Níveis de flexibilidade e força muscular em mulheres praticantes e não praticantes de hidroginástica / Levels of fl exibility and muscle strength in women that are practicing and non-practicing of aqua-aerobics

O estudo se propôs comparar os níveis de fl exibilidade e força muscular em mulheres praticantes e não praticantes de hidroginástica da cidade de Guanambi/BA. Para isso, realizou-se uma pesquisa de campo de caráter quantitativo, descritivo e explicativo, composta por uma amostra de quarenta mulheres, sendo vinte mulheres praticantes e vinte mulheres não praticantes de hidroginástica, com a faixa etária dos 50 aos 77 anos de idades. A coleta dos dados foi através de três testes: "teste de sentar e alcançar", "teste de força de preensão manual" e "teste de levantar da cadeira em 30 segundos". Os dados foram tabulados e organizados no Programa da Microsoft Excel versão 2013. Em seguida, os resultados foram transpostos para a planilha do programa Graph Pad Prism 6, para comparar à média e o desvio padrão das variáveis (testes), utilizando o teste "t". Para análise estatística dos dados usou o programa Graph Pad Prism 6, que se atribui como nível de signifi cância valor de p<0,05. Após a análise dos dados notou-se que no "teste de sentar e alcançar", as praticantes de hidroginástica encontra-se na faixa recomendável e na baixa aptidão. Já no "teste de preensão manual direita e esquerda" foram classifi cadas como regular e fraca, e no "teste de levantar da cadeira em 30 segundos" encontram-se no valor de repetições recomendável....(AU)

The present study aimed to compare the levels of fl exibility and muscle strength in women from the city of Guanambi/Bahia, which were practicing and non-practicing of aqua-aerobics. For this, a fi eld research was done with 20 practicing and 20 non-practicing women of 50 to 77 years old. They were submitted to a "sit and reach test", "manual grip strength test" and "chair lift test in 30 seconds" and the quantitative, descriptive and explanatory data were obtained, transferred and tabulated in the Microsoft Excel 2013 software and in the Graph Pad Prism 6 software. The t test was used to compare the means and the standard deviations of the variables (tests) and a P value < 0.05 was considered to be statistically signifi cant. The results showed that practicing women were classifi ed in the group of recommendable range and low aptitude for the "sit-and-reach test". On the other hand, they were classifi ed as regular and weak for the "right and left hand grip test" and in the recommended repetition value for the "lift test of the chair in 30 seconds"....(AU)

Measuring herpes zoster disease burden in São Paulo, Brazil: a clinico-epidemiological single-center study

OBJECTIVES: Herpes zoster is characterized by acute neuritis and post-herpetic neuralgia. Currently, data concerning the zoster-associated impact on quality of life and healthcare resource utilization in Brazil are scarce. This study measured the zoster-associated burden in a Brazilian population. METHODS: This was a prospective, observational, single-cohort study conducted in a primary hospital's emergency room in São Paulo, Brazil. Patients enrolled at various timepoints during a zoster episode were followed over 180 days. The Zoster Brief Pain Inventory and the Initial Zoster Impact Questionnaire assessed zoster-associated pain. The EuroQoL assessed the impact of herpes zoster and/or zoster-associated pain on quality of life. Healthcare resource utilization was assessed by patient-reported questionnaires. RESULTS: One-hundred forty-six zoster patients were enrolled [mean (SD) age of 69.9 (10.9) years]. Mean (SD) worst pain scores decreased from 5.3 (3.5) at baseline to 1.9 (3.0) 180 days following rash onset. Mean (SD) EuroQoL scores significantly decreased from 0.9 (0.2) before rash appearance to 0.7 (0.2) after rash onset (p<0.001), followed by gradual improvements in quality of life over 180 days, with pre-herpes zoster quality of life achieved at the end of the observation period. The majority of patients purchased prescription medications (89.7%) and required doctor's office visits (65.8%) for zoster episodes. CONCLUSIONS: Herpes zoster is associated with a significant disease burden, including zoster-associated pain, impaired quality of life and increased healthcare resource utilization in Brazil. These results support the implementation of early intervention and prevention programs such as vaccinations to reduce the herpes zoster-associated disease burden in Brazil.

How Does Your Garden Flow? The Impact of Domestic Front Gardens on Urban Flooding.

Aims: To quantify rainwater runoff from domestic front gardens as a consequence of increased impervious surface area and climate change impacts, thus allowing the runoff contribution from both newly and previously covered front gardens to be assessed in terms of the overall urban flood burden. Study Design: Numerical simulation of the runoff from a typical front garden in response to simulated rainfall events for four UK cities (Edinburgh, Manchester, London, and Exeter). Methodology: A typical front garden was simulated with varying areas of impermeable surface area (0%, 10%, 25%, 50%, 75%, and 100%) to represent observed trends in garden paving. Storm events representing current design and projected future rainfall intensities were applied to each of the four cities. The resultant runoff volumes were then quantified. Results: Runoff is shown to be directly proportional to both the impermeable surface area and the rainfall intensity. Areas of impermeable paving can generate substantial volumes of runoff during a storm event which can contribute to localized flooding or add to the urban flood burden. Increased rainfall intensities and frequencies due to climate change are likely to increase runoff further. Conclusion: Domestic front gardens play a vital role in managing surface water runoff in towns and cities. Growing trends of paving over front gardens put this role in jeopardy, while increasing rainfall intensities due to climate change make this role increasingly important. The quantification of domestic front garden runoff provides a mechanism for facilitating the protection, and enhancement, of this important asset in terms of water and urban flood management.

Prevalence of joint hypermobility syndrome in Oman

The aim of this article is to document the prevalence of joint hypermobility and joint hypermobility syndrome [JHS] among young adults [aged 16-45 years] in a previously unstudied Middle Eastern population using observational and consecutive case studies. From 1 March to 1 April 2007, 222 young Omani men and women were interviewed at the Sohar Regional Hospital in Sohar, Oman, and examined for the five recognized features of hypermobility [i.e. laxity of the thumbs, little fingers, elbows, spine and knees] as well as 15 other musculoskeletal features. Approximately 45% of the study cohort had at least one lax joint, but only 4% possessed all five features of JHS and JHS could be diagnosed in only 6.3% of subjects. The women studied were older than the men [P<0.001], more overweight [P<0.05] and almost twice as likely to have JHS. A very high frequency [86%] of Marfanoid features was found among subjects with joint hypermobility. JHS in association with Marfanoid features appears to be a cause of musculoskeletal problems in Oman that is frequently unrecognized and may be almost twice as common in women than men

Validation of patient symptom diary in acute posterior vitreous detachment

The purpose of the study is to determine the validity of an original patient symptom diary in recording symptoms of posterior vitreous detachment [PVD]. In this prospective cohort study, all patients presenting to the Hotel Dieu hospital emergency eye clinic between September 2008 and July 2009 diagnosed with acute PVD were offered enrollment in the study. Patients were given the Queen's University posterior vitreous detachment patient diary at the initial visit after detailed eye examination, assessment of risk factors for retinal tears and detachments and a thorough explanation of their presenting complaints to record their symptoms related to PVD. At a random point during their six-week follow up, the patients were verbally asked the same questions being recorded in the diary over the phone. At the six-week follow up visit, the diaries were collected and the verbal results were compared with the written results. There was substantial to near perfect agreement between the verbal questions and written answers. Cohen's kappa scores for flash frequency, flash intensity, floater frequency, and floater type were 0.6229, 0.6389, 0.6495, and 0.8603, respectively. The Queen's University posterior vitreous detachment patient diary is a useful tool for investigating the quantity, quality and change in symptoms of patients presenting with PVD in the first 6 weeks of initial presentation

Triggers of Atopic Dermatitis / 소아알레르기및호흡기학회지

Atopic dermatitis (AD) is a complex, chronic inflammatory skin disorder associated with cutaneous hyperreactivity to environmental triggers. Atopic dermatitis is often the first step in the "atopic march, " which leads to asthma and allergic rhinitis in the majority of patients. Many allergic and non-allergic triggers impact the clinical course of AD through stimulation of immunologic mediators and cell types in the skin of affected individuals. Allergic triggers of AD include hypersensitivity responses to foods, aeroallergens and microorganisms. Non- allergic triggers include factors such as climate, irritants, infection, psychosocial stressors and occupational exposures. This review will focus on triggers of atopic dermatitis and the clinical diagnosis and management of disease.

Endothelial dysfunction: therapy revisited (brief excerpts) (round table discussion on 18/01/2001 at Mumbai).

Indians have highest incidence of coronary heart disease. Here it occurs much more prematurely. Endothelial dysfunction has been increasingly recognised as an early event for the development of various cardiovascular disease. Long acting nifedipine has a definite role to play in reversing endothelial dysfunction.

A clinico-pathological study of Cushing's syndrome at the University Hospital of the West Indies and a review of the literature

Cushing's syndrome is an uncommon but important disease. Twenty-one confirmed cases of spontaneous Cushing's syndrome were documented at the University Hospital of the West Indies over a 21-year period. They were predominantly young females (F:M ratio of 17:4; mean age 25 years and 3 months). The commonest presenting symptoms were amenorrhoea (41) and obesity (19). Common clinical features were cushingnoid features (95), hypertension (76) and hirsutism (82). Twenty-nine per cent had frank hyperglycaemia. Cushing's syndrome was due to Cushing's disease in 10 cases, adrenal adenoma in 3 and adrenal carcinoma in 2 cases. In 4 cases with presumed adrenal hyperplasia, the histology was either unavailable or was not consistent with the diagnosis. Two cases appear now to have had the ectopic ACTH Syndrome. Adrenalectomy was the commonest treatment offered. There were no intra-operative or post-operative deaths but recurrence was common after subtotal adrenalectomy in Cushing's disease. Twenty-seven per cent of the patients developed Nelson's syndrome, which was fatal in 50. Long-term hormone replacement therapy was unnecessary after surgery for adrenal adenomas. Treatment of Cushing's syndrome was well tolerated by the patients.

Acute liver failure.

Acute liver failure is a rare but potentially fatal disease. Adult definition of fulminant hepatic failure, which includes the development of hepatic necrosis and encephalopathy within 8 weeks of onset of liver disease does not apply to acute liver failure in children particularly if secondary to autoimmune or metabolic liver disease. The etiology of acute liver failure varies with the age of the child. In neonates, infection or an inborn error of metabolism are common, while viral hepatitis and drug induced liver failure are more likely in older children. The clinical presentation of acute liver failure includes jaundice, coagulopathy and encephalopathy. In neonates, encephalopathy may be subclinical. The management of acute liver failure includes assessment of prognosis for liver transplantation; prevention and treatment of complications while awaiting hepatic regeneration or a donor liver and hepatic support. The major complications of acute liver failure are sepsis, gastro-intestinal bleeding, cerebral edema, renal and cardiac failure. Selection for liver transplantation depends on the etiology of the disease, prognostic factors, the presence or absence of multisystem disease and/or reversible brain damage. Prognostic factors for survival are less well established in children than in adults but children with metabolic liver disease, prothrombin time > 50 seconds, rising bilirubin and falling transaminase, grade II or higher grade of hepatic coma indicate poor prognosis. Most children receive a reduced or split liver graft. Living related donations for acute liver failure are also carried out by some centres. Survival post liver transplantation for acute liver failure has improved and most recipients can expect a 70% five year survival.

Nutrition and growth in patients with chronic liver disease.

Protein energy malnutrition leading to growth failure is an inevitable consequence of chronic liver disease in childhood. Although the precise pathophysiology is not understood considerable progress has been made in understanding the mechanisms of fat malabsorption and protein turnover in liver disease. There are many difficulties with the correct assessment of nutritional parameters in children with liver disease related to their abnormal body composition and energy expenditure and care needs to be taken with the interpretation of results. The effects of malnutrition secondary to chronic liver disease are varied and include fat soluble vitamin deficiencies, generalised growth failure, impairment of gastrointestinal function, immunosuppression and hypotonia. It is now recognised that malnutrition is an important risk factor for liver transplantation and increases both mortality and morbidity. Strategies to prevent or reverse malnutrition are now established and include the use of specific infant formulas based on low salt protein and an increased concentration of medium train triglyceride (50-70%). Careful nutritional support in association with generous fat soluble vitamin supplementation may produce dramatic improvement in catch up weight gain but for those children in whom growth failure persists, the only management is liver transplantation.

Disseminated infection caused by penicillin-resistant gonococci in two jamaicans

Disseminated gonococcal infection due to penicillin-resistant organisms is very unusual. Two such cases occuring at the University Hospital of the West Indies are described. Implications for therapy are discussed

A serological survey of scrub, tick, and endemic typhus in Sabah, East Malaysia.

A seroepidemiological survey of 837 people and 383 febrile patients was performed in rural areas of Sabah. We determined that the rickettsial diseases scrub typhus and endemic typhus were uncommon causes of febrile illness, as was tick typhus, except in forest dwelling peoples. The rate of occurrence of SFGR specific antibody was 16.5% among 412 forest dwellers, indicating that tick typhus may be a frequent cause of illness in this population.