Scielo RSS <![CDATA[Clinics]]> http://www.scielo.br/rss.php?pid=1807-593220100012&lang=en vol. 65 num. 12 lang. en <![CDATA[SciELO Logo]]> http://www.scielo.br/img/en/fbpelogp.gif http://www.scielo.br <![CDATA[<b>In the December, 2010 issue of CLINICS</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200001&lng=en&nrm=iso&tlng=en <![CDATA[<b>Evaluation of machine learning classifiers in keratoconus detection from orbscan II examinations</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200002&lng=en&nrm=iso&tlng=en PURPOSE: To evaluate the performance of support vector machine, multi-layer perceptron and radial basis function neural network as auxiliary tools to identify keratoconus from Orbscan II maps. METHODS: A total of 318 maps were selected and classified into four categories: normal (n = 172), astigmatism (n = 89), keratoconus (n = 46) and photorefractive keratectomy (n = 11). For each map, 11 attributes were obtained or calculated from data provided by the Orbscan II. Ten-fold cross-validation was used to train and test the classifiers. Besides accuracy, sensitivity and specificity, receiver operating characteristic (ROC) curves for each classifier were generated, and the areas under the curves were calculated. RESULTS: The three selected classifiers provided a good performance, and there were no differences between their performances. The area under the ROC curve of the support vector machine, multi-layer perceptron and radial basis function neural network were significantly larger than those for all individual Orbscan II attributes evaluated (p<0.05). CONCLUSION: Overall, the results suggest that using a support vector machine, multi-layer perceptron classifiers and radial basis function neural network, these classifiers, trained on Orbscan II data, could represent useful techniques for keratoconus detection. <![CDATA[<b>Pathological and ultrastructural analysis of surgical lung biopsies in patients with swine-origin influenza type A/H1N1 and acute respiratory failure</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200003&lng=en&nrm=iso&tlng=en BACKGROUND: Cases of H1N1 and other pulmonary infections evolve to acute respiratory failure and death when co-infections or lung injury predominate over the immune response, thus requiring early diagnosis to improve treatment. OBJECTIVE: To perform a detailed histopathological analysis of the open lung biopsy specimens from five patients with ARDS with confirmed H1N1. METHODS: Lung specimens underwent microbiologic analysis, and examination by optical and electron microscopy. Immunophenotyping was used to characterize macrophages, natural killer, T and B cells, and expression of cytokines and iNOS. RESULTS: The pathological features observed were necrotizing bronchiolitis, diffuse alveolar damage, alveolar hemorrhage and abnormal immune response. Ultrastructural analysis showed viral-like particles in all cases. CONCLUSIONS: Viral-like particles can be successfully demonstrated in lung tissue by ultrastructural examination, without confirmation of the virus by RT-PCR on nasopharyngeal aspirates. Bronchioles and epithelium, rather than endothelium, are probably the primary target of infection, and diffuse alveolar damage the consequence of the effect of airways obliteration and dysfunction on innate immunity, suggesting that treatment should be focused on epithelial repair. <![CDATA[<b>Influence of preoperative serum N-terminal pro-brain type natriuretic peptide on the postoperative outcome and survival rates of coronary artery bypass patients</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200004&lng=en&nrm=iso&tlng=en BACKGROUND: The N-terminal fragment of pro-brain type natriuretic peptide (NT-proBNP) is an established biomarker for cardiac failure. OBJECTIVE: To determine the influence of preoperative serum NT-proBNP on postoperative outcome and mid-term survival in patients undergoing coronary artery bypass grafting (CABG). METHODS: In 819 patients undergoing isolated CABG surgery preoperative serum NT-proBNP levels were measured. NT-proBNP was correlated with various postoperative outcome parameters and survival rate after a median follow-up time of 18 (0.5-44) months. Risk factors of mortality were identified using χ2, Mann-Whitney test, and Cox regression. RESULTS: NT-proBNP levels &gt;430 ng/ml and &gt;502 ng/ml predicted hospital and overall mortality (p<0.05), with an incidence of 1.6% and 4%, respectively. Kaplan-Meier analysis revealed decreased survival rates in patients with NT-proBNP &gt;502 ng/ml (p=0.001). Age, preoperative serum creatinine, diabetes, chronic obstructive pulmonary disease, low left ventricular ejection fraction and BNP levels &gt;502 ng/ml were isolated as risk factors for overall mortality. Multivariate Cox regression analysis, including the known factors influencing NT-proBNP levels, identified NT-proBNP as an independent risk factor for mortality (OR = 3.079 (CI = 1.149-8.247), p = 0.025). Preoperative NT-proBNP levels &gt;502 ng/ml were associated with increased ventilation time (p=0.005), longer intensive care unit stay (p=0.001), higher incidence of postoperative hemofiltration (p=0.001), use of intra-aortic balloon pump (p<0.001), and postoperative atrial fibrillation (p=0.031) CONCLUSION: Preoperative NT-proBNP levels &gt;502 ng/ml predict mid-term mortality after isolated CABG and are associated with significantly higher hospital mortality and perioperative complications. <![CDATA[<b>Reliability of the Brazilian version of the Functional Assessment of Cancer Therapy-Lung (FACT-L) and the FACT-Lung Symptom Index (FLSI)</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200005&lng=en&nrm=iso&tlng=en OBJECTIVES: The purpose of this study was to assess the reliability of the Brazilian version of the Functional Assessment of Cancer Therapy-Lung (FACT-L) with the FACT-Lung Symptom Index (FLSI) questionnaire. INTRODUCTION: The assessment of quality of life in patients with lung cancer has become an important evaluative endpoint in current clinical trials. For lung cancer patients, one of the most common quality of life tools available is the FACT-L. Despite the amount of data available regarding this questionnaire, there are no data on its performance in Brazilian lung cancer patients. METHODS: The FACT-L with the FLSI questionnaire was prospectively administered to 30 consecutive, stable, lung cancer outpatients at baseline and at 2 weeks. RESULTS: The intraclass correlation coefficient between test and retest for the FACT-L ranged from 0.79 to 0.96 and for the FLSI was 0.87. There was no correlation between these questionnaire dimensions and clinical or functional parameters. CONCLUSIONS: The Brazilian version of the FACT-L with FLSI questionnaire is reliable and is quick and simple to apply. This instrument can now be used to properly evaluate the quality of life of Brazilian lung cancer patients. <![CDATA[<b>Isokinetic assessment of the hip muscles in patients with osteoarthritis of the knee</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200006&lng=en&nrm=iso&tlng=en OBJECTIVES: To evaluate the difference in isokinetic strength of hip muscles between patients with knee osteoarthritis (OA) and matched healthy controls, and to establish the correlation between this isokinetic strength and pain and function in patients with knee OA. METHODS: 25 patients with a diagnosis of unilateral knee OA, 25 patients with bilateral knee OA, and 50 matched controls were evaluated using the visual analog scale for pain, knee Lequesne index, Western Ontario and McMaster Universities questionnaire and an isokinetic test. RESULTS: The groups were matched for age, gender and body mass index. The results of the isokinetic test revealed lower peak torque of the hip in patients with OA of the knee than in the control group for all movements studied. Strong correlations were found between the peak torque, visual analog scale and function. CONCLUSIONS: Patients with OA of the knee exhibit lower isokinetic strength in the hip muscles than healthy control subjects. Strengthening the muscles surrounding the hip joint may help to decrease pain in people with knee OA. Some correlations between pain/function and peak torque were found. <![CDATA[<b>An evaluation of children with Kawasaki disease in Istanbul</b>: <b>a retrospective follow-up study</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200007&lng=en&nrm=iso&tlng=en BACKGROUND: Kawasaki disease (KD) is an acute, self-limiting vasculitis of unknown etiology. The incidence of KD is increasing world wide. However, the epidemiological data for KD in Turkey has not been well described. OBJECTIVE: To describe the demographic, clinical, and laboratory features of children with KD who were diagnosed and managed in the American Hospital, Istanbul, Turkey. METHOD: Patients with KD were retrospectively identified from the hospital discharge records between 2002 and 2010. Atypical cases of KD were excluded. A standardized form was used to collect demographic data, clinical information, echocardiography and laboratory results. RESULTS: Thirty-five patients with KD, with a mean age of 2.5 + 1.9 years, were identified. Eighty-five point seven per cent of patients were under 5 years of age. A seasonal pattern favouring the winter months was noticed. In addition to fever and bilateral conjunctival injection, changes in the oral cavity and lips were the most commonly detected clinical signs in our cases. Coronary artery abnormalities were detected in nine patients. The majority of our patients had started treatment with intravenous immunoglobulin in the first 10 days of the onset of fever, and only one patient required systemic steroids for intravenous immunoglobulin-resistant KD. The coronary artery abnormalities resolved in all nine patients within 8 months. CONCLUSION: This study is the most comprehensive series of children from Turkey with KD included in Medline. As adult-onset ischemic heart disease may be due to KD in childhood, further prospective clinical investigations are needed to understand the epidemiology, management and long-term follow-up of the disease. <![CDATA[<b>Pediatric lymphomas in Brazil</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200008&lng=en&nrm=iso&tlng=en OBJECTIVE: This study provides the clinical pathological characteristics of 1301 cases of pediatric/adolescent lymphomas in patients from different geographic regions of Brazil. METHODS: A retrospective analyses of diagnosed pediatric lymphoma cases in a 10-year period was performed. We believe that it represents the largest series of pediatric lymphomas presented from Brazil. RESULTS: Non-Hodgkin lymphomas represented 68% of the cases, including those of precursor (36%) and mature (64%) cell origin. Mature cell lymphomas comprised 81% of the B-cell phenotype and 19% of the T-cell phenotype. Hodgkin lymphomas represented 32% of all cases, including 87% of the classical type and 13% of nodular lymphocyte predominant type. The geographic distribution showed 38.4% of the cases in the Southeast region, 28.7% in the Northeast, 16.1% in the South, 8.8% in the North, and 8% in the Central-west region. The distribution by age groups was 15-18 years old, 33%; 11-14 years old, 26%; 6-10 years old, 24%; and 6 years old or younger, 17%. Among mature B-cell lymphomas, most of the cases were Burkitt lymphomas (65%), followed by diffuse large B-cell lymphomas (24%). In the mature T-cell group, anaplastic large cell lymphoma, ALK-positive was the most prevalent (57%), followed by peripheral T-cell lymphoma, then not otherwise specified (25%). In the group of classic Hodgkin lymphomas, the main histological subtype was nodular sclerosis (76%). Nodular lymphocyte predominance occurred more frequently than in other series. CONCLUSION: Some of the results found in this study may reflect the heterogeneous socioeconomical status and environmental factors of the Brazilian population in different regions. <![CDATA[<b>Prognostic value of podoplanin expression in intratumoral stroma and neoplastic cells of uterine cervical carcinomas</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200009&lng=en&nrm=iso&tlng=en OBJECTIVE: To investigate the clinicopathological significance of podoplanin expression in the intratumoral stroma and neoplastic cells of early stage uterine cervical cancer. MATERIALS AND METHODS: A total of 143 patients with clinical stage I and IIA uterine cervical carcinomas underwent surgery between 2000 and 2007. Clinicopathological data and slides associated with these cases were retrospectively reviewed. Immunodetection of podoplanin expression in histologic sections of tissue microarray blocks was performed using the monoclonal antibody D2-40. RESULTS: Expression of podoplanin was detected in neoplastic cells in 31/143 (21.6%) cases, with 29/31 (93.5%) of these cases diagnosed as squamous carcinoma. For all of the cases examined, the strongest signal for podoplanin expression was observed at the proliferating edge of the tumor nests. The rate of positive podoplanin expression for node-positive cases was lower than that of node-negative (18.9% vs. 22.6%, respectively). Furthermore, the rate of positive podoplanin expression in fatal cases was 10.5% vs. 21.6%, respectively. In 27/143 (18.8%) cases, podoplanin expression was detected in fibroblasts of the intratumoral stroma, and this expression did not correlate with patient age, clinical stage, tumor size, histologic type, depth of infiltration, or vascular involvement. Moreover, expression of podoplanin in intratumoral stroma fibroblasts was only negatively associated with nodal metastasis. A greater number of fatal cases was observed among negative intratumoral stroma fibroblasts (15.5% vs. 3.7%, respectively), although this difference was not significant. CONCLUSIONS: These preliminary results suggest that podoplanin may have a role in host-tumor interactions and, as a result, may represent a favorable prognostic factor for squamous cervical carcinomas. <![CDATA[<b>Clinical and epidemiological aspects of hepatocellular carcinoma in Brazil</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200010&lng=en&nrm=iso&tlng=en OBJECTIVES: We performed a national survey to update hepatocellular carcinoma (HCC) epidemiology in Brazil and determined the clinical and epidemiological profiles of patients with HCC in different Brazilian regions. METHODS: Data from 29 centers included 1,405 patients diagnosed with HCC from 2004 to 2009. RESULTS: The median age was 59 (1-92 years old; 78% male). At diagnosis, females were older than males (median age: 62 vs. 59 years old respectively; p<0.0001). Ninety-eight percent of the patients had cirrhosis (1279/1308). Hepatitis C virus was the main etiology (54%), followed by hepatitis B virus (16%) and alcohol (14%). In Southeastern and Southern Brazil, hepatitis C virus accounted for over 55% of cases. In the Northeast and North, hepatitis C virus accounted for less than 50%, and hepatitis B virus accounted for 22-25% of cases; hepatitis B was more prevalent in the Northern than in the Southern regions. Some 43%, 35%, and 22% of patients were in early, intermediate, and advanced stages respectively. Initial therapies for HCC included chemoembolization or embolization (36%), percutaneous ablation (13%), liver resection (7%), and sorafenib (1%). Liver transplantation was performed in 242 patients (19%), but it was the initial therapy for only 56 patients (4%). CONCLUSION: The epidemiology, classification, and therapy selection for HCC varied among Brazilian regions. Hepatitis C infection was the most common etiology of liver cirrhosis; chemoembolization was the most common therapy employed. Liver cirrhosis was the main risk factor for HCC development in Brazil. <![CDATA[<b>Depression and conservative surgery for breast cancer</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200011&lng=en&nrm=iso&tlng=en BACKGROUND: Depression is prevalent among women and associated with reduced quality of life, and therefore it is important to determine its incidence in adult women, especially in those with breast cancer. OBJECTIVE: To determine the occurrence of depression in women who underwent conservative surgery for breast cancer with or without breast reconstruction. METHODS: Seventy-five women aged between 18 and 65 years were enrolled. Patients had undergone conservative surgery for breast cancer with immediate breast reconstruction (n = 25) or without breast reconstruction (n = 25) at least one year before the study. The control group consisted of 25 women without cancer, but of similar age and educational level distribution as the other two groups. The Beck Depression Inventory was used to measure depression. The collected data were assessed using analysis of variance and the χ2 test. RESULTS: There were no significant differences between groups in age (p = 0.72) or educational level (p = 0.20). A smaller number of patients had undergone the menopause (p = 0.02) in the control group than in other groups. There were no significant differences in occurrence of depression between groups (χ2=9.97; p = 0.126). CONCLUS√ćON: Conservative surgery for breast cancer did not affect the occurrence of depression in women, regardless of whether breast reconstruction was performed. <![CDATA[<b>Forced oscillation technique in the detection of smoking-induced respiratory alterations</b>: <b>diagnostic accuracy and comparison with spirometry</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200012&lng=en&nrm=iso&tlng=en INTRODUCTION: Detection of smoking effects is of utmost importance in the prevention of cigarette-induced chronic airway obstruction. The forced oscillation technique offers a simple and detailed approach to investigate the mechanical properties of the respiratory system. However, there have been no data concerning the use of the forced oscillation technique to evaluate respiratory mechanics in groups with different degrees of tobacco consumption. OBJECTIVES: (1) to evaluate the ability of the forced oscillation technique to detect smoking-induced respiratory alterations, with special emphasis on early alterations; and (2) to compare the diagnostic accuracy of the forced oscillation technique and spirometric parameters. METHODS: One hundred and seventy subjects were divided into five groups according to the number of pack-years smoked: four groups of smokers classified as <20, 20-39, 40-59, and &gt;60 pack-years and a control group. The four groups of smokers were compared with the control group using receiver operating characteristic (ROC) curves. RESULTS: The early adverse effects of smoking in the group with <20 pack-years were adequately detected by forced oscillation technique parameters. In this group, the comparisons of the ROC curves showed significantly better diagnostic accuracy (p<0.01) for forced oscillation technique parameters. On the other hand, in groups of 20-39, 40-59, and &gt;60 pack-years, the diagnostic performance of the forced oscillation technique was similar to that observed with spirometry. CONCLUSIONS: This study revealed that forced oscillation technique parameters were able to detect early smoking-induced respiratory involvement when pathologic changes are still potentially reversible. These findings support the use of the forced oscillation technique as a versatile clinical diagnostic tool in helping with chronic obstructive lung disease prevention, diagnosis, and treatment. <![CDATA[<b>Repercussions of training and detraining by water-based exercise on functional fitness and quality of life</b>: <b>a short-term follow-up in healthy older women</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200013&lng=en&nrm=iso&tlng=en OBJECTIVE: To evaluate the effects of short-term exercise detraining on the functional fitness of older women after a 12-week water-based exercise (WE) program. METHODS: Healthy older women (trained (TR) group) were submitted to 12 weeks WE (three 45 min sessions per week) followed by a 6-week detraining period. A group of aged-matched women without any exercise training (UN group) were evaluated during the same period. The aerobic power, measured by VO2max and 800 meters performance, and the neuromuscular fitness and quality of life were evaluated. All assessments were made at baseline, after 12 weeks of training and after 4 and 6 weeks of detraining. RESULTS: No changes were found for the UN group during the follow-up study, but WE induced significant improvement in aerobic capacity, neuromuscular fitness and quality of life score. However, the upper and lower body strength, agility, flexibility, and body balance returned to UN levels (p>0.05) after 6 weeks of detraining. CONCLUSIONS: The results confirmed that 12 weeks of WE improves the functional fitness parameters and quality of life of older women. However, after a short detraining period of 4-6 weeks, the neuromuscular parameters and the quality of life score returns to baseline or untrained subject levels. <![CDATA[<b>Acute effect of phosphodiesterase type 5 inhibitor on serum oxidative status and prolidase activities in men with erectile dysfunction</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200014&lng=en&nrm=iso&tlng=en OBJECTIVES: To investigate the acute effect of phosphodiesterase type 5 (PDE5) inhibitor on erectile dysfunction by evaluating serum oxidative status and prolidase activity. METHODS: Serum samples of 36 patients with erectile dysfunction and 30 control cases were analyzed for total antioxidant status, total oxidant status, and prolidase activity, before and after the administration of tadalafil citrate. RESULTS: Before and after tadalafil citrate administration, serum total antioxidant status, total oxidant status, and prolidase were 1.1+0.0 vs. 1.6 + 0.0 umol H2O2 Eq/L, 10.3+1.1 vs. 6.9 + 1.2 umol H2O2 Eq/L, and 236.4+19.5 vs. 228.2 + 19.2 U/L, respectively (p<0.0001 for all). CONCLUSIONS: Evaluation of serum oxidative status and prolidase activity confirmed the beneficial acute effects of PDE5 inhibitor in patients with erectile dysfunction. <![CDATA[<b>Morphological and hemodynamic patterns of carotid stenosis treated by endarterectomy with patch closure versus stenting</b>: <b>a duplex ultrasound study</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200015&lng=en&nrm=iso&tlng=en OBJECTIVES: A duplex ultrasound study was performed to investigate morphological and hemodynamic patterns of carotid stenoses treated by endarterectomy with patch closure versus stenting. MATERIALS AND METHOD: Twenty-nine carotid stenoses were treated with stenting and 65 with patch closure. Duplex ultrasound parameters (luminal diameter, mm; peak systolic velocity and end-diastolic velocity, cm/s) were measured 24 hours after the procedures and also at 12 months post-procedure. Residual stenoses (immediately postprocedure) and restenoses (within 12 months of procedure) were defined as narrowings of >50% on duplex ultrasound examination. RESULTS: In stented patients, the luminal diameter of the proximal internal carotid artery increased in the interval between the 24-hour and 12-month post-procedure studies, while in the patch closure patients, the diameter decreased. Carotid hemodynamics normalized immediately after both patching and stenting and remained relatively stable thereafter up to 12 months. No statistically elevated flow velocities (in the absence of residual stenosis or restenosis) were observed in the patched or stented carotid arteries. No significant differences in residual stenosis rates were observed between the stenting group (3 cases, 10.34%) and the patch closure group (1 case, 1.53%, P = 0.08). At 12 months, 2 stenting patients (6.88%) and 2 patch closure patients (3.07%) had $50% restenosis (P = 0.58). One case of late stroke due to restenosis was observed in the stenting group; the patient died 12 months postoperatively, before receiving new intervention. CONCLUSION: Measurements over time in luminal diameter signalized differences in arterial remodeling mechanisms between patched and stented carotids. Both stenting and patch closure were associated with carotid patency and flow restoration. This study does not support a general approach to new velocity criteria indiscriminately applied to stented or patched carotids. <![CDATA[<b>Association between ear creases and peripheral arterial disease</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200016&lng=en&nrm=iso&tlng=en INTRODUCTION: Peripheral arterial disease is a severe manifestation of atherosclerosis that can lead to critical ischemia of the lower limbs and is also associated with high cardiovascular risk. Diagonal lobular and anterior tragal ear creases have been associated with coronary artery disease, but they have not yet been investigated in patients with peripheral arterial disease. OBJECTIVES: To evaluate the prevalence of ear creases among patients with peripheral arterial disease of the lower limbs, compared with patients without documented atherosclerotic disease. METHODS: Cross-sectional study including 60 male patients with peripheral arterial disease of the lower limbs and 60 dermatologic outpatients matched for age and gender. The associations were adjusted for other risk factors by conditional logistic regression. RESULTS: The prevalence of diagonal and anterior tragal ear creases was higher among cases (73% vs. 25% and 80% vs. 43%, respectively) than controls; these associations remained significant even when adjusting for other known risk factors of atherosclerosis (odds ratio = 8.1 and 4.1, respectively). CONCLUSIONS: Ear creases are independently associated with peripheral arterial disease and may be an external marker for risk identification. <![CDATA[<b>Beneficial effects of treadmill training in experimental diabetic nerve regeneration</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200017&lng=en&nrm=iso&tlng=en OBJECTIVES: We investigated the effects of treadmill training (10 weeks) on hindlimb motor function and nerve morphometric parameters in diabetic rats submitted to sciatic nerve crush. MATERIALS AND METHOD: Wistar rats (n = 64) were divided into the following groups: non-diabetic; trained non-diabetic; non-diabetic with sciatic nerve crush; trained non-diabetic with sciatic nerve crush; diabetic; trained diabetic; diabetic with sciatic nerve crush or trained diabetic with sciatic nerve crush. Diabetes was induced by streptozotocin injection (50 mg/kg, iv). Hindlimb motor function was evaluated weekly by assessing sciatic functional indices, and the proximal and distal portions of the sciatic nerve were used for morphometric analysis. RESULTS: At 13 weeks post-injury, the distal nerve portion of all injured groups and the proximal nerve portion of the diabetic with sciatic nerve crush group presented altered morphometric parameters such as decreased myelinated fiber diameter (~7.4 + 0.3μm vs ~4.8 + 0.2μm), axonal diameter (~5 + 0.2μm vs ~3.5 + 0.1μm) and myelin sheath thickness (~1.2 + 0.07μm vs ~0.65 + 0.07μm) and an increase in the percentage of area occupied by endoneurium (~28 + 3% vs ~60 + 3%). In addition, in the non-diabetic with sciatic nerve crush group the proximal nerve portion showed a decreased myelinated fiber diameter (7.4+0.3μm vs 5.8 + 0.3μm) and myelin sheath thickness (1.29 + 0.08μm vs 0.92 + 0.08μm). The non-diabetic with sciatic nerve crush, trained non-diabetic with sciatic nerve crush, diabetic with sciatic nerve crush and trained diabetic with sciatic nerve crush groups showed normal sciatic functional index from the 4th,4th,9th and 7th week post-injury, respectively. Morphometric alterations in the proximal nerve portion of the diabetic with sciatic nerve crush and non-diabetic with sciatic nerve crush groups were either prevented or reverted to values similar to the non-diabetic group by treadmill training. CONCLUSION: Diabetic condition promoted delay in sciatic nerve regeneration. Treadmill training is able to accelerate hindlimb motor function recovery in diabetic injured rats and prevent or revert morphometric alterations in proximal nerve portions in non-diabetic and diabetic injured rats. <![CDATA[<b>ATZ (3-amino-1,2,4-triazole) injected into the fourth cerebral ventricle influences the Bezold-Jarisch reflex in conscious rats</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200018&lng=en&nrm=iso&tlng=en OBJECTIVES: Many studies have investigated the importance of oxidative stress on the cardiovascular system. In this study we evaluated the effects of central catalase inhibition on cardiopulmonary reflex in conscious Wistar rats. METHODS: Male Wistar rats were implanted with a stainless steel guide cannula in the fourth cerebral ventricle. The femoral artery and vein were cannulated for mean arterial pressure and heart rate measurement and for drug infusion, respectively. After basal mean arterial pressure and heart rate recordings, the cardiopulmonary reflex was tested with a dose of phenylbiguanide (PBG, 8 μg/kg, bolus). Cardiopulmonary reflex was evaluated before and μl15 minutes after 1.0 μl 3-amino-1,2,4-triazole (ATZ, 0.01g/100μl)0.01 g/100 μl) injection into the fourth cerebral ventricle. Vehicle treatment did not change cardiopulmonary reflex responses. RESULTS: Central ATZ significantly increased hypotensive responses without influencing the bradycardic reflex. CONCLUSION: ATZ injected into the fourth cerebral ventricle increases sympathetic inhibition but does not change the parasympathetic component of the cardiopulmonary reflex in conscious Wistar rats. <![CDATA[<b>Renin angiotensin system and cardiac hypertrophy after sinoaortic denervation in rats</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200019&lng=en&nrm=iso&tlng=en OBJECTIVE: The aim of this study was to evaluate the role of angiotensin I, II and 1-7 on left ventricular hypertrophy of Wistar and spontaneously hypertensive rats submitted to sinoaortic denervation. METHODS: Ten weeks after sinoaortic denervation, hemodynamic and morphofunctional parameters were analyzed, and the left ventricle was dissected for biochemical analyses. RESULTS: Hypertensive groups (controls and denervated) showed an increase on mean blood pressure compared with normotensive ones (controls and denervated). Blood pressure variability was higher in denervated groups than in their respective controls. Left ventricular mass and collagen content were increased in the normotensive denervated and in both spontaneously hypertensive groups compared with Wistar controls. Both hypertensive groups presented a higher concentration of angiotensin II than Wistar controls, whereas angiotensin 1-7 concentration was decreased in the hypertensive denervated group in relation to the Wistar groups. There was no difference in angiotensin I concentration among groups. CONCLUSION: Our results suggest that not only blood pressure variability and reduced baroreflex sensitivity but also elevated levels of angiotensin II and a reduced concentration of angiotensin 1-7 may contribute to the development of left ventricular hypertrophy. These data indicate that baroreflex dysfunction associated with changes in the renin angiotensin system may be predictive factors of left ventricular hypertrophy and cardiac failure. <![CDATA[<b>Comparison of prophylactic and therapeutic use of short-chain fatty acid enemas in diversion colitis</b>: <b>a study in Wistar rats</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200020&lng=en&nrm=iso&tlng=en OBJECTIVES: To study the effect of short-chain fatty-acids on atrophy and inflammation of excluded colonic segments before and after the development of diversion colitis. INTRODUCTION: Diversion colitis is a chronic inflammatory process affecting the dysfunctional colon, possibly evolving with mucous and blood discharge. The most favored hypotheses to explain its development is short-chain fatty-acid deficiency in the colon lumen. METHODS: Wistar rats were submitted to colostomy with distal colon exclusion. Two control groups (A1 and B1) received rectally administered physiological saline, whereas two experimental groups (A2 and B2) received rectally administered short-chain fatty-acids. The A groups were prophylactically treated (5th to 40th days postoperatively), whereas the B groups were therapeutically treated (after post-operative day 40). The mucosal thickness of the excluded colon was measured histologically. The inflammatory reaction of the mucosal lamina propria and the lymphoid tissue response were quantified through established scores. RESULTS: There was a significant thickness recovery of the colonic mucosa in group B2 animals (p = 0.0001), which also exhibited a significant reduction in the number of eosinophilic polymorphonuclear cells in the lamina propria (p = 0.0126) and in the intestinal lumen (p = 0.0256). Group A2 showed no mucosal thickness recovery and significant increases in the numbers of lymphocytes (p = 0.0006) and eosinophilic polymorphonuclear cells in the lamina propria of the mucosa (p = 0.0022). CONCLUSION: Therapeutic use of short-chain fatty-acids significantly reduced eosinophilic polymorphonuclear cell numbers in the intestinal wall and in the colonic lumen; it also reversed the atrophy of the colonic mucosa. Prophylactic use did not impede the development of mucosal atrophy. <![CDATA[<b>Effects of <i>Urtica dioica</i> on hepatic ischemia-reperfusion injury in rats</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200021&lng=en&nrm=iso&tlng=en OBJECTIVES: To evaluate the effects of Urtica dioica on hepatic ischemia-reperfusion injury. METHODS: Thirty adult male Wistar albino rats were divided into three groups: sham group (group 1), control group (group 2), and Urtica dioica group (group 3). All the rats were exposed to hepatic ischemia for 60 min, followed by 60 min of reperfusion. In group 2, a total of 2 ml/kg 0.9% saline solution was given intraperitoneally. In group 3, a total of 2 ml/kg Urtica dioica was given intraperitoneally. At the end of the procedure, liver tissue and blood samples were taken from all rats. Serum aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, ceruloplasmin, catalase, paraoxonase, arylesterase, and lipid hydroperoxide levels were measured. Liver tissue histopathologies were also evaluated by light microscopy. RESULTS: Serum aspartate aminotransferase, alanine aminotransferase and lactate dehydrogenase levels were significantly higher in group 2 than in group 1, and significantly lower in group 3 than in group 2. Also, group 2 had higher serum lipid hydroperoxides and ceruloplasmin levels but lower catalase, paraoxonase, and arylesterase levels than group 1. In group 3, serum lipid hydroperoxides and ceruloplasmin levels were significantly lower, and catalase, paraoxonase, and arylesterase levels were higher than those in group 2. Histopathological examination showed that liver tissue damage was significantly decreased in group 3 compared with group 2. CONCLUSIONS: Urtica dioica has a protective effect on the liver in hepatic ischemia-reperfusion-injured rats. <![CDATA[<b>Passive stiffness of rat skeletal muscle undernourished during fetal development</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200022&lng=en&nrm=iso&tlng=en OBJECTIVES: The aim of the study was to investigate the effect of fetal undernutrition on the passive mechanical properties of skeletal muscle of weaned and young adult rats. INTRODUCTION: A poor nutrition supply during fetal development affects physiological functions of the fetus. From a mechanical point of view, skeletal muscle can be also characterized by its resistance to passive stretch. METHODS: Male Wistar rats were divided into two groups according to their mother's diet during pregnancy: a control group (mothers fed a 17% protein diet) and an isocaloric low-protein group (mothers fed a 7.8% protein diet). At birth, all mothers received a standardized meal ad libitum. At the age of 25 and 90 days, the soleus muscle and extensor digitorum longus (EDL) muscles were removed in order to test the passive mechanical properties. A first mechanical test consisted of an incremental stepwise extension test using fast velocity stretching (500 mm/s) enabling us to measure, for each extension stepwise, the dynamic stress (σd) and the steady stress (σs). A second test consisted of a slow velocity stretch in order to calculate normalized stiffness and tangent modulus from the stress-strain relationship. RESULTS: The results for the mechanical properties showed an important increase in passive stiffness in both the soleus and EDL muscles in weaned rat. In contrast, no modification was observed in young adult rats. CONCLUSIONS: The increase in passive stiffness in skeletal muscle of weaned rat submitted to intrauterine undernutrition it is most likely due to changes in muscle passive stiffness. <![CDATA[<b>Hot water extract of <i>Chlorella vulgaris</i> induced DNA damage and apoptosis</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200023&lng=en&nrm=iso&tlng=en OBJECTIVES: The aim of this study was to determine the antiproliferative and apoptotic effects of hot water extracts of Chlorella vulgaris on hepatoma cell line HepG2. INTRODUCTION: The search for food and spices that can induce apoptosis in cancer cells has been a major study interest in the last decade. Chlorella vulgaris, a unicellular green algae, has been reported to have antioxidant and anti-cancer properties. However, its chemopreventive effects in inhibiting the growth of cancer cells have not been studied in great detail. METHODS: HepG2 liver cancer cells and WRL68 normal liver cells were treated with various concentrations (0-4 mg/ml) of hot water extract of C. vulgaris after 24 hours incubation. Apoptosis rate was evaluated by TUNEL assay while DNA damage was assessed by Comet assay. Apoptosis proteins were evaluated by Western blot analysis. RESULTS: Chlorella vulgaris decreased the number of viable HepG2 cells in a dose dependent manner (p < 0.05), with an IC50 of 1.6 mg/ml. DNA damage as measured by Comet assay was increased in HepG2 cells at all concentrations of Chlorella vulgaris tested. Evaluation of apoptosis by TUNEL assay showed that Chlorella vulgaris induced a higher apoptotic rate (70%) in HepG2 cells compared to normal liver cells, WRL68 (15%). Western blot analysis showed increased expression of pro-apoptotic proteins P53, Bax and caspase-3 in the HepG2 cells compared to normal liver cells WRL68, and decreased expression of the anti-apoptotic protein Bcl-2. CONCLUSIONS: Chlorella vulgaris may have anti-cancer effects by inducing apoptosis signaling cascades via an increased expression of P53, Bax and caspase-3 proteins and through a reduction of Bcl-2 protein, which subsequently lead to increased DNA damage and apoptosis. <![CDATA[<b>The locomotor system as seen in Brazilian scientific journals</b>: <b>a mini review</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200024&lng=en&nrm=iso&tlng=en OBJECTIVE: To make recent selected publications on the locomotor system available to the readership of Clinics. METHOD: A general survey of articles published in selected Brazilian journals was inspected and 91 articles were critically analyzed. They were categorized and briefly described. A final summary of themes is reproduced here. RESULTS: Papers fall into two main categories: articular and muscular pathology and therapeutics; medical sports. A number of papers are not classifiable under these headings. CONCLUSION: The locomotor system has been extensively analyzed and discussed in the Brazilian scientific press in recent years. Not surprisingly, knee and ankle pathology, soccer and running are dominant themes. <![CDATA[<b>Genital and oral human papillomavirus infection in a patient from the group of women who have sex with women</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200025&lng=en&nrm=iso&tlng=en OBJECTIVE: To make recent selected publications on the locomotor system available to the readership of Clinics. METHOD: A general survey of articles published in selected Brazilian journals was inspected and 91 articles were critically analyzed. They were categorized and briefly described. A final summary of themes is reproduced here. RESULTS: Papers fall into two main categories: articular and muscular pathology and therapeutics; medical sports. A number of papers are not classifiable under these headings. CONCLUSION: The locomotor system has been extensively analyzed and discussed in the Brazilian scientific press in recent years. Not surprisingly, knee and ankle pathology, soccer and running are dominant themes. <![CDATA[<b>Reexpansion pulmonary edema after therapeutic thoracentesis</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200026&lng=en&nrm=iso&tlng=en OBJECTIVE: To make recent selected publications on the locomotor system available to the readership of Clinics. METHOD: A general survey of articles published in selected Brazilian journals was inspected and 91 articles were critically analyzed. They were categorized and briefly described. A final summary of themes is reproduced here. RESULTS: Papers fall into two main categories: articular and muscular pathology and therapeutics; medical sports. A number of papers are not classifiable under these headings. CONCLUSION: The locomotor system has been extensively analyzed and discussed in the Brazilian scientific press in recent years. Not surprisingly, knee and ankle pathology, soccer and running are dominant themes. <![CDATA[<b>Clinical signs of alcohol intoxication as markers of refusal to provide blood alcohol readings in emergency rooms</b>: <b>an exploratory study</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200027&lng=en&nrm=iso&tlng=en OBJECTIVE: To make recent selected publications on the locomotor system available to the readership of Clinics. METHOD: A general survey of articles published in selected Brazilian journals was inspected and 91 articles were critically analyzed. They were categorized and briefly described. A final summary of themes is reproduced here. RESULTS: Papers fall into two main categories: articular and muscular pathology and therapeutics; medical sports. A number of papers are not classifiable under these headings. CONCLUSION: The locomotor system has been extensively analyzed and discussed in the Brazilian scientific press in recent years. Not surprisingly, knee and ankle pathology, soccer and running are dominant themes. <![CDATA[<b>Double-chambered left ventricle in an adult</b>: <b>diagnosis by CMRI</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200028&lng=en&nrm=iso&tlng=en OBJECTIVE: To make recent selected publications on the locomotor system available to the readership of Clinics. METHOD: A general survey of articles published in selected Brazilian journals was inspected and 91 articles were critically analyzed. They were categorized and briefly described. A final summary of themes is reproduced here. RESULTS: Papers fall into two main categories: articular and muscular pathology and therapeutics; medical sports. A number of papers are not classifiable under these headings. CONCLUSION: The locomotor system has been extensively analyzed and discussed in the Brazilian scientific press in recent years. Not surprisingly, knee and ankle pathology, soccer and running are dominant themes. <![CDATA[<b>Interesting facts on the antihyerlipidemic effect of <i>peucedanum pastinacifolium</i></b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200029&lng=en&nrm=iso&tlng=en OBJECTIVE: To make recent selected publications on the locomotor system available to the readership of Clinics. METHOD: A general survey of articles published in selected Brazilian journals was inspected and 91 articles were critically analyzed. They were categorized and briefly described. A final summary of themes is reproduced here. RESULTS: Papers fall into two main categories: articular and muscular pathology and therapeutics; medical sports. A number of papers are not classifiable under these headings. CONCLUSION: The locomotor system has been extensively analyzed and discussed in the Brazilian scientific press in recent years. Not surprisingly, knee and ankle pathology, soccer and running are dominant themes. <![CDATA[<b>LCT-22018G>A single nucleotide polymorphism is a better predictor of adult-type hypolactasia/lactase persistence in Japanese-Brazilians than LCT-13910C>T</b>]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200030&lng=en&nrm=iso&tlng=en OBJECTIVE: To make recent selected publications on the locomotor system available to the readership of Clinics. METHOD: A general survey of articles published in selected Brazilian journals was inspected and 91 articles were critically analyzed. They were categorized and briefly described. A final summary of themes is reproduced here. RESULTS: Papers fall into two main categories: articular and muscular pathology and therapeutics; medical sports. A number of papers are not classifiable under these headings. CONCLUSION: The locomotor system has been extensively analyzed and discussed in the Brazilian scientific press in recent years. Not surprisingly, knee and ankle pathology, soccer and running are dominant themes.