O sexo masculino como o principal fator de risco associado ao infarto agudo do miocárdio em pacientes jovens

Fundamento: Embora o infarto agudo do miocárdio (IAM) em pacientes jovens apresente crescente incidência nos últimos anos. Foram observadas as incidências em pacientes jovens, avaliaram 36 pacientes com idade média de 38 anos(29-44), sendo a grande maioria do sexo masculino, com história de tabagismo... Background: Although acute myocardial infarction (AMI) in young patients present increasing incidence in recent years. Incidences were observed in young patients, evaluated 36 patients with mean age of 38 years (29-44), while the vast majority of males with a history of smoking ... .

Flow injection preconcentration system using a new functionalized resin for determination of cadmium and nickel in tobacco samples.

A solid-phase extraction method combined with flow injection (FI) on-line flame atomic absorption spectrometry (FAAS) for the determination of cadmium and nickel in tobacco samples is presented. The 2-aminothiophenol functionalized Amberlite XAD-4 (AT-XAD) resin was synthesized by covalent coupling of the ligand with the copolymer through a methylene group. A minicolumn packed with AT-XAD was connected into the automated on-line preconcentration system. Elution of metal ions from minicolumn can be made with 0.50 mol L(-1) hydrochloric acid solution. With a consumption of 21.0 mL of sample solution, detection limits (3 s) of 0.3 (Cd) and 0.8 microg L(-1) (Ni) were achieved at a sample throughput of 18 h(-1). Enrichment factors (EF) of 99 (cadmium) and 43 (nickel) were obtained compared with the slope of the linear portion of the calibration curves before and after preconcentration. The contents of Cd and Ni in a certified reference material (NIST 1570a, spinach leaves) determined by the present method was in good agreement with the certified value. The developed procedure was also successfully applied to the determination of Cd and Ni in local tobacco samples.

The effect of timpanoplasty on tinnitus in patients with conductive hearing loss: a six month follow-up.

UNLABELLED: Tympanoplasty is done to eradicate ear pathology and to restore the conductive hearing mechanism (eardrum and ossicles). Some patients, however, do not tolerate tinnitus and question physicians about the results of surgery when tinnitus persists. AIM: to evaluate the progression of tinnitus in patients with conductive hearing loss after tympanoplasty. STUDY DESIGN: a prospective cohort study. MATERIAL AND METHODS: 23 consecutive patients with tinnitus due to chronic otitis media underwent tympanoplasty. The patients underwent a medical and audiological protocol for tinnitus before and after tympanoplasty. RESULTS: 82.6% of patients had improvement or elimination of tinnitus after tympanoplasty The mean score of postoperative intolerance to tinnitus (1.91 for 30 and 180 days) was significantly different from preoperative scores (5.26). As to hearing loss, patients improved medically 30 and 180 days after surgery (3.65 and 2.91) compared to the preoperative condition (6.56). Audiometry revealed improvement at all frequencies from 0.25 to 6KHz, except at 8KHz. The air-bone gap was closed or was within 10dB in 14 cases (61%). An intact tympanic membrane was achieved in 78% of the cases. CONCLUSION: Aside from the classical improvement of hearing loss, tympanoplasty also offers good control of tinnitus.

Efeito da timpanoplastia no zumbido de pacientes com hipoacusia condutiva: seguimento de seis meses / The effect of timpanoplasty on tinnitus in patients with conductive hearing loss: a six month follow-up

O timpanoplastia tem como objetivos erradicar a doença da orelha média e restaurar os mecanismos de condução sonora. Contudo, alguns pacientes apresentam incômodo com o zumbido e muitas vezes questionam o médico sobre os resultados da cirurgia em relação ao zumbido. OBJETIVO: Avaliar a evolução do zumbido em pacientes com hipoacusia condutiva após timpanoplastia. Forma de Estudo: Coorte prospectiva. CASUíSTICA E MÉTODO: Foram avaliados 23 pacientes com queixa de zumbido e diagnóstico de otite média crônica simples com indicação cirúrgica. Os pacientes foram submetidos a um protocolo de investigação médica e audiológica do zumbido antes, 30 e 180 dias após a timpanoplastia. RESULTADOS: 82,6 por cento dos pacientes apresentaram melhora ou abolição do zumbido. Melhora significante do incômodo do zumbido no pré-operatório (5,26) em relação ao pós-operatório (1,91 com 30 e 180 dias), assim como entre o incômodo da perda auditiva pré-operatória (6,56) e pós-operatória (3,65 e 2,91). A audiometria revelou melhora do limiar tonal em todas as freqüências, com exceção de 8KHz, havendo fechamento ou gap máximo de 10dB NA em 61 por cento dos casos. Pega total do enxerto em 78 por cento dos casos. CONCLUSÃO: Além da melhora da perda auditiva, a timpanoplastia também proporciona bons resultados sobre o controle do zumbido.

Tympanoplasty is done to eradicate ear pathology and to restore the conductive hearing mechanism (eardrum and ossicles). Some patients, however, do not tolerate tinnitus and question physicians about the results of surgery when tinnitus persists. AIM: to evaluate the progression of tinnitus in patients with conductive hearing loss after tympanoplasty. STUDY DESIGN: a prospective cohort study. Material and Methods: 23 consecutive patients with tinnitus due to chronic otitis media underwent tympanoplasty. The patients underwent a medical and audiological protocol for tinnitus before and after tympanoplasty. RESULTS: 82.6 percent of patients had improvement or elimination of tinnitus after tympanoplasty The mean score of postoperative intolerance to tinnitus (1.91 for 30 and 180 days) was significantly different from preoperative scores (5.26). As to hearing loss, patients improved medically 30 and 180 days after surgery (3.65 and 2.91) compared to the preoperative condition (6.56). Audiometry revealed improvement at all frequencies from 0.25 to 6KHz, except at 8KHz. The air-bone gap was closed or was within 10dB in 14 cases (61 percent). An intact tympanic membrane was achieved in 78 percent of the cases. CONCLUSION: Aside from the classical improvement of hearing loss, tympanoplasty also offers good control of tinnitus.

The effect of stapedotomy on tinnitus in patients with otospongiosis.

Stapedotomy is primarily performed to treat hearing loss secondary to otospongiosis, although some patients find that the accompanying tinnitus is more bothersome than the hearing loss. We prospectively studied 23 consecutive patients with tinnitus secondary to otospongiosis who had undergone stapedotomy, and we compared their pre- and postoperative medical and audiologic findings. Patients' annoyance with their tinnitus was quantified by means of a visual analog scale, and their air-conduction thresholds were determined by measurements of a 4-frequency pure-tone average (0.5, 1, 2, and 4 kHz). Statistical analysis was performed using the paired Student's t test and Fisher's exact test. In the group as a whole, the mean tinnitus annoyance visual analog scores were 8.34 preoperatively and 1.56 postoperatively, a highly significant difference. Clinically, 22 of the 23 patients (95.7%) achieved satisfactory control of their tinnitus (improvement or complete resolution) following stapedotomy. With respect to hearing loss, all patients clinically improved postoperatively, and audiometry confirmed improvement at all 4 frequencies between 0.5 and 4 kHz. An air-bone gap of less than 10 dB was noted in 17 patients (73.9%). We conclude that in addition to improving hearing, stapedotomy also provides good control of tinnitus.

Efeito da melhora da audição sobre o zumbido em pacientes com hipoacusia condutiva submetidos à timpanoplastia e estapedotomia / Effect of hearing improvement on tinnitus in patients with conductive hearing loss submitted to timpanoplasty and stapedotomy

Com o objetivo de avaliar a correlação entre a melhora da audição e do zumbido em pacientes com hipoacusia condutiva e sua estabilidade a médio prazo, analisamos 33 pacientes submetidos à timpanoplastia ou estapedotomia por meio da audiometria tonal e da nota de incômodo pela escala numérica de 0 a 10, repetindo os procedimentos após 1 e 6 meses de cirurgia. Houve melhora significante do incômodo com a hipoacusia e com o zumbido após 1 e 6 meses, assim como uma correlação positiva entre a variação do incômodo de ambos os sintomas após 1 e 6 meses. Concluímos que os pacientes com zumbido e hipoacusia condutiva submetidos à timpanoplastia ou estapedotomia incomodam-se mais com a hipoacusia do que o zumbido, mas ambos os sintomas apresentam melhora significante no pós-operatório, que se mantém estável entre 1 e 6 meses / In clinical practice, hearing improvement procedures often promote tinnitus improvement as well. The aims of this study were to evaluate: 1) the correlation between hearing improvement and tinnitus evolution in patients with conductive hearing loss submitted to tympanoplasty or stapedotomy; 2) the stability of such results after 1 and 6 months of surgery. Patients with tinnitus and hearing loss with indication of stapedotomy and tympanoplasty have major bannoyance with hearing loss than with tinnitus and show significant and stable improvement after 5 months of surgical follow-up. Tinnitus improvement is correlated with annoyance with hearing loss but not do the audiometric thresholds...

Candidíase oral e leucoplasia pilosa como marcadores de progressão da infecção pelo HIV em pacientes brasileiros / Oral candidiasis and hairy leukoplakia as progression markers of HIV infection in Brazilian patients

Candidíase oral (CO) e leucoplasia pilosa (LP) são importantes indicadores da progressão da infecção pelo vírus da imunodeficiência humana (HIV) para o quadro de AIDS, principalmente em locais onde exames específicos são inacessíveis. OBJETO: Relacionar CO e LP ao número de células CD4+ e à carga viral (CV) em pacientes brasileiros HIV-positivos, confirmando-as como marcadores clínicos confiáveis de progressão da doença. FORMA DE ESTUDO: Coorte longitudinal. CASUíSTICA E MÉTODO: Avaliamos prospectivamente 124 pacientes HIV-positivos, isentos de terapia antiretroviral. Todos foram submetidos a exame ORL, dosagem de células CD4+ e CV, sendo divididos em dois grupos: P e A, de acordo com a presença ou ausência de CO e LP. Depois de seis meses, os pacientes do grupo A foram subdivididos nos subgrupos P6 (presença de lesões) e A6. Dosamos novamente CD4+ e carga viral. Os resultados foram analisados estatisticamente. RESULTADOS: No grupo P (43 pacientes, 28 CO e 15 LP) a contagem de células CD4+ foi menor e a carga viral maior em relação ao grupo A (p<0,001). Após 6 meses, 15 dos 81 pacientes do grupo A foram excluídos por iniciarem terapia antiretroviral. Dezoito (11 CO e 7 LP), passaram a compor o grupo P6. Os demais, sem lesões, compuseram o grupo A6. A contagem de células CD4+ no grupo P6 foi menor (p< 0,001) que no grupo A6. O inverso ocorreu com a carga viral. DISCUSSÃO E CONCLUSÃO: CO e LP indicam contagem de células CD4+ abaixo de 300 cels/mm³ e carga viral elevada, sendo marcadores clínicos confiáveis da progressão da doença.

Reprodutibilidade do teste de modulação somática do zumbido e resultados após treinamento com contrações musculares repetidas / Reliability os tinnitus modulation through muscle contration and results after training with repetitive contractions

Contrações musculares freqüentemente modulam a intensidade do zumbido, sugerindo a existência de conexões anatomofisiológicas entre as vias auditivas e somatossensoriais.