RESUMEN
Natural disasters such as public health epidemics may potentially affect suicide rates. The global COVID-19 pandemic poses an unprecedented challenge for healthcare systems and general populations worldwide. In this retrospective ecological study, we aimed to examine any changes in the suicide rates during the COVID-19 pandemic and to assess the relationship between COVID-19 death rates and deaths by suicide in Brazil. Data on suicide and COVID-19 case numbers were extracted from the Ministry of Health agencies and grouped weekly. We performed a time series analysis of suicide rates, a comparison of mean suicide rates between the pre-COVID-19 period and the COVID-19 period, and conducted a Poisson regression to examine the relationship between deaths due to COVID-19 and suicide rates. Our results showed decreased suicide rates during the COVID-19 pandemic. We also found that deaths owing to COVID-19 impact those owing to suicide after 10 weeks in the upward direction; however, we did not observe for enough time to see a change in the suicide rate curve. These findings are fundamental to understand suicidal behaviors in epidemic situations. However, the field needs more studies evaluating the impact of significant public health events on suicidality, incorporating extended follow-up periods.
Asunto(s)
COVID-19 , Suicidio , Humanos , Brasil/epidemiología , Pandemias , Estudios RetrospectivosRESUMEN
BACKGROUND: Poor eye contact and joint attention are early signs of autism spectrum disorder (ASD) and important prerequisites for developing other socio-communicative skills. Teaching parents evidence-based techniques to improve these skills can impact the overall functioning of children with ASD. We aimed to analyse the impact of conducting a group parent-training intervention with video modelling to improve the intelligent quotient (IQ), social and communication functioning and to minimise symptoms in children with ASD and intellectual disability (ID). METHODS: Study design: A multicentre, single-blinded, randomised clinical pilot trial of parent training using video modelling was conducted. SAMPLE: Sixty-seven parents of children with ASD, aged between 3 and 6 years and with IQs between 50 and 70, were randomised: 34 to the intervention group and 33 to the control group. Intervention program: The intervention group received parent training over 22 sessions, and the control group received the standard community treatment. INSTRUMENTS: Pre-evaluation and post-evaluation (week 28), the following were used: Autism Diagnostic Interview, Vineland Adaptive Behaviour Scale I, Snijders-Oomen Nonverbal Intelligence Test, Autism Behaviour Checklist and Hamilton Depression Rating Scale. DATA ANALYSIS: Intention to treat and complier-average causal effect (CACE) were used to estimate the effects of the intervention. RESULTS: There was a statistically significant improvement in the Vineland standardized communication scores in CACE (Cohen's d = 0.260). There was a non-statistically significant decrease in autism symptomatology (Autism Behaviour Checklist total scores) and a significant increase in the non-verbal IQ in the intervention group. After the false discovery rate correction was applied, IQ remained statistically significant under both paradigms. The effect size for this adjusted outcome under the intention-to-treat paradigm was close to 0.4, and when considering adherence (CACE), the effect sizes were more robust (IQ's Cohen's d = 0.433). CONCLUSIONS: Parent training delivered by video modelling can be a useful technique for improving the care given to children with ASD and ID, particularly in countries that lack specialists.
Asunto(s)
Trastorno del Espectro Autista/terapia , Educación no Profesional , Discapacidad Intelectual/terapia , Evaluación de Resultado en la Atención de Salud , Padres , Adulto , Niño , Preescolar , Educación no Profesional/métodos , Femenino , Humanos , Masculino , Proyectos Piloto , Método Simple Ciego , Grabación en VideoRESUMEN
Fear behavioral studies provide knowledge on animal welfare, and fearful behaviors can be used as selection criteria of individuals adapted to intensive rearing system. The survival analysis methodology was applied to estimate tonic immobility (TI) duration, as an indicator of fear, of red-winged tinamous (Rhynchotus rufescens) reared in captivity and to determine if TI is genetically influenced. A number of 539 birds born between 2006 and 2010 were evaluated. The exploratory data analysis was performed using the Kaplan-Meier estimate (KM), and the covariates were then fit to a Cox model, considering month of observation nested within year of birth and body weight as fixed effects and the random effect of sire as frailty term. In order to predict genetic values and to estimate heritability, the model of proportional hazards was applied, using a Weibull distribution as the baseline hazard. Birds born in the last year presented shorter TI duration than those born in the previous year, as shown by the survival KM curves, indicating a decline in fearfulness from one year to the next. The Cox analysis detected that hazard function was reduced as body weight increased. The frailty term was significant (p<0.05), showing that sires induced variation in the TI duration of the offspring. Heritability estimated as 0.37, indicating the influence of additive genes. These findings suggest that the selection of for short TI duration may allow reducing fearfulness of a red-winged tinamou population after some generations.
Asunto(s)
Animales , Aves/anomalías , Aves/genética , Pérdida de Tono PosturalRESUMEN
Fear behavioral studies provide knowledge on animal welfare, and fearful behaviors can be used as selection criteria of individuals adapted to intensive rearing system. The survival analysis methodology was applied to estimate tonic immobility (TI) duration, as an indicator of fear, of red-winged tinamous (Rhynchotus rufescens) reared in captivity and to determine if TI is genetically influenced. A number of 539 birds born between 2006 and 2010 were evaluated. The exploratory data analysis was performed using the Kaplan-Meier estimate (KM), and the covariates were then fit to a Cox model, considering month of observation nested within year of birth and body weight as fixed effects and the random effect of sire as frailty term. In order to predict genetic values and to estimate heritability, the model of proportional hazards was applied, using a Weibull distribution as the baseline hazard. Birds born in the last year presented shorter TI duration than those born in the previous year, as shown by the survival KM curves, indicating a decline in fearfulness from one year to the next. The Cox analysis detected that hazard function was reduced as body weight increased. The frailty term was significant (p<0.05), showing that sires induced variation in the TI duration of the offspring. Heritability estimated as 0.37, indicating the influence of additive genes. These findings suggest that the selection of for short TI duration may allow reducing fearfulness of a red-winged tinamou population after some generations.(AU)
Asunto(s)
Animales , Aves/anomalías , Aves/genética , Pérdida de Tono PosturalRESUMEN
OBJECTIVE: In adulthood, the diagnosis of attention-deficit/hyperactivity disorder (ADHD) has been subject of recent controversy. We searched for a neuroanatomical signature associated with ADHD spectrum symptoms in adults by applying, for the first time, machine learning-based pattern classification methods to structural MRI and diffusion tensor imaging (DTI) data obtained from stimulant-naïve adults with childhood-onset ADHD and healthy controls (HC). METHOD: Sixty-seven ADHD patients and 66 HC underwent high-resolution T1-weighted and DTI acquisitions. A support vector machine (SVM) classifier with a non-linear kernel was applied on multimodal image features extracted on regions of interest placed across the whole brain. RESULTS: The discrimination between a mixed-gender ADHD subgroup and individually matched HC (n = 58 each) yielded area-under-the-curve (AUC) and diagnostic accuracy (DA) values of up to 0.71% and 66% (P = 0.003) respectively. AUC and DA values increased to 0.74% and 74% (P = 0.0001) when analyses were restricted to males (52 ADHD vs. 44 HC). CONCLUSION: Although not at the level of clinically definitive DA, the neuroanatomical signature identified herein may provide additional, objective information that could influence treatment decisions in adults with ADHD spectrum symptoms.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Encéfalo/diagnóstico por imagen , Encéfalo/fisiopatología , Imagen por Resonancia Magnética/métodos , Máquina de Vectores de Soporte , Adulto , Imagen de Difusión Tensora/métodos , Femenino , Humanos , Masculino , NeurobiologíaRESUMEN
BACKGROUND: Low- and middle-income countries (LMICs) face a lack of epidemiological data. The development of high-quality surveys is a key research priority in countries such as Brazil. Our aim is to discuss the difficulties in conducting a longitudinal epidemiological survey in a pilot study of a school-based sample in São Paulo. METHODS: Data came from a cohort of school-attending adolescents in two neighborhoods with different levels of urbanicity in São Paulo. Students born in 2002 and in the 7th grade during 2014 were recruited from nine public schools. Adolescents and caregivers were interviewed separately at baseline and at one year follow-up, using several instruments, including the Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime Version (K-SADS-PL). RESULTS: Achieving unbiased sampling, keeping an updated register of participants' contact information, using a full clinical interview without an algorithm for its scoring, and maintaining a highly-trained research team were among the difficulties faced. CONCLUSION: Working closely with community leaders, organizing group efforts to perform interviews, using a short, easy to understand instrument and providing some reward for participants were identified as alternatives to dealing with these difficulties, useful not only in Brazil, but also in other LMICs.
Asunto(s)
Recolección de Datos/métodos , Trastornos del Humor/epidemiología , Proyectos de Investigación , Esquizofrenia/epidemiología , Estudiantes/estadística & datos numéricos , Adolescente , Sesgo , Brasil/epidemiología , Niño , Femenino , Humanos , Renta , Estudios Longitudinales , Masculino , Proyectos Piloto , Sistema de Registros , Reproducibilidad de los Resultados , Instituciones Académicas/estadística & datos numéricos , Estudiantes/psicologíaRESUMEN
1. objective of the present study was to estimate heritability for hatch weight (HW), body weight at 90 (W90) and 180 (W180) d of age in Brazilian ostriches. 2. The heritability estimates were obtained through the restricted maximum likelihood method for an animal model. Least squares method was used to define possible fixed effects for consideration in the analysis model. 3. The estimates of heritability were 0.42 ± 0.05, 0.16 ± 0.04 and 0.24 ± 0.08 for HW, W90 and W180, respectively. 4. Heritability estimates showed that there are sufficient levels of additive genetic variation present in the traits studied, and these traits may respond to selection.
Asunto(s)
Peso Corporal/genética , Struthioniformes/anatomía & histología , Animales , Hibridación Genética , Masculino , Fenotipo , Carácter Cuantitativo Heredable , Struthioniformes/genéticaRESUMEN
In most studies on beef cattle longevity, only the cows reaching a given number of calvings by a specific age are considered in the analyses. With the aim of evaluating all cows with productive life in herds, taking into consideration the different forms of management on each farm, it was proposed to measure cow longevity from age at last calving (ALC), that is, the most recent calving registered in the files. The objective was to characterize this trait in order to study the longevity of Nellore cattle, using the Kaplan-Meier estimators and the Cox model. The covariables and class effects considered in the models were age at first calving (AFC), year and season of birth of the cow and farm. The variable studied (ALC) was classified as presenting complete information (uncensored = 1) or incomplete information (censored = 0), using the criterion of the difference between the date of each cow's last calving and the date of the latest calving at each farm. If this difference was >36 months, the cow was considered to have failed. If not, this cow was censored, thus indicating that future calving remained possible for this cow. The records of 11 791 animals from 22 farms within the Nellore Breed Genetic Improvement Program ('Nellore Brazil') were used. In the estimation process using the Kaplan-Meier model, the variable of AFC was classified into three age groups. In individual analyses, the log-rank test and the Wilcoxon test in the Kaplan-Meier model showed that all covariables and class effects had significant effects (P < 0.05) on ALC. In the analysis considering all covariables and class effects, using the Wald test in the Cox model, only the season of birth of the cow was not significant for ALC (P > 0.05). This analysis indicated that each month added to AFC diminished the risk of the cow's failure in the herd by 2%. Nonetheless, this does not imply that animals with younger AFC had less profitability. Cows with greater numbers of calvings were more precocious than those with fewer calvings.
Asunto(s)
Bovinos/fisiología , Longevidad , Parto , Envejecimiento , Animales , Brasil , Femenino , Estimación de Kaplan-Meier , Modelos Biológicos , Embarazo , Modelos de Riesgos ProporcionalesRESUMEN
The objective of this study was to fit growth curves using nonlinear and linear functions to describe the growth of ostriches in a Brazilian population. The data set consisted of 112 animals with BW measurements from hatching to 383 d of age. Two nonlinear growth functions (Gompertz and logistic) and a third-order polynomial function were applied. The parameters for the models were estimated using the least-squares method and Gauss-Newton algorithm. The goodness-of-fit of the models was assessed using R(2) and the Akaike information criterion. The R(2) calculated for the logistic growth model was 0.945 for hens and 0.928 for cockerels and for the Gompertz growth model, 0.938 for hens and 0.924 for cockerels. The third-order polynomial fit gave R(2) of 0.938 for hens and 0.924 for cockerels. Among the Akaike information criterion calculations, the logistic growth model presented the lowest values in this study, both for hens and for cockerels. Nonlinear models are more appropriate for describing the sigmoid nature of ostrich growth.
Asunto(s)
Struthioniformes/crecimiento & desarrollo , Envejecimiento/fisiología , Agricultura , Animales , Brasil , Modelos BiológicosRESUMEN
Egg production curves describe the laying patterns of hen populations over time. The objectives of this study were to fit the weekly egg production rate of selected and nonselected lines of a White Leghorn hen population, using nonlinear and segmented polynomial models, and to study how the selection process changed the egg-laying patterns between these 2 lines. Weekly egg production rates over 54 wk of egg production (from 17 to 70 wk of age) were measured from 1,693 and 282 laying hens from one selected and one nonselected (control) genetic line, respectively. Six nonlinear and one segmented polynomial models were gathered from the literature to investigate whether they could be used to fit curves for the weekly egg production rate. The goodness of fit of the models was measured using Akaike's information criterion, mean square error, coefficient of determination, graphical analysis of the fitted curves, and the deviations of the fitted curves. The Logistic, Yang, Segmented Polynomial, and Grossman models presented the best goodness of fit. In this population, there were significant differences between the parameter estimates of the curves fitted for the selected and nonselected lines, thus indicating that the effect of selection changed the shape of the egg production curves. The selection for egg production was efficient in modifying the birds' egg production curve in this population, thus resulting in genetic gain from the 5th to the 54th week of egg laying and improved the peak egg production and the persistence of egg laying.
Asunto(s)
Pollos/genética , Pollos/fisiología , Oviposición/genética , Oviposición/fisiología , Selección Genética/fisiología , Animales , Femenino , Modelos BiológicosRESUMEN
This study puts together genetic data and an approximate bayesian computation (ABC) approach to infer the time at which the tree Geoffroea spinosa colonized the Galápagos Islands. The genetic diversity and differentiation between Peru and Galápagos population samples, estimated using three chloroplast spacers and six microsatellite loci, reveal significant differences between two mainland regions separated by the Andes mountains (Inter Andean vs. Pacific Coast) as well as a significant genetic differentiation of island populations. Microsatellites identify two distinct geographical clusters, the Galápagos and the mainland, and chloroplast markers show a private haplotype in the Galápagos. The nuclear distinctiveness of the Inter Andean populations suggests current restricted pollen flow, but chloroplast points to cross-Andean dispersals via seeds, indicating that the Andes might not be an effective biogeographical barrier. The ABC analyses clearly point to the colonization of the Galápagos within the last 160,000 years and possibly as recently as 4750 years ago (475 generations). Founder events associated with colonization of the two islands where the species occurs are detected, with Española having been colonized after Floreana. We discuss two nonmutually exclusive possibilities for the colonization of the Galápagos, recent natural dispersal vs. human introduction.
Asunto(s)
Fabaceae/genética , Variación Genética , Teorema de Bayes , Cloroplastos/genética , Ecuador , Efecto Fundador , Haplotipos , Especies Introducidas , Repeticiones de Microsatélite , Modelos Genéticos , Datos de Secuencia Molecular , Perú , Filogeografía , Factores de TiempoRESUMEN
In this study, the objective was to estimate genetic parameters of body weight at 210 (BW210) and 365 (BW365) days of age in relation to rib eye area (REA), subcutaneous back fat thickness (BF) and rump fat (RF), and their respective genetic trends, in Nelore beef cattle. Estimates of genetic parameters and breeding values for the studied traits were obtained using the REML method. The direct and maternal heritability estimates were respectively: 0.25±0.02 and 0.21±0.01, for BW210, and 0.29±0.02 and 0.09±0.01, for BW365. The heritability estimates for transformed REA, BF and RF were 0.29±0.03, 0.21±0.02 and 0.23±0.03, respectively. There were genetic associations between BW210 and REA, BW365 and REA, and BF and RF, while the other correlations were low. The selection process that was conducted at the farms participating in the breeding program, taking the proposed selection index into consideration, caused genetic changes to these traits.
Asunto(s)
Tejido Adiposo/metabolismo , Peso Corporal/genética , Cruzamiento/métodos , Bovinos/genética , Grasas de la Dieta/análisis , Carne/análisis , Carácter Cuantitativo Heredable , Animales , Bovinos/crecimiento & desarrolloRESUMEN
The objectives of this paper were to identify the phenotypic egg-laying patterns in a White Leghorn line mainly selected for egg production, to estimate genetic parameters of traits related to egg production and to evaluate the genetic association between these by principal components analysis to identify trait(s) that could be used as selection criteria to improve egg production. Records of 54 wk of egg production from a White Leghorn population were used. The data set contained records of the length:width ratio of eggs at 32, 37, and 40 wk of age; egg weight at 32, 37, and 40 wk of age; BW at 54 and 62 wk of age; age at first egg; early partial egg production rate from 17 to 30 wk and from 17 to 40 wk of age; late partial egg production rate from 30 to 70 wk and from 40 to 70 wk of age; and total egg production rate (TEP). The estimates of genetic parameters between these traits were estimated by the restricted maximum likelihood method. Multivariate analyses were performed: a hierarchical cluster analysis, a nonhierarchical clustering analysis by the k-means method of weekly egg production rate to describe the egg-laying patterns of hens, and a principal components analysis using the breeding values of all traits. The highest heritability estimates were obtained for BW at 54 wk of age (0.68 ± 0.07) and age at first egg (0.53 ± 0.07). It is recommended that a preliminary clustering analysis be performed to obtain the population structure that takes into account the pattern of egg production, rather than the TEP, because hens may have the same final egg production with different patterns of egg laying. Early partial production periods were not good indicators for use in improving total egg production because these traits presented an overestimated genetic correlation with TEP because of the part-whole genetic correlation component. Egg production might be improved by selecting individuals based on TEP.
Asunto(s)
Cruzamiento , Pollos/genética , Pollos/fisiología , Huevos , Oviposición/genética , Carácter Cuantitativo Heredable , Animales , Análisis por Conglomerados , Femenino , Fenotipo , Análisis de Componente Principal , Selección GenéticaRESUMEN
BACKGROUND: This study evaluated the effectiveness of adjunctive cognitive behavioral group therapy (CBGT) to prevent recurrence of episodes in euthymic patients with bipolar disorder. METHODS: A randomized controlled single-blind trial was conducted with 50 patients with bipolar disorder types I and II followed up for at least 12 months in an outpatient service and whose disease was in remission. An experimental CBGT manual was developed and added to treatment as usual (TAU), and results were compared with TAU alone. RESULTS: Intention-to-treat analysis showed that there was no difference between groups in terms of time until any relapse (Wilcoxon = 0.667; p = 0.414). When considering type of relapse, there was still no difference in either depressive (Wilcoxon = 3.328; p = 0.068) or manic episodes (Wilcoxon = 1.498; p = 0.221). Although occurrence of episodes also did not differ between groups (χ(2) = 0.28; p = 0.59), median time to relapse was longer for patients treated with CBGT compared to TAU (Mann-Whitney = -2.554; p = 0.011). CONCLUSIONS: Time to recurrence and number of episodes were not different in the group of patients treated with CBGT. However, median time to relapse was shorter in the TAU group. Studies with larger samples may help to clarify whether our CBGT approach prevents new episodes of bipolar disorder. Our findings also indicated that CBGT is feasible in euthymic patients with bipolar disorder and should be investigated in future studies. To our knowledge, this is the first publication of a controlled trial of CBGT for euthymic patients with bipolar disorder.
Asunto(s)
Trastorno Bipolar/terapia , Terapia Cognitivo-Conductual/métodos , Adolescente , Adulto , Brasil , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Método Simple Ciego , Estadísticas no Paramétricas , Resultado del Tratamiento , Adulto JovenRESUMEN
Neural networks are capable of modeling any complex function and can be used in the poultry and animal production areas. The aim of this study was to investigate the possibility of using neural networks on an egg production data set and fitting models to the egg production curve by applying 2 approaches, one using a nonlinear logistic model and the other using 2 artificial neural network models [multilayer perceptron (MLP) and radial basis function]. Two data sets from 2 generations of a White Leghorn strain that had been selected mainly for egg production were used. In the first data set, the mean weekly egg-laying rate was ascertained over a 54-wk egg production period. This data set was used to adjust and test the logistic model and to train and test the neural networks. The second data set, covering 52 wk of egg production, was used to validate the models. The mean absolute deviation, mean square error, and R(2) were used to evaluate the fit of the models. The MLP neural network had the best fit in the test and validation phases. The advantage of using neural networks is that they can be fitted to any kind of data set and do not require model assumptions such as those required in the nonlinear methodology. The results confirm that MLP neural networks can be used as an alternative tool to fit to egg production. The benefits of the MLP are the great flexibility and their lack of a priori assumptions when estimating a noisy nonlinear model.
Asunto(s)
Pollos/fisiología , Modelos Biológicos , Oviposición/fisiología , Animales , Femenino , Modelos Logísticos , Redes Neurales de la Computación , Factores de TiempoRESUMEN
Today, the Seasonally Dry Tropical Forests (SDTF) of eastern South America occur as large, well-defined nuclei (e.g. Caatinga in the northeast) and as smaller enclaves within other vegetations (e.g. Cerrado and Chaco). In order to infer the way the present SDTF distribution was attained, the genetic structure of Astronium urundeuva, a tree confined to SDTF, was assessed using two chloroplast spacers and nine microsatellite loci. Five haplotypes were identified, whose distribution was spatially structured. The distribution of the two most common and divergent haplotypes suggested former vicariance and progressive divergence due to isolation. More recent range expansions of these two lineages subsequently occurred, leading to a secondary contact at the southern limit of the Caatinga SDTF nucleus. The multilocus-Bayesian approach using microsatellites consistently identified three groups of populations (Northeast, Central and Southwest). Isolation by distance was found in Northeast and Southwest groups whereas admixture was detected in the Central group, located at the transition between Caatinga and Cerrado domains. All together, the results support the existence of range expansions and secondary contact in the Central group. This study provides arguments that favour the existence of a previously more continuous formation of SDTF in eastern South America.
Asunto(s)
Anacardiaceae/genética , Árboles/genética , Clima Tropical , Anacardiaceae/clasificación , Anacardiaceae/crecimiento & desarrollo , Análisis por Conglomerados , ADN de Cloroplastos/química , ADN de Cloroplastos/genética , Ecosistema , Variación Genética , Genética de Población , Geografía , Repeticiones de Microsatélite/genética , Datos de Secuencia Molecular , Filogenia , Estaciones del Año , Análisis de Secuencia de ADN , América del Sur , Árboles/clasificación , Árboles/crecimiento & desarrolloRESUMEN
Paciente feminina, 59 anos, branca, hipertensa há 20 anos, apresentou hipertensão grave e hipocalemia. Hiperaldosteronismo primário (HAP) foi comprovado após triagem laboratorial, que indicou aldosterona plasmática elevada e renina plasmática baixa. A tomografia computadorizada de abdômen superior detectou a presença de uma massa na glândula adrenal direita. A paciente foi submetida à adrenalectomia por videolaparoscopia. Após a cirurgia, a hipertensão persistiu mas foi controlada com uso de drogas antihipertensivas. HAP é uma das formas mais comuns de hipertensão secundária. Pode ser causada por adenoma produtor de aldosterona (APA) ou hiperplasia adrenal bilateral (HAB). A doença é caracterizada principalmente por retenção de sódio, supressão da atividade da renina plasmática e aumento da secreção de aldosterona. O "padrão-ouro" para confirmar o diagnóstico de HAP é a ausência da supressão de aldosterona em resposta à fludrocortisona e/ou à dieta hipersódica. O cateterismo das veias adrenais é o melhor método para diferenciar APA de HAB, uma vez que a presença de uma massa adrenal unilateral nos estudos por imagem não garante o diagnóstico de APA. O tratamento para APA é a adrenalectomia unilateral, que pode ser realizada por videolaparoscopia ou por cirurgia aberta (AU)
A 59-year-old female white patient, hipertensive for 20 years, presented severe hipertension and hipokalemia. Primary hiperaldosteronism (PHA) was confirmed after laboratory screening, which indicated high plasmatic aldosterone and low plasmatic renin. Computerized tomography (CT) of the upper abdomen detected the presence of a mass in the right adrenal gland. The patient underwent a videolaparoscopic adrenalectomy. After surgery, hypertension persisted but was controled by use of anti-hypertensive drugs. PHA is one of the most common forms of secondary hypertension. It can be caused by aldosterone producing adenoma (APA) or bilateral adrenal hyperplasia (BAH). The disease is characterized mainly by sodium retention, supression of plasma renin activity and increased aldosterone secretion. The "gold-standard" to the diagnosis of PHA is the absence of aldosterone supression in response to fludrocortisone and/or high sodium diet. The catheterism of adrenal veins is the best method to differentiate APA from BAH since the presence of a unilateral adrenal mass as confirmed by imaging studies does not warrant the diagnosis of APA. The treatment of APA is unilateral adrenalectomy, which can be performed by videolaparoscopy or open surgery (AU)
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Hiperaldosteronismo/fisiopatología , Hiperaldosteronismo/diagnóstico , Hiperaldosteronismo/terapiaRESUMEN
Serum plasma total cholesterol levels were measured in 85 male or female outpatients with panic disorder (PD; N=41), generalized anxiety disorder (GAD; N=23) and major depression (MD; N=21) according to DSM-IV criteria. All the patients had a mean cholesterol level within the normal range; males (N=22) and females (N=63) had approximately the same serum cholesterol levels (p >.05). No significant differences in cholesterol levels emerged between PD, GAD and MD patient groups. Both female PD and female GAD subjects had a mean cholesterol level similar to their male counterparts (p>. 05). It is concluded that both Hayward and colleagues and Bajwa et al. findings could not be replicated by our study.
Asunto(s)
Trastornos de Ansiedad/sangre , Colesterol/sangre , Depresión/sangre , Trastorno de Pánico/sangre , Adulto , Análisis de Varianza , Femenino , Humanos , Masculino , Reproducibilidad de los ResultadosAsunto(s)
Trasplante de Riñón/estadística & datos numéricos , Terapia de Reemplazo Renal/estadística & datos numéricos , Academias e Institutos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Derivación Arteriovenosa Quirúrgica/efectos adversos , Brasil , Niño , Preescolar , Nefropatías Diabéticas/epidemiología , Nefropatías Diabéticas/terapia , Femenino , Hepatitis Viral Humana/epidemiología , Humanos , Lactante , Fallo Renal Crónico/epidemiología , Fallo Renal Crónico/terapia , Masculino , Persona de Mediana Edad , Nefrología , Diálisis Peritoneal Ambulatoria Continua/efectos adversos , Diálisis Peritoneal Ambulatoria Continua/estadística & datos numéricos , Grupos Raciales , Terapia de Reemplazo Renal/efectos adversos , Terapia de Reemplazo Renal/mortalidadRESUMEN
No período de julho de 1986 a dezembro de 1995, foram operados 12 pacientes com rotura traumática da aorta torácica. Nove pacientes apresentavam rotura aguda da aorta e 3 rotura crônica. Em todos os pacientes a lesäo localizava-se logo abaixo da emergência da artéria subclávia esquerda (istmo). Onze pacientes foram operados sob pinçamento aortico simples e em apenas 1 associamos shunt näo heparinizado entre a artéria subclávia esquerda e a aorta descendente. O tempo médio de pinçamento aórtico foi de 33,2 minutos. Onze pacientes sobreviveram. Um paciente faleceu no pós-operatório imediato, devido a sangramento, e outro apresentou paresia de membros inferiores. Dez pacientes evoluíram sem complicaçöes no pós-operatório. Concluímos que a correçäo da rotura traumática da aorta torácica, sob pinçamento aórtico simples, é técnica aceitável no tratamento cirúrgico desta lesäo.