Distância biológica entre sambaquieiros fluviais (Moraes – Vale do Ribeira-SP) e construtores de sítios litorâneos (Piaçaguera e Tenório-SP e Jabuticabeira IISC)

Traços não-métricos cranianos foram utilizados para testar se os indivíduos do sambaqui fluvial Moraes assemelham-se ou não morfologicamente aos habitantes de sítios costeiros do sul-sudeste do Brasil. Vinte e sete traços de 52 crânios pertencentes a quatro sitios arqueológicos foram usados em comparações intra- (Jaccard) e inter-sítio (Medida Média de Divergência, Distância de Sanghvi, Análise de Cluster). Os resultados indicam homogeneidade morfológica intragrupo, permitindo comparações intergrupo. Essas revelam que os indivíduos de Moraes possuem uma morfologia significativamente distinta da dos construtores de sítios costeiros.

A new early Holocene human skeleton from Brazil: implications for the settlement of the New World

Increasing skeletal evidence from the U.S.A., Mexico, Colombia, and Brazil strongly suggests that the first settlers in the Americas had a cranial morphology distinct from that displayed by most late and modern Native Americans. The Paleoamerican morphological pattern is more generalized and can be seen today among Africans, Australians, and Melanesians. Here, we present the results of a comparative morphological assessment of a late Paleoindian/early archaic specimen from Capelinha Burial II, southern Brazil. The Capelinha skull was compared with samples of four Paleoindian groups from South and Central America and worldwide modern groups from W.W. Howells' studies. In both analyses performed (classical morphometrics and geometric morphometrics), the results show a clear association between Capelinha Burial II and the Paleoindians, as well as Australians, Melanesians, and Africans, confirming its Paleoamerican status.

The people of Jabuticabeira II: reconstruction of the way of life in a Brazilian shellmound

Sambaquis are huge shellmounds built along almost the entire Brazilian coast between 8000 and 600 years ago. In the present article, 14 osteological markers from 89 individuals excavated at the Sambaqui Jabuticabeira II (2890+/-55/2186+/-60 BP) are analyzed in order to reconstruct the population's health status and way of life. The present palaeopathological findings (such as lower frequency of degenerative joint diseases in legs, as compared to arms, and the rarity of traumas) together with archaeological findings support the idea of nearby resource abundance and infrequent interpersonal competition. The presence of auditory exostoses mainly in males corroborates previous findings indicating the importance of marine resources. The low caries frequency and the high degrees of dental wear point to a diet poor in cariogenic food, and rich in abrasives such as sand, shell fragments and phytoliths. This suggests a broader diet, based on marine protein as well as plants, than previously thought. The etiology of cribra orbitalia could be explained by gastrointestinal parasites or other sources of physiological stress. These parasites, in turn, could have led to higher frequencies of infectious diseases, either by the debilitation of the immune system or by the direct contact with infectious agents. Despite the periods of illness various individuals experienced, the daily life among the builders of the Sambaqui Jabuticabeira II seems to have been relatively easy due to the abundance and predictability of resources and the paucity of violent traumas.

The impact of the weight status on subjective symptomatology of the Polycystic Ovary Syndrome: a cross-cultural comparison between Brazilian and Austrian women

Group differences in symptomatology and symptom perception of young women ageing between 18 and 32 years suffering from polycystic ovarian syndrome (PCOS) were tested according to cultural background and weight status. In detail 31 Austrian women, living in Carinthia, Austria, and 102 Brazilian women, living in São Paulo, Brazil, were enrolled in the present study. All participants suffered from diagnosed PCOS. The prevalence of hirsutism, infertility, menstrual disturbances and overweight/obesity and their individual impact on health related quality of life were analysed. Furthermore the impact of weight status (BMI) on symptom perception was tested. It turned out, that the Brazilian sample exhibited higher prevalence of PCOS symptoms and these symptoms had a more negative impact on quality of life. The only exception was body weight. Although significantly leaner, the Austrian women showed a higher Cronin score of body weight than their Brazilian counterparts. The results of the present study may indicate that in western industrialized societies the fear of overweight is much more prevalent than in a developing country such as Brazil and thus it has more influence on the quality of life than all the other symptoms.

Lipoma of the larynx. Report of 2 cases and review of the literature

Among the primary mesenchymal tumors of the hypopharynx and larynx lipomas are very rare, as they often look macroscopically like retention cysts. Up today approximately 112 cases have been described in literature. We present two further cases of laryngeal lipomas, which were removed endoscopically and by an external approach. Both patients were free of local recurrence.

The polycystic ovary syndrome--a medical condition but also an important psychosocial problem

PCOS, the leading cause of anovulatory infertility that affects up to one fifth of the female population, is a complex chronic disease of genetic as well as environmental determination, but still unclear etiology. Besides of infertility, PCOS leads to menstrual dysfunctions, hirsutism and obesity--symptoms that are known to cause profound psychosocial distress. The present paper review the problematic of etiology and symptom expression of PCOS, which is not only a disease needing medical treatment but also a psychosocial problem for the affected women. PCOS may not only coinduced by psychosocial factors, the main symptoms of PCOS such as infertility, menstrual dysfunctions, hirsutism and obesity cause by themselves increased psychosocial stress.

[Long-term outcome of frontal sinus surgery: comparison of extranasal and endonasal surgical techniques]

BACKGROUND

During the last decades rhinosurgery largely developed up to endonasal accesses. Meanwhile many of the new techniques are established, so that the outcome of traditional extranasal methods should be compared with those of endonasal accesses, in order to estimate the status and for critical consideration.

METHODS

A retrospective analysis recorded the results of 236 patients, operated on primary frontal sinus disease 1985-1993. The records were consulted concerning inpatient treatment and outpatient aftercare during standardized paranasal sinus consulting hours.

RESULTS

During the follow-up period (3-10 years) 8% of the patients underwent resurgery. The lowest revision rate was found after using endonasal technique (5.9%), compared with osteoclastic methods (Ritter-Jansen, Riedel: 10.6%). The domain of osteoplastic operations with a revision rate of 9.4% were fractures, osteomas and mucoceles, because of an impossible endonasal access. In decision on osteoclastic procedures, the already osteoclastically operated site was of prime importance, especially since 1990.

CONCLUSION

Already during the early years endonasal techniques of paranasal sinus surgery showed better outcome than osteoclastic accesses. The analysis indicates that the change to endonasal functional paranasal sinus surgery is justified and should be kept up. The traditional methods still have their rare authorization in case of special indications, especially if an osteoclastic procedure has been carried out already.

P relim in ary p a laeo p ath o lo g y study in the Jaboticabeira II shellmound population: Jaguaruna, SC

O presente trabalho é um estudo preliminar em paleopatologia da amostra de esqueletos humanos recuperada durante a primeira campanha de pesquisas no sambaqui Jaboticabeira II (SC), em 1997. Padrões metodológicos internacionalmente aceitos foram utilizados para a obtenção de parâmetros de composição demográfica, aspectos de saúde e modo de vida. A ausência de cáries, a grande ocorrência de infecções e a baixa prevalência de artrite foram alguns dos resultados obtidos.

Genetic counseling for childless women at risk for Duchenne muscular dystrophy

The aim of the present study was to assess the impact of genetic counseling in young women at risk to have Duchenne muscular dystrophy (DMD) children prior to childbearing. A total of 263 potential DMD carriers, who had had genetic counseling and were given different genetic risks, were included in this investigation. Their reproductive outcome and future plans as well as their requests for DNA tests (for carrier detection and prenatal diagnosis) were analyzed according to genetic risk magnitude, comprehension of genetic counseling is- sues, family and personal history, socio-educational level, and subjective opinion about selective abortion. We noted that genetic risk magnitude had no significant influence on reproductive plans or outcome nor on the request for additional DNA testing, even considering only those clients with good comprehension and retention of issues discussed during genetic counseling. On the other hand, counselees who had more than one affected or at least one deceased DMD case in their family understood genetic counseling significantly better, suggesting that "learning with life" has a stronger impact than genetic counseling.

[Concepts for measuring quality of life in patients with chronic sinusitis]

BACKGROUND

In 1997, Benninger developed the Rhinosinusitis Disability Index (RSBI) for patients who suffered from chronic sinusitis. Its content related validity and construct related validity were established, as were its sensitivity and reliability. The aim of our study is to introduce a concept to measure quality of life in these patients according to circumstances prevalent in Germany.

METHODS

The questionnaire (Rhinusitis-Beeinträchtigungs-Index, RSBI) contains 30 questions that describe the 5 aspects of quality of life. Moreover we used a standardized data sheet to acquire further information about history and diagnostic results. Using this method it is possible to specificity more precisely the patients current complaints and condition. Evaluation is possible according to complex of questions as well as simple items. The influence of treatment on quality of life can be measured as the sum of the specific scores and is expressed comprehensively in the total score. The concept of the study includes a prospective inquiry as well as before and after surgical intervention.

CONCLUSION

A disadvantage of the American RSDI is that the clinical symptoms are not described in a detailed catalogue which allows the correlation of the clinical factors. Therefore we added a detailed questionnaire concerning the clinical symptoms and the individual treatment of the patient (RSBI). That permits comprehensive analysis of quality of life as it relates to different aspects of disease and different strategies in treatment.

Iodine absorption in patients undergoing ERCP compared with coronary angiography

BACKGROUND

Systemic absorption of iodinated contrast material occurs during endoscopic retrograde cholangiopancreatography (ERCP), the clinical significance of which has not yet been determined.

METHODS

Urinary iodine excretion was measured before and after coronary angiography (n = 20) and ERCP (n = 12). Thyroid hormone levels were determined before iodine load and after 6 and 24 weeks.

RESULTS

Before coronary angiography, iodine excretion was 101 +/- 38.3 micromol/mol creatinine and increased to 865. 10(5) +/- 721. 10(5) micromol/mol on the next day (p </= 0.001). After 6 weeks, it was still elevated (167 +/- 88.8 micromol/mol, p < 0.01). Before ERCP, iodine excretion was 115 +/- 60.3 micromol/mol and reached a peak of 5.3. 10(5) +/- 4.9. 10(5) micromol/mol (p < 0.001). Six weeks later, it had returned to baseline. Two patients in the coronary angiography group but none in the ERCP group had suppressed thyrotropin after 6 weeks.

CONCLUSIONS

The systemic iodine load during ERCP is approximately 0.6% of the iodine load during coronary angiography. Therefore routine measurement of thyroid hormones before ERCP is not recommended.

How the magnitude of clinical severity and recurrence risk affects reproductive decisions in adult males with different forms of progressive muscular dystrophy

The reproductive history of 177 male patients affected with Becker (BMD) (n=69), limb-girdle (LGMD) (n=54), and facioscapulohumeral (FSHMD) (n=54) muscular dystrophy (MD) was analysed according to severity of the disease (BMD>LGMD>FSHMD) and magnitude of recurrence risk (RR) (high for FSHMD, intermediate for BMD, and low for LGMD). Additionally, 62 male patients were interviewed on psychosocial issues, in order to disentangle the factors influencing reproductive decisions among patients affected with MD. Among male adults, significantly more FSHMD than LGMD or BMD patients were married and had children. Age specific reproductive outcome was 0.31-0.32 for BMD, 0.51-0.62 for LGMD, and 0.58-1.02 for FSHMD, reflecting the influence of the disease's severity. High RRs did not significantly diminish reproduction after genetic counselling or correlate with less prospective desire for children. Instead, early onset, severity of the disease, and past reproductive history were found to diminish reproductive outcome after genetic counselling, and prospective family planning was also found to be influenced by past reproductive history as well as by emotional/sexual dysfunction with the opposite sex.

Social adjustment in adult males affected with progressive muscular dystrophy

Adult male patients affected with Becker (BMD, N = 22), limb girdle (LGMD, N = 22) and facioscapulohumeral (FSHMD, N = 18) muscular dystrophy were interviewed to assess for the first time how the disease's severity and recurrence risk (RR) magnitude alter their social adjustment. BMD (X-linked recessive) is the severest form and confers an intermediate RR because all daughters will be carriers, LGMD (autosomal-recessive) is moderately severe with a low RR in the absence of consanguineous marriage, and FSHMD (autosomal-dominant) is clinically the mildest of these three forms of MD but with the highest RR, of 50%. Results of the semistructured questionnaire [WHO (1988): Psychiatric Disability Assessment Schedule] showed no significant difference between the three clinical groups, but more severely handicapped patients as well as patients belonging to lower socioeconomic levels from all clinical groups showed poorer social adjustment. Taken together, myopathic patients displayed intermediate social dysfunction compared to controls and schizophrenics studied by Jablensky [1988: WHO Psychiatric Disability Assessment Schedule]. Since the items of major dysfunction proportion among myopathic patients concern intimate relationships (70%), interest in working among those unemployed (67%), and social isolation (53%), emotional support and social and legal assistance should concentrate on these aspects. Interestingly, the results of this study also suggest that high RRs do not affect relationships to the opposite sex.

[Re-amplification of differentially expressed mRNA fragments of head-neck cancers without cloning]

BACKGROUND

mRNA expression of healthy and malignant cells can be compared to each other by employing the "differential display" (DD) technique. Most studies describe sequence analysis of differentially expressed fragments after reamplification by a second round of PCR and subsequent molecular cloning to gain a sufficient amount of DNA for sequencing. The aim of this study was to show whether a sufficient amount of differentially expressed mRNA of squamous cell carcinoma cells of the head and neck region can be generated by PCR alone without cloning steps.

MATERIAL AND METHODS

mRNA isolated from cultivated keratinocytes and squamous cell carcinoma cells was reverse transcribed into cDNA which was amplified with PCR. Differentially expressed fragments detected after gel electrophoresis were isolated from the gel and reamplified in a second PCR. The resulting cDNA amounts of the second PCR were suitable for cloning but not for direct sequencing. A third round of PCR with the undiluted final product of the second PCR as template regularly failed. Dilutions of the second PCR products between 1:10 and 1:10(10) were prepared. The third round of PCR was carried out with these various template concentrations.

RESULTS

A sufficient amount of differentially expressed fragments for sequencing procedures resulted when dilutions of the second PCR products ranging from 1:10(2) to 1:10(7) were used as templates in the third round of PCR.

CONCLUSION

Modifications of PCR parameters provide high DNA copy numbers of differentially expressed mRNA fragments from squamous cell carcinoma cells of the upper aerodigestive tract in amounts that are needed for sequence analysis. This may make it possible to avoid labor-intensive cloning procedures requiring high safety standards.

Why is the reproductive performance lower in Becker (BMD) as compared to limb girdle (LGMD) muscular dystrophy male patients?

We had previously reported that patients affected with BMD have a significantly reduced reproductive performance (f = 0.12) as compared to male LGMD patients of similar age and physical impairment (f = 0.98). In the present study parameters such as the socio-economic level, as well as psychosocial, intellectual, and psychiatric functionings could not explain the low fitness of BMD patients. The effect of genetic counseling, a greater difficulty in coping with the disease, and relating to women and/or a potential malfunction of reproductive physiology are discussed as possible causes.

Becker and limb-girdle muscular dystrophies: a psychiatric and intellectual level comparative study

There are some indications that Becker muscular dystrophy (BMD) might be related to mental disorders and mental retardation (MR). To investigate this question, we made a standardized psychiatric and intellectual level assessment of 22 BMD patients in comparison with 22 limb-girdle muscular dystrophy (LGMD) patients. There were not significant differences between the two groups. Twelve patients (54.5%) in each group received at least one lifetime psychiatric diagnosis, the most frequent being depressive disorders. The intelligence quotient means for BMD was 85.9 and 87.8 for LGMD. There was one case of mild MR among BMD patients and two cases among LGMD patients.

Facioscapulohumeral muscular dystrophy: aspects of genetic counselling, acceptance of preclinical diagnosis, and fitness

A questionnaire about the interest in and demand for preclinical diagnosis for facioscapulohumeral muscular dystrophy (FSH) was sent to 46 patients. Most stated that they would have liked to have known their diagnosis earlier in order to seek more efficient help, to avoid strenuous activities, to prepare themselves emotionally, or to choose an appropriate profession. Similar arguments were used to explain their interest in preclinical diagnosis for their children. Most patients also favoured prenatal diagnosis although only two stated they would abort a pregnancy in the case of an affected fetus. Genetic counselling had apparently little influence on family planning. According to this study, FSH does not seem to reduce reproductive performance in our population.

Etiology and antibiotic susceptibility of bloodstream Streptococcus sp

249 episodes of Streptococcus bacteraemia in hospitalized patients were evaluated for both clinical and microbiological features. Specification of the isolates demonstrated that infective endocarditis was predominantly associated with Streptococcus sanguis and Streptococcus bovis whereas Streptococcus pyogenes and Streptococcus milleri were the most common cause of local and/or systemic infections. In vitro-susceptibility tests towards 9 selected antibiotics proved that beta-lactam antibiotics are potent compounds for the treatment of Streptococcus sp. with the exception of enterococci; that ampicillin turned out to be highly effective against enterococci; and that vancomycin may be regarded as a potent alternative in the treatment of streptococcal infections.

A deletion including the brain promoter of the Duchenne muscular dystrophy gene is not associated with mental retardation

A total of 161 unrelated Duchenne (DMD) and Becker muscular dystrophy (BMD) patients were screened for deletions in the brain promoter region of the dystrophin gene. Southern blot analysis using a probe for the brain promoter detected a deletion in this region in only one of the DMD families, in a patient with normal intelligence. This deletion also included the promoter of the muscle-type dystrophin and the exons encoding the actin-binding and part of the spectrin-like domains. Our data suggest that deletions in the brain promoter region are rare in DMD and are compatible with normal intelligence.

[Juvenile plantar dermatosis: when are epicutaneous tests indicated?]

The aetiology of juvenile plantar dermatosis (JPD) is probably multifactorial. Atopy, frictional factors and the frequent alternation between a hot and wet microclimate and a dry one seem to favour the dermatosis. An allergic contact dermatitis does not only involve a difficult differential diagnosis; it can also cause secondary deterioration of existing JPD. For these reasons, an attempt is made in this paper to specify the situations in which patch tests are indicated.