Alopecia em pacientes anticoagulados / Alopecia in anticoagulated patients

Resumo A alopecia é uma complicação comum da terapia anticoagulante que pode ter repercussões psicológicas importantes nos pacientes, especialmente nos do sexo feminino, e interferir na decisão de extensão da anticoagulação. Esta revisão tem como objetivo descrever os mecanismos potencialmente envolvidos na gênese da alopecia durante a terapia anticoagulante, pois eles ainda não estão totalmente esclarecidos, e as terapias existentes, para a adoção das condutas mais adequadas.

Abstract Alopecia is a common complication of anticoagulant therapy that may have important psychological repercussions for patients, especially female patients, and can interfere with the decision to extend anticoagulation. This review aims to describe the mechanisms potentially involved in the genesis of alopecia during anticoagulant therapy, since these are not yet fully understood, and discusses the existing therapies for the most appropriate management.

Effects of human head hair on performance and thermoregulatory responses during 10-km outdoor running in healthy men / Efeitos do cabelo da cabeça humana no desempenho e na resposta termorregulatória durante a corrida de 10 km ao ar livre em homens saudáveis

Abstract The aim of the present study was to evaluate the effects of human head hair on performance and thermoregulatory responses during 10-km outdoor running in healthy men. Twelve healthy males (29.5 ± 3.7 years, 174.9 ± 4.3 cm, 72.7 ± 3.2 kg and VO2max 44.6 ± 3.4 ml.kg-1.min-1) participated in two self-paced outdoor 10-km running trials separated by 7 days: 1) HAIR, subjects ran with their natural head hair; 2) NOHAIR, subjects ran after their hair had been totally shaved. Average running velocity was calculated from each 2-km running time. Rectal temperature, heart rate and physiological strain index were measured before and after the 10-km runs and at the end of each 2 km. The rate of heat storage was measured every 2 km. The environmental stress (WBGT) was measured every 10 min. The running velocity (10.9 ± 1 and 10.9 ± 1.1 km.h-1), heart rate (183 ± 10 and 180 ± 12 bpm), rectal temperature (38.82 ± 0.29 and 38.81 ± 0.49oC), physiological strain index (9 ± 1 and 9 ± 1), or heat storage rate (71.9 ± 64.1 and 80.7 ± 56.7 W.m-1) did not differ between the HAIR and NOHAIR conditions, respectively (p>0.05). There was no difference in WBGT between the HAIR and NOHAIR conditions (24.0 ± 1.4 and 23.2 ± 1.5ºC, respectively; p=0.10). The results suggest that shaved head hair does not alter running velocity or thermoregulatory responses during 10-km running under the sun.

Resumo O objetivo do presente estudo foi avaliar os efeitos do cabelo da cabeça humana no desempenho e na resposta termorregulatória durante 10 km de corrida ao ar livre em homens saudáveis. Doze saudável do sexo masculino (29,5 ± 3,7 anos, 174,9 ± 4,3 cm, 72,7 ± 3,2 kg e VO2máx 44,6 ± 3,4 ml.kg-1.min-1) participaram de 2 corridas de 10km separadas por 7 dias de intervalo em ritmo auto regulado: 1) HAIR- voluntários correram com seus cabelos intactos, 2) NOHAIR- voluntários correrram após terem seus cabelos totalmente raspado. A velocidade média da corrida foi calculada a cada série de 2 km. Temperatura retal, freqüência cardíaca e índice de estresse fisiológico foram medidos antes e depois dos 10 km da corrida e no fim de cada 2 km. Taxa de armazenamento de calor foi medida a cada 2 km. Além disso, o estresse ambiental (WBGT) foi medido a cada 10 min. A velocidade de corrida (10,9 ± 1 e 10,9 ± 1,1 km.h-1: freqüência cardíaca (183 ± 10 e 180 ± 12 bpm), temperatura retal (38,82 ± 0,29 e 38,81 ± 0,49º C), índice estresse fisiológico (9 ± 1 e 9 ± 1) e taxa de armazenamento de calor (71,9 ± 64,1 e 80,7 ± 56,7 Wm-1), não foi diferente entre as situações HAIR e NOHAIR, respectivamente (p>0,05). Não houve diferença no WBGT entre HAIR e NOHAIR (24,0 ± 1.4º C e 23,2 ± 1,5º C, respectivamente; p=0,10). Os resultados sugerem que raspar o cabelo da cabeça não altera a velocidade da corrida e as respostas termorregulatórias durante 10 km de corrida sob o sol.

Caracterización del tricograma en pacientes chilenos / Characterization of trichogram in Chilean patients

Introducción: El tricograma consiste en extraer pelos del cuero cabelludo que luego son examinados mediante un microscopio para determinar qué porcentaje de éstos se encuentra en telógeno, anágeno o catágeno. Objetivos: Caracterizar el tricograma en pacientes chilenos y determinar las diferencias existentes entre los porcentajes de anágeno y telógeno entre cuero cabelludo normal y la zona de menor densidad. Material y Métodos: Estudio observacional descriptivo y retrospectivo de análisis de tricogramas diferenciales de cuero cabelludo. Resultados: Las diferencias del porcentaje de anágeno y telógeno entre cuero cabelludo normal y la zona de menor densidad fueron estadísticamente significativas.

Introduction: Trichogram consists in removing hair follicles from the scalp and examining them under a microscope to determine the percentage of them that are in telogen, anagen or catagen. Aim: To characterize trichogram in chilean patients and determine the differences in anagen and telogen percentages between normal scalp and a lower density zone. Material and Methods: Observational, descriptive and retrospective study of the analysis of differential trichograms of the scalp. Results: The differences in anagen and telogen percentages between normal scalp and the lower density zone were statistically significant.Key words: Trichogram, anagen, telogen.

Excess of counterclockwise scalp hair-whorl rotation in homosexual men.

While most men prefer women as their sexual partners, some are bisexual and others are homosexuals. It has been debated for a long time whether a person's sexual preference is innate, learned, or due to a combination of both causes. It was recently discovered that the human right-versus-left-hand use preference and the direction of scalp hair-whorl rotation develop from a common genetic mechanism. Such a mechanism controls functional specialization of brain hemispheres. Whether the same mechanism specifying mental makeup influences sexual preference was determined here by comparing hair-whorl rotation in groups enriched with homosexual men with that in males at large. Only a minority of 8.2% (n = 207) unselected 'control' group of males had counterclockwise rotation. In contrast, all three samples enriched with homosexual men exhibited highly significant (P < 0.0001), 3.6-fold excess (29.8%, n = 272) counterclockwise rotation. These results suggest that sexual preference may be influenced in a significant proportion of homosexual men by a biological/genetic factor that also controls direction of hair-whorl rotation.

Vigilância toxicológica: comprovação do uso de álcool e drogas através de testes toxicológicos / Toxicological surveillance: evidence of alcohol and drugs by toxicological tests

O objetivo deste livro é ser uma fonte de informação para profissionais que têm que lidar com testes toxicológicos para comprovação do uso de álcool e drogas, no seu dia-a-dia, auxiliando-os na escolha dos mesmos e nos critérios para sua aplicação...

Self-assessment of sexual maturation in Thai children by Tanner photograph.

Assessment of sexual maturation in adolescence is crucially important in clinical practice, because the possibility of concealed disease during the earlier period of child development needs to be detected. However, to undress children sometimes is problematic and unethical in several countries. Therefore, in this study the authors evaluated the concordance between children's self-assessment by Tanner photograph with a written description, and examination by pediatricians. One hundred and ninety four children (100 girls, 94 boys), aged 7-15 years, were recruited in this study. The outcome demonstrated that the two processes of investigation were in good concord: the weight kappa of 0.76 and 0.79 for the breast stage (B) and pubic hair stage (PH), respectively, in girls. In boys, the weight kappa were 0.59 and 0.73 for genital stage (G) and pubic hair (PH) stage, respectively. However, the weight kappa for genital stage was improved after the subjects were provided more time to examine themselves before choosing the photograph. In girls, the mean chronological age (CA) for B stage II, III, IV was 10.4+/-1.3, 12.5+/-1.3, 13.6+/-0.7 years and for PH stage II, III, IV was 11.9+/-1.4, 12.9+/-1.2, 13.5+/-0.9 years. The normal CA for the onset of puberty in girls was between 7.8-13.0 years. In boys, the mean CA for G stage II, III, IV was 11.3+/-1.7, 12.4+/-1.2, 13.2+/-1.2 years, and for PH II, III, IV was 12.2+/-1.3, 13.1+/-1.0, 13.9+/-1.7 years. The normal CA for the onset of puberty in boys was 7.9-14.7 years. In addition, the authors constructed the normal value for penile length in Thai boys, aged between 9-15 years, to be used as a reference. Therefore, this study demonstrated a good concordance between the self-assessment by Tanner photograph and examination by pediatricians. This can be applied for use in filed research, school screening and clinical practice.

Sloth biology: an update on their physiological ecology, behavior and role as vectors of arthropods and arboviruses

This is a review of the research undertaken since 1971 on the behavior and physiological ecology of sloths. The animals exhibit numerous fascinating features. Sloth hair is extremely specialized for a wet tropical environment and contains symbiotic algae. Activity shows circadian and seasonal variation. Nutrients derived from the food, particularly in Bradypus, only barely match the requirements for energy expenditure. Sloths are hosts to a fascinating array of commensal and parasitic arthropods and are carriers of various arthropod-borne viruses. Sloths are known reservoirs of the flagellate protozoan which causes leishmaniasis in humans, and may also carry trypanosomes and the protozoan Pneumocystis carinii

Occurrence and severity of alopecia in patients on combination chemotherapy.

The aim of the study was to evaluate the occurrence and severity of alopecia resulting from combination chemotherapy on cancer patients. The study was conducted during the period 1994-1996 on 58 confirmed cases of malignancies attending the Kasturba Medical College Hospital, Mangalore, South India. The treatment regimens followed were standard protocols recommended for those malignancies and which are widely adopted. Specific drug combinations, their dosage and routes and schedules of administration were studied. The influence of 20 different treatment regimens, most of them in combination chemotherapy, were studied. The patients studied were not receiving any other medication which could have caused alopecia as observed in the present study. The pathophysiology of the hair, as influenced by the treatment regimens, were studied by examination of samples of the affected hairs under a Leica compound microscope. Alopecia was the most dominant side effect influencing 35 of the 58 patients undergoing the treatment (60%). The severity of alopecia was assessed by grouping them in four distinct grades. Specific drugs and their combinations causing varying degrees of severity were identified. The initiation of hair loss in different treatment regimens were analysed. It is seen that alopecia is an early manifestation of cutaneous side effects of cancer chemotherapy. In a majority of patients, the manifestation initiated after the first or the second cycle of administration of the rapeutic regimen, indicating a time interval of 1 to 8 weeks after the start of chemotherapy. Single agent drugs, when used alone or in combination with immunomodulator drugs seem to cause much less side effects, including alopecia, when compared to multiple drug regimens. Microscopic examination of the affected hair showed trichorrhexis, fragmentation, decrease in diameter and depigmentation of the hair shaft.

Análise dos cabelos eliminados espontaneamente / Analysis of the spontaneously fallen hair

A análise dos cabelos eliminados espontaneamente faz parte de um grupo de exames propedêuticos para o diagnóstico das alopecias. Em algumas patologias esse exame se torna primordial para o diagnóstico. Neste trabalho säo discutidas forma de coleta dos cabelos, técnica de leitura e interpretaçöes.

El exceso de vello corporal en mujeres / Excess of body hair in women

El aumento de vello es un motivo frecuente de preocupación y de consulta femenina. Se definen los términos de hipertricosis, hirsutismo y virilismo, destacando que el hirsutismo es la aparción de vellosexual en zonas en las que su presencia es normal en el hombre pero no en la mujer. Se señalan los principales efectos cosméticos y funcionales del hiperandrogenismo en la mujer: hirsutismo, acné, seborrea, amenorrea, anovulación, atrofia mamaria, cliteromegalia, hiperplasia endometrial, obesidad, etc.Se enumeran las causas del hirsutismo, señalando que fisiol+ogicamente derivan de un aumento en la producción de andrógenos o de la sensibilidad frente a ellos de los folículos pilosos

Vello puboabdominal e infección de herida quirúrgica por apendicectomía / Puboabdominal hair in wound infection of appendectomy

El objetivo fue comparar la frecuencia de infección de herida quirúrgica en dos grupos de pacientes apendicectomizados: uno con ausencia natural o inducida de vello puboabdominal y el otro con presencia natural del mismo. Se realizó un estudio prospectivo, comparativo, observacional y transversal, en el que se incluyó a pacientes con diagnóstico presuncional de apendicitis aguda. Se investigó en cada caso, para determinar el grado de comparabilidad de ambos grupos, edad, sexo, tipo de incisión abdominal, estado del apéndice, presencia de material purulento en cavidad peritoneal, realización de lavado incisional o cavitario, técnica de manejo del muñon apendicular y uso de antibióticos. Se investigo la presencia de infección de herida quirúrgica diez días después de la apendicectomía, de acuerdo a los criterios de Ljungqvist. La comparación entre los grupos se realizó mediante la chi cuadrada o la prueba de Fisher. Cada grupo se integró con 70 pacientes y ambos mostraron buen grado de comparabilidad; cinco casos de cada grupo desarrollaron infección de la herida quirúrgica (7 por ciento) (p=0.789). La infección se relacionó solamente con un estado apendicular deteriorado (p=0.017) y con el material purulento dentro de la cavidad abdominal (p=0.044), por lo que se concluyó que la presencia o ausencia de vello puboabdominal no fue un factor determinante de infección.

Study of transcutaneous electrical potentials hairy and non-hairy areas of the face in adult males

Transcutaneous voltage potentials were recorded form points in the face of 30 healthy adult males. 240 points in the beard area and another 240 points in the adjacent non-hairy areas were studied. Potentials recorded from all these surface points-stratum corneum-were electronegative with respect to the dermis. Potentials in the hairy areas were found to be significantly lower than those in the non-hairy areas. This finding confirms earlier reports and excludes other factors, thus attributing the lower potential to the presence of hair

Etiological review of hirsutism in 250 patients

Two hundred fifty women with hirsutism were studied, with a mean age of 25.5 years (ranging from 13 to 38 years). The evolution of hirsutism varied from 3 months to 13 years, being minimal in 82 patients (33 per cent), mild in 101 (40 per cent), moderate in 56 (23 per cent) and severe in the remaining 11 women (4 per cent). Polycystic ovary syndrome (PCOS) was diagnosed in 134 patients (53 per cent), overweight or obesity in 45 (18 per cent), late-onset adrenal hyperplasia in five (2 per cent), ovarian tumor in two (0.8 per cent), drug-induced hirsutism and Cushing's syndrome in one patient each (0.4 per cent), and idiopathic hirsutism in 62 cases (25 per cent). Among 67 patients with moderate or severe hirsutism, testosterone was elevated in 21 (31 per cent). In 117 out of 206 (57 per cent) cases polycystic ovaries were observed by ultrasound. Fifty-four patients were treated with a combination of 2 mg cyproterone acetate and 0.035 mg ethinyl estradiol, observing improvement of hirsutism in 32 patients (59 per cent). It is concluded that PCOS is the most frequent cause of hirsutism, but an important proportion of cases without evident etiology remain classified as idiopathic hirsutism

Hirsutismo / Hirsutism

El hirsutismo representa para el médico una posible enfermedad sistemática, sin embargo para la paciente connotaciones emocionales. De una buena comprensión fisiopatológica del problema, resultará un buen diagnóstico y un manejo racional de este importante problema. Se realiza una actualización del tema, enfatizando el rol de la piel como órgano blanco de la acción hormonal

O tricograma: Parte I. Significado e método de realizaçäo / The trichogram Part I. Significance and method of performing

O tricograma é um exame que analisa o cabelo em um determinado momento. Alteraçöes fisiológicas e anatômicas do ciclo biológico do pêlo podem ser detectadas por exame. Neste trabalho é descrita a técnica de realizaçäo do exame