High HTLV-1 proviral load, a marker for HTLV-1 associated myelopathy/tropical spastic paraparesis, is also detected in patients with infective dermatitis associated with HTLV-1

Salvador (BA, Brazil) is an endemic area for human T-cell lymphotrophic virus type 1 (HTLV-1). The overall prevalence of HTLV-1 infection in the general population has been estimated to be 1.76%. HTLV-1 carriers may develop a variety of diseases such as adult T-cell leukemia/lymphoma, HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and infective dermatitis associated with HTLV-1 (IDH). IDH is a chronic and severe form of childhood exudative and infective dermatitis involving mainly the scalp, neck and ears. It has recently been observed that 30% of patients with IDH develop juvenile HAM/TSP. The replication of HTLV-1 has been reported to be greater in adult HAM/TSP patients than in asymptomatic HTLV-1 carriers. In the current study, the proviral load of 28 children and adolescents with IDH not associated with HAM/TSP was determined and the results were compared to those obtained in 28 HTLV-1 adult carriers and 28 adult patients with HAM/TSP. The proviral load in IDH patients was similar to that of patients with HAM/TSP and much higher than that found in HTLV-1 carriers. The high levels of proviral load in IDH patients were not associated with age, duration of illness, duration of breast-feeding, or activity status of the skin disease. Since proviral load is associated with neurological disability, these data support the view that IDH patients are at high risk of developing HAM/TSP.

Ganhos funcionais e sua relação com os componentes de função em trabalhadores com lesão de mão / Functional gains and their relationship with functional components among workers with hand injuries

OBJETIVO: Este estudo teve como objetivos documentar os resultados da intervenção da Terapia Ocupacional em pacientes com lesões de mão por acidente de trabalho e examinar a relação entre os escores da avaliação funcional Canadian Occupational Performance Measure (COPM) com as variáveis força de preensão e diagnóstico, em três momentos (admissão, alta e follow-up). METODOLOGIA: Foi realizado um estudo observacional do tipo longitudinal. A amostra foi constituída de 42 indivíduos encaminhados ao Setor de Terapia Ocupacional de um Hospital da rede pública de Belo Horizonte. A instrumentação utilizada consistiu de dinamômetro Jamar para a mensuração da força de preensão, goniômetro de punho e dedos para a amplitude de movimento, monofilamentos de Semmes-Weinstein para a sensibilidade e a avaliação funcional COPM. RESULTADOS: Os parâmetros clínicos (força de preensão, amplitude de movimento, sensibilidade e desempenho funcional) mostraram ganhos importantes após a intervenção. Os escores do COPM inicial dobraram após a Terapia Ocupacional, fornecendo evidência de que os clientes melhoraram e ficaram satisfeitos com seu desempenho funcional. A força de preensão apresentou uma associação de baixa magnitude com as medidas avaliadas pelo COPM. Outros fatores podem estar associados ao uso funcional da mão, sendo que a força pode não ser suficiente para predizer a função da mão. Não foi detectada diferença entre os diagnósticos encontrados na amostra e os escores do COPM. CONCLUSÃO: As relações documentadas neste estudo indicam variáveis relevantes associadas aos ganhos após intervenção da Terapia Ocupacional e podem contribuir para uma atuação mais direcionada dos profissionais, no que concerne às expectativas do cliente.

OBJECTIVE: To document the outcomes from occupational therapy intervention among patients with hand injury resulting from work-related accidents, and to examine the relationships between the scores from the Canadian Occupational Performance Measure (COPM) functional assessment and variables such as grip strength and diagnosis, at three times (admission, discharge and follow-up). METHOD: An observational longitudinal study was conducted. The sample consisted of 42 individuals who were referred for occupational therapy services at a public hospital in Belo Horizonte. The instruments used included a Jamar dynamometer to measure grip strength, hand goniometer for wrist and finger range of motion, Semmes-Weinstein monofilaments for sensitivity and the COPM functional test. RESULTS: The clinical parameters (grip strength, range of motion, sensitivity and functional performance) showed significant gains after the intervention. The initial COPM scores doubled after occupational therapy, thus providing evidence that the patients improved and were satisfied with their functional performance. There was a slight association between grip strength and the measurements evaluated by COPM. Other factors may be associated with functional use of the hand, since strength may be insufficient for predicting hand function. No differences were found between the diagnoses found in the sample and the COPM scores. CONCLUSION: The relationships documented in this study indicate the variables that are relevant to gains following occupational therapy interventions. This may contribute towards achieving interventions that are better focused, in terms of patients' expectations.

A profissionalização da fisioterapia em Minas Gerais / Professionalization of physical therapy in Minas Gerais

OBJETIVO: Com base em estudo qualitativo, utilizando a história oral e a análise de documentos, procurou-se identificar as raízes da fisioterapia em Minas Gerais, a fim de discutir o processo de profissionalização e o desenvolvimento da identidade do fisioterapeuta neste Estado. METODOLOGIA: O foco do estudo foi dirigido principalmente a Belo Horizonte, no período compreendido entre 1950 e 1980. O referencial teórico utilizado foi a sociologia das profissões, e teve como guia os cinco passos de profissionalização descritos por Wilensky¹ que são a necessidade da ocupação tornar-se de dedicação exclusiva, o estabelecimento de procedimentos de instrução e seleção, a formação de uma associação profissional, a regulamentação da profissão e a adoção do código de ética. Na pesquisa de campo, foram utilizadas entrevistas do tipo semi-estruturada para colher depoimentos de pessoas consideradas chave, mediante amostragem em série, e o método escolhido foi a análise de conteúdo. RESULTADOS: Avalia-se que o processo de profissionalização da fisioterapia em Minas Gerais é marcado pela hegemonia médica na saúde e que a indefinição das atribuições e competências foram os fatores que motivaram os conflitos internos e externos. CONCLUSÕES: Conclui-se que, para a afirmação efetiva da fisioterapia como profissão, torna-se necessária a delimitação das especificidades do seu saber e do seu fazer (teoria e prática), identificando o papel do fisioterapeuta na equipe multidisciplinar de saúde.

Prevalence of antibodies to human herpesvirus-8 in populations with and without risk for infection in São Paulo State

Human herpesvirus 8 (HHV-8) is a newly described herpesvirus that is etiologically associated with all forms of Kaposi's sarcoma (KS). Seroepidemiological studies have shown high prevalence rates of HHV-8 antibodies among men who have sex with men (MSM) and AIDS patients, African children, Brazilian Amerindians, and elderly individuals in certain regions of Europe. The aim of the present study was to determine the prevalence of HHV-8 antibodies in healthy children and young adults from different cities in São Paulo State, and in a population at high risk for HHV-8 infection: HIV-negative MSM, and AIDS patients with and without KS. Antibodies to HHV-8 latency-associated nuclear antigen and lytic-phase antigens were detected by immunofluorescence assays. In 643 healthy children and young adults from the general population attending a vaccination program for yellow fever in ten different cities in São Paulo State, the prevalence of HHV-8 antibodies detected by the presence of latent or lytic antigens ranged from 1.0 to 4.1 percent in the different age groups (mean = 2.5 percent). In the MSM group, the prevalence was 31/95 (32.6 percent). In the group of patients with AIDS, the prevalence was 39.2 percent (51/130) for non-KS patients and 98.7 percent (77/78) for AIDS patients with the diagnosis of KS confirmed by histopathological examination. We conclude that HHV-8 has a restricted circulation among healthy children and young adults in the general population of São Paulo State and a high prevalence among MSM and AIDS patients.

Arterial blood pressure of term newborns during the first week of life

The progressive behavior of the blood pressure of term newborns during the first week of life was assessed by the simultaneous use of oscillometric and Doppler methods. A total of 174 term neonates born at the Municipal Hospital Odilon Behrens in Belo Horizonte, from March 1996 to February 1997, were prospectively assessed. The oscillometric and Doppler ultrasonic methods were simultaneously used for four consecutive recordings obtained at 12 ± 6, 24 ± 6 and 72 ± 24 h and on the 7th ± 1 day of life. The combined use of the two methods simplified the procedure, with automatic cuff inflation and deflation, and speed was properly controlled with an automatic pressure monitor. The procedure was performed using a Y-connection to the mercury sphygmomanometer, with blood pressure being recorded with an automatic device and systolic blood pressure being measured simultaneously by Doppler ultrasound. The newborns were awake, not crying and in the supine position. A statistically significant increase in systolic and diastolic blood pressure was observed between the first and second, and the third and fourth measurements by Doppler and oscillometric methods. No significant correlation between birth weight, length, ponderal index and blood pressure was observed. The technique used represents a simpler and more accurate procedure for blood pressure measurement

Generation of protective immune sera by Crotalus durissus terrificus venom detoxified by controlled iodination

1. Whole soluble venom from the snake Crotalus durissus terrificus was detoxified by controlled iodination. Doses equivalent to 100 LD50 of the native venom were administerd to mice, without signs of intoxication. 2. The non-toxic iodinated derivative were able to stimulate antibodies in rabbits and horses within a short period (6 months) of inmunization. Horse antisera attained titers of 0.5 to 0.9 mg/ml for protection aginst native venom. 3. Horse antisera obrained in horses from native and iodinated venom were run against both native and iodinated venoms, as antigens, in gel immunodiffusion. The precipitation lines showed total identity of the types of sera

Fibrose muscular congenita como causa de estrabismo. Relato clinico-patologico de um caso. / Congenital muscular fibrosis causing strabismus. Clinico-patological report of a case

O relato clinico-patologico de um caso de fibrose muscular congenita, levando a estrabismo, e apresentado. O diagnostico clinico foi suspeitado pelo desvio do olho direito para cima e para fora com fixacao do globo ocular nesta posicao, pelo teste de duccao forcada positivo e pelo aspecto e consistencia dos musculos reto superior lateral e inferior observados durante as cirurgias. A presenca de tecido fibroso colagenizado, demonstrada anatomo-patologicamente, inclusive atraves a coloracao pelo tricomio de Massom, confirmou o diagnostico de fibrose muscular

Dacriocistorrinostomia. Tecnica de Kasper. / Dacryocystorhinostomy. Kasper's technic

Os autores apresentam os resultados da sua experiencia com a utilizacao da tecnica de dacriotorrinostomia segundo Kasper, salientando o elevado indice de cura obtido bem como a simplicidade de execucao da mesma