RESUMO
Saddle height influences cycling performance and would be expected to influence cyclists physically, perceptually, and emotionally. We investigated how different saddle positions and cadences might affect cyclists' torque, heart rate, rate of perceived exertion (RPE), and affective responses (Feeling scale). Nine male recreational cyclists underwent cycling sessions on different days under different conditions with a constant load. On Day 1, the saddle was at the reference position (109% of the distance from the pubic symphysis to the ground), and on Days 2 and 3, the saddle was in the "upward position" (reference + 2.5%) and "downward position" (reference - 2.5%) in random order. Each session lasted 30 minutes and was divided into three cadence-varied 10-minute stages without interruption: (a) freely chosen cadence (FCC), (b) FCC - 20%, and (c) FCC + 20%. We assessed all dependent measures at the end of each 10 minute stage. While there was no significant interaction (Saddle × Cadence) for any of the analyzed variables, torque values were higher at lower cadences in all saddle configurations, and the FCC + 20% cadence was associated with faster heart rate, higher RPE, and lower affect compared with FCC and FCC - 20% in all saddle positions. At all cadences, the saddle at "downward position" generated a higher RPE compared with "reference position" and "upward position." The affective response was lower in the "downward position" compared with the "reference position." Thus, while cyclists perceived the downward (versus reference) saddle position as greater exercise effort, they also associated it with unpleasant affect.
Assuntos
Ciclismo/fisiologia , Frequência Cardíaca/fisiologia , Percepção , Esforço Físico , Postura , Torque , Adulto , Ciclismo/psicologia , Exercício Físico/psicologia , Teste de Esforço , Humanos , Masculino , Consumo de Oxigênio/fisiologia , Resistência Física , Adulto JovemRESUMO
We aimed to follow the epidemiologic evolution of bovine digital dermatitis (BDD) and other podal diseases grouped in a dairy farm in Central Brazil between the years 2010 and 2016. This study was carried out in a farm in Jataí, Goiás, Central Brazil, where the prevalence data of bovine digital dermatitis (BDD) and other podal diseases, as well as the composition, history, and management of the herd, was collected. We analyzed the collected data into the two annual pluviometric precipitation values in Central Brazil: rainy season and dry season. The cumulative frequency for comparison of prevalence between seasons throughout the years was calculated from 2011 to 2016. The comparison was carried out by post hoc chi-square test with the Bonferroni correction adopting a level of significance of 5% (p < 0.05). BDD was not diagnosed at the property in 2010; however, the disease became endemic from 2011, which coincides with the arrival of new animals to the herd. The comparison of the accumulated frequencies for prevalence of the diseases in the herd between 2011 and 2016 revealed BDD, as well as the grouped nutritional and metabolic foot diseases, has the highest prevalence in the period of lower annual precipitation in Central Brazil, which occurs between May and October. For a better control of BDD, we recommend greater attention in cattle management in the dry season of the year in Brazil, as well as in any other place in the world in which rainfall is seasonal.
Assuntos
Doenças dos Bovinos/epidemiologia , Dermatite Digital/epidemiologia , Doenças do Pé/veterinária , Chuva , Estações do Ano , Animais , Brasil/epidemiologia , Bovinos , Fazendas , Feminino , Doenças do Pé/epidemiologia , Masculino , Modelos Estatísticos , PrevalênciaRESUMO
Rossato, M, Dellagrana, RA, Sakugawa, RL, Lazzari, CD, Baroni, BM, and Diefenthaeler, F. Time response of photobiomodulation therapy on muscular fatigue in humans. J Strength Cond Res 32(11): 3285-3293, 2018-The aim of this study was to identify the effects of 2 different time responses on fatigue of knee extensor. Sixteen male volunteers (26 ± 6.0 years, 81 ± 12 kg, and 181 ± 7.4 cm) participated in the study. Participants performed the same protocol in 5 sessions {control, placebo (placebo applied both 6 hours before and immediately before the test), 6 hours before + immediately before (photobiomodulation therapy [PBMT] applied both 6 hours before and immediately before the test), 6 hours before (PBMT applied 6 hours before and placebo applied immediately before the test), and immediately before (placebo applied 6 hours before and PBMT applied immediately before the test)}. Photobiomodulation therapy was applied on knee extensor (9 sites; 30 J per site). Maximal isometric voluntary contraction (MIVC) was assessed before and after an isokinetic fatigue (45 flexion-extension concentric at 180°·s), associated with electromyography (root mean square [RMS] and median of frequency [MF]). For MIVC, there was no treatment × time interaction for all variables. Time effect was observed for peak torque (PT), RMS, and MF. Treatment effect was verified for PT, and 6 hours before + immediately before condition presented higher PT during MIVCpre than control (p = 0.004) and placebo (p = 0.044). The immediately before presented higher PT values than control (p = 0.047). Regarding MIVCpost, the PT for 6 hours before + immediately before presented higher values than control (p = 0.001) and placebo (p = 0.004). Peak torque during MIVC (pre to post) was reduced in 6 hours before + immediately before treatment (26%) compared with control (33%), placebo (29%), and immediately before (32%). The application of PBMT 6 hours + immediately before and immediately before exercise protocol is able to reduce the fatigue.
Assuntos
Fadiga/radioterapia , Terapia com Luz de Baixa Intensidade , Fadiga Muscular , Músculo Esquelético/efeitos da radiação , Adulto , Estudos Cross-Over , Método Duplo-Cego , Eletromiografia , Exercício Físico/fisiologia , Humanos , Contração Isométrica , Articulação do Joelho , Masculino , Músculo Esquelético/fisiologia , Fatores de Tempo , Torque , Adulto JovemRESUMO
Despite claims that genitalia are among the fastest evolving phenotypes, few studies have tested this trend in a quantitative and phylogenetic framework. In systems where male and female genitalia coevolve, there is a growing effort to explore qualitative patterns of evolution and their underlying mechanisms, but the temporal aspect remains overlooked. An intriguing question is how fast male and female genitalia may change in a coevolutionary scenario. Here, we apply a series of comparative phylogenetic analyses to reveal a scenario of correlated evolution and to investigate how fast male and female external, nonhomologous and functionally integrated genitalia change in a group of stink bugs. We report three findings: the female gonocoxite 8 and the male pygophore showed a clear pattern of correlated evolution, both genitalia were estimated to evolve much faster than nongenital traits, and rates of evolution of the male genitalia were twice as fast as the female genitalia. Our results corroborate the widely held view that male genitalia evolve fast and add to the scarce evidence for rapidly evolving female genitalia. Different rates of evolution exhibited by males and females suggest either distinct forms or strengths of selection, despite their tight functional integration and coevolution. The morphological characteristics of this coevolutionary trend are more consistent with a cooperative adjustment of the genitalia, suggesting a scenario of female choice, morphological accommodation, lock-and-key or some combination of the three.
Assuntos
Evolução Biológica , Genitália Feminina , Genitália Masculina , Heterópteros , Animais , Feminino , Genitália , Masculino , Filogenia , Comportamento Sexual AnimalRESUMO
Phototherapy has been used for reducing muscle fatigue. In view of the various types of phototherapy cluster probes available in the market, the purpose of this study was to compare the effects of a similar phototherapy dosage with two different cluster probes on elbow flexor muscle fatigue: small cluster probe (SC = 9 diodes; 7.5 cm(2)) vs. large cluster probe (LC = 33 diodes; 30.2 cm(2)). Ten physically active male aged 18-35 years participate in a randomized, crossover, double-blind, placebo-controlled trial, which each participant was submitted to the same testing protocol in four sessions (separated by at least 48 h) with different treatments: LC-phototherapy, SC-phototherapy, LC-placebo, and SC-placebo. The elbow flexion maximal isometric voluntary contraction (MIVC) was performed before and after a fatigue protocol (60 % of MIVC until exhaustion). Electromyography (EMG) of the biceps brachii muscle was collected during all testing procedure. Phototherapy with dose of 60 J per muscle [LC: 33 diodes = 5 lasers (850 nm), 12 LEDs (670 nm), 8 LEDs (880 nm), and 8 LEDs (950 nm); SC: 9 diodes = 5 lasers (850 nm) and 4 LEDs (670 nm)] or placebo applications occurred before fatigue protocol. Two-way ANOVA (treatment and time factors) and one-way ANOVA were used, followed by LSD post hoc. Time to exhaustion was significantly higher in active LC (15 %; p = 0.031) and SC (14 %; p = 0.038) in comparison with their respective placebo treatments, without differences between LC and SC (p > 0.05) or between placebo conditions (p > 0.05). This larger exercise tolerance in phototherapy conditions was not accompanied by a higher decrement in the volunteers' maximal strength capacity (11-15 %; p > 0.05 for all). EMG signals presented no difference between the four condition tested here. In both large and small cluster probes (according parameters tested in this study) led to reduced fatigue in elbow flexor muscles, without difference between them.
Assuntos
Cotovelo , Fadiga Muscular/fisiologia , Músculo Esquelético/fisiologia , Músculo Esquelético/efeitos da radiação , Fototerapia/métodos , Adolescente , Adulto , Braço , Estudos Cross-Over , Método Duplo-Cego , Eletromiografia , Tolerância ao Exercício , Humanos , Masculino , Amplitude de Movimento Articular , Adulto JovemRESUMO
This study investigated the presence of Toxoplasma gondii antibodies in experimentally infected New World primates, by means of an enzyme linked immunosorbent assay (ELISA) for IgG and IgM, and the pattern of polypeptide recognition using Western-blotting. Seven days after infection all primates yielded positive results in both ELISA-IgG and ELISA-IgM. Western blotting documented four major polypeptides with apparent molecular weight of 160, 120, 80 and 35- 30 kDa. The 35-30 kDa polypeptide was identified by antibodies from all infected primates and should be further evaluated for use in specific diagnosis of T. gondii infection.
O presente estudo investigou a presença de anticorpos para Toxoplasma gondii em primatas do Novo Mundo experimentalmente infectados, por meio de um ensaio imunoenzimático (ELISA) para as classes de imunoglobulina IgG e IgM, e o padrão de reconhecimento de polipeptídeos no soro desses mesmos animais utilizando a técnica de "Westernblotting. Todos os primatas mostraram-se positivos aos sete dias de infecção tanto no ELISA-IgG como no ELISA-IgM. O "Western blotting" revelou quatro principais polipeptídeos com pesos moleculares aparentes de 160, 120, 80 e 35-30 kDa. O polipeptídeo de 35-30 kDa foi identificado pelos anticorpos de todos os primatas infectados e deve ser melhor investigado para uso no diagnóstico específico de infecções por T. gondii.
RESUMO
This study investigated the presence of Toxoplasma gondii antibodies in experimentally infected New World primates, by means of an enzyme linked immunosorbent assay (ELISA) for IgG and IgM, and the pattern of polypeptide recognition using Western-blotting. Seven days after infection all primates yielded positive results in both ELISA-IgG and ELISA-IgM. Western blotting documented four major polypeptides with apparent molecular weight of 160, 120, 80 and 35- 30 kDa. The 35-30 kDa polypeptide was identified by antibodies from all infected primates and should be further evaluated for use in specific diagnosis of T. gondii infection.
O presente estudo investigou a presença de anticorpos para Toxoplasma gondii em primatas do Novo Mundo experimentalmente infectados, por meio de um ensaio imunoenzimático (ELISA) para as classes de imunoglobulina IgG e IgM, e o padrão de reconhecimento de polipeptídeos no soro desses mesmos animais utilizando a técnica de "Westernblotting. Todos os primatas mostraram-se positivos aos sete dias de infecção tanto no ELISA-IgG como no ELISA-IgM. O "Western blotting" revelou quatro principais polipeptídeos com pesos moleculares aparentes de 160, 120, 80 e 35-30 kDa. O polipeptídeo de 35-30 kDa foi identificado pelos anticorpos de todos os primatas infectados e deve ser melhor investigado para uso no diagnóstico específico de infecções por T. gondii.
RESUMO
This study investigated the presence of Toxoplasma gondii antibodies in experimentally infected New World primates, by means of an enzyme linked immunosorbent assay (ELISA) for IgG and IgM, and the pattern of polypeptide recognition using Western-blotting. Seven days after infection all primates yielded positive results in both ELISA-IgG and ELISA-IgM. Western blotting documented four major polypeptides with apparent molecular weight of 160, 120, 80 and 35- 30 kDa. The 35-30 kDa polypeptide was identified by antibodies from all infected primates and should be further evaluated for use in specific diagnosis of T. gondii infection.
O presente estudo investigou a presença de anticorpos para Toxoplasma gondii em primatas do Novo Mundo experimentalmente infectados, por meio de um ensaio imunoenzimático (ELISA) para as classes de imunoglobulina IgG e IgM, e o padrão de reconhecimento de polipeptídeos no soro desses mesmos animais utilizando a técnica de "Westernblotting. Todos os primatas mostraram-se positivos aos sete dias de infecção tanto no ELISA-IgG como no ELISA-IgM. O "Western blotting" revelou quatro principais polipeptídeos com pesos moleculares aparentes de 160, 120, 80 e 35-30 kDa. O polipeptídeo de 35-30 kDa foi identificado pelos anticorpos de todos os primatas infectados e deve ser melhor investigado para uso no diagnóstico específico de infecções por T. gondii.
RESUMO
Using a variational approach we have studied the shape preserving coherent propagation of light pulses in a resonant dispersive medium in the presence of the Kerr nonlinearity. Within the framework of a combined nonintegrable system composed of one nonlinear Schrödinger and a pair of Bloch equations, we show the existence of a solitary wave. We have tested our analytical solution through numerical simulations confirming its solitary wave nature.
RESUMO
Using a numerical approach we report on the cloning dynamics of simultaneous self-induced transparency (SIT) and nonlinear Schrödinger (NLS) solitons in a doped nonlinear dispersive medium. This technique involves a three-level atomic system interacting resonantly with two optical fields within a Lambda scheme. As a result, a pulse in the signal frequency is transformed into a replica of the pulse in the pump frequency. The atomic population evolution shows that the basic mechanism behind the cloning process is the coherent population trapping effect. Furthermore, it is shown that the signal clone presents characteristics of both the SIT soliton and NLS soliton.
RESUMO
We observe experimentally the transfer of angular spectrum and image formation in the process of stimulated parametric down-conversion. Images and interference patterns can be transferred from either the pump or the auxiliary laser beams to the stimulated down-converted one. The stimulated field propagates as the complex conjugate of the auxiliary laser. The phase conjugation is observed through intensity pattern measurements.
RESUMO
The aim of this work is to describe the prevalence of the disease in the same cattery after three years, and to report a case of human sporotrichosis following a cat scratch. In May 1997, four felines presenting a cachexy state and ulcerous lesions on the head, nose and limbs were examined in a veterinary clinic in the town of Rio Grande (RS-Brazil). Exudate and crusts were collected for microbiological diagnosis. The cat's owner returned to the clinic reporting that another eleven felines presented similar lesions. She had ulcerous lesions on her hand and ascending lymphangitis. She was conducted to medical examination where exudate and crusts from the lesions were collected and after the culture Sporothrix schenckii was isolated. After three years the same person sought veterinary assistance for seven more cats with similar lesions to the five previously described. Microbiological tests resulted again in isolation of S. schenckii. Treatment with potassium iodine was effective for the cure of human sporotrichosis, whereas for the felines it showed toxic effect. Only one showed regression of the disease while all the others presented progression of the lesions or even death. The authors call attention to the possible persistence of S. schenckii in cat populations.
RESUMO
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.
Assuntos
Transtornos de Ansiedade/sangue , Colesterol/sangue , Depressão/sangue , Transtorno de Pânico/sangue , Adulto , Análise de Variância , Feminino , Humanos , Masculino , Reprodutibilidade dos TestesRESUMO
The efficacy and safety of tianeptine were compared, in the course of a multicentre randomised, double-blind, parallel group study, to those of placebo in the treatment of Major Depressions and Bipolar Disorder, Depressed with or without melancholia, without psychotic features. After a 1-week run-in placebo period, 126 depressed out-patients presenting DSM-III-R Major Depression or Bipolar Disorder, Depressed, with a total MADRS score of at least 25, were treated for 42 days with either tianeptine (25-50 mg/day) or placebo. Efficacy assessments were MADRS, CGI, HARS, Zung Depression Self Rating Scale and a VAS. Better efficacy of tianeptine was shown, and confirmed by covariance analyses, in final MADRS scores of the intention-to-treat population, of patients treated for at least 14 days and of completers; also in CGI items 1 and 2, MADRS item 10, and VAS. The results confirmed the efficacy of tianeptine (mean dosage: 37.5 mg/day) in the treatment of Major Depression and Bipolar Disorder, Depressed, with or without melancholia, compared to placebo. Tianeptine's acceptability did not differ from that of placebo. For adverse events, a higher incidence of headaches was found with tianeptine.
Assuntos
Antidepressivos Tricíclicos/uso terapêutico , Transtorno Bipolar/tratamento farmacológico , Transtorno Depressivo/tratamento farmacológico , Tiazepinas/uso terapêutico , Adolescente , Adulto , Antidepressivos Tricíclicos/efeitos adversos , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inventário de Personalidade , Tiazepinas/efeitos adversosRESUMO
Os antiinflamatórios näo hormonais (AINHs) podem lesar a mucosa colônica, mimetizando aspectos clínicos e endoscópicos da doença inflamatória intestinal idiopática. Um caso de colite induzida por diclofenaco é relatado. O tratamento de eleiçäo é a retirada imediata da droga. A reexposiçäo à mesma classe de AINHs deve ser evitada pelo risco de recidiva do quadro
Assuntos
Humanos , Masculino , Adulto , Colite/induzido quimicamente , Diclofenaco/efeitos adversos , Colite/diagnóstico , Colite/patologia , Colonoscopia , Intestino Grosso/patologiaRESUMO
É apresentado o resultado de um estudo multicêntrico brasileiro cujos objetivos foram: aplicar em condições reais o modelo de farmacovigilância da clozapina no país (Sistema de Farmacovigilância de Leponex ð SFL) para detectar e corrigir eventuais falhas e proporcionar a diversos psiquiatras a experiência com o medicamento dentro das normas de segurança do SFL. Foram estudados 34 pacientes com diagnóstico de esquizofrenia crônica, refratários e/ou intolerantes ao tratamento com neurolépticos, que apresentavam exames hematológicos dentro dos parâmetros exigidos pelo SFL. A avaliação da eficácia antipsicótica da CZP foi feita pela BPRS e pela CGI e a tolerabilidade geral foi avalidada pela escala UKU, ao lado da avaliação hematológica semanal nas primeiras 18 semanas e mensal nos meses subseqüentes. O tratamento com a CZP incluiu doses crescentes e variáveis, tendo sido observado, ao final dos seis meses de tratamento, que a dose de manutenção se situava entre 75 e 700mg (mediana de 400mg). A análise da média dos escores da BPRS mostrou que houve melhora estatisticamente significante dos sintomas (ANOVA F = 112,24; p < 0,001), e essa diferença estatística ocorreu a partir do primeiro mês de tratamento. A avaliação préðtratamento, mostrou que houve redução significante da gravidade da doença, com remissão em 14,7 por cento (5/34) e melhora parcial em 70 por cento (24/34). Com relação à tolerabilidade, destacaðse a ausência de reações extrapiramidais bem como a boa adesão à rotina de controles hematológicos; um paciente apresentou trombocitopenia, que levou à interrupção da CZP, e outro interrompeu o tratamento devido a efeitos colaterais nãoðhematológicos. Os autores concluem que o efeito terapêutico da CZP foi promissor e ressaltam o bom resultado obtido com a operacionalização do SFL no Brasil
Assuntos
Humanos , Masculino , Feminino , Clozapina , Tolerância a Medicamentos , Vigilância de Produtos Comercializados , Esquizofrenia , Resultado do TratamentoRESUMO
E apresentado o resultado de um estudo multicentrico brasileiro cujos objetivos foram: aplicar em condicoes reais o modelo da farmacovigilancia da clozapina no pais (Sistema de Farmacovigilancia de Leponex - SFL) para detectar e corrigir eventuais falhas e proporcionar a diversas psiquiatras a experiencia com o medicamento dentro das normas de seguranca do SFL. Foram estudados 34 pacientes com diagnostico de esquizofrenia cronica, refratarios e/ou intolerantes ao tratamento com neurolepticos, que apresentavam exames hermatologicos dentro dos parametros exigidos pelo SFL. A avaliacao da eficacia antipsicotica da CZP foi feita pela BPRS e pela CGI e a tolerabilidade geral foi avaliada pela escala UKU, ao lado da avaliacao hematologica semanal nas primeiras 18 semanas e mensal nos meses subsequentes. O tratamento com a CZP incluiu doses crescentes e variaveis, tendo sido observado, ao final dos seis meses de tratamento, que a dose de manutencao se situava entre 75 e 700mg (mediana de 400mg). A analise da media dos escores da BPRS mostrou que houve melhora estatisticamente significante dos sintomas (ANOVA F=112,24; p<0,001), e essa diferenca estatistica ocorreu a partir do primeiro mes de tratamento. A avaliacao final dos pacientes, em comparacao a avaliacao pre-tratamento, mostrou que houve reducao significante da gravidade da doenca, com remissao em 14,7 por cento (5/34) e melhora parcial em 70 por cento (24/34). Com relacao a tolerabilidade, detaca-se a ausencia de reacoes extrapiramidais bem como a boa adesao a rotina de controles hematologicos; um paciente apresentou trombocitopenia, que levou a interrupcao da CZP, e outro interrompeu o tratamento devido a efeitos colaterais nao-hematologicos. Os autores concluem que o efeito terapeutico da CZP foi promissor e ressaltam o bom resultado obtido com a operacionalizacao do SFL no Brasil.
Assuntos
Clozapina , Esquizofrenia , Tratamento Farmacológico , Clozapina , Antipsicóticos , Esquizofrenia , Tratamento FarmacológicoRESUMO
Foram estudados 140 pacientes submetidos a cirurgias eletivas, divididos em dois grupos: 70 com e 70 sem sonda nasogastrica. No pre-operatorio todos os pacientes foram submetidos a uma anamnese e exame fisico detalhados, radiografia de torax e seios paranasais, dosagem serica de sodio, potassio e bicabornato, e endoscopia digestiva alta. Houve prevalencia de afeccoes das vias aereas no grupo com sonda nasogastrica. Neste mesmo grupo, 26 pacientes foram submetidos a endoscopia digestiva alta, onde se constatou lesoes traumaticas e esofagite em 92 por cento, em comparacao com 23 pacientes do grupo sem sonda nasogastrica que apresentaram, em 91 por cento das endoscopias, um resultado normal.
Assuntos
Doenças do Sistema Digestório/terapia , Intubação Gastrointestinal/efeitos adversos , Endoscopia do Sistema Digestório , Cuidados Pós-OperatóriosRESUMO
Os autores apresentam uma técnica simplificada de tratamento de esofagite alcalina de refluxo decorrente da ressecçäo polar do estômago e esofagogastroanastomose. Quatro pacientes foram operados e o resultado pós-operatório foi excelente e persiste a longo prazo. O piloro é ligado com uma fita cardíaca, que passa por baixo dos vasos gástricos diretos e gastroepilóicos direitos, uma gastroenteroanastomose em Y de Roux é realizada na face anterior do antro gástrico e o trânsito biliar é refeito a 50 cm de distância do estômago. A análise dos resultados é feita no pós-operatório imediato e o acompanhamento dos pacientes é realizado até 3 anos. Destaca-se a remissäo dos sintomas e boa evoluçäo neste período
Assuntos
Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Esofagite Péptica/cirurgia , Refluxo Gastroesofágico , Métodos , Período Pós-OperatórioRESUMO
A Desordem de Panico (DP) e ainda muito pouco conhecida entre as especialidades medicas. O presente trabalho fornece dados clinicos e laboratoriais que podem ajudar no diagnostico diferencial entre DP e outras doencas fisicas que podem eventualmente produzir uma sindrome de panico: feocromocitoma, hipertireoidismo, alteracao do ritmo cardiaco, isquemias do miocardio, epilepsia com manifestacoes afetivas e autonomicas, hipoglicemia, uso de drogas/sindrome de abstinencia. E concluido que a DP, por ser ainda pouco conhecida em nosso meio, geralmente e confundida com essas doencas fisicas, o que traz prejuizos para o paciente em termos de gastos desnecessarios com exames sofisticados e procedimentos terapeuticos ineficazes, retardando, assim, para o paciente os beneficios de um tratamento adequado que evite as complicacoes fobicas advindas da repeticao das crises de panico.