Do patients with migraine experience an increased prevalence of falls and fear of falling? A cross-sectional study.

OBJECTIVE: To assess the prevalence of falls and fear of falling in patients with migraine compared with controls. DESIGN: Cross-sectional. SETTING: Tertiary headache clinic. PARTICIPANTS: This study consisted of 105 controls and 105 consecutive patients diagnosed with migraine with aura (MA, n=35), migraine without aura (MO, n=35) and chronic migraine (CM, n=35). MAIN OUTCOME MEASURES: Patients were interviewed using a questionnaire containing questions about the history of falls and impairment in balance, and completed the International Falls Efficacy Scale (FES-I). Groups were contrasted using Student's t-test and analysis of variance, and prevalence ratios were estimated. RESULTS: Falls and self-reported impairment in balance are more prevalent in patients with migraine (54% and 69%, respectively) than in controls (2% and 2%, respectively). In particular, patients with CM and MA reported a greater mean number of falls during the previous year {CM 1.4 [standard deviation (SD) 2.2]; MA 2.2 (SD 2.3)} compared with patients with MO [0.5 (SD 1.0); P <0.04] and controls [0.05 (SD 0.2); P <0.002]. The prevalence ratio of falls was greater in patients with MA (7.2; P <0.002) and CM (4.5; P <0.002) compared with controls. Patients with migraine experienced a high level of concern about falls during their daily activities compared with controls (29.8 vs 20.1 points in the FES-I questionnaire; P<0.0001). CONCLUSIONS: The balance impairment of patients with migraine may have a functional impact. Migraine is associated with risk of falling, and patients exhibit a higher prevalence of impairment in balance, falls and fear of falling.

The Role of Resource Density on Energy Allocation in the Neotropical Termite Nasutitermes aff. coxipoensis (Termitidae: Nasutitermitinae).

Organisms acquire energy from environment and must allocate it among different life traits (growth, maintenance and reproduction). Social insects must manage the energy allocation to various levels such as colony growth and caste functions. Here, we addressed the question of whether resource density affects the energy allocation to the number of individuals and caste functions as well as nest's growth rate in the Neotropical termite Nasutitermes aff. coxipoensis (Homgren) (Termitidae: Nasutitermitinae). In a manipulative field experiment, colonies of N. aff. coxipoensis, with known volume, were maintained in plots with three different resource's density (0.32, 0.64 and 1.92 baits/m2) over 3 months. After this period, the number of individuals as well as the caste identity and nest volume were measured. Surprisingly, our results showed that colonies reared in the extremes of resource's density (0.32 and 1.92 baits/m2) produced a higher number of individuals compared with colonies reared with intermediate resource density (0. 64 baits/m2). The mean number of workers increased linearly with resource density; however, the average number of immature was higher in colonies reared with 0.32 baits/m2 compared with colonies reared with 0.64 and 1.92 baits/m2. No significant differences of resource density were observed in the mean number of soldiers, worker/soldier ratio as well as in the nest's growth rate. In conclusion, the resource's density seems to play an important role in determining the investment of energy in the number of individuals and caste in N. aff. coxipoensis colonies.

Analysis of genetic diversity of Hyptis pectinata (L.) Poit. plants using ISSR markers.

Hyptis pectinata, popularly known as 'sambacaitá' or 'canudinho', is a medicinal and aromatic species widely used in the Brazilian Northeast. In Sergipe, the excessive extraction of natural resources may reduce the genetic variability of native plants. Thus, molecular markers have frequently been applied to the characterization of genetic diversity as the basis for germplasm conservation and breeding programs. The objective of the present study was to evaluate the genetic diversity of H. pectinata plants collected in different municipalities of the State of Sergipe using ISSR molecular markers. Thirty-four primers were tested, nine of which were selected for providing reproducible and analyzable amplification products, resulting in 67 polymorphic bands. The expected heterozygosity ranged from 0.32 to 0.45, with a mean of 0.39. Polymorphism information content was of 0.49, which classifies the markers as moderately informative. A dendrogram was constructed using unweighted pair group method with arithmetic mean, forming three clusters: Cluster I (79 plants); Cluster II (4 plants); and Cluster III (2 plants). Jaccard's similarity coefficients ranged from 0.06 to 0.98. The plants SAM-117 and SAM-119 presented greater similarity. Conversely, SAM-107 and SAM-171 were the most genetically distant. In general, H. pectinata plants collected in the State of Sergipe presented low to moderate genetic diversity.

The impact of edge effect on termite community (Blattodea: Isoptera) in fragments of Brazilian Atlantic Rainforest / O impacto do efeito de borda na comunidade de cupins (Blattodea: Isoptera) em fragmentos de florestas da Mata Atlântica

Abstract Habitat fragmentation is considered to be one of the biggest threats to tropical ecosystem functioning. In this region, termites perform an important ecological role as decomposers and ecosystem engineers. In the present study, we tested whether termite community is negatively affected by edge effects on three fragments of Brazilian Atlantic Rainforest. Termite abundance and vegetation structure were sampled in 10 transects (15 × 2 m), while termite richness, activity, and soil litter biomass were measured in 16 quadrants (5 × 2 m) at forest edge and interior of each fragment. Habitat structure (i.e. number of tree, diameter at breast height and soil litter biomass) did not differ between forest edge and interior of fragments. Termite richness, abundance and activity were not affected by edge effect. However, differences were observed in the β diversity between forest edge and interior as well as in the fragments sampled. The β diversity partitioning indicates that species turnover is the determinant process of termite community composition under edge effect. Our results suggest that conservation strategies should be based on the selection of several distinct sites instead of few rich sites (e.g. nesting).

Resumo A fragmentação do habitat é considerada uma das maiores ameaças para o funcionamento do ecossistema tropical. Nesta região, os cupins desempenham um papel ecológico importante como decompositores e engenheiros do ecossistema. No presente estudo, testamos se comunidades de cupins são negativamente afetadas pelo efeito de borda em três fragmentos de Mata Atlântica. Para isso, foram amostrados a abundância de cupins e a estrutura da vegetação em 10 transectos (15 × 2 m), enquanto a riqueza, abundância de cupins e biomassa da serrapilheira foram amostrados em 16 parcelas (5 × 2 m) na borda e no interior de cada um dos três fragmentos. A estrutura do habitat (número de árvores, diâmetro à altura do peito e biomassa da serrapilheira) não diferiu entre a borda e o interior dos fragmentos. A riqueza, abundância e atividade dos cupins também não foram afetados pelo efeito de borda. No entanto, foram observadas diferenças na diversidade β entre borda e interior dos fragmentos, bem como nos fragmentos amostrados. O particionamento da diversidade β indicou que a substituição de espécies ("turnover") é o processo determinante da composição da comunidade de cupins sob efeito de borda. Nossos resultados sugerem que as estratégias de conservação devem ser baseadas na seleção de locais distintos em vez de poucos locais (via processo de aninhamento - "nesting").

Serum levels of nitric oxide and cytokines in smokers at the beginning and after 4months of treatment for smoking cessation.

INTRODUCTION: Nitric oxide (NO) modulates inflammatory reactions, having beneficial or toxic effects depending on the concentration. Its elevation can cause proinflammatory effects amplifying the inflammatory process with the participation of cytokines. Smoking has a negative impact on health and is considered one of the risk factors that influence disease development facilitating inflammatory processes. AIM: To compare the serum concentration of NO and cytokines in smokers at baseline and after 4months of abstinence treatment. METHODS: Blood samples which were collected to obtain the serum, at baseline and after 4months, were stored at -80°C until analysis. NO was measured by the total dose of nitrite determined by the Greiss method. CBA was the used technique to determine the concentration of cytokines in supernatants serum. The initial and final results of NO, TNF-α, IL-1, IL-6, IL-8, IL-10 and IL-12 that remained after 4months treatment were compared. Wilcoxon test was used to compare the data and Spearman test for correlations between NO and other variables. A significance level of p<0.05 was adopted. RESULTS: The analysis of NO observed a significant reduction (p=0.001) of the initial median value of 18.80 (3.55-80.01) µmol/L to 8.10 (2.85-14.97) µmol/L after 4months of treatment. There were no significant differences in cytokines from baseline to the end of treatment. CONCLUSION: The results may not mean harm to the body, but an adaptive process, decreasing the metabolism of abstinents due to the reduction of the use of nicotine.

The impact of edge effect on termite community (Blattodea: Isoptera) in fragments of Brazilian Atlantic Rainforest.

Habitat fragmentation is considered to be one of the biggest threats to tropical ecosystem functioning. In this region, termites perform an important ecological role as decomposers and ecosystem engineers. In the present study, we tested whether termite community is negatively affected by edge effects on three fragments of Brazilian Atlantic Rainforest. Termite abundance and vegetation structure were sampled in 10 transects (15 × 2 m), while termite richness, activity, and soil litter biomass were measured in 16 quadrants (5 × 2 m) at forest edge and interior of each fragment. Habitat structure (i.e. number of tree, diameter at breast height and soil litter biomass) did not differ between forest edge and interior of fragments. Termite richness, abundance and activity were not affected by edge effect. However, differences were observed in the ß diversity between forest edge and interior as well as in the fragments sampled. The ß diversity partitioning indicates that species turnover is the determinant process of termite community composition under edge effect. Our results suggest that conservation strategies should be based on the selection of several distinct sites instead of few rich sites (e.g. nesting).

Resin Bonding to a Hybrid Ceramic: Effects of Surface Treatments and Aging.

The aim of this study was to verify the effects of different surface treatments on the microtensile bond strength between resin cement and a hybrid ceramic. Thirty-two hybrid ceramic slices (8 × 10 × 3 mm) were produced and allocated among four groups according to the surface treatment: Cont = no treatment, HA = 10% hydrofluoric acid applied for 60 seconds, PA = 37% phosphoric acid applied for 60 seconds and CJ = air abrasion with silica particle coated alumina (Cojet Sand, 3M ESPE, 30 µm/2.8 bar). As a control group, eight blocks of feldspathic ceramic (8 × 10 × 3 mm) were etched by hydrofluoric acid for 60 seconds (VMII). After the surface treatments, the ceramic slices were silanized (except the Cont group) and adhesively cemented to composite resin blocks (8 × 10 × 3 mm ) with a load of 750 g (polymerized for 40 seconds each side). The cemented blocks were cut into beams (bonded surface area of ∼1 mm(2)). Half of the beams were aged (thermocycling of 5°C-55°C/6000 cycles + water storage at 37°C/60 days), and the other half were tested immediately after being cut. Data were analyzed by Kruskal-Wallis and Dunn tests (non-aged groups) and by one-way analysis of variance and Tukey test (aged groups; α=0.05%). The mode of failure was classified by stereomicroscopy. The surface treatment significantly affected the bond strength in each set of groups: non-aged (p=0.001) and aged (p=0.001). Before being aged, samples in the CJ, HA, and PA groups achieved the highest bond strength values. However, after being aged, only those in the HA group remained with the highest bond strength values. Adhesive failure was found most often. In conclusion, hydrofluoric acid etching should be used for surface conditioning of the studied hybrid ceramic.

Germinoma de haste hipofisária: relato de caso e revisão de literatura / Pituitary stalk germinoma: case report and literature review

Os germinomas intracranianos são histologicamente indistinguíveis do neurinoma testicular e disgerminoma ovariano; eles ocorrem mais frequentemente na região pineal, supra-selar e gânglios da base. O envolvimento primário do germinoma na haste hipofisária é raro. Neste artigo, relatamos um germinoma da haste hipofisária e revisamos a literatura sobre o assunto.

Positive predictive values of selected clinical signs associated with skull base fractures.

BACKGROUND: The goal of this study was to determinate the positive predictive values of selected clinical signs for skull base fractures and associated intracranial lesions. EXPERIMENTAL DESIGN: Clinical and radiological data were collected prospectively for all patients with selected clinical signs of skull base fractures, and their admission criteria were: 1) recent head injury story; 2) presence of one or more of following clinical signs: unilateral or bilateral blepharohaematoma, bloody otorrhea, and Battle's sign. SETTING: Emergency service of a institutional hospital. PATIENTS: One hundred forty two patients with the selected clinical signs for skull base fracture. RESULTS: Frontal bone fractures were the most frequent in patients with selected clinical signs. Battle's sign (100%) and unilateral blepharohaematoma (90%) were the signs with higher positive predictive values for skull base fractures; bilateral blepharohaematoma (70%) and bloody otorrhea (70%) were those with less values. The positive predictive values of the selected signs for intracranial lesions (acute extradural haematoma, pneumocephalus, brain contusion, brain sweLling, and acute subdural haematoma) were: unilateral and bilateral blepharohaematoma with positive predictive values of 85% and 68%, respectively; Battle's sign was 66%; and bloody otorrhea was 46%. For patients at admission on the 13-15 Glasgow Coma Scale only, the positive predictive values for that intracranial lesions were: blepharohaematoma=78%; Battle's sign=66%; and bloody otorrhea=41%. CONCLUSIONS: Our data demonstrated that the selected signs of skull base fractures have high positive predictive values for the presence of skull fracture and intracranial lesions, even in those patients classified in the Glasgow Coma Scale between 13 and 15. This indicates that all patients with the selected clinical signs should be submitted to computerized tomography of skull and with bone window, with the aim to detect associated lesions.

Surgical treatment of active valvular infective endocarditis.

A review is presented of 20 patients consecutively operated on for acute valvular endocarditis. The diagnosis was established from at least two of the criteria: (a) typical clinical features, (b) two blood cultures positive for the same causal microorganism, and (c) echocardiographic evidence of vegetations. In all cases there was histologic evidence of active infection in the surgical specimen. Only three of the 20 patients had no previous cardiac disease. The most common causal agent was Staphylococcus aureus. The indications for surgery were refractory cardiac failure or infection (18 and 2 cases, respectively). Aortic valve replacement was performed in 16 of the 20 cases, suggesting that aortic valvulopathy aggravates the course of infective endocarditis and increases the risk of heart failure. The overall mortality rate was 30%. All surviving patients were infection-free at postoperative bacteriologic follow-up. Surgery is considered to be the management of choice in active valvular, therapy-resistant bacterial endocarditis with or without cardiac failure.