Intrinsic predictive factors for ankle sprain in active university students: a prospective study.

The ankle is the joint most affected among the sports-related injuries. The current study investigated whether certain intrinsic factors could predict ankle sprains in active students. The 125 participants were submitted to a baseline assessment in a single session were then followed-up for 52 weeks regarding the occurrence of sprain. The baseline assessment were performed in both ankles and included the questionnaire Cumberland ankle instability tool - Portuguese, the foot lift test, dorsiflexion range of motion, Star Excursion Balance Test (SEBT), the side recognition task, body mass index, and history of previous sprain. Two groups were used for analysis: one with those who suffered an ankle sprain and the other with those who did not suffer an ankle sprain. After Cox regression analysis, participants with history of previous sprain were twice as likely to suffer subsequent sprains [hazard ratio (HR) 2.21 and 95% confidence interval (CI) 1.07-4.57] and people with better performance on the SEBT in the postero-lateral (PL) direction were less likely to suffer a sprain (HR 0.96 and 95% CI 0.92-0.99). History of previous sprain was the strongest predictive factor and a weak performance on SEBT PL was also considered a predictive factor for ankle sprains.

Turnera ulmifolia L. (Turneraceae): preliminary study of its antioxidant activity.

Turnera ulmifolia L. is used in Brazilian folk medicine as an anti-inflammatory. Since this activity may be correlated with the presence of antioxidant compounds, a leaf extract was evaluated for its radical scavenging capacity (RSC). The in vitro RSC of a 50% hydroethanolic (HE) extract was evaluated by beta-carotene/linoleic acid coupled oxidation system for the inhibition of oxidation and the lipid peroxidation inhibition in rat brain homogenates, using thiobarbituric acid reactive substances (TBARS) and chemiluminescence (CL). Results indicated, through peroxidation suppression, that this extract exhibited greater antioxidative activity (77.4% +/- 10%) than alpha-tocopherol (58.4% +/- 3.7%). TBARS and CL inhibition was concentration-dependent and Q(1/2) values were 8.2 and 6.0 microg/mL for TBARS and CL, respectively. For alpha-tocopherol these values were 7.1 microg/mL (TBARS) and 9.8 microg/mL (CL). Phenolic compounds may be responsible for this antioxidant capacity.

[Isolated ileocecal tuberculosis simulating malignant neoplasia and Crohn's disease]. / Tuberculose ileocecal isolada simulando neoplasia maligna e doença de Crohn.

BACKGROUND: Isolated ileocecal involvement by tuberculosis in the absence of pulmonar disease is rare in Brasil, therefore causes a diagnostic dilemma as it mimics colonic malignancy and Crohn's disease. METHODS: Between 1969 and 1989, eight patients with isolated hypertrophic ileocecal tuberculosis were treated by surgery in the Gastroenterology Surgery Department of the HSPE-FMO. The most common complaint among them was abdominal pain (100%) with associated symptoms of weight loss (62.5%); nausea, vomiting, fever and general weekness appeared in half of the patients. A right iliac fossa mass was present in seven (87.5% ) of them. The mean duration of symptoms was 14.7 month (range 5-36 months). In all eight patients chest x-rays were negative for tuberculosis. Barium contrast studies showed abnormalities in all cases, but these could not be distinguished from carcinoma. Colonoscopy was helpful in establishing the diagnosis of suboclusive lesions of the ileocecal regions in three patients. Tuberculosis diagnosis was suspected in two of them because ofr the presence of granulomas in colonic biopsy material. RESULTS: Six patients were submitted to elective right hemicolectomy. The two remaining with suspect of tuberculosis were operated with signals of intestinal occlusion, and underwent a limited ileocaecal resection. The positive diagnosis of intestinal tuberculosis was made in all the patients by identification of acid-fast bacilli and by the presence of caseating granulomas in intestinal or lymph node tissue on histological examination. The outcome in all of them was favorable. They received treatment with three antituberculosis drugs over a twelve month period. CONCLUSION: Hypertrophic ileocecal tuberculosis must still be considered in the differential diagnosis of abdominal pathology localized in the right lower quadrant.

Tuberculose ileocecal isolada simulando neoplasia maligna e doença de Crohn / Isolated ileocecal tuberculosis simulating malignant neoplasia and Crohn's disease

OBJETIVO: No Brasil, a tuberculose ileocecal isolada, na ausência de tuberculose pulmonar ativa ou cicatrizada, é rara, sendo freqüentemente confundida com neoplasia e a doença de Crohn. MÉTODOS: Os autores apresentam oito doentes com essas características, tratados por cirurgia, em período de 20 anos. A dor abdominal na fossa ilíaca direita foi o principal sintoma (100 por cento), seguido da presença de perda de peso (62,5 por cento), febre, náuseas e vômitos e fadiga em 50 por cento dos doentes. Sete enfermos (87,5 por cento) apresentaram massa palpável na fossa ilíaca direita. A duraçäo média dos sintomas foi de 14,7 meses, variando de 5 a 36 meses. Todas as lesöes foram detectadas pelo enema opaco e mimetizavam aspecto neoplásico. A colonoscopia foi realizada em três doentes, evidenciando lesöes sub-oclusivas da regiäo íleo-cecal em dois; as biópsias foram sugestivas de tuberculose, näo sendo possível diferenciá-las da doença de Crohn. RESULTADOS: Seis enfermos com diagnóstico presuntivo de neoplasia foram submetidos a cirurgia eletiva, realizando-se neles a colectomia direita clássica. Os outros dois, com suspeita de tuberculose, foram operados na vigência de obstruçäo intestinal, sendo submetidos a ressecçäo limitada (ileocecectomia). O estudo anatomopatológico estabeleceu o diagnóstico final pelo encontro de necrose caseosa e de bacilos álcool ácido-resistentes no intestino ou nos linfonodos. A evoluçäo pós-operatória foi satisfatória, com pequena morbidade resolvida clinicamente. Posteriormente, todos os doentes receberam o esquema tríplice por 12 meses, variando a droga de acordo com a época do tratamento. CONCLUSÄO: Apesar de rara, a tuberculose hipertrófica ileocecal isolada freqüentemente é confundida com neoplasias e com a doença de Crohn, devendo ser lembrada no diagnóstico diferencial das lesöes localizadas no quadrante inferior direito do abdome

In vitro study of the effect of clonidine on human umbilical artery motility.

The umbilical-placental circulation is of vital importance for fetal survival and has a dominant effect on the cardiorespiratory physiology of the fetus. The mechanisms of regulation of umbilical vessels appear to differ from those regulating other vessels. Both clonidine and alpha-methyldopa have been used in the management of hypertensive complications of pregnancy. In contrast to alpha-methyldopa, clonidine does not require previous metabolization but acts directly on the receptors. The action of the two drugs on human umbilical artery was studied in vitro. Forty-eight human umbilical artery segments were dissected and perfused as follows: 9 segments with alpha-methyldopa, 10 with clonidine, 10 with yohimbine, 9 with alpha-methyldopa in combination with yohimbine, and 10 with pure Tyrode's solution. alpha-Methyldopa had a statistically significant vasoconstrictive effect starting at 40 min (p < 0.05) and this effect was blocked by yohimbine (p < 0.05). Clonidine had no vasoconstrictive effect. The present data for clonidine do not confirm the presence of alpha 2-adrenergic receptors in the umbilico-placental circulation which had been indicated by the action of methyldopa.

Action of alpha-methyldopa on human umbilical circulation in vitro.

To determine the possible effects of alpha-methyldopa on the motility of human umbilical artery, a total of 53 arterial segments were perfused with different concentrations of the drug as follows: 38 segments with 125, 250 and 500 ng/ml of the drug, 9 segments with 500 ng/ml alpha-methyldopa in combination with 10(-7) M yohimbine, and 6 segments with 10(-7) M yohimbine alone. alpha-Methyldopa had a vasoconstrictor effect at all doses employed, with a clear dose-effect correlation (p less than 0.01). The vasoconstrictor effect of 500 ng/ml alpha-methyldopa was fully inhibited in the presence of 10(-7) M yohimbine. These results suggest that alpha 2-adrenergic receptors are present in the umbilical circulation and that alpha-methyldopa may play a role in the control of this circulation.

Hemangioma do seio maxilar: flebólitos; discussäo sobre um caso / Hemangioma of the maxillary sinus: phleboliths: discussion about a case

É estudado um caso de tumor vascular benigno do antro maxilar, o hemangioma. Säo revistos aspectos da etiopatogenia do tumor e da formaçäo de flebólitos em seu interior. É feita revisäo da literatura que demonstra ser incomum o achado desse angioma. Poucos casos estäo descritos na literatura com a demonstraçäo de formaçöes cálcicas em seu interior. A conduta terapêutica tomada e o resultado da mesma, säo comentados

Dandy-Walker syndrome: posterior fossa craniectomy and cyst fenestration after several shunt revisions.

Ventriculoperitoneal or cyst-peritoneal shunts are the usual treatment for children with Dandy-Walker syndrome. A combined ventricular and cyst shunt is often necessary and, in some cases, multiple revisions have to be done. Two patients with this syndrome were treated with posterior fossa exploration and cyst fenestration after several shunt revisions. The procedure was well tolerated with good results in both cases. The patients' data and preliminary results are presented here.

Successful treatment of Capillaria hepatica infection in an acutely ill adult.

A man with massive Capillaria hepatica infection survived after treatment with prednisone, disophenol, and pyrantel tartrate. He remained well during an 8-year follow-up.

Osteoblastoma de coluna cervical. / Osteoblastoma of the cervical spine

Os osteoblastomas sao tumores osseos benignos raros. Os autores descrevem os aspectos clinicos, o quadro radiologico, angiografico e cintilografico e a tomografia por computacao de 1 doente portador de osteoblastoma de coluna cervical. A remocao cirurgica seguida de artrodese de coluna resultou em alivio da sintomatologia apresentada pelo doente

Infeccao humana por Capillaria hepatica.Relato de um caso tratado com exito. / Human infection due to Capillaria hepatica. Report of a case sucessfully treated

Os autores tecem comentarios a respeito da biologia da Capillaria hepatica, encontrando na mesma a justificativa para a raridade da verdadeira infeccao humana, separando-a da pseudo-infeccao. Relatam o caso de um paciente cujas manifestacoes clinicas eram febre elevada, anorexia, emagrecimento, mialgias e artralgias, gigantesca hepatomegalia dolorosa discreta esplenomegalia, leucocitose com intensa eosinofilia (superior a 60%), hemossedimentacao muito acelerada, discreta elevacao das transaminases e fosfatase alcalina. O diagnostico foi conseguido merce de biopsia cirurgica do figado. Dada a ausencia de indicacoes terapeuticas, os A.A. formularam um esquema a base de prednisona, di-isofenol e tartarato de pirantel que resultou totalmente eficaz. Este caso constitui-se no unico registrado na literatura nacional com diagnostico em vida. Outro houve, mas como achado necroscopico