[Seroprevalence of COVID-19 and Psychosocial Effects in the General Population: Results of the STAAB-COVID-One Program]. / Seroprävalenz von COVID-19 und psychosoziale Auswirkungen in der Allgemeinbevölkerung: Ergebnisse des STAAB-COVID-One Programms.

BACKGROUND: Research of SARS-CoV-2 has so far largely focused on symptomatic cases. The STAAB-COVID study therefore examined the seroprevalence of COVID-19 in the general population and the psychosocial effects of the pandemic. METHODS: From June-October 2020, a sub-study was conducted within the "Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB)" cohort study. 4,860 study participants identified from a representative age-stratified sample of Würzburg residents were asked to provide a blood sample and to fill in a questionnaire. All participants also received an offer to take part in a point prevalence assessment (nasal swab taken from the participant at the beginning of November 2020). RESULTS: A total of 3,034 subjects took part in the STAAB-COVID program (response rate 62%). Antibodies against SARS-CoV-2 were detected in 33 participants (1.1%; 95% confidence interval 0.7-1.5%). Higher values on the GAD-7 anxiety scale were associated with lower rates of SARS-CoV-2 antibodies (Odds Ratio=0.78 for each+1 point in GAD-7; 95% confidence interval 0.65-0.95). Within this rather anxious group of subjects, however, the rate of cancellation of medical appointments was also increased (Odds Ratio=1.13 for each+1 point in GAD-7; 95% confidence interval 1.10-1.16). An acute infection was detected in six of a total of 2,451 participants in the point prevalence assessment (0.24%; 95% confidence interval 0.09-0.53%). CONCLUSION: Between the first and second COVID-19 waves in Germany, we found a low level of SARS-CoV-2 contamination in the city of Würzburg. A more anxious personality was associated with a lower seroprevalence. Conducting the study was largely facilitated by the existing cohort study.

Lung Ultrasound as a Screening Method for Interstitial Lung Disease in Patients With Systemic Sclerosis.

BACKGROUND: Patients with systemic sclerosis (SSc) undergo chest radiographs and high-resolution computed tomography (HRCT) of the thorax both for interstitial lung disease (ILD) detection and for disease progression monitoring. OBJECTIVE: The aim of this study was to assess whether lung ultrasound (LUS) is a useful screening tool for ILD in patients with SSc in comparison with HRCT. METHODS: This was a longitudinal cohort study carried out from December 2015 to April 2016. An LUS was performed to examine B-lines in 67 consecutive patients who met the 2013 American College of Rheumatology/European League Against Rheumatism classification criteria for SSc and had a previous HRCT. B-lines were quantified and classified according to the score modified from Picano. Severity and extent of lung involvement on the HRCT were determined by means of the Warrick score. RESULTS: Twenty-nine patients had both abnormal HRCT (Warrick score >7) and abnormal LUS, 2 had a mild score (6-15 B-lines), and 27 had either moderate or severe scores (≥16 B-lines). Of the 38 patients with negative HRCT, 25 presented some degree of lung involvement on the LUS. Thus, LUS has a sensitivity of 100% and a specificity of 34%. Receiver operating characteristic curve analysis showed the analytic relation between the number of B-lines and the presence of ILD on the HRCT (area under the curve, 0.80; 95% confidence interval, 0.69-0.90). CONCLUSIONS: Lung ultrasound may be a method to detect abnormal lung findings in a noninvasive manner in patients with SSc. Because of its high sensitivity, a low score almost rules out the need for an HRCT.

Brain State Differentiation and Behavioral Inflexibility in Autism.

Autism spectrum disorders (ASDs) are characterized by social impairments alongside cognitive and behavioral inflexibility. While social deficits in ASDs have extensively been characterized, the neurobiological basis of inflexibility and its relation to core clinical symptoms of the disorder are unknown. We acquired functional neuroimaging data from 2 cohorts, each consisting of 17 children with ASDs and 17 age- and IQ-matched typically developing (TD) children, during stimulus-evoked brain states involving performance of social attention and numerical problem solving tasks, as well as during intrinsic, resting brain states. Effective connectivity between key nodes of the salience network, default mode network, and central executive network was used to obtain indices of functional organization across evoked and intrinsic brain states. In both cohorts examined, a machine learning algorithm was able to discriminate intrinsic (resting) and evoked (task) functional brain network configurations more accurately in TD children than in children with ASD. Brain state discriminability was related to severity of restricted and repetitive behaviors, indicating that weak modulation of brain states may contribute to behavioral inflexibility in ASD. These findings provide novel evidence for a potential link between neurophysiological inflexibility and core symptoms of this complex neurodevelopmental disorder.

The neural basis of contextual influences on face categorization.

From only brief exposure to a face, individuals spontaneously categorize another's race. Recent behavioral evidence suggests that visual context may affect such categorizations. We used fMRI to examine the neural basis of contextual influences on the race categorization of faces. Participants categorized the race of faces that varied along a White-Asian morph continuum and were surrounded by American, neutral, or Chinese scene contexts. As expected, the context systematically influenced categorization responses and their efficiency (response times). Neuroimaging results indicated that the retrosplenial cortex (RSC) and orbitofrontal cortex (OFC) exhibited highly sensitive, graded responses to the compatibility of facial and contextual cues. These regions showed linearly increasing responses as a face became more White when in an American context, and linearly increasing responses as a face became more Asian when in a Chinese context. Further, RSC activity partially mediated the effect of this face-context compatibility on the efficiency of categorization responses. Together, the findings suggest a critical role of the RSC and OFC in driving contextual influences on face categorization, and highlight the impact of extraneous cues beyond the face in categorizing other people.

Group-based discrimination in judgments of moral purity-related behaviors: experimental and archival evidence.

Knowledge of individuals' group membership can alter moral judgments of their behavior. We found that such moral judgments were amplified when judgers learned that a person belonged to a group shown to elicit disgust in others. When a person was labeled as obese, a hippie, or "trailer trash," people judged that person's behavior differently than when such descriptors were omitted: Virtuous behaviors were more highly praised, and moral violations were more severely criticized. Such group-based discrimination in moral judgment was specific to the domain of moral purity. Members of disgust-eliciting groups but not members of other minorities were the target of harsh judgments for purity violations (e.g., lewd behavior) but not for other violations (e.g., refusing to help others). The same pattern held true for virtuous behaviors, so that members of disgust-eliciting groups were more highly praised than others but only in the purity domain. Furthermore, group-based discrimination was mediated by feelings of disgust toward the target group but not by other emotions. Last, analysis of New York Police Department officers' encounters with suspected criminals revealed a similar pattern to that found in laboratory experiments. Police officers were increasingly likely to make an arrest or issue a summons as body mass index increased (i.e., as obesity rose) among people suspected of purity crimes (e.g., prostitution) but not of other crimes (e.g., burglary). Thus, moral judgments in the lab and in the real world exhibit patterns of discrimination that are both group and behavior specific.

Asma bronquial y Medicinas complementarias-alternativas

La frecuencia y patrones de uso de Medicinas Complementarias-Alternativas (MCA) entre pacientes con asma bronquial es desconocida en nuestro país. El objetivo de este trabajo fue evaluar el uso de MCA entre pacientes con asma y comparar sus características con quienes no usaban esos recursos. Materiales y métodos: Entre 30-6-2005 y 30-6-2012, 635 pacientes mayores de 16 años con diagnóstico de asma fueron evaluados mediante entrevistas cara a cara con su médico en tres centros de las ciudades de Buenos Aires y General Rodríguez. La encuesta tuvo el carácter de anónima y voluntaria e incluyó variables demográficas, el tiempo de evolución de la enfermedad, la obstrucción al flujo aéreo medido por espirometria, parámetros de severidad y niveles control del asma. Se interrogó sobre el uso de al menos una vez por el lapso de un mes de alguna MCA, el tiempo de uso, la utilización simultánea o no de medicina alopática (MA), el tipo de MCA elegida y el resultado obtenido. Resultados: No se registraron rechazos a participar en el estudio; 246/635 (38.7%) de los pacientes usaron MCA con un valor de mediana de 12 meses (rango 0-359); entre ellos, un 39% habían abandonado la MA y un 15% todavía recurrían a alguna MCA. En el grupo con MCA había pacientes de mayor edad, mayor presencia de mujeres, tiempos de evolución más prolongados, niveles más altos de severidad y menor frecuencia de asma controlada, frente al grupo sin uso de MCA. Los resultados principales fueron mejoría o sin cambios (46% cada uno). Las MCA más frecuentemente elegidas fueron hierbas, homeopatía, acupuntura y yoga, encontrándose diferencias significativas según características demográficas, el uso simultáneo de MA y el reporte de resultados. Conclusiones: El uso de MCA entre nuestros pacientes con asma se asemeja a otras experiencias internacionales. Sin embargo, se requieren nuevas encuestas multicéntricas para alcanzar un estudio más profundo sobre los patrones regionales y nacionales de uso de MCA.(AU)

The frequency and patterns of Complementary-Alternative Medicines (CAM) use among asthmatic patients are unknown in our country. The objective of this work was to evaluate the CAM use in asthmatic patients and to compare their characteristics with those of asthmatic patients who are not CAM users. Materials and methods: Between 30 June 2005 and 30 June 2012, 635 patients with a diagnosis of asthma older than 15 years were evaluated through face-to-face interviews carried out by their own physicians in three clinics of Buenos Aires and General Rodriguez cities. The interviews were anonymous and free, and included the registry of variables such as demographic characteristics, evolution time from onset, airway obstruction by spirometry, levels of severity and control measures. Patients were asked if they had used any CAM at least once by a minimum period of a month, time of the intervention, simultaneous or not use of allopathic medicine (AM), type of CAM chosen and self-reported results. Results: All patients agreed to co-operate, and 246/635 (38.7%) referred having used CAM for a median period of 12 months (range 0-359); while using the alternative treatment, 39% of them had abandoned the AM and 15% were still using any kind of CAM. In comparison with non users, alternative users tended to be older and females, and to have longer time from the onset of symptoms, higher levels of severity and lower periods of controlled asthma. The main reported results were improvement and no change (46% each). The mainly CAM chosen were herbs, homeopathy, acupuncture and yoga. Significant differences were found according to demographic characteristics, simultaneous use of AM and self-reported results. Conclusions: Use of CAM among our asthmatic patients appears to be similar to that reported in other international experiences. However, new multicenter surveys are needed to reach a deeper insight into both regional and national patterns of use.(AU)

Asma bronquial y Medicinas complementarias-alternativas / Bronchial Asthma and Complementary-Alternative Medicines

La frecuencia y patrones de uso de Medicinas Complementarias-Alternativas (MCA) entre pacientes con asma bronquial es desconocida en nuestro país. El objetivo de este trabajo fue evaluar el uso de MCA entre pacientes con asma y comparar sus características con quienes no usaban esos recursos. Materiales y métodos: Entre 30-6-2005 y 30-6-2012, 635 pacientes mayores de 16 años con diagnóstico de asma fueron evaluados mediante entrevistas cara a cara con su médico en tres centros de las ciudades de Buenos Aires y General Rodríguez. La encuesta tuvo el carácter de anónima y voluntaria e incluyó variables demográficas, el tiempo de evolución de la enfermedad, la obstrucción al flujo aéreo medido por espirometria, parámetros de severidad y niveles control del asma. Se interrogó sobre el uso de al menos una vez por el lapso de un mes de alguna MCA, el tiempo de uso, la utilización simultánea o no de medicina alopática (MA), el tipo de MCA elegida y el resultado obtenido. Resultados: No se registraron rechazos a participar en el estudio; 246/635 (38.7%) de los pacientes usaron MCA con un valor de mediana de 12 meses (rango 0-359); entre ellos, un 39% habían abandonado la MA y un 15% todavía recurrían a alguna MCA. En el grupo con MCA había pacientes de mayor edad, mayor presencia de mujeres, tiempos de evolución más prolongados, niveles más altos de severidad y menor frecuencia de asma controlada, frente al grupo sin uso de MCA. Los resultados principales fueron mejoría o sin cambios (46% cada uno). Las MCA más frecuentemente elegidas fueron hierbas, homeopatía, acupuntura y yoga, encontrándose diferencias significativas según características demográficas, el uso simultáneo de MA y el reporte de resultados. Conclusiones: El uso de MCA entre nuestros pacientes con asma se asemeja a otras experiencias internacionales. Sin embargo, se requieren nuevas encuestas multicéntricas para alcanzar un estudio más profundo sobre los patrones regionales y nacionales de uso de MCA.

The frequency and patterns of Complementary-Alternative Medicines (CAM) use among asthmatic patients are unknown in our country. The objective of this work was to evaluate the CAM use in asthmatic patients and to compare their characteristics with those of asthmatic patients who are not CAM users. Materials and methods: Between 30 June 2005 and 30 June 2012, 635 patients with a diagnosis of asthma older than 15 years were evaluated through face-to-face interviews carried out by their own physicians in three clinics of Buenos Aires and General Rodriguez cities. The interviews were anonymous and free, and included the registry of variables such as demographic characteristics, evolution time from onset, airway obstruction by spirometry, levels of severity and control measures. Patients were asked if they had used any CAM at least once by a minimum period of a month, time of the intervention, simultaneous or not use of allopathic medicine (AM), type of CAM chosen and self-reported results. Results: All patients agreed to co-operate, and 246/635 (38.7%) referred having used CAM for a median period of 12 months (range 0-359); while using the alternative treatment, 39% of them had abandoned the AM and 15% were still using any kind of CAM. In comparison with non users, alternative users tended to be older and females, and to have longer time from the onset of symptoms, higher levels of severity and lower periods of controlled asthma. The main reported results were improvement and no change (46% each). The mainly CAM chosen were herbs, homeopathy, acupuncture and yoga. Significant differences were found according to demographic characteristics, simultaneous use of AM and self-reported results. Conclusions: Use of CAM among our asthmatic patients appears to be similar to that reported in other international experiences. However, new multicenter surveys are needed to reach a deeper insight into both regional and national patterns of use.

Math anxiety in second and third graders and its relation to mathematics achievement.

Although the detrimental effects of math anxiety in adults are well understood, few studies have examined how it affects younger children who are beginning to learn math in a formal academic setting. Here, we examine the relationship between math anxiety and math achievement in second and third graders. In response to the need for a grade-appropriate measure of assessing math anxiety in this group we first describe the development of Scale for Early Mathematics Anxiety (SEMA), a new measure for assessing math anxiety in second and third graders that is based on the Math Anxiety Rating Scale. We demonstrate the construct validity and reliability of the SEMA and use it to characterize the effect of math anxiety on standardized measures of math abilities, as assessed using the Mathematical Reasoning and Numerical Operations subtests of the Wechsler Individual Achievement Test (WIAT-II). Math achievement, as measured by the WIAT-II Math Composite score, was significantly and negatively correlated with SEMA but not with trait anxiety scores. Additional analyses showed that SEMA scores were strongly correlated with Mathematical Reasoning scores, which involves more complex verbal problem solving. SEMA scores were weakly correlated with Numerical Operations which assesses basic computation skills, suggesting that math anxiety has a pronounced effect on more demanding calculations. We also found that math anxiety has an equally detrimental impact on math achievement regardless of whether children have an anxiety related to numbers or to the situational and social experience of doing math. Critically, these effects were unrelated to trait anxiety, providing the first evidence that the specific effects of math anxiety can be detected in the earliest stages of formal math learning in school. Our findings provide new insights into the developmental origins of math anxiety, and further underscore the need to remediate math anxiety and its deleterious effects on math achievement in young children.

Oxytocin Receptor (OXTR) Polymorphisms and Attachment in Human Infants.

Ordinary variations in human infants' attachment behaviors - their proclivity to seek and accept comfort from caregivers - are associated with a wide range of individual differences in psychological functioning in adults. The current investigation examined variation in the oxytocin receptor (OXTR) gene as one possible source of these variations in infant attachment. One hundred seventy-six infants (77 Caucasian, 99 non-Caucasian) were classified as securely or insecurely attached based on their behavior in the Strange Situation (Ainsworth et al., 1978). The A allele of OXTR rs2254298 was associated with attachment security in the non-Caucasian infants (p < 0.005). These findings underscore the importance of oxytocin in the development of human social behavior and support its role in social stress-regulation and the development of trust.

What difference does a year of schooling make? Maturation of brain response and connectivity between 2nd and 3rd grades during arithmetic problem solving.

Early elementary schooling in 2nd and 3rd grades (ages 7-9) is an important period for the acquisition and mastery of basic mathematical skills. Yet, we know very little about neurodevelopmental changes that might occur over a year of schooling. Here we examine behavioral and neurodevelopmental changes underlying arithmetic problem solving in a well-matched group of 2nd (n = 45) and 3rd (n = 45) grade children. Although 2nd and 3rd graders did not differ on IQ or grade- and age-normed measures of math, reading and working memory, 3rd graders had higher raw math scores (effect sizes = 1.46-1.49) and were more accurate than 2nd graders in an fMRI task involving verification of simple and complex two-operand addition problems (effect size = 0.43). In both 2nd and 3rd graders, arithmetic complexity was associated with increased responses in right inferior frontal sulcus and anterior insula, regions implicated in domain-general cognitive control, and in left intraparietal sulcus (IPS) and superior parietal lobule (SPL) regions important for numerical and arithmetic processing. Compared to 2nd graders, 3rd graders showed greater activity in dorsal stream parietal areas right SPL, IPS and angular gyrus (AG) as well as ventral visual stream areas bilateral lingual gyrus (LG), right lateral occipital cortex (LOC) and right parahippocampal gyrus (PHG). Significant differences were also observed in the prefrontal cortex (PFC), with 3rd graders showing greater activation in left dorsal lateral PFC (dlPFC) and greater deactivation in the ventral medial PFC (vmPFC). Third graders also showed greater functional connectivity between the left dlPFC and multiple posterior brain areas, with larger differences in dorsal stream parietal areas SPL and AG, compared to ventral stream visual areas LG, LOC and PHG. No such between-grade differences were observed in functional connectivity between the vmPFC and posterior brain regions. These results suggest that even the narrow one-year interval spanning grades 2 and 3 is characterized by significant arithmetic task-related changes in brain response and connectivity, and argue that pooling data across wide age ranges and grades can miss important neurodevelopmental changes. Our findings have important implications for understanding brain mechanisms mediating early maturation of mathematical skills and, more generally, for educational neuroscience.

Tasas de conversiones tuberculínicas entre trabajadores de la salud / Tuberculin conversion rates among health care workers

Las tasas de conversiones tuberculínicas (TCT) permiten detectar tempranamente nuevos infectados entre los trabajadores de la salud (TS). Sobre 544 trabajadores con reacciones negativas, 275 aceptaron realizarse una nueva dosis de 2 UT de PPD al año siguiente. Se evaluaron enfermeras, médicos, técnicos, administrativos, bioquímicos, kinesiólogos, instrumentadoras, farmacéuticas, psicólogos y otros. Se consideró convertidor tuberculínico a aquel TS con reacción al PPD de 10 mm o mayores, al que se le indicó isoniazida a razón de 5 mg/kg una vez descartada tuberculosis en actividad. La media de edad fue de 45.6 ± 11.3 años y el sexo femenino constituyó el 76.3% de la muestra (210/275). Un 36.7% la integraron enfermeras (101/275), 17.7% fueron médicos, 14.9% técnicos, 10.9% administrativos, 5.1% bioquímicos y otros (14.5%). La tasa de conversión global fue de 8.3%, 11.8% en enfermeras, 10% en administrativos, 7.3% en técnicos, 7.1% en bioquímicos y 2% en médicos (p = NS). Se indicó isoniazida en 23 TS, con un cumplimiento del 52%. En el año de observación se denunciaron 8 casos nuevos de tuberculosis entre TS de nuestro hospital. La TCT en nuestro hospital es aún elevada, la actividad de enfermería es el grupo más vulnerable. Se considera ineludible la adopción de medidas de bioseguridad adecuadas.

At the intersection of social and cognitive development: internal working models of attachment in infancy.

Three visual habituation studies using abstract animations tested the claim that infants' attachment behavior in the Strange Situation procedure corresponds to their expectations about caregiver-infant interactions. Three unique patterns of expectations were revealed. Securely attached infants expected infants to seek comfort from caregivers and expected caregivers to provide comfort. Insecure-resistant infants not only expected infants to seek comfort from caregivers but also expected caregivers to withhold comfort. Insecure-avoidant infants expected infants to avoid seeking comfort from caregivers and expected caregivers to withhold comfort. These data support Bowlby's (1958) original claims-that infants form internal working models of attachment that are expressed in infants' own behavior.

Exercise and muscle strength training and their effect on quality of life in patients with chronic heart failure.

BACKGROUND: There is now evidence that moderate training plays an important role in the treatment of chronic heart failure. No clear instructions exist to date as to how such training programs should be carried out. AIM: to assess the efficiency of a training program including bicycle ergometer training, moderate muscle strength training and the 6-min walk test and their influence on quality of life, anxiety and depression. METHODS AND RESULTS: Patients (67 male, 21 female) underwent a standardized 4-week training program. BASELINE DATA: LVEF=31+/-8%; LVEDD=143+/-59 ml; peak VO(2)=13.9+/-4.6 kg/ml. No adverse side effects could be observed. At discharge LVEF was 37+/-9%, (P=0.001); LVEDD=131+/-44ml (P=0.01); and peak VO(2)=15.4+/-5.0 kg/ml. Quality of life improved significantly in nearly all domains and in summary score. There were no significant changes in anxiety and depression. There is a negative correlation between the initial workload and changes in physical health (r=-0.42, P=0.001) and only a weak correlation between age and positive changes in physical health (r=0.26, P=0.05). CONCLUSIONS: A standardized training program including moderate muscle strength training could be performed safely and demonstrated improvement in clinical parameters and quality of life.

Resultados preliminares de um programa de deteccao precoce para o hipotireoidismo congenito no Rio Grande do Sul / Preliminary results of one program of precocious detection by congenital hypothyroidism in the Rio Grande do Sul

Este trabalho tem por objetivo relatar os primeiros resultados do programa de deteccao precoce de hipotireoidismo congenito realizado no periodo de janeiro de 1988 a junho de 1989 no Rio Grande do Sul. Dos 307.781 nascimentos ocorridos naquele periodo, 21.722 criancas com idade entre 7 e 90 dias foram testadas (5,7% da populacao). No estudo, uma amostra de sangue foi coletada em papel filtro para dosagem de T4 por RIE. Das 21722 criancas testadas no periodo, 42 tiveram resultados anormais (abaixo de 6 ng%) e foram encaminhadas para avaliacao complementar em um centro de referencia. Nas 30, nas quais a investigacao diagnostica pode ser completada, encontraram-se 8 casos com T4 serico baixo, o que correspondeu a uma frequencia de 1:2750 recem-nascidos testados. O T4 serico baixo ocorre em situacoes comuns: hipotireoidismo congenito e deficienciade TBG. O valor preditivo positivo do teste de triagem foi de 27%. Tanto a frequencia dos disturbios quanto o valor preditivo deste sao comparaveis com os encontrados na literatura .

Resultados preliminares de um programa de deteccao precoce para aminoacidopatias no Rio Grande do Sul / Preliminary results of one program of detectation precocious for amino acid diseases in the Rio Grande do Sul

Este trabalho apresenta os primeiros resultados de um programa de deteccao para aminoacidopatias realizado na populacao de criancas nascidas entre 1987 e 1989 no Rio Grande do Sul. 28.576 criancas de 7 a 90 dias de vida foram triadas atraves de uma cromatografia em camada delgada. Destas, 33 criancas tiveram resultados anormais. Encontraram-se 7 casos de tirosinemia neonataltransitoria, 2 casos de fenilcetonuria classica, 1 caso de hiperfenilalaninemia transitoria e 5 casos com disturbios inespecificos transitorios. Estes resultados correspondem a uma frequencia de tirosinemia transitoria de 1:4082 recem-nascidos e de fenilcetonuria classica de 1:14.288. O valor preditivo positivo do teste foi de 54% .

Age-related concentrations of glycosaminoglycans in Random urine: a contribution to the lavoratorial detection of mucopolysaccharidoses

As mucopolissacridoses (MPS) säo rotineiramente detectadas pela dosagem de glicosaminoglicanos (GAG), usualmente realizadas em urina de 24 horas. Como os pacientes suspeitos säo geralmente crianças sem controle miccional e a excreçäo de GAG varia com a idade, nós estudamos os valores de GAG em amostras ocasionais de urina de 78 crianças normais e de 16 pacientes com MPS de 6 meses a 12 anos de idade. Este trabalho teve objetivos (a) estabelecer valores normais para os índices urinários GAG/volume (GAG/L e GAG/cratinina (GAG/creat), relacionados com a idade, e (b) testar a utilidade desses índices na identificaçäo de pacientes com MPS. Nos dois índices a concentraçäo de GAG diminui com a idade. Os índices GAG/L e GAG/CREAT discriminaram todos os pacientes, com uma exceçäo em cada índice, em pacientes diferentes. Nossos resultados indicam que amostras ocasionais de urina säo adequadas para a dosagem de GAG desde que os índices de GAG/L e GAG/CREAT sejam avaliados simultanemante e que a idade do paciente seja considerada na interpretaçäo dos resultados, especialmente em crianças pequenas

Dosagem de ácido siálico urinário em crianças normais e sua aplicaçäo para a determinaçäo de sialidoses e sialúrias / Urinary sialic acid measurement in normal childrens and it application in sialidosis and sialuria determination

A determinaçäo do ácido siálico urina é um método útil para a detecçäo de diversas doenças genéticas nas quais há um distúrbio no metabolismo desse composto, denominadas "sialidoses" (incluindo sialidose e galactosialidose) "sialúrias" (incluindo doenças de Salla e doença infantil de acúmulo de ácido siálico). Neste trabalho foram determinadas as concentraçöes urinárias de ácido siálico em 43 crianças normais, cujas idades variaram de 6 meses a 8 anos e meio. Foram estabelecidos os níveis normais para a concentraçäo urinária de ácido siálico livre e total, os quais declinaram sensivelmente com o aumento da idade. A medida da fraçäo livre é recomendada uma vez que seu aumento ocorre nas sialúrias, enquanto que nas sialidoses o que ocorre é um aumento da fraçäo ligada. Os dados apresentados säo importantes para a interpretaçäo dos resultados da dosagem de ácido siálico urinário em crianças, tendo sua utilidade sido comprovada pela avaliaçäo de dois casos de sialidose previamente diagnosticados