Anatomy of the mastoid triangle and morphometric sex differences.

OBJECTIVE OF THE STUDY: This study aimed to quantify the area of the mastoid triangle (MT) and assess potential morphometric differences between males and females. PATIENTS: The sample consisted of 244 dry human skulls, with biological sex known based on genetic analysis, collected from a medicolegal osteological database from Central-Western Brazil. MATERIALS AND METHODS: The study was observational, analytical, and cross-sectional. The skulls were analyzed using Heron's equation to calculate the area of the MT. The landmarks connecting each of the sides of the triangle were: Porion (Po)>Mastoidale (Ma)>Asterion (Ast). Morphometric references were calculated and compared based on sex. RESULTS: The area of the MT was nearly 14% larger in males compared to females (p<0.05). The mean MT area for the right and left sides of males were 684.11±93.25mm2 and 668.94±111.95mm2, respectively. In females, the mean MT for the right and left sides were 588.93±91.09mm2 and 582.88±102.98mm2, respectively. Right and left side measurements were significantly different (p<0.05), except for Po-Ast (p=0.232). CONCLUSION: Morphometric features regarding the MT were slightly different between males and females. Application of the MT as a dimorphic tool should be adjuvant. Moreover, this tool should be considered carefully, especially because the sex-based differences were statistically significant, but discrete between males and females.

Cross-cultural measurement equivalence of the Healthy Eating Index adapted version for children aged 1-2 years.

The objectives of this study were to evaluate the cross-cultural measurement equivalence of the Healthy Eating Index (HEI) for children aged 1-2 years and to analyse the quality of nutrition of preterm infants. This was a cross-sectional study with 106 premature infants attended in two specialised outpatient clinics of university hospitals. The quality of the diet was analysed through an adapted HEI to meet the dietary recommendations of Brazilian children aged 1-2 years. Food consumption was measured by 24-h recalls. The reliability of the instrument was evaluated by internal consistency analysis and inter-observer reliability using Cronbach's α coefficient and κ with quadratic ponderation. The construct validity was evaluated by principal component analysis and by Spearman's correlation coefficient with total energy and consumption of some groups' food. The diet quality was considered adequate when the total HEI score was over 80 points. Cronbach's α was 0·54. Regarding inter-observer reliability, ten items showed strong agreement (κ > 0·8). The item scores had low correlations with energy consumed (r ≤ 0·30), and positive and moderate correlation of fruit (r 0·67), meat (r 0·60) and variety of diet (r 0·57) with total scores. When analysing the overall quality of the diet, most patients need improvement (median 78·7 points), which can be attributed to low total vegetable intake and the presence of ultraprocessed foods in the diet. The instrument showed auspicious psychometric properties, being promising to evaluate the quality of the diet in children aged 1-2 years.

Prevalence of agenesis of frontal sinus in human skulls with metopism.

BACKGROUND: The frontal bone is an anatomical structure of the skull separated by the metopic suture in the childhood. The scientific literature indicates that metopic suture consolidates with closure in the early stages of life. Metopism is the term used to describe a metopic suture that persists up to the adulthood. Persistent metopic suture is associated potentially with the agenesis of the frontal sinus. AIM: To investigate the prevalence of absent frontal sinuses in dry skulls with metopism. MATERIALS AND METHODS: The present study was performed after the approval of the local Committee of Ethics in Research. The sample consisted of dry skulls (n=245), aging between 17 and 50 years old, of the Forensic Medical Institute of Goiânia, Brazil. The skulls underwent anthropological exam in the search for metopism. Radiographic exam was performed in the skulls with metopism to verify the presence or absence of the frontal sinus. The radiographic assessment was performed with a Mobile DaRt Evolution device (Shimadzu, Kyoto, Japan) with protocol set in 64 kV and 16 mA). RESULTS: From the 245 dry skulls, 17 presented metopism. The length of the metopic suture in the skulls, considering the distances between nasio and bregma craniometric landmarks, ranged between 114 mm and 137 mm. Radiographic exams were performed on 16 skulls (one skull was not analysed radiographically because of extensive destruction). Only one skull (6.25%) had the frontal sinus absent. Besides the agenesis, the present study also found four (12.5%) skulls with aplasia and eight (25.0%) hyperplasia of the frontal sinus in dry skulls with metopism. CONCLUSION: The present study found a low prevalence rate of the agenesis of frontal sinuses in dry skulls with metopism.

Neurophysiological, behavioral and morphological abnormalities in the Fabry knockout mice.

Fabry disease (OMIM 301500) is a rare X-linked recessive disorder caused by mutations in the alpha-galactosidase gene (GLA). Loss of alpha-galactosidase (alpha-Gal) activity leads to the abnormal accumulation of glycosphingolipids in lysosomes predominantly of vascular endothelial cells. Clinically the disorder presents with angiokeratomas, clouding of the cornea, and renal, cardiac, and cerebrovascular complications. In addition, there is an increased incidence of neuropathic pain in Fabry patients. In this study, we investigated the implications of loss of alpha-galactosidase A activity on sensorimotor function and peripheral nervous system. Similar to the described in Fabry disease patients, the sensorimotor assessment of Fabry mice revealed diminished locomotor activity and warm hypoalgesia as assessed in the hot-plate. Moreover Fabry mice displayed alterations both in balance and co-ordination. By histological analysis, the cyto-architecture of Fabry mice sciatic nerves showed an increase in mean cross-sectional area accompanied by a decrease in the density of non-myelinated fibers as well as a trend for a decreased number of small myelinated fibers, a well established feature of Fabry disease. A relative preservation of large myelinated fibers and nerve conduction velocity measurements was observed. Our findings demonstrate for the first time that Fabry knockout mice have Gb3 accumulation in the peripheral nervous system, alterations in sensorimotor function, hypoalgesia and no impairment of motor nerve conduction.

Methamphetamine exacerbates the toxic effect of kainic acid in the adult rat retina.

The recreational use of the psychoactive drug, methamphetamine has increased markedly over the last three decades. It has long been known that this drug has detrimental effects upon the mammalian brain monoaminergic system, but the long- or short-term effects on the retina, a neurological extension of the central nervous system, have received little attention. The aim of this study was, therefore, to determine whether intraocular injection of methamphetamine (MA) is toxic to the healthy adult rat retina and to analyse its effects on the compromised retina after an injection of the ionotropic glutamate receptor agonist, kainate, which is known to cause retinal neuropathology. The equivalent of 1 mM (in the vitreous humour) MA and/or kainate (40 microM) were injected intravitreally. Flash electroretinograms (ERGs) were recorded before and 2 and 4 days after treatment. Five days after treatment, animals were killed and the retinas analysed either for the immunohistochemical localisation of various antigens or for electrophoresis/Western blotting. Some animals were kept for 19 days after treatment and the retinas analysed for tyrosine hydroxylase immunoreactivity. No differences could be found between vehicle- and MA-treated retinas with respect to the nature or localisation of either tyrosine hydroxylase immunoreactivity after 5 or 19 days or other antigens after 5 days. Moreover, the normal ERG and GFAP and calretinin protein antigens were unaffected by MA. Kainate treatment, however, caused a change in the ERGs after 2 and 4 days, an alteration in every antigen localised by immunohistochemistry and an increase in the retinal levels of calretinin and GFAP proteins. Significantly, the changes seen in the b-wave amplitude and implicit time of the ERG after 4 days and the increased level of GFAP protein after 5 days following kainate treatment were enhanced when MA was co-injected. Intravitreal injection of methamphetamine had no detectable detrimental effect on the normal adult rat retina but exacerbated the damaging effects of kainic acid. Such data suggest that a neurotoxic effect of MA may be more obviously illustrated when the tissue is already compromised as occurs in, for example, ischemia.

Validation of national algorithms for the diagnosis of sexually transmitted diseases in Brazil: results from a multicentre study.

OBJECTIVE: To validate STD flow charts for the management of genital discharge and genital ulcer currently recommended by the National STD Control Programme in Brazil. METHODS: A study was conducted in five Brazilian STD clinics from January to June 1995. After an interview, a clinical examination was performed by a physician, who recorded a presumptive diagnosis, based on his/her clinical experience. This diagnosis was compared with a gold standard laboratory diagnosis in order to calculate sensitivity, specificity, and positive predictive value of the clinical diagnosis. The validity of the simulated national flow charts was assessed using the same method. RESULTS: A total of 607 men and 348 women participated in the study. Gonorrhoea was the aetiology most frequently detected in men with urethral discharge. The sensitivity of the clinical diagnosis was far lower than the sensitivity fo the national flow chart, using the syndromic approach, for both gonococcal and chlamydial urethritis. Adding a simple laboratory test (Gram stain) to the national flow chart increased the specificity and positive predictive value for gonorrhoea. Among the women with vaginal discharge, a cervical infection was detected in 17%, a vaginal infection in 74%, and mixed infection in 9%. The sensitivity of the diagnosis for cervical infection increased from 16% (clinical aetiological approach) to 54% (when adding a syndromic approach) and to 68% when adding a risk assessment, as in the national flow charts. The cure or improved rate of genital ulcers was 96% after 1 week. CONCLUSIONS: The results of the study will help to convince policy makers and those involved in training healthcare workers in Brazil of the public health advantages of the syndromic approach, as an essential part of STD/HIV control activities.

AIDS in Brazil, 1982-1988.

AIDS was first identified in Brazil in 1982, and by mid-1988 a total of 3,952 cases had been detected. The highest concentrations of cases have occurred in the Southeast region of the country (81.8%), which includes the States of Rio de Janeiro and São Paulo, and in the 25-to-40 year-old age group (58.2%). Sexual transmission is responsible for 72.8% of the cases; 18.8% of the cases were transmitted by contact with contaminated blood or blood products; perinatal transmission is responsible for 1.0% of the total recorded cases. On the basis of serologic surveys of certain population groups and projections of the prevalence of infection based on the number of actual cases at the end of 1987, the number of asymptomatic infected individuals would be between 200,000 and 400,000.

[Updating data and stimulating participation]. / Atualizando dados e estimulando a participacao.

PIP: The analysis of the Brazilian epidemiological situation as of August 1, 1987 showed an annual increase of primary cases of AIDS of 3.5% since 1986 (2.3% to 4.8%). 82.2% of cumulative reported cases occurred in the Southeast region, 62.3% of them in Sao Paulo. Two federal districts, Amapa and Acre, reported no incidence of AIDS. In decreasing order, the populations of Sao Paulo, Rio de Janeiro, the Federal District, and Rio Grande do Sul face a major risk of acquiring infection by HIV. The 25-39 age group had the highest risk. Sexual transmission was the preponderant mode of transmission (78.4%), followed by blood (14.1%), not specified (7.0%), and perinatal (.5%). In the under 15 age group, transmission by blood was the highest (76.4%), followed by perinatal transmission (19.6%). Male adolescents and adults accounted for most cases of AIDS. The sexual mode of transmission (heterosexual) was 37.5% of not specified cases among adolescent and adult females. Mortality has been decreasing as a result of longer survival time of patients and earlier detection because of an improved system of epidemiological surveillance. Using the mathematical model adopted by the World Health Organization, it is estimated that 1000 cases have not been diagnosed or reported to the Minister of Health (33.3%) increasing cumulatively to 3000 for the period. 9000 to 15,000 persons have showed symptoms of infection by HIV. Asymptomatic carriers are estimated to be 150,000 to 300,000. The large number of this group is particularly important in the chain of transmission. The epidemiology of the profile of the AIDS syndrome in Brazil is very similar to that observed in Western Europe and the Americas, but it is distinctly different from that in the countries of Central Africa, especially regarding the mode of transmission.^ieng

Resources needed to culture Chlamydia trachomatis in laboratories of clinics for sexually transmitted diseases.

Genital infections with Chlamydia trachomatis may be more prevalent than infection with Neisseria gonorrhoeae and may have serious sequelae such as epididymitis and pelvic inflammatory disease in adults and conjunctivitis and pneumonia in neonates. A culture of the organism is the most sensitive and specific means for detecting C. trachomatis in the genital tract, yet this procedure is available only in specialized centers and universities. Establishment of a chlamydia laboratory as part of a clinic for sexually transmitted diseases (STD) requires major technical and financial resources. Technical resources include the expertise of technicians as well as specialized equipment, glassware, and reagents. The current (August, 1981) minimal cost of performing a chlamydial culture is estimated to be $14.69.