ABSTRACT Extrapulmonary tuberculosis associated with immune thrombocytopenia (ITP) is extremely rare. A likely association between ITP and pulmonary and lymph node tuberculosis was reported in a 29-year-old male patient. His platelet count decreased to 4,000/µL. Chest tomography revealed mediastinal adenomegaly, lymph node clusters in the aorta, and consolidation in the left upper lung lobe. Immunoglobulin and methylprednisolone were administered intravenously. The histopathology of the left upper lung lobe confirmed tuberculosis. The rifampicin/isoniazid/pyrazinamide/ethambutol regimen was initiated, and the corticosteroids were tapered off. This case suggests an association of tuberculosis with ITP, since the platelet count effectively normalized after tuberculosis treatment.

Dental treatment and surgery is a well-established method of correcting dentofacial deformities, and such treatment has an impact on the quality of life of individuals. The objective of this study was to evaluate the effect of orthognathic surgery on the quality of life of patients receiving treatment at the Universidade Federal do Paraná – UFPR. Clinical data were evaluated for the control group, and a quality-of-life evaluation questionnaire was completed [Oral Health Impact Profile (OHIP-14)]. For the case group, the same data were gathered along with information regarding their dentofacial deformity. The OHIP-14 questionnaire was also completed at three distinct stages of the experiment. The median age in the control group was 23.5 years. In the case group, the predominant gender was female, and the mean age of patients was 29.4 years. There was a statistically significant association between gender and OHIP-14 (p< 0.001). No such association was observed between age and OHIP-14 scores (p= 0.616). In the control group the OHIP-14 median score was 11.5. In the case group, the average OHIP-14 score at was 18 at T0, 21 at T1, and 8 at T2. The results demonstrated a statistically significant association between the three time stages at which OHIP-14 was analyzed (p< 0.001). There was a smaller reduction in the negative impact for transversal deformities of the jaw when compared with other deformities. Orthognathic surgery led to a reduction in the negative effects on the quality of life of patients.

Neste trabalho apresentamos a eficiência da correção dos efeitos atmosféricos nos dados de raios cósmicos do telescópio de muons de São Martinho da Serra e do monitor de nêutrons de Newark. Utilizamos a análise espectral Multitaper das séries temporais dos raios cósmicos, para mostrar as principais periodicidades presentes nos dados corrigidos e não corrigidos dos efeitos atmosféricos. Este tipo de correção é de extrema importância quando se pretende estudar as variações de raios cósmicos de origem extraterrestre.

In this work we present an analysis on the correction efficiency of atmospheric effects on cosmic ray São Martinho da Serra's muon telescope and Newark's neutron monitor data. We use a Multitaper spectral analysis of cosmic rays time series to show the main periodicities present in the corrected and uncorrected data for the atmospheric effects. This kind of correction is very important when intends to study cosmic rays variations of extra-terrestrial origin.

Para verificar a variabilidade do controle glicêmico em um estudo não controlado de diabéticos durante um ano de acompanhamento, nós avaliamos retrospectivamente 113 pacientes diabéticos. Com os valores das HBA1c (hemoglobina glicada) dosadas em 1998 calculamos um índice de controle que foi associado à idade, duração do diabetes, IMC e dose de insulina. A HBA1c foi maior em pacientes DM1 do que DM2, respectivamente [7,9 (4,4-13,3) vs. 7,0 (4,4-13,4)%; p= 0,007]. Nos 90 pacientes com no mínimo duas HBA1c, 68 (75,6%) mantiveram o controle: 51 (76,1%) em bom, 8 (11,1%) em regular e 9 (11,9%) em péssimo controle. Nenhum manteve todas as HBA1c na faixa da normalidade, sendo que 26 pacientes (28,9%) tiveram pelo menos uma HBA1c normal. No grupo geral, 44 pacientes (48,9%) apresentaram aumento da HBA1c, 41 (45,6%) diminuição e 5 pacientes (5,6%) mantiveram o mesmo valor, sem diferença entre DM1 e DM2 (p= 0,77). Observamos diferença na HBA1c e tempo de duração de diabetes entre os pacientes com DM2 que tratavam com dieta, hipoglicemiante oral, terapia combinada e monoterapia com insulina, respectivamente (5,4±0,5 vs. 6,3±1,3 vs. 7,6±1,4 vs. 8,4±2,0%; p= 0,001) e (8,5±9,9 vs. 5,3±4,2 vs. 14,1±9,6 vs. 16,9±8,1 anos; p= 0,003). O coeficiente de variação intraindividual da HBA1c foi de 11,6±7,4% (p= 0,0000), sendo de 12,8±7,6% (p= 0,0000) em DM1 e 10,4±7,2% em DM2 (p= 0,0000) sem diferença entre ambos. Concluímos que em nossa amostra a maioria dos pacientes manteve um bom controle apesar da variabilidade intraindividual e da dificuldade em normalizar os níveis de HBA1c.

To evaluate the variability of glicemic control in diabetic patients followed during one year, we conducted a retrospective study in which the record data of 113 diabetic patients were analyzed. The value of HBA1c (glycated hemoglobin) measured during a year were registered and an index of glicemic control was calculated. This index was associated with duration of diabetes, BMI and dose of insulin. HBA1c were higher in type 1 diabetes than type 2, respectively, [7.9 (4.4-13.3) vs. 7.0 (4.4-13.4)%; p= 0.007]. In 90 patients with at least two HBA1c measurements, 68 (75.6%) had no change in glicemic control: 51 (76.1%) had good, 8 (11.1%) regular and 9 (11.9%) poor control. None of them sustained all the HBA1c in the normal range: 26 (28.9%) had at least one normal HBA1c value. In general group, 44 patients (48.9%) showed increase, 41 (45.6%) decreased and 5 (5.6%) remained with the same level of HBA1c, without difference between DM1 and DM2 (p= 0,77). A difference in HBA1c and diabetes duration among patients with DM2 treated with diet, oral hipoglycemic agents, combined therapy and monotherapy with insulin, was noted respectively (5.4±0.5 vs. 6.3±1.3 vs. 7.6±1.4 vs. 8.4±2.0%; p= 0.001) and (8.5±9.9 vs. 5.3±4.2 vs. 14.1±9.6 vs. 16.9±8.1 years; p= 0,003). The intraindividual coefficient of variation of HBA1c was 11.6±7.4% (p= 0.0000) being 12.8±7.6 (p= 0.0000) in type 1 and 10.4±7.2% in type 2 (p= 0.0000) without difference between both groups. In conclusion: the majority of the patients in our study maintained a good control despite the intraindividual variability of HBA1c and the difficulty to keeping it in the normal range.