Showing papers by "Universidade de Pernambuco published in 1998"

The short variant of the polymorphism within the promoter region of the serotonin transporter gene is a risk factor for late onset Alzheimer's disease

Abstract: We analyzed a deletion/insertion polymorphism within the promoter region of the serotonin transporter gene (5-HTTPLR) in 81 patients with late onset Alzheimer's (AD) disease (mean age 70.02 +/- 8.13 years). Control groups included 81 normal subjects with comparable age (mean age 75.6 +/- 10.2) and 82 younger normal subjects (mean age 37.4 +/- 9.1). Statistical analysis showed a significant difference in the genotype and gene frequencies between the AD group and normal controls (chi 2 = 9.021; 2 d.f. and chi 2 = 5.59, 1 d.f., respectively, P 0.05). The present study confirms, in a different population, that the short variant of the 5-HTTPLR polymorphism may be a risk factor for late onset AD.

Correlation between Waardenburg syndrome phenotype and genotype in a population of individuals with identified PAX3 mutations

Abstract: Waardenburg syndrome (WS) type 1 is an autosomal dominant disorder characterized by sensorineural hearing loss, pigmentary abnormalities of the eye, hair, and skin, and dystopia canthorum. The phenotype is variable and affected individuals may exhibit only one or a combination of several of the associated features. To assess the relationship between phenotype and gene defect, clinical and genotype data on 48 families (271 WS individuals) collected by members of the Waardenburg Consortium were pooled. Forty-two unique mutations in the PAX3 gene, previously identified in these families, were grouped in five mutation categories: amino acid (AA) substitution in the paired domain, AA substitution in the homeodomain, deletion of the Ser-Thr-Pro-rich region, deletion of the homeodomain and the Ser-Thr-Pro-rich region, and deletion of the entire gene. These mutation classes are based on the structure of the PAX3 gene and were chosen to group mutations predicted to have similar defects in the gene product. Association between mutation class and the presence of hearing loss, eye pigment abnormality, skin hypopigmentation, or white forelock was evaluated using generalized estimating equations, which allowed for incorporation of a correlation structure that accounts for potential similarity among members of the same family. Odds for the presence of eye pigment abnormality, white forelock, and skin hypopigmentation were 2, 8, and 5 times greater, respectively, for individuals with deletions of the homeodomain and the Pro-Ser-Thr-rich region compared to individuals with an AA substitution in the homeodomain. Odds ratios that differ significantly from 1.0 for these traits may indicate that the gene products resulting from different classes of mutations act differently in the expression of WS. Although a suggestive association was detected for hearing loss with an odds ratio of 2.6 for AA substitution in the paired domain compared with AA substitution in the homeodomain, this odds ratio did not differ significantly from 1.0.

Marked improvement in bone mass after parathyroidectomy in osteitis fibrosa cystica

Abstract: Departments of Medicine (C.A.M.K., S.M.S., S.J.S., J.P.B.) and Pharmacology (J.P.B.), College of Physicians and Surgeons, Columbia University, New York, New York 10032; the Department of Endocrinology, Hospital de Clinicas, Federal University of Parana (C.A.M.K.), Curitiba, Parana, Brazil; and the Endocrine Unit, Hospital dos Servidores do Estado (C.B., D.V.), and the Endocrine Unit, Hospital Agamenon Magalhaes, Secretaria da Saude de Pernambuco, University of Pernambuco (F.B.), Recife, Pernambuco, Brazil

Mortalidade materna em Recife: causas de óbitos maternos

Abstract: Este estudo avaliou os casos de obitos de mulheres com idade de 10 a 49 anos, ocorridos em Recife, Pernambuco, nos anos 1992 e 1993, com a finalidade de identificar as causas de obitos maternos. As informacoes foram obtidas a partir de 1.013 declaracoes de obito, sendo complementadas com consultas aos prontuarios medicos, fichas de anestesia, relatorios de enfermagem, necropsias e por meio de entrevistas com os medicos que assistiram estes obitos ou com familiares das mulheres. As principais causas basicas de obito materno identificadas foram hipertensao arterial (23,8%), infeccoes (19,0%), aborto (11,9%), hemorragias (9,5%), embolia pulmonar (4,8%) e acidentes anestesicos (2,4%). Cerca de 70% das mortes maternas ocorridas em Recife neste periodo foram por causas obstetricas diretas.

Ultrasonography of the liver and spleen in Brazilian patients with hepatosplenic schistosomiasis and cirrhosis

Abstract: Ultrasonography is now widely used in the diagnosis and management of patients with chronic Schistosoma mansoni infections. The present study was undertaken to evaluate the use of ultrasonography in patients with hepatosplenic schistosomiasis (HSS) with and without cirrhosis. Ninety-seven patients (52 males; median age 38 years, range 19–68 years) with HSS, 65 with well compensated (HSSC) and 32 with decompensated (HSSD) disease and cirrhosis, were systematically examined by ultrasound. Hepatic fibrosis was graded according to WHO recommendations. Typical atrophy of the right hepatic lobe accompanied by hypertrophy of the left lobe, with a rounded inferior marginal edge, was seen in 86 (88·7%) patients. Periportal fibrosis was observed in 83 (85·6%) cases and confirmed histologically in all. In 66 patients (68·0%) thickening of the gallbladder wall, associated with periportal fibrosis and extending from the branches of the porta hepatis, was noted. No evidence of biliary disease was found in these patients and gallstones were present in only 3 cases. Fourteen (43·8%) of the HSSD patients could not be classified for grade of fibrosis because of the advanced stage of cirrhosis related to hepatitis B or C viral infection. Of the remaining 18 HSSD patients, none had only grade I fibrosis (vs. 10·8% of HSSC, P = 0·054) and only 6 had grade II (vs. 67·7% of HSSC, P < 0·0005), while the frequency of grade III was significantly higher in the HSSD patients than in those with HSSC (37·5% vs. 21·5%, P = 0·049). These findings indicate that although ultrasonography is a very valid technique for assessing patients with pure HSS, and should be considered the ‘gold standard’, it is not reliable for assessing periportal fibrosis in patients with concomitant cirrhosis due to other causes.

Fatores sócio-demográficos e de assistência médica associados ao óbito materno

Abstract: O presente estudo avaliou os obitos de mulheres com idade de 10 a 49 anos, ocorridos em Recife, Pernambuco, nos anos 1992 e 1993, com a finalidade de identificar os fatores socio-demograficos, gestacionais e da assistencia medica associados a esses obitos maternos. Foram levantadas e revisadas 1.013 declaracoes de obito, sendo identificados 42 casos de morte materna. Os dados desses obitos foram complementados com informacoes clinicas, de necropsias e de entrevistas com medicos dos hospitais onde ocorreram os obitos e com familiares das mulheres falecidas. Quase dois tercos (62%) dos obitos maternos ocorreram em mulheres de 20 a 29 anos de idade e mais da metade delas era solteira. Houve um maior numero de obitos nos partos cesarianos em relacao aos vaginais. A maioria dos obitos ocorreu nos tres primeiros dias de hospitalizacao e aproximadamente 90% das despesas hospitalares foram custeadas pelo Sistema Unico de Saude (SUS).

Concatenated coding performance for FSK modulation on time-correlated Rician fading channels

Abstract: We present an analytical method for evaluating the performance of noninterleaved concatenated codes over channels modeled as a nonfrequency selective correlated Rician fading channel with a known power spectral density. The main idea is to model the communication system from the modulator input to the demodulator output as a finite state channel (FSC) model, and apply powerful enumeration techniques to such a discrete channel in order to gain useful information on the system performance. The concatenated scheme makes use of two codes; Reed-Solomon codes are employed for the outer code, and binary block codes are used as the inner code. Next, the method is extended to study the effect on the performance when an interleaving with finite depth is incorporated into the communication system. A comparison between symbol and bit interleaving is made. Finally, we study the potential gain produced when channel information is passed on to the outer decoder in the form of an erasure symbol. In all cases, analytical expressions for the probability of the number of error symbols produced by the FSC model were obtained in terms of a coefficient in a formal power series. This is an interesting alternative approach with respect to computer simulations.

Diagnóstico precoce da hanseníase: o caso dos serviços de saúde no Recife(Pernambuco), Brasil

Abstract: O presente trabalho e um estudo descritivo, realizado na cidade do Recife de marco a setembro de 1994. O estudo buscou caracterizar as condicoes existentes nos servicos de saude para o diagnostico precoce de hanseniase, com enfase na acessibilidade dos usuarios aos servicos e na qualidade do atendimento. A amostra constou de 32 servicos de saude utilizados durante o processo diagnostico de 183 pacientes de hanseniase. A infra-estrutura organizacional foi caracterizada atraves de entrevistas com os gerentes dos servicos. O funcionamento foi investigado atraves de observacoes da rotina dos servicos, em particular as atividades de arquivo e triagem. Um total de 1998 pacientes foram entrevistados para determinar a facilidade de acesso. Para 1 000 pacientes foi estabelecido o tempo de consulta com os 123 medicos que estavam nas unidades no momento da amostragem. Para explorar a atitude e o conhecimento dos medicos sobre a hanseniase, selecionou-se, aleatoriamente, a partir de uma listagem nominal, 133 medicos destes servicos. Identificaram-se como dificuldades para o diagnostico precoce de hanseniase: a sistematica demanda reprimida (pessoas que procuravam os servicos mas nao eram atendidas); o longo tempo entre momento de marcacao e momento de realizacao de consultas (para pessoas que nao eram atendidas no mesmo dia); os longos tempos de espera pela consulta dentro dos servicos; a curta duracao da consulta; a baixa disponibilidade de recursos humanos treinados; a baixa proporcao de medicos que examinam toda a superficie corporal; as deficiencias no reconhecimento clinico da doenca e no conhecimento que leva ao diagnostico diferencial. Estes obstaculos podem facilitar a deterioracao fisica dos portadores de hanseniase e a persistencia da transmissibilidade; portanto, necessitam ser superados para que seja possivel eliminar a hanseniase.

O cuidar da pessoa idosa no âmbito domiciliar: uma relação de ajuda na enfermagem

Abstract: Este estudo teve por objetivo estabelecer uma relacao de ajuda enfermeira e pessoa idosa no âmbito domiciliar, fundamentada naTeoria das Relacoes Interpessoais de Peplau, visando a melhoria da qualidade de vida do cliente. Trata-se de uma pesquisa qualitativa do tipo estudo de caso que teve como sujeito um individuo do sexo masculino, 68 anos de idade, viuvo, residindo com seus familiares em Recife-PE. Para a coleta dos dados, utilizou-se o processo interpessoal, as tecnicas de observacao assistematica, a entrevista nao-estruturada, alem da aplicacao do Mini Mental Test e da Escala de Depressao Abreviada de ZUNG, sendo estas tecnicas e instrumentos viabilizados por doze visitas domiciliares. Os dados foram analisados qualitativamente a partir do processo interpessoal enfermeira e cliente, utilizado durante as fases do processo de enfermagem, culminando numa relacao de ajuda. Os resultados obtidos permitiram perceber que a relacao de ajuda estabelecida segundo os pressupostos de Peplau, realizada a partir da assistencia de enfermagem domiciliar a pessoa idosa, contribuiu para a melhoria da sua qualidade de vida.

Esquistossomose hepato-esplênica em crianças: avaliaçao morfológica e funcional após esplenectomia e auto-implante esplênico

Abstract: A esquistossomose mansonica hepato-esplenica com varizes sangrantes do esofago e infrequente em criancas, entretanto, determina morbidade atingindo a produtividade desses futuros adultos. Uma das opcoes para o tratamento cirurgico e a esplenectomia associada a ligadura da veia gastrica esquerda e esclerose endoscopica das varizes, nos casos de recidiva hemorragica. Auto-implante esplenico tem sido adicionado em criancas. Ha evidencias de que a esplenose pos-esplenectomia por trauma mantem, de forma parcial, as funcoes imunologica e de filtracao esplenicas. Todavia, estudos semelhantes nao foram realizados em pacientes esquistossomoticos. Foram analisados 23 pacientes, de 9 a 18 anos, com esquistossomose hepato-esplenica submetidos a esplenectomia, ligadura de veia gastrica esquerda e auto-implante esplenico no omento maior. Avaliou-se a funcao de filtracao atraves da pesquisa de corpusculos de Howell-Jolly em esfregacos de sangue periferico, cuja presenca indica ausencia ou insuficiencia de funcao de filtracao esplenica. Foi realizada analise morfologica da esplenose atraves de exame cintilografico, usando enxofre coloidal, marcado com Tecnecio 99m. Observou-se captacao dos implantes esplenicos em todos os pacientes, entretanto, em dois (8,7%), o numero de nodulos esplenicos observados foi inferior a cinco, sendo considerado insuficiente. Em correspondencia, esses dois pacientes foram os unicos que apresentaram positividade para corpusculos de Howell-Jolly. Os dados confirmam o auto-implante esplenico no omento maior como metodo eficaz de producao de esplenose e manutencao da funcao de filtracao esplenica em mais de 90% dos pacientes.

Lack of anti‐GOR antibody among subjects with GB virus C/hepatitis G virus RNA

Abstract: Homologies were sought between the putative amino acid sequences of GB virus C/hepatitis G virus (GBV-C/HGV) and the GOR epitope or the liver/kidney microsome-1 (LKM-1) epitope, which share partial sequence identity with the hepatitis C virus (HCV) polyprotein. Anti-GOR antibody (anti-GOR) was assayed among 100 subjects with GBV-C/HGV RNA. Twenty-one and 25 subjects were coinfected with hepatitis B virus (HBV) or HCV, respectively. Homologies were found between the NS5 or E2 polyproteins of GBV-C/HGV and the GOR epitope or the LKM-1 epitope, respectively. These segments of GBV-C/HGV polyproteins sharing identity with the GOR or the LKM-1 epitope were well conserved among three genotypes of GBV-C/HGV. However, only 1 of 55 subjects (1.8%) with GBV-C/HGV RNA, but not with HBV or HCV, was positive for anti-GOR. The positivity for anti-GOR among the group with GBV-C/HGV RNA alone was significantly lower than that among the groups with HCV RNA (P < 0.01 and P < 0.05, respectively). Only 2 of 55 subjects (3.6%) with GBV-C/HGV RNA alone exhibited elevation of alanine aminotransferase. The incidence of liver dysfunction among the group with GBV-C/HGV RNA alone was significantly lower than the incidence among the groups with GBV-C/HGV RNA and hepatitis B surface antigen (HBsAg) or HCV RNA (P< 0.01 and P< 0.01, respectively). These data indicate that 1) there is no association between GBV-C/HGV infection and the presence of anti-GOR, and 2) GBV-C/HGV infection is not related to chronic liver dysfunction.

The home healt care for elderly person: a help relationship in nursing

Abstract: This study had the following objective: to establish a relationship between the nurse and the aging person in the home extent, based on the Peplau theory of Interpersonal Relationship, aiming at the improvement of client's life quality. It involves a qualitative research of a unique type case, which had as the subject, a man of sixty years of age, widower, living with his relatves in Recife-PE. In order to collect the data, it was used the interpersonal process, the techniques of assistematic observation, a nonstructured interview, in addition to the application of the Mini Mental Test and the Abbreviated Depression Scale by ZUNG. Were used these techniques and instruments were made possible by means of twelve home visists. The data have been analyzed qualitatively according to the Interpersonal Process between the nurse and the client, resulting in multual help. The results gathered, made it possible for us to reflect on the helping relation according To Peplau's presuppositions, which made possible the home nursing assistance to the elderly man and contributed to improve his life quality.

[Early diagnosis of Hansen disease: study of the health services in Recife (Pernambuco), Brazil].

Abstract: This paper presents the results of a descriptive study carried out in the city of Recife, state of Pernambuco, Brazil, between March and September 1994. The study aimed at health services available for performing early diagnosis of Hansen's disease with emphasis on accessibility and quality of the services provided. The sample consisted of 32 health clinics visited for diagnostic purposes by 183 patients with Hansen's disease. Information on organizational infrastructures was collected by means of interviews with health clinic managers. Information regarding routine procedures in the 32 clinics was collected by observation, with special attention given to archival and inspection activities. A total of 1,998 patients were interviewed to determine accessibility of services. Time spent in consultation with the physician was determined for 1,000 patients who were seen by 123 physicians at the clinics during the interviews. To explore physicians' attitude and knowledge regarding Hansen's disease, 133 were randomly selected from a list of names. The following factors were identified as hindering early diagnosis of Hansen's disease: the large number of people seeking service who could not be seen by a physician on the same day; the long time elapsed between appointment scheduling and the actual visit (for those not seen on the same day); the long wait for the consultation; the brevity of the consultation; the low availability of trained personnel; the low proportion of physicians who examined all body surfaces; difficulties in the clinical recognition of the disease; and physicians not prepared to make a differential diagnosis. These obstacles can precipitate the physical deterioration of Hansen's disease patients and stimulate the persistence of transmissibility; therefore, they need to be overcome if Hansen's disease is to be eliminated.

Are mothers encouraged to identify the risk signs of diarrhea

Abstract: OBJECTIVES: To acknowledge the mothers' perception of the diarrhea episode and their ability in identifying the signs of risk; to characterize, in the health services, at ambulatory level, the activities that stimulate a timely attention to the disease.METHODS: An inquiry was applied to a representative sample of 1026 children under 5 years old who live in the pilot areas of Pernambuco selected to receive interference concerning diarrhea, and an interconnected transversal study in 14 health services: 11 health centres and 3 hospitals.RESULTS: A high proportion of the mothers of children with diarrhea give importance clinical manifestations that do not allow an early identification of dehydration. Only one fourth of them mentions dehydration as a complication. The mothers perception of the episode has a striking influence on the adopted conduct, particularly in the Metropolitan Area, in which, in the absence of preoccupation, no children were taken to the physician and a significant smaller proportion received care to hydration. In the health services, in general, collective educational programs are not the routine, the consult with the physician is limited to the main complaint, there is no post-consult with the nurses nor articulation with community health agents. Besides that, half of the mothers did not know the signs of dehydration.CONCLUSIONS: The findings of both the inquiry and the evaluation of the health services showed a quite critical situation: mother's little perception of the mothers of diarrhea worsening signs, as well as the insufficiency of these services concerning educational activities towards stimulating mothers to recognize and valorize them.

É pior o prognóstico do segundo gemelar

Abstract: Muito se discute sobre as desvantagens que sofre o gemeo que nasce por derradeiro, em relacao as condicoes de seu nascimento. Neste estudo foram revistos 90 casos de partos gemelares ocorridos na Maternidade da Encruzilhada (CISAM) em Recife, entre Janeiro de 1992 e Dezembro de 1993, com o objetivo de comparar variaveis perinatais entre o 1o e o 2o gemelar. Foram pesquisados a estatica fetal, a via de parto, o peso ao nascer, o Apgar do 1o e 5o minutos, a ocorrencia de complicacoes neonatais como a sindrome da membrana hialina, taquipneia transitoria e infeccao neonatal e, finalmente, o prognostico de cada um dos gemelares. Nao houve diferenca estatisticamente significativa na incidencia de apresentacoes nao cefalicas, operacao cesariana, baixo peso ao nascer, Apgar < 7 no 1o e 5o minutos ou das complicacoes neonatais acima referidas. Nao houve tambem diferenca na mortalidade perinatal entre os gemeos. Nossos resultados sugerem ser iguais as condicoes de nascimento dos gemelares de uma mesma gestacao, devendo ser prestada uma assistencia igualmente apurada a ambos pela equipe de perinatologia.