.gov (United States)

    Li, Lu; Ebner, Ford F

    2006-07-01

    Rats tactually explore a nearly spherical space field around their heads with their whiskers. The information sampled by the two sets of whiskers is integrated bilaterally at the cortical level in an activity dependent manner via the corpus callosum. We have recently shown that sensory activity in one barrel field cortex (BFC) modulates the processing of incoming sensory information to the other BFC. Whether interhemispheric integration is dynamically linked with corticothalamic modulation of incoming sensory activity is an important hypothesis to test, since subcortical relay neurons are directly modulated by cortical neurons through top-down processes. In the present study, we compared the direct sensory responses of single thalamic relay neurons under urethane anesthesia before and after inactivating the BFC contralateral to a thalamic neuron. The data show that silencing one BFC reduces response magnitude in contralateral thalamic relay neurons, significantly and reversibly, in response to test stimuli applied to the principal whisker at two times response threshold (2T) intensity for each unit. Neurons in the ventral posterior medial (VPM) nucleus and the medial division of the posterior nucleus (POm) react in a similar manner, although POm neurons are more profoundly depressed by inactivation of the contralateral BFC than VPM neurons. The results support the novel idea that the subcortical relay of sensory information to one hemisphere is strongly modulated by activity levels in the contralateral as well as in the ipsilateral SI cortex. The mechanism of the modulation appears to be based on shifting the stimulus-response curves of thalamic neurons, thereby rendering them more or less sensitive to sensory stimuli. We conclude that global sensory processing is created by combining activity in each cerebral hemisphere and continually balancing the flow of information to cortex by adjusting the responsiveness of ascending sensory pathways.

  16. Dissociation of the pathways mediating ipsilateral and contralateral motor-evoked potentials in human hand and arm muscles

    Science.gov (United States)

    Ziemann, Ulf; Ishii, Kenji; Borgheresi, Alessandra; Yaseen, Zaneb; Battaglia, Fortunato; Hallett, Mark; Cincotta, Massimo; Wassermann, Eric M

    1999-01-01

    Growing evidence points toward involvement of the human motor cortex in the control of the ipsilateral hand. We used focal transcranial magnetic stimulation (TMS) to examine the pathways of these ipsilateral motor effects.Ipsilateral motor-evoked potentials (MEPs) were obtained in hand and arm muscles of all 10 healthy adult subjects tested. They occurred in the finger and wrist extensors and the biceps, but no response or inhibitory responses were observed in the opponens pollicis, finger and wrist flexors and the triceps.The production of ipsilateral MEPs required contraction of the target muscle. The threshold TMS intensity for ipsilateral MEPs was on average 1.8 times higher, and the onset was 5.7 ms later (in the wrist extensor muscles) compared with size-matched contralateral MEPs.The corticofugal pathways of ipsilateral and contralateral MEPs could be dissociated through differences in cortical map location and preferred stimulating current direction.Both ipsi- and contralateral MEPs in the wrist extensors increased with lateral head rotation toward, and decreased with head rotation away from, the side of the TMS, suggesting a privileged input of the asymmetrical tonic neck reflex to the pathway of the ipsilateral MEP.Large ipsilateral MEPs were obtained in a patient with complete agenesis of the corpus callosum.The dissociation of the pathways for ipsilateral and contralateral MEPs indicates that corticofugal motor fibres other than the fast-conducting crossed corticomotoneuronal system can be activated by TMS. Our data suggest an ipsilateral oligosynaptic pathway, such as a corticoreticulospinal or a corticopropriospinal projection as the route for the ipsilateral MEP. Other pathways, such as branching of corticomotoneuronal axons, a transcallosal projection or a slow-conducting monosynaptic ipsilateral pathway are very unlikely or can be excluded. PMID:10420023

  17. Avaliação do consumo de corantes artificiais por lactentes, pré-escolares e escolares Evaluation of artificial dye intake by children

    Directory of Open Access Journals (Sweden)

    Simone Pinheiro Alves Schumann

    2008-09-01

    Full Text Available O objetivo do presente trabalho foi avaliar o consumo, por 150 crianças de até 10 anos, de pó para gelatina, preparado sólido para refresco e refrigerante. Foi feita aplicação de questionário de freqüência quantitativa e qualitativa com população infantil atendida no ambulatório de pediatria do Hospital Universitário Gafrée Guinle, Rio de Janeiro. Os dados foram tratados estatisticamente pelo programa SPSS 8.0. Verificou-se que os alimentos pesquisados são ampla e freqüentemente consumidos, sendo introduzidos na dieta, em muitos dos casos, antes da criança completar 1 ano de idade. Sabe-se que os produtos estudados não são adequados nutricionalmente, pois apresentam, além dos corantes, outros aditivos alimentares e não contêm nenhum nutriente importante para o funcionamento do organismo. Em relação aos corantes presentes nos produtos mencionados pela população estudada, constatou-se que os mais informados na rotulagem destes produtos, no item ingredientes, são amarelo crepúsculo, tartrazina e amaranto. Estimando que o teor dos corantes nos alimentos analisados esteja no limite máximo permitido pela legislação, observou-se que a grande maioria das crianças avaliadas pode estar excedendo a ingestão diária aceitável para o corante amaranto e que cerca de 20% da população pode estar excedendo o consumo recomendado para o amarelo crepúsculo. É importante que os valores máximos permitidos de corantes em alimentos, no Brasil, sejam adequados às recomendações realizadas pelo órgão internacional que avalia a segurança dos aditivos, e que ações educativas sejam realizadas.This study aimed at evaluating the intake of solid jelly powder, solid juice powder and soft drinks by children. The intakes were estimated through the application of a quantitative and qualitative food frequency questionnaire. The study was pursued in the pediatric nutrition ambulatory of Gaffrée Guinle University Hospital in Rio de

  18. Comparação do desenvolvimento motor de lactentes de mães adolescentes e adultas Motor development comparison between infants of adolescent and adult mothers

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    Naiane Sartori

    2010-12-01

    Full Text Available Este estudo objetivou caracterizar o desempenho motor de bebês de 0 a 16 meses, comparando o de bebês nascidos de mães adolescentes ao de bebês de mães adultas. Participaram 80 bebês, sendo 40 de mães adolescentes e 40 de mães adultas. Os instrumentos avaliativos foram a escala motora infantil de Alberta AIMS (Alberta infant motor scale e questionário para identificar as características biológicas. Os dados foram analisados estatisticamente. Os resultados da AIMS mostram pior desempenho motor dos bebês de mães adolescentes (p=0,002; p=0,001, além de suas inadequadas aquisições motoras nas posturas prono e em pé. Não foi encontrada associação significativa entre a maioria dos fatores biológicos analisados e o desenvolvimento motor dos bebês. Os resultados sugerem que a idade materna pode ser considerada fator de risco para atraso motor em crianças, porém ressalta-se a interação de diferentes fatores, aqui não controlados, influenciando as aquisições motoras de crianças, tais como as demandas da tarefa e as condições do ambiente.The purpose of the study was to compare motor development of infants aged 0 to 16 months born of teenage mothers to those of adult mothers. Eighty babies were assessed, 40 of which the children of teenage mothers, and 40 of adult mothers. Instruments used were the Alberta infant motor scale (AIMS and a questionnaire to collect biological information. Data were statistically analysed. Results show teenage mothers' infants to have delayed motor development as compared to adult mothers' ones (p=0.002; p=0.001, as well as their poor motor acquisitions in prone and standing positions. No association was found between infants' motor development and most of the biological factors analysed. Results hence suggest that early maternal age may be considered a risk factor to motor delay in infants, but attention should be paid to other factors such as task requirements and environmental conditions (here

  19. Aerodynamic Interactions Between Contralateral Wings and Between Wings and Body of a Model Insect at Hovering and Small Speed Motions

    Institute of Scientific and Technical Information of China (English)

    LIANG Bin; SUN Mao

    2011-01-01

    In this paper,we study the aerodynamic interactions between the contralateral wings and between the body and wings of a model insect,when the insect is hovering and has various translational and rotational motions,using the method numerically solving the Navier-Stokes equations over moving overset grids.The aerodynamic interactional effects are identified by comparing the results of a complete model insect,the corresponding wing pair,single wing and body without the wings.Horizontal,vertical and lateral translations and roll,pitch and yaw rotations at small speeds are considered.The results indicate that for the motions considered,both the interaction between the contralateral wings and the interaction between the body and wings are weak.The changes in the forces and moments of a wing due to the contralateral wing interaction,of the wings due to the presence of the body,and of the body due to the presence of the wings are generally less than 4.5%.Results show that aerodynamic forces of wings and body can be measured or computed separately in the analysis of flight stability and control of hovering insects.

  20. Contralateral Metabolic Activation Related to Plastic Changes in the Spinal Cord after Peripheral Nerve Injury in Rats

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    Ran Won

    2015-01-01

    Full Text Available We have previously reported the crossed-withdrawal reflex in which the rats with nerve injury developed behavioral pain responses of the injured paw to stimuli applied to the contralateral uninjured paw. This reflex indicates that contralateral plastic changes may occur in the spinal cord after unilateral nerve injury. The present study was performed to elucidate the mechanisms and morphological correlates underlying the crossed-withdrawal reflex by using quantitative 14C-2-deoxyglucose (2-DG autoradiography which can examine metabolic activities and spatial patterns simultaneously. Under pentobarbital anesthesia, rats were subjected to unilateral nerve injury. Mechanical allodynia was tested for two weeks after nerve injury. After nerve injury, neuropathic pain behaviors developed progressively. The crossed-withdrawal reflex was observed at two weeks postoperatively. Contralateral enhancement of 2-DG uptake in the ventral horn of the spinal cord to electrical stimulation of the uninjured paw was observed. These results suggest that the facilitation of information processing from the uninjured side to the injured side may contribute to the crossed-withdrawal reflex by plastic changes in the spinal cord of nerve-injured rats.

  1. Sensory Feedback in Interlimb Coordination: Contralateral Afferent Contribution to the Short-Latency Crossed Response during Human Walking

    Science.gov (United States)

    Gervasio, Sabata; Voigt, Michael; Kersting, Uwe G.; Farina, Dario; Sinkjær, Thomas

    2017-01-01

    A constant coordination between the left and right leg is required to maintain stability during human locomotion, especially in a variable environment. The neural mechanisms underlying this interlimb coordination are not yet known. In animals, interneurons located within the spinal cord allow direct communication between the two sides without the need for the involvement of higher centers. These may also exist in humans since sensory feedback elicited by tibial nerve stimulation on one side (ipsilateral) can affect the muscles activation in the opposite side (contralateral), provoking short-latency crossed responses (SLCRs). The current study investigated whether contralateral afferent feedback contributes to the mechanism controlling the SLCR in human gastrocnemius muscle. Surface electromyogram, kinematic and kinetic data were recorded from subjects during normal walking and hybrid walking (with the legs moving in opposite directions). An inverse dynamics model was applied to estimate the gastrocnemius muscle proprioceptors’ firing rate. During normal walking, a significant correlation was observed between the magnitude of SLCRs and the estimated muscle spindle secondary afferent activity (P = 0.04). Moreover, estimated spindle secondary afferent and Golgi tendon organ activity were significantly different (P ≤ 0.01) when opposite responses have been observed, that is during normal (facilitation) and hybrid walking (inhibition) conditions. Contralateral sensory feedback, specifically spindle secondary afferents, likely plays a significant role in generating the SLCR. This observation has important implications for our understanding of what future research should be focusing on to optimize locomotor recovery in patient populations. PMID:28060839

  2. The effects of ipsilateral, contralateral, and bilateral broadband noise on the mid-level hump in intensity discrimination.

    Science.gov (United States)

    Roverud, Elin; Strickland, Elizabeth A

    2015-11-01

    Previous psychoacoustical and physiological studies indicate that the medial olivocochlear reflex (MOCR), a bilateral, sound-evoked reflex, may lead to improved sound intensity discrimination in background noise. The MOCR can decrease the range of basilar-membrane compression and can counteract effects of neural adaptation from background noise. However, the contribution of these processes to intensity discrimination is not well understood. This study examined the effect of ipsilateral, contralateral, and bilateral noise on the "mid-level hump." The mid-level hump refers to intensity discrimination Weber fractions (WFs) measured for short-duration, high-frequency tones which are poorer at mid levels than at lower or higher levels. The mid-level hump WFs may reflect a limitation due to basilar-membrane compression, and thus may be decreased by the MOCR. The noise was either short (50 ms) or long (150 ms), with the long noise intended to elicit the sluggish MOCR. For a tone in quiet, mid-level hump WFs improved with ipsilateral noise for most listeners, but not with contralateral noise. For a tone in ipsilateral noise, WFs improved with contralateral noise for most listeners, but only when both noises were long. These results are consistent with MOCR-induced WF improvements, possibly via decreases in effects of compression and neural adaptation.

  3. Desenvolvimento do olhar e do contato ocular em lactentes de zero a quatro meses de idade The development of looking behavior and eye-contact in breast feeding children aged between 0 and 4 months

    Directory of Open Access Journals (Sweden)

    Aline Elise Gerbelli Belini

    2010-03-01

    Full Text Available OBJETIVOS: investigar o desenvolvimento do contato ocular e do comportamento visual de bebês entre zero e quatro meses. MÉTODOS: dezessete bebês típicos foram filmados mensalmente por 30 minutos, sendo transcritas 11 categorias de observação do olhar, quantificadas e tratadas estatisticamente através dos testes de Friedman (α = 0,050 e dos Postos Sinalizados de Wilcoxon (α de Bonferroni = 0,010. RESULTADOS: houve diferenças estatisticamente significantes nas frequências das categorias: "olhar para os olhos da mãe" (pOBJECTIVES: to investigate the development of eye-contact and visual behavior in babies aged between 0 and 4 months. METHODS: sixteen normal babies were filmed monthly for 30 minutes, and 11 eleven visual behavior categories observed and transcribed. These were then quantified and treated statistically using the Friedman test (α = 0.050 and Wilcoxon's Signed Rank test (Bonferroni's α = 0,010. RESULTS: there were statistical differences in frequency between the various categories: "looking mother in the eye" (p<0.001, "looking mother in the face" (p<0.001, "looking at an object" (p<0.001, "looking at the researcher" (p<0.001, "actively looking at the surroundings" (p<0.001, "passively looking at the surroundings" (p<0.001, "looking at own body" (p=0.001 and "eyes closed" (p=0.005. Eye-contact was detected in the third week of life in 64.7% and developed during the first five months of life (p=0.010 in 50% of the intervals between data collection. CONCLUSIONS: eye-contact can be detected from the neonatal period onwards and develops over the first few months of life. The frequency of the baby's eye-contact with its mother increases longitudinally in the first four months. Other focuses of attention, apart from the mother's eyes, are also fundamental during the early stages of development outside the womb.

  4. Reference Gene Selection in the Desert Plant <em>Eremosparton songoricuem>m>

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    Dao-Yuan Zhang

    2012-06-01

    Full Text Available <em>Eremosparton songoricum em>(Litv. Vass. (<em>E. songoricumem> is a rare and extremely drought-tolerant desert plant that holds promise as a model organism for the identification of genes associated with water deficit stress. Here, we cloned and evaluated the expression of eight candidate reference genes using quantitative real-time reverse transcriptase polymerase chain reactions. The expression of these candidate reference genes was analyzed in a diverse set of 20 samples including various <em>E. songoricumem> plant tissues exposed to multiple environmental stresses. GeNorm analysis indicated that expression stability varied between the reference genes in the different experimental conditions, but the two most stable reference genes were sufficient for normalization in most conditions.<em> EsEFem> and <em>Esα-TUB> were sufficient for various stress conditions, <em>EsEF> and <em>EsACT> were suitable for samples of differing germination stages, and <em>EsGAPDH>and <em>Es>UBQ em>were most stable across multiple adult tissue samples. The <em>Es18Sem> gene was unsuitable as a reference gene in our analysis. In addition, the expression level of the drought-stress related transcription factor <em>EsDREB2em>> em>verified the utility of<em> E. songoricumem> reference genes and indicated that no single gene was adequate for normalization on its own. This is the first systematic report on the selection of reference genes in <em>E. songoricumem>, and these data will facilitate future work on gene expression in this species.

  5. Análise da utilização de medicamentos antimicrobianos sistêmicos em criança e adolescentes em dois hospitais de ensino

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    ADRIANA CRISTINA DE SOUZA GONçALVES

    2009-12-01

    Full Text Available A farmacoterapia pediátrica exige uma variedade de formas farmacêuticas adequadas às diferentes fases do desenvolvimento da criança. O objetivo deste estudo foi identificar os antimicrobianos utilizados em dois hospitais e verificar se realmente havia adequação das formas farmacêuticas aos pacientes pediátricos. Os antimicrobianos foram identificados pelo sistema informatizado das farmácias. Os medicamentos foram analisados, levando-se em consideração a necessidade de transformação da forma farmacêutica, o fracionamento e a porcentagem de desperdício. Verificou-se que 97,2% dos medicamentos analisados foram considerados inadequados para utilização em recém-nascido prematuro; 82,5% foram considerados inadequados para uso em recém-nascido a termo e 68,1% foram considerados inadequados para lactentes. A falta de formulações adequadas para essas faixas etárias acarreta freqüentes manipulações, o que pode comprometer o uso adequado dos medicamentos, principalmente dos medicamentos parenterais. Identificou-se, também, a necessidade de transformação dos medicamentos sólidos de uso oral. Essas atividades, sem dúvida, elevam o risco de contaminação e/ou de inexatidão da dose. Os resultados mostram uma falta de formulações farmacêuticas de antimicrobianos adequadas para utilização nas diversas faixas etárias pediátricas, sendo, portanto, necessárias ações das autoridades sanitárias para assegurar a disponibilidade de formulações apropriadas, contribuindo para a promoção do uso racional de medicamentos em pediatria. Palavras-chave: Pediatria. Forma farmacêutica. Assistência hospitalar. Antimicrobianos.

  6. Derivação ventriculoperitoneal com válvula no tratamento da hidrocefalia do lactente Ventriculo-peritoneal shunt with valve in the treatment of hydrocephalus

    Directory of Open Access Journals (Sweden)

    Gilberto Machado de Almeida

    1969-12-01

    Full Text Available As derivações ventriculovenosas, se bem que tenham propiciado grande progresso no tratamento da hidrocefalia, não podem ser consideradas como solução definitiva do problema. Entre os vários inconvenientes que surgiram com estas técnicas, o embolismo e a fibrose pulmonares avultam entre os mais sérios, sendo suas conseqüências tardias ainda desconhecidas. Julgamos, portanto, justificada a busca de novas técnicas cirúrgicas ou o aprimoramento de outras já conhecidas. De dezembro de 1965 a março de 1969 empregamos a derivação ventriculoperitoneal com válvula em 110 doentes, 79 dos quais eram crianças com hidrocefalia. Nossos resultados permitiram verificar que, do ponto de vista mecânico, as derivações para a corrente sangüínea e para o peritônio funcionam de maneira semelhante, não sendo necessárias revisões freqüentes, como ocorria quando eram feitas drenagens para o peritônio sem válvula. Por outro lado, com as derivações ventriculoperitoneais evitamos a microembolia pulmonar; além disso as infecções no sistema de drenagem provocam quadro menos grave e de mais fácil solução que o observado nas ventrículo -atriostomias.In spite of being a significant advance in the treatment of hydrocephalus, ventriculo-venous shunts cannot be considered a definitive solution. Among several disadvantages which have ariven from the widespread use of such techniques pulmonary embolism and fibrosis should be emphasized, the late consequences of which are unknown as yet. The search for new techniques and/or the improvement of old procedures thus seem quite justified. During the last four years we have employed a ventriculo-peritoneal shunt with valve in 110 patients, including 79 hydrocephalic children. The results have shown that physically both the valve shunts draining into the peritoneum or into the blood stream work similarly. In both instances reoperations have not been frequent, as it was the case when no valves were used

  7. In newly diagnosed breast cancer, screening MRI of the contralateral breast detects mammographically occult cancer, even in elderly women: the mayo clinic in Florida experience.

    Science.gov (United States)

    Bernard, Johnny Ray; Vallow, Laura A; DePeri, Elizabeth R; McNeil, Rebecca B; Feigel, Deborah G; Amar, Surabhi; Buskirk, Steven J; Perez, Edith A

    2010-01-01

    The role of magnetic resonance imaging (MRI) in patients with newly diagnosed breast cancer is somewhat controversial. The purpose of this study was to evaluate the prevalence of synchronous, occult contralateral breast cancer detected by MRI but not by mammography or clinical breast examination in women with newly diagnosed breast cancer, including those aged 70 years or older at our institution. MRI results for women with newly diagnosed breast cancer who underwent bilateral breast MRI after negative mammography and clinical examination between February 2003 and November 2007 at Mayo Clinic in Florida were reviewed. The prevalence of pathologically confirmed contralateral carcinoma diagnosed solely by MRI was determined and analyzed in the context of age, family history, menopausal status, breast density, and primary-tumor characteristics. Logistic regression was used to explore the association between contralateral carcinoma and potential patient risk factors. A total of 425 women were evaluated, of whom 129 (30%) were aged 70 years or older. A contralateral biopsy was recommended and performed solely on the basis of MRI in 72 of the 425 women (17%). Sixteen of these 72 women (22%) had pathologically confirmed carcinoma, including seven in the older subgroup. The prevalence of clinically and mammographically occult contralateral carcinoma detected by MRI was 3.8% (16/425) overall and 5.4% (7/129) in the group of older women. When potential risk factors for contralateral breast cancer were evaluated, postmenopausal status was the only significant predictor of contralateral cancer detected by MRI (p = 0.016). We concluded that contralateral breast screening with MRI should be considered in postmenopausal women with newly diagnosed breast cancer, even those aged 70 years or older at diagnosis.

  8. Aspectos relacionados ao estabelecimento e à manutenção do aleitamento materno exclusivo na perspectiva de mulheres atendidas em uma unidade básica de saúde

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    Elizabeth Fujimori

    Full Text Available Com a proposta de conhecer aspectos que envolvem o período de estabelecimento e manutenção do aleitamento materno exclusivo (AME, na perspectiva de mulheres, realizou-se estudo qualitativo com 12 mães de lactentes menores de seis meses, atendidas em unidade básica de saúde. Entrevistas semiestruturadas, gravadas, transcritas e submetidas à análise de conteúdo revelaram as categorias: traumas mamilares; livre demanda; "leite fraco"; saúde psicológica da nutriz; experiência anterior em amamentação; amamentação e os múltiplos papéis da mulher; influência de pessoas próximas. O estabelecimento do AME associou-se a experiências e percepções acerca da suficiência do leite, gerando preocupações e insegurança. Pessoas próximas, em especial familiares, influenciam no estabelecimento e manutenção do AME, da mesma forma que a sobrecarga de trabalho da mulher, dentro e fora do lar. É fundamental que os profissionais de saúde conheçam esses aspectos que dificultam ou que facilitam o estabelecimento e a manutenção do aleitamento materno para orientarem ações.

  9. Neuromuscular blockade in children Bloqueadores neuromusculares em crianças

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    João Fernando Lourenço de Almeida

    2000-06-01

    Full Text Available Neuromuscular blocking agents (NMBAs have been widely used to control patients who need to be immobilized for some kind of medical intervention, such as an invasive procedure or synchronism with mechanical ventilation. The purpose of this monograph is to review the pharmacology of the NMBAs, to compare the main differences between the neuromuscular junction in neonates, infants, toddlers and adults, and moreover to discuss their indications in critically ill pediatric patients. Continuous improvement of knowledge about NMBAs pharmacology, adverse effects, and the many other remaining unanswered questions about neuromuscular junction and neuromuscular blockade in children is essential for the correct use of these drugs. Therefore, the indication of these agents in pediatrics is determined with extreme judiciousness. Computorized (Medline 1990-2000 and active search of articles were the mechanisms used in this review.Os bloqueadores neuromusculares têm sido amplamente utilizados para controlar pacientes que necessitem imobilidade para algum tipo de intervenção médica, desde a realização de procedimentos invasivos até a obtenção de sincronismo com a ventilação mecânica. O objetivo básico desta monografia é revisar a farmacologia dos principais bloqueadores neuromusculares, analisar as diferenças existentes na junção neuromuscular de neonatos, lactentes, pré-escolares e adultos, além de discutir suas indicações em pacientes criticamente enfermos internados em unidade de terapia intensiva pediátrica. Revisão computadorizada da literatura (Medline 1990-2000 associado a busca ativa de artigos compuseram o mecanismo de busca dos dados desta revisão.

  10. Suporte farmacológico a lactentes e crianças com choque séptico Pharmacologic support of infants and children in septic shock

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    José Irazuzta

    2007-05-01

    Full Text Available OBJETIVOS: O choque séptico (CS é uma causa freqüente de internação na unidade de tratamento intensivo pediátrica e requer reconhecimento e intervenção imediatos para que haja um desfecho favorável. Nosso objetivo é revisar a literatura relacionada ao diagnóstico e manejo do CS e apresentar um manejo seqüencial para seu tratamento. FONTES DOS DADOS: Revisão não-sistemática da literatura médica através de pesquisa na base de dados MEDLINE. Os artigos foram selecionados de acordo com sua relevância em termos do objetivo proposto e com base na opinião dos autores. SÍNTESE DOS DADOS: O desfecho da sepse e do CS depende do reconhecimento precoce e da implementação de tratamentos sensíveis ao tempo e guiados por objetivos. Esses tratamentos incluem reanimação agressiva com fluidos seguida de tratamento medicamentoso bem elaborado. Os objetivos da reanimação são a restauração da microcirculação e a melhora da perfusão tecidual. Os marcadores clínicos e laboratoriais são importantes para avaliar a adequação dos tratamentos. Respostas farmacocinéticas e farmacodinâmicas alteradas indicam que os agentes vasoativos devem ser ajustados a fim de atingirem o objetivo pré-estabelecido. Na reanimação inicial com soluções isotônicas (> 60 mL/kg, é possível usar infusão tanto de cristalóides (solução salina normal como de colóides. Apesar da reanimação adequada com fluidos, se: (a uma pressão de pulso com grande amplitude, pressão arterial baixa, ou pulso oscilante (débito cardíaco alto, baixa resistência vascular sistêmica - RVS estiverem presentes, o uso de noradrenalina deve ser considerado; (b reenchimento capilar prolongado, pulso fraco e filiforme, pressão arterial normal (baixo débito cardíaco, alta RVS, deve-se considerar o uso de dopamina, adrenalina ou dobutamina. O tratamento concomitante com dose de estresse de corticosteróides é indicado em populações selecionadas. CONCLUSÕES: A

  11. Improvement in Cerebral and Ocular Hemodynamics Early after Carotid Endarterectomy in Patients of Severe Carotid Artery Stenosis with or without Contralateral Carotid Occlusion

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    Jian Wang

    2016-01-01

    Full Text Available Purpose. To investigate the alternation in cerebral and ocular blood flow velocity (BFV in patients of carotid stenosis (CS with or without contralateral carotid occlusion (CO early after carotid endarterectomy (CEA. Patients and Methods. Nineteen patients underwent CEA for ≥50% CS. Fourteen patients had the unilateral CS, and five patients had the ipsilateral CS and the contralateral CO. Transcranial Doppler (TCD and Color Doppler Imaging (CDI were performed before and early after CEA. Results. In patients with unilateral CS, significant improvements in BFV were observed in anterior cerebral artery (ACA and middle cerebral artery (MCA on the ipsilateral side after CEA. In patients of ipsilateral CS and contralateral CO, significant improvements in BFV were observed in the ACA and MCA not only on the ipsilateral side but also on the contralateral side postoperatively. The ipsilateral ophthalmic artery (OA retrograde flows in two patients were recovered to anterograde direction following CEA. The BFV in short posterior ciliary artery (SPCA of the ipsilateral side significantly increased postoperatively irrespective of the presence of contralateral CO. Conclusions. CEA improved cerebral anterior circulation hemodynamics especially in patients of unilateral CS and contralateral CO, normalized the OA reverse flow, and increased the blood perfusion of SPCA.

  12. Effect of ipsilateral ureteric obstruction on contralateral kidney and role of renin angiotensin system blockade on renal recovery in experimentally induced unilateral ureteric obstruction

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    Shasanka S Panda

    2013-01-01

    Full Text Available Aims: To study, the effects of ipsilateral ureteric obstruction on contralateral kidney and the role of renin angiotensin system (RAS blockade on renal recovery in experimentally induced unilateral ureteric obstruction. Materials and Methods: Unilateral upper ureteric obstruction was created in 96 adult Wistar rats that were reversed after pre-determined intervals. Losartan and Enalapril were given to different subgroups of rats following relief of obstruction. Results: The severity of dilatation on the contralateral kidney varied with duration of ipsilateral obstruction longer the duration more severe the dilatation. There is direct correlation between renal parenchymal damage, pelvi-ureteric junction (PUJ fibrosis, inflammation and severity of pelvi-calyceal system dilatation of contralateral kidney with duration of ipsilateral PUJ obstruction. Conclusions: Considerable injury is also inflicted to the contralateral normal kidney while ipsilateral kidney remains obstructed. Use of RAS blocking drugs has been found to significantly improve renal recovery on the contralateral kidney. It can, thus, be postulated that contralateral renal parenchymal injury was mediated through activation of RAS.

  13. Fatores associados ao desenvolvimento neuropsicomotor em crianças de 6-18 meses de vida inseridas em creches públicas do Município de João Pessoa, Paraíba, Brasil

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    Ângela Cristina Dornelas da Silva

    2015-09-01

    Full Text Available O estudo objetivou verificar a prevalência de alteração no desenvolvimento neuropsicomotor em lactentes inseridos nas creches públicas de João Pessoa, Paraíba, Brasil, e analisar fatores associados ao desenvolvimento infantil. Realizou-se um estudo seccional com o censo de crianças entre 6 e 18 meses de vida inseridas nas creches. O desenvolvimento infantil foi avaliado pelo Teste de Triagem de Denver II. Variáveis de natureza biológica, materna, social, demográfica e relativas à creche foram investigadas através de questionário e formulário. As associações foram ajustadas por regressão logística. A prevalência de alteração no desenvolvimento foi 52,7%. Associou-se à alteração no desenvolvimento a criança ter mais que 12 meses de idade (RC = 4,3, o parto vaginal (RC = 4,4, a fototerapia (RC = 7,9 e a creche não ter apoio da Estratégia Saúde da Família (RC = 2,9. Os achados sugerem que o desenvolvimento infantil é o reflexo das condições familiares, bem como da assistência recebida pelos serviços de educação e saúde.

  14. Synthesis, Crystal Structure and Luminescent Property of Cd (II Complex with <em>N-Benzenesulphonyl-L>-leucine

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    Xishi Tai

    2012-09-01

    Full Text Available A new trinuclear Cd (II complex [Cd3(L6(2,2-bipyridine3] [L =<em> Nem>-phenylsulfonyl-L>-leucinato] has been synthesized and characterized by elemental analysis, IR and X-ray single crystal diffraction analysis. The results show that the complex belongs to the orthorhombic, space group<em> Pem>212121 with<em> aem> = 16.877(3 Å, <em>b> em>= 22.875(5 Å, <em>c em>= 29.495(6 Å, <em>α> em>= <emem>= <emem>= 90°, <em>V> em>= 11387(4 Å3, <em>Z> em>= 4, <em>Dc>= 1.416 μg·m−3, <emem>= 0.737 mm−1, <em>F> em>(000 = 4992, and final <em>R>1 = 0.0390, <em>ωR>2 = 0.0989. The complex comprises two seven-coordinated Cd (II atoms, with a N2O5 distorted pengonal bipyramidal coordination environment and a six-coordinated Cd (II atom, with a N2O4 distorted octahedral coordination environment. The molecules form one dimensional chain structure by the interaction of bridged carboxylato groups, hydrogen bonds and p-p interaction of 2,2-bipyridine. The luminescent properties of the Cd (II complex and <em>N-Benzenesulphonyl-L>-leucine in solid and in CH3OH solution also have been investigated.

  15. Conhecimento de pediatras e nutricionistas sobre o tratamento da alergia ao leite de vaca no lactente Pediatricians and nutritionists knowledge about treatment of cow milk allergy in infants

    Directory of Open Access Journals (Sweden)

    Ana Paula B. Cortez

    2007-06-01

    Full Text Available OBJETIVO: Avaliar o conhecimento de pediatras e nutricionistas sobre a dieta de exclusão do leite de vaca e seus derivados, com ênfase em questões relacionadas à nutrição da criança. MÉTODOS: Estudo transversal descritivo, do qual participaram pediatras (n=53 e nutricionistas (n=29, vinculados a hospitais públicos do Município de São Paulo, no ano de 2005. Os dados foram coletados por questionário auto-administrado. RESULTADOS: A idade dos profissionais variou de 21 a 50 anos. Quanto ao tempo de graduação, 41,2% eram formados a menos de cinco anos e 91,6% possuíam especialização, mestrado e/ou doutorado. A maioria (97,5% afirmou avaliar a dieta de crianças submetidas à exclusão do leite de vaca, entretanto, somente 48% o faziam de forma mais detalhadas, incluindo o cálculo da ingestão alimentar. Apenas 38,7% comparam a ingestão alimentar da criança com algum padrão de recomendação. A recomendação diária da ingestão de cálcio para crianças com até 36 meses foi corretamente assinalada por 22% dos pediatras e 60,7% dos nutricionistas (p=0,001. Produtos não adequados como substitutos do leite de vaca seriam recomendados por 66% dos pediatras e 48,3% dos nutricionistas. Com relação à leitura de rótulos de produtos industrializados, 81,6% dos pediatras e 96,4% dos nutricionistas orientam os pais a ler todos os termos que indicam a presença das proteínas do leite de vaca. CONCLUSÕES: Os pediatras e nutricionista demonstraram erro conceitual no que se refere às principais recomendações terapêuticas na alergia às proteínas do leite de vaca.OBJECTIVE: Evaluate the knowledge of pediatricians and nutritionists regarding the exclusion diet of cow milk and derivates, with emphasis on questions related to the nutrition of children submitted to such diet. METHODS: Cross-sectional study that enrolled pediatricians (n=53 and nutritionists (n=29 from public hospitals in São Paulo, Brazil, during 2005. Data was

  16. Reproductive Status at First Diagnosis Influences Risk of Radiation-Induced Second Primary Contralateral Breast Cancer in the WECARE Study

    Energy Technology Data Exchange (ETDEWEB)

    Brooks, Jennifer D., E-mail: brooksj@mskcc.org [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Boice, John D. [International Epidemiology Institute, Rockville, MD and Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, TN (United States); Stovall, Marilyn [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Reiner, Anne S. [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Bernstein, Leslie [Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute and City of Hope Comprehensive Cancer Center, Duarte, CA (United States); John, Esther M. [Cancer Prevention Institute of California, Fremont, CA, and Stanford University School of Medicine and Stanford Cancer Institute, Stanford, CA (United States); Lynch, Charles F. [Department of Epidemiology, University of Iowa, Iowa City, IA (United States); Mellemkjaer, Lene [Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen (Denmark); Knight, Julia A. [Dalla Lana School of Public Health, University of Toronto and Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario (Canada); Thomas, Duncan C.; Haile, Robert W. [Department of Preventive Medicine, University of Southern California, Los Angeles, CA (United States); Smith, Susan A. [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Capanu, Marinela; Bernstein, Jonine L. [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Shore, Roy E. [Department of Environmental Medicine, New York University, New York, NY (United States); Radiation Effects Research Foundation, Hiroshima (Japan)

    2012-11-15

    Purpose: Our study examined whether reproductive and hormonal factors before, at the time of, or after radiation treatment for a first primary breast cancer modify the risk of radiation-induced second primary breast cancer. Methods and Materials: The Women's Environmental, Cancer and Radiation Epidemiology (WECARE) Study is a multicenter, population-based study of 708 women (cases) with asynchronous contralateral breast cancer (CBC) and 1399 women (controls) with unilateral breast cancer. Radiotherapy (RT) records, coupled with anthropomorphic phantom simulations, were used to estimate quadrant-specific radiation dose to the contralateral breast for each patient. Rate ratios (RR) and 95% confidence intervals (CI) were computed to assess the relationship between reproductive factors and risk of CBC. Results: Women who were nulliparous at diagnosis and exposed to {>=}1 Gy to the contralateral breast had a greater risk for CBC than did matched unexposed nulliparous women (RR = 2.2; 95% CI, 1.2-4.0). No increased risk was seen in RT-exposed parous women (RR = 1.1; 95% CI, 0.8-1.4). Women treated with RT who later became pregnant (8 cases and 9 controls) had a greater risk for CBC (RR = 6.0; 95% CI, 1.3-28.4) than unexposed women (4 cases and 7 controls) who also became pregnant. The association of radiation with risk of CBC did not vary by number of pregnancies, history of breastfeeding, or menopausal status at the time of first breast cancer diagnosis. Conclusion: Nulliparous women treated with RT were at an increased risk for CBC. Although based on small numbers, women who become pregnant after first diagnosis also seem to be at an increased risk for radiation-induced CBC.

  17. Esophagus and contralateral lung-sparing IMRT for locally advanced lung cancer in the community hospital setting

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    Johnny eKao

    2015-06-01

    Full Text Available Background: The optimal technique for performing lung IMRT remains poorly defined. We hypothesize that improved dose distributions associated with normal tissue sparing IMRT can allow for safe dose escalation resulting in decreased acute and late toxicity. Methods: We performed a retrospective analysis of 82 consecutive lung cancer patients treated with curative intent from 1/10 to 9/14. From 1/10 to 4/12, 44 patients were treated with the community standard of 3-dimensional conformal radiotherapy or IMRT without specific esophagus or contralateral lung constraints (standard RT. From 5/12 to 9/14, 38 patients were treated with normal tissue-sparing IMRT with selective sparing of contralateral lung and esophagus. The study endpoints were dosimetry, toxicity and overall survival.Results: Despite higher mean prescribed radiation doses in the normal tissue-sparing IMRT cohort (64.5 Gy vs. 60.8 Gy, p=0.04, patients treated with normal tissue-sparing IMRT had significantly lower lung V20, V10, V5, mean lung, maximum esophagus and mean esophagus doses compared to patients treated with standard RT (p≤0.001. Patients in the normal tissue-sparing IMRT group had reduced acute grade ≥3 esophagitis (0% vs. 11%, p<0.001, acute grade ≥2 weight loss (2% vs. 16%, p=0.04, late grade ≥2 pneumonitis (7% vs. 21%, p=0.02. The 2-year overall survival was 52% with normal tissue-sparing IMRT arm compared to 28% for standard RT (p=0.015.Conclusion: These data provide proof of principle that suboptimal radiation dose distributions are associated with significant acute and late lung and esophageal toxicity that may result in hospitalization or even premature mortality. Strict attention to contralateral lung and esophageal dose volume constraints are feasible in the community hospital setting without sacrificing disease control.

  18. Risk of second primary cancers after testicular cancer in East and West Germany: a focus on contralateral testicular cancers.

    Science.gov (United States)

    Rusner, Carsten; Streller, Brigitte; Stegmaier, Christa; Trocchi, Pietro; Kuss, Oliver; McGlynn, Katherine A; Trabert, Britton; Stang, Andreas

    2014-01-01

    Testicular cancer survival rates improved dramatically after cisplatin-based therapy was introduced in the 1970s. However, chemotherapy and radiation therapy are potentially carcinogenic. The purpose of this study was to estimate the risk of developing second primary cancers including the risk associated with primary histologic type (seminoma and non-seminoma) among testicular cancer survivors in Germany. We identified 16 990 and 1401 cases of testicular cancer in population-based cancer registries of East Germany (1961-1989 and 1996-2008) and Saarland (a federal state in West Germany; 1970-2008), respectively. We estimated the risk of a second primary cancer using standardized incidence ratios (SIRs) with 95% confidence intervals (95% CIs). To determine trends, we plotted model-based estimated annual SIRs. In East Germany, a total of 301 second primary cancers of any location were observed between 1961 and 1989 (SIR: 1.9; 95% CI: 1.7-2.1), and 159 cancers (any location) were observed between 1996 and 2008 (SIR: 1.7; 95% CI: 1.4-2.0). The SIRs for contralateral testicular cancer were increased in the registries with a range from 6.0 in Saarland to 13.9 in East Germany. The SIR for seminoma, in particular, was higher in East Germany compared to the other registries. We observed constant trends in the model-based SIRs for contralateral testicular cancers. The majority of reported SIRs of other cancer sites including histology-specific risks showed low precisions of estimated effects, likely due to small sample sizes. Testicular cancer patients are at increased risk especially for cancers of the contralateral testis and should receive intensive follow-ups.

  19. Positive, negative, and disparate--women's differing long-term psychosocial experiences of bilateral or contralateral prophylactic mastectomy.

    Science.gov (United States)

    Altschuler, Andrea; Nekhlyudov, Larissa; Rolnick, Sharon J; Greene, Sarah M; Elmore, Joann G; West, Carmen N; Herrinton, Lisa J; Harris, Emily L; Fletcher, Suzanne W; Emmons, Karen M; Geiger, Ann M

    2008-01-01

    Because of recent studies showing strong prevention benefit and acceptable psychosocial outcomes, more women may be considering prophylactic mastectomy. A growing literature shows some positive psychosocial outcomes for women with bilateral prophylactic mastectomy, but less is known about women with contralateral prophylactic mastectomy. Several surveys have shown that a large majority of women with prophylactic mastectomy report satisfaction with their decisions to have the procedure when asked in a quantitative, closed-ended format. We sought to explore the nuances of women's satisfaction with the procedure using a qualitative, open-ended format. We included open-ended questions as part of a mailed survey on psychosocial outcomes of prophylactic mastectomy. The research team coded and analyzed these responses using qualitative methods. We used simple descriptive statistics to compare the demographics of the entire survey sample to those women who answered the open-ended questions; the responses to the open- and closed-ended satisfaction questions, and the responses of women with bilateral and contralateral prophylactic mastectomy. Seventy-one percent of women with prophylactic mastectomy responded to the survey and 48% provided open-ended responses about psychosocial outcomes. Women's open-ended responses regarding psychosocial outcomes could be coded into one of three general categories--positive, negative, and disparate. In the subgroup of women with both open- and closed-ended responses, over 70% of women providing negative and disparate comments to the open-ended question simultaneously indicated satisfaction on a closed-ended question. Negative and disparate open-ended responses were twice as common among women with bilateral prophylactic mastectomy (52%) than women with contralateral prophylactic mastectomy (26%). These findings suggest that even among women who report general satisfaction with their decision to have prophylactic mastectomy via closed

  20. Effects of age on contralateral suppression of distortion product otoacoustic emissions in human listeners with normal hearing.

    Science.gov (United States)

    Kim, SungHee; Frisina, D Robert; Frisina, Robert D

    2002-01-01

    The auditory efferent system presumably plays a role in enhancing signals in noise and, in particular, speech perception in background noise. This study measured the age-related changes of the medial olivocochlear (MOC) system by comparing distortion product otoacoustic emissions (DPOAEs) with and without contralateral white noise stimulation. Otoacoustic emissions were typically reduced in level (magnitude) when white noise was presented to the contralateral ear. This contralateral suppression (CS) is attributed to activation of the MOC system, which has an inhibitory effect on the outer hair cell (OHC) system. By studying CS on cochlear output in human listeners of different ages, it is possible to describe aging effects on the MOC system. Human subjects were young adult, middle aged and old (n = 10/group). All subjects had normal hearing and middle-ear function based upon standard audiometric criteria. The present study recorded 2f(1)-f(2) DPOAE-grams in response to moderate primary tones (L1 = 75, L2 = 65 dB SPL), from 1 to 6.3 kHz. The principal findings were that DPOAE levels were smaller in the old compared to the young group and that CS declined with age for the middle-aged and old groups. In addition, CS in the 1- to 2-kHz range was greater than in the 4- to 6-kHz range for all ages, but especially for the old group. These findings suggest that a functional decline of the MOC system with age precedes OHC degeneration. Moreover, the MOC system maintains better function in the 1- to 2-kHz range than in the 4- to 6-kHz range as a function of age.

  1. Comparação de períodos de observação no teste de inoculação em camundongos para o isolamento do vírus da raiva | Comparison of observation periods in mouse inoculation test for the isolation of rabies virus

    Directory of Open Access Journals (Sweden)

    Ana Carolina Nunes de Morais

    2015-08-01

    Full Text Available O teste de inoculação intracerebral em camundongos (IC é rotineiramente utilizado no diagnóstico da raiva para ratificar o teste de imunofluorescência direta (IFD; no entanto não existe concordância sobre o tempo mínimo de observação dos animais. O objetivo do presente estudo foi avaliar a IC com confirmação por IFD, comparando o desempenho do diagnóstico em sete dias com aquele realizado em 21 dias de observação em camundongos lactentes e desmamados. Foram utilizadas 2.953 amostras de animais suspeitos, recebidas para diagnóstico de raiva no período de 2005 a 2011 na Secretaria Municipal de Saúde da Prefeitura da Cidade do Rio de Janeiro. A análise estatística demonstrou elevada sensibilidade do diagnóstico (97,43%; 95,45%; 100% e excelente concordância (99,76%; 99,29%; 98,71% ao comparar os resultados na IFD com os obtidos em camundongos lactentes observados por sete e 21 dias e desmamados, respectivamente. Estes resultados inferem que a IC realizada em sete dias em camundongos lactentes possibilita a precocidade do diagnóstico de raiva, o que pode antecipar a tomada de decisões dos serviços de saúde envolvidos com o tratamento profilático antirrábico humano, bem como as ações dos serviços de vigilância epidemiológica da doença. ----------------------------------------------------------------------------------------------- Mouse inoculation test (MIT is routinely used in rabies diagnosis to attest the direct fluorescent antibody test (DFA, however there is no agreement on the minimum observation period. The aim of this study was to evaluate MIT with confirmation by DFA, comparing the diagnostic performance between seven and 21 days held in suckling and weaned mice. For this, 2,953 samples received for rabies diagnosis in the period of 2005- 2011 by Secretaria Municipal de Saúde da Prefeitura da Cidade do Rio de Janeiro were analyzed. Statistical analysis showed high diagnostic sensitivity (97.43%; 95.45%; 100

  2. Asymptomatic carotid lesions after endarterectomy of contralateral carotid artery. Five-year follow-up study and prognosis

    DEFF Research Database (Denmark)

    Schroeder, T; Helgstrand, U J; Egeblad, M R

    1987-01-01

    patients developed symptoms referable to the territory of the previously asymptomatic ICA (five strokes and eight transient ischemic attacks). Using life-table analysis, the annual stroke rate was estimated to be 1% and 2.2% considering the previously asymptomatic and symptomatic ICA, respectively......Of 185 patients who consecutively underwent carotid endarterectomy five years ago, 135 had a patent asymptomatic contralateral internal carotid artery (ICA). During follow-up (median, 59 months), 36 patients developed new neurologic symptoms (18 strokes and 18 transient ischemic attacks). Thirteen...

  3. PS1-42: Beyond Risk Reduction: Decision-Making Factors Among Breast Cancer Patients Undergoing Contralateral Prophylactic Mastectomy

    Science.gov (United States)

    Rendle, Katharine; Halley, Meghan; Ventre, Nicole; Frosch, Dominick; May, Suepattra

    2013-01-01

    Background/Aims Women diagnosed with unilateral breast cancer are electing to undergo contralateral prophylactic mastectomy (CPM)—or removal of the healthy breast—at rapidly increasing rates worldwide. CPM significantly reduces the risk of recurrence of contralateral breast cancer; however, it is also believed to be unnecessary for most patients due to the relatively low risk of contralateral breast cancer, and the effectiveness of less invasive treatment options. Additionally, since the risk of systemic metastases often exceeds the risk of contralateral breast cancer, most patients will not receive any survival benefit. As such, there is a growing need to understand why patients are electing to have CPM. Drawing from prospective, in-depth interviews with breast cancer patients, we explore how women are making this decision and investigate what factors beyond risk reduction may be impacting their decision. Methods Participants were recruited from a multispecialty clinic in Northern California. Participants were interviewed at four time points during their treatment journey. Medical records for each participant were reviewed to confirm therapies received. Analysis of interview transcripts used grounded theory to identify emergent decision-making factors across participants. Results Of the 41 patients enrolled in the study, 11 (27%) women elected to have CPM. The majority of these women underwent BCRA testing (9 or 82%), but only two women received a positive result. Influential factors identified across participants were: 1) desire to reduce or avoid breast cancer treatment; 2) having a close relationship with someone who died from breast cancer; 3) wanting to maintain (or improve) breast appearance; and 4) receiving imaging results that showed “suspicious” but ultimately benign changes in their healthy breast. Conclusions The decision to undergo CPM is impacted by a variety of factors including, but not limited to, risk reduction. Moreover, perceptions of

  4. A case of sudden unilateral sensorineural hearing loss with contralateral psychogenic hearing loss induced by gunshot noise.

    Science.gov (United States)

    Hong, Young-Ho; Mun, Seog-Kyun

    2011-10-01

    The reasons behind sudden sensorineural hearing loss are mostly unknown, but viral infections, blood disorders, ototoxicity, noise trauma, autoimmune disease, acoustic tumor, and even mental stress may be related to the disease. In cases of hearing loss as a result of psychogenic factors, early diagnosis and adequate treatment under collaboration with the psychiatric department are crucial, since failure to take appropriate measures may result in permanent sequela. We report a case, with a review of the literature, of sudden unilateral sensorineural hearing loss with contralateral psychogenic hearing loss induced by gunshot noise.

  5. Salmonella Enteritidis Empyema Preceding the Diagnosis of Non-Hodgkin’s Lymphoma and Subsequent Contralateral Chylothorax Treated with Radiolabeled Rituximab

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    Syed Ali

    2015-12-01

    Full Text Available Salmonella infection is common, but pleural involvement has rarely been reported. Only seven cases of Salmonella enteritidis pleural empyema have been reported; all had an associated preexisting underlying immunosuppresion or malignancy. We report the case of an apparently healthy man who developed S. enteritidis empyema. On further follow-up and surveillance, he eventually presented with non-Hodgkin’s lymphoma and a contralateral recurrent chylothorax. The latter was successfully controlled with radiolabeled rituximab, which has never been described for the above purpose in literature before.

  6. Endovascular treatment for hemothorax via contralateral internal thoracic artery branch after Nuss procedure – A case report

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    Daisuke Kanamori

    2017-02-01

    Full Text Available The Nuss procedure is performed widely as a standard surgical treatment for pectus excavatum. Compared to conventional methods, the Nuss procedure excels in cosmetic terms and involves fewer complications. A 14-year-old boy developed right hemothorax with a sudden shock one month after the Nuss procedure. We identified the bleeding from left internal thoracic artery (ITA branch and achieved hemostasis by endovascular coil embolization. To the best of our knowledge, this is the first to report that the ITA on the contralateral side of the hemothorax was responsible for the bleeding.

  7. Computer-aided detection system performance on current and previous digital mammograms in patients with contralateral metachronous breast cancer

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    Kim, Seung Ja (Dept. of Radiology, Seoul Metropolitan Government - Seoul National Univ. Boramae Medical Center, Seoul (Korea, Republic of)); Moon, Woo Kyung; Cho, Nariya; Chang, Jung Min (Dept. of Radiology, Seoul National Univ. Hospital, Seoul (Korea, Republic of)), email: moonwk@snu.ac.kr

    2012-05-15

    Background: The computer-aided detection (CAD) system is widely used for screening mammography. The performance of the CAD system for contralateral breast cancer has not been reported for women with a history of breast cancer. Purpose: To retrospectively evaluate the performance of a CAD system on current and previous mammograms in patients with contralateral metachronous breast cancer. Material and Methods: During a 3-year period, 4945 postoperative patients had follow-up examinations, from whom we selected 55 women with contralateral breast cancers. Among them, 38 had visible malignant signs on the current mammograms. We analyzed the sensitivity and false-positive marks of the system on the current and previous mammograms according to lesion type and breast density. Results: The total visible lesion components on the current mammograms included 27 masses and 14 calcifications in 38 patients. The case-based sensitivity for all lesion types was 63.2% (24/38) with false-positive marks of 0.71 per patient. The lesion-based sensitivity for masses and calcifications was 59.3% (16/27) and 71.4% (10/14), respectively. The lesion-based sensitivity for masses in fatty and dense breasts was 68.8% (11/16) and 45.5% (5/11), respectively. The lesion-based sensitivity for calcifications in fatty and dense breasts was 100.0% (3/3) and 63.6% (7/11), respectively. The total visible lesion components on the previous mammograms included 13 masses and three calcifications in 16 patients, and the sensitivity for all lesion types was 31.3% (5/16) with false-positive marks of 0.81 per patient. On these mammograms, the sensitivity for masses and calcifications was 30.8% (4/13) and 33.3% (1/3), respectively. The sensitivity in fatty and dense breasts was 28.6% (2/7) and 33.3% (3/9), respectively. Conclusion: In the women with a history of breast cancer, the sensitivity of the CAD system in visible contralateral breast cancer was lower than in most previous reports using the same CAD

  8. Valor preditivo do teste tuberculínico padronizado em crianças vacinadas com BCG

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    Gilberto Ribeiro Arantes

    1992-08-01

    Full Text Available A aplicabilidade do teste tuberculínico em crianças menores de 5 anos vacinadas com BCG é assunto controvertido. Visando contribuir para esclarecê-lo foi analisado o valor preditivo positivo do teste tuberculínico padronizado em população sob elevada cobertura vacinal e baixa prevalência de infecção tuberculosa. A partir da proporção de reatores fortes em lactentes e escolares vacinados e não vacinados, foram calculadas a razão de declínio da alergia tuberculínica nos vacinados e a razão de crescimento nos não vacinados, o que possibilitou a estimativa dos respectivos valores nas idades intermediárias. A expectativa de falsos-positivos (FP foi então calculada por diferença. Conhecidas a sensibilidade e a especificidade do teste (E=1-FP, a cobertura BCG e a prevalência de infecção, os valores preditivos (para a infecção tuberculosa foram: 1,52%, 4,22%, 8,26%, 14,86% e 23,00%, do primeiro ao quinto ano de vida. Nessas condições, a probabilidade de uma reação forte ser devida ao BCG é grande, especialmente nos dois primeiros anos, o que reduz a aplicabilidade clínica e epidemiológica do teste.

  9. <em>α>-Glucosidase Inhibitory Constituents from <em>Acanthopanax senticosusem> Harm Leaves

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    Hai-Xue Kuang

    2012-05-01

    Full Text Available A new triterpene glycoside, 3-<em>O-[(α>-L-rhamnopyranosyl(1→2]-[<em>β>-D-glucuronopyranosyl-6-<em>O>-methyl ester]-olean-12-ene-28-olic acid (1 and a new indole alkaloid, 5-methoxy-2-oxoindolin-3-acetic acid methyl ester (5 were isolated from the leaves of <em>Acanthopanax senticosusem> Harms along with six known compounds. The structures of the new compounds were determined by means of 2D-NMR experiments and chemical methods. All the isolated compounds were evaluated for their glycosidase inhibition activities and compound 6 showed significant <em>α>-glucosidase inhibition activity.

  10. Achados clínicos e endoscópicos em crianças com estridor

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    Lubianca Neto José F.

    2002-01-01

    Full Text Available Introdução: As anomalias da via aérea freqüentemente se apresentam com estridor. A sua principal causa em recém-nascidos e lactentes são as alterações congênitas da laringe. O diagnóstico etiológico específico pode ser realizado com a fibronasolaringobroncoscopia, a qual é fundamental para o manejo adequado dessas crianças. Forma de estudo: prospectivo clínico de delineamento transversal de análise descritiva. Objetivo: Descrever as principais causas e achados clínicos associados ao estridor das crianças que se apresentam em nosso hospital. Material e Método: Realizou-se um estudo prospectivo, no período de março de 2000 a abril de 2001, que avaliou todas as crianças encaminhadas ao Serviço de Otorrinolaringologia Pediátrica do Hospital da Criança Santo Antônio, cujo critério de inclusão foi a presença de estridor. Os pacientes foram então avaliados segundo protocolo definido a priori, que incluía, além de perguntas sobre história, exame físico e comorbidades associadas, o exame fibronasolaringobroncoscópico padronizado. Resultados: Foram avaliadas 125 crianças com estridor: 69 masculinos e 56 femininos. A idade média de apresentação foi de 19 meses. A maior parte dos pacientes avaliados veio da unidade de tratamento intensivo. Foram encontradas comorbidades em quase todos os casos, sendo a intubação prolongada a mais comum (n=36, 28,8%. Os diagnósticos mais freqüentes foram laringomalácia em 51 (40,8% pacientes e estenose subglótica em 22 (17,6%. Conclusões: Mesmo que se tenha avaliado pacientes mais selecionados do que as grandes séries mundiais, as anomalias congênitas da laringe também foram a maior causa de estridor em nossa casuística. Em alguns casos com história de intubação prolongada foi difícil diferenciar a estenose subglótica congênita da adquirida. A presença de comorbidades é freqüente e pode auxiliar na seleção dos pacientes que necessitam de exame endoscópico.

  11. The Effects of Abdominal Hollowing in Lower-limb PNF Pattern Training on the Activation of Contralateral Muscles.

    Science.gov (United States)

    Yoo, Byungho; Park, Hankyu; Heo, Kwangjin; Lee, Joongsook; Lee, Jaeseok; Oh, Taeyoung; Han, Dongwook

    2013-10-01

    [Purpose] The purpose of this study was to determine the effects of abdominal hollowing during lower-limb proprioceptive neuromuscular facilitation (PNF) training on the activation of contralateral muscles. [Subjects] Twenty male college students without symptoms or signs of muscular or nervous disease participated in this experiment after signing a consent form. [Methods] All the subjects were measured with electromyography (EMG) in a muscle activation test before and after abdominal hollowing. In the PNF program, the lower-limb pattern of PNF training, was maintained for 5 seconds, followed by a 2-minute break. This was repeated three times. The resting time between sets was 30 minutes. Surface EMG (Keypoint, Medtronic Inc., USA) was used for the measurements, and the highest value of three measurements was used in the analysis. [Result] The results revealed a significant change in the muscular activation of the opposite-side lower limbs. The muscular activations of the vastus lateralis, tibialis anterior, semitendinosus and gastrocnemius were increased significantly after the abdominal hollowing. [Conclusion] The findings suggest that abdominal hollowing in PNF pattern training can be effective at promoting muscular activation of the contralateral muscles. To promote muscular activation of the opposite side in lower-limb PNF pattern training, abdominal hollowing should be considered to improve the effect of PNF pattern training.

  12. A contralateral repeated bout effect attenuates induction of NF-κB DNA binding following eccentric exercise.

    Science.gov (United States)

    Xin, Ling; Hyldahl, Robert D; Chipkin, Stuart R; Clarkson, Priscilla M

    2014-06-01

    We investigated the existence of contralateral repeated bout effect and tested if the attenuation of nuclear factor-kappa B (NF-κB; an important regulator of muscle inflammation) induction following eccentric exercise is a potential mechanism. Thirty-one healthy men performed two bouts of knee extension eccentric exercise, initially with one leg and then with the opposite leg 4 wk later. Vastus lateralis muscle biopsies of both exercised and control legs were taken 3 h postexercise. Knee extension isometric and isokinetic strength (60°/sec and 180°/sec) were measured at baseline, pre-exercise, immediately postexercise, and 1/day for 5 days postexercise. Serum creatine kinase (CK) activity and muscle soreness were assessed at baseline and 1/day for 5 days postexercise. NF-κB (p65) DNA-binding activity was measured in the muscle biopsies. Isometric strength loss was lower in bout 2 than in bout 1 at 24, 72, and 96 h postexercise (P eccentric exercise (compared with the control leg) in bout 1 (122.9% ± 2.6%; P eccentric exercise results in a contralateral repeated bout effect, which could be due to the attenuated increase in NF-κB activity postexercise. Copyright © 2014 the American Physiological Society.

  13. Contralateral interlaminar approach for intraforaminal lumbar degenerative disease with special emphasis on L5-S1 level: A technical note

    Science.gov (United States)

    Zekaj, Edvin; Menghetti, Claudia; Saleh, Christian; Isidori, Alessandra; Bona, Alberto R.; Aimar, Enrico; Servello, Domenico

    2016-01-01

    Background: Intraforaminal disc herniations at the L5-S1 level are extremely surgically challenging lesions. Intracanal approaches frequently require partial or total facetectomy, which may lead to instability. Solely extraforaminal approaches may offer limited visualization of the more medial superiorly exiting and inferiorly exiting nerve roots; this approach is also more complicated at L5-S1 due to the often large L5 transverse process and the iliac wing. Methods: Nine patients with intraforaminal L5-S1 disc herniations, foraminal stenosis, or synovial cysts underwent contralateral interlaminar approaches for lesion resection. Preoperative and postoperative visual analog scale scores were evaluated, and complications were reviewed. Results: All 9 patients demonstrated immediate postoperative clinical improvement. None of the patients exhibited complications and none developed instability or neuropathic disorders. Conclusions: Although the number of cases in our sample was very small (9 in total), the contralateral interlaminar approach appeared to effectively address multiple degenerative L5-S1 foraminal pathologies. Large studies are needed to further evaluate the pros and cons of this approach. PMID:27713854

  14. Ipsilateral pedicle screw placement with contralateral percutaneous facet screws: Early results with an alternative in lumbar arthrodesis

    Directory of Open Access Journals (Sweden)

    Richard B Rhiew

    2009-03-01

    Full Text Available Richard B Rhiew, Sunil Manjila, Andrew M Lozen, David Hong, Murali Guthikonda, S S RengacharyDepartment of Neurosurgery, Wayne State University, Detroit, MI, USAAbstract: Transforaminal lumbar interbody fusion (TLIF is a widely used method of surgical treatment for a variety of lumbar spinal disorders. Bilateral transpedicular instrumentation is routinely used in conjunction with an interbody graft to provide additional stability. In this technical note, we describe our fusion construct using ipsilateral pedicle screw placement on the side of TLIF and contralateral facet screw placement. We performed this construct at six levels in four patients. Suggested advantages include: low morbidity, small incision and lower cost. Outcomes parameters included radiographic evidence of solid union at four months and improvement in Oswestry Disability Index. A mean improvement from a preoperative score of 73 to 26 after surgery was observed at one-year follow-up. There were no instrument-related complications. In conclusion, this hybrid screw system minimizes contralateral dissection and is an attractive alternative to standard bilateral pedicle screw fixation.Keywords: TLIF, facet screw, pedicle screw, lumbar spine fusion

  15. Tumor size is associated with compensatory hypertrophy in the contralateral kidney after radical nephrectomy in patients with renal cell carcinoma.

    Science.gov (United States)

    Park, Bong Hee; Sung, Hyun Hwan; Jeong, Byong Chang; Seo, Seong Ii; Jeon, Seong Soo; Lee, Hyun Moo; Choi, Han Yong; Jeon, Hwang Gyun

    2016-06-01

    To assess the association between tumor size and postoperative compensatory hypertrophy of the contralateral kidney estimated with preoperative and postoperative CT in patients with renal cell carcinoma (RCC). We prospectively identified 728 patients who underwent radical nephrectomy for RCC between 2012 and 2014. Contrast-enhanced CT was done within 3 months preoperatively and 1 year postoperatively. A tissue segmentation tool program with CT images was used to estimate kidney volume. We divided patients into three groups according to tumor size (A: ≤4 cm, B: 4-7 cm, C: >7 cm). Preoperative and postoperative volumetric kidney parameters were compared and multivariable linear regression model was used to analyze predictors associated with postoperative compensatory hypertrophy. The preoperative median contralateral kidney volume was significantly larger in group C than in groups A and B (A: 170.3, B: 176.9, C: 186.8 mL, p hypertrophy after surgery.

  16. Cortical inhibition effect in musicians and non-musicians using P300 with and without contralateral stimulation.

    Science.gov (United States)

    Rabelo, Camila Maia; Neves-Lobo, Ivone Ferreira; Rocha-Muniz, Caroline Nunes; Ubiali, Thalita; Schochat, Eliane

    2015-01-01

    Musicians have more robust and efficient neural responses in the cortical and sub-cortical regions, demonstrating that musical experience benefits the processing of both non-linguistic and linguistic stimuli. This study aimed to verify P300's latency and amplitude behavioral using contralateral stimulation in musicians and non-musicians. This was a case-control study. Subjects were divided in two groups: musicians, comprising 30 professional musicians, and non-musicians, comprising 25 subjects without musical experience. The present study showed that the musicians had lower latencies and higher amplitudes than the non-musicians in the P300 without contralateral noise. For the P300 amplitude values, the difference between groups persisted, and the musicians presented significantly higher amplitude values compared with the non-musicians; additionally, the analysis of the noise effect on the P300 response showed that the latency values were significantly increased in the musicians. The central auditory nervous system of musicians presents peculiar characteristics of electrophysiological responses probably due to the plasticity imposed by musical practice. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  17. Efeito do uso da tadalafila, inibidor da fosfodiesterase tipo 5, na isquemia-reperfusão renal : estudo experimental em suínos

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    Cláudio Miguel Pinto Morales

    2010-01-01

    Objetivo: Avaliar os efeitos da tadalafila, um inibidor da fosfodiesterase tipo 5, nos valores teciduais renais de malondialdeído (produto da lipoperoxidação celular), nos níveis séricos de uréia e creatinina e na histologia renal em suínos submetidos à isquemia-reperfusão renal em rim único. Material e métodos: Doze suínos Large-White foram submetidos à uninefrectomia seguida por isquemia-reperfusão renal contralateral e separados aleatoriamente em dois grupos com ou sem tratamento com tadal...

  18. Ipsilateral inhibition and contralateral facilitation of simple reaction time to non-foveal visual targets from non-informative visual cues.

    Science.gov (United States)

    Tassinari, G; Biscaldi, M; Marzi, C A; Berlucchi, G

    1989-05-01

    Orienting to an extrafoveal light cue without foveating it induces a temporary inhibition of responses to subsequent targets presented in the same visual hemifield, as evinced from the fact that reaction time (RT) to targets ipsilateral to the cue relative to fixation is longer than RT to targets contralateral to the cue. This study has tested the hypothesis that ipsilateral RT inhibition is associated with contralateral RT facilitation by attempting to divide the difference between ipsilateral and contralateral RTs into costs and benefits. A neutral condition suited to this purpose should involve a cue that does not require a lateral orientation. Such neutral condition was provided by measuring RT to lateralized light targets following a central overhead auditory cue (experiment 1) or a foveal visual cue (experiment 2). In both experiments RT in the neutral condition was intermediate between ipsilateral and contralateral RTs, and the differences reaches significance in the second experiment. Benefits over the neutral condition measured in the contralateral condition were thus associated with costs in the ipsilateral condition. These results suggest that a reciprocal antagonism between opposite turning tendencies underlies the organization of covert orienting. They also agree with general multi-channel theories of selective attention according to which the facilitation of given channels is an obligatory accompaniment of the inhibition of other competing channels and vice versa.

  19. Three New Myrsinol Diterpenes from <em>Euphorbia proliferaem> and Their Neuroprotective Activities

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    Yuanqiang Guo

    2012-08-01

    Full Text Available Three new myrsinol diterpenes were isolated from the roots of<em> em>>Euphorbia proliferaem>. Their structures were elucidated as 2<em>α-O>-isobutyryl-3<em>β>,5<em>α>,7<em>β>,10,15<em>β-penta-O>-acetyl-14<em>α-O>-benzoyl-10,18-dihydromyrsinol (1, 2<em>α-O>-isobutyryl-3<em>β-O>-propion-yl-5<em>α>,7<em>β>,10,15<em>β-tetra-O>-acetyl-10,18-dihydromyrsinol (2, and 2<em>α>,14<em>α-di-O>-benzoyl-3<em>β>,5<em>α>,7<em>β>,10,15<em>β-penta-O>-acetyl-10,18-dihydromyrsinol (3 on the basis of spectroscopic data analyses (IR, ESI-MS, HR-ESI-MS, and 1D and 2D NMR. Their neuroprotective activities were evaluated and compounds 1 and 2 showed neuroprotective effects against MPP+-induced neuronal cell death in SH-SY5Y cells.

  20. Contralateral breast doses in radiotherapy: effect of wedges introduction versus supraclavicular field; Dosis a la mama contralateral en radioterapia: effecto de la introduccion de las cunas frente a la del campo supraclavicular

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    Carrera, Francisco; Velazquez, Santiago; Bayo, Eloisa [Hospital Juan Ramon Jimenez, Huelva (Spain); Ojeda, Carmen; Ruiz-Cruzes, Rafael; Diez de los Rios, Antonio [Universidad de Malaga (Spain). Grupo de Investigacion en Proteccion Radiologica (PRUMA)

    2001-07-01

    It is interesting the influence of physical wedges on medial tangential field, and subsequent extrafocal electronic contamination on the contralateral breast dose (CBD). This st