De Clinicas Research Articles

Birth weight classification in gestational diabetes: is there an ideal chart?

Introduction : Gestational diabetes mellitus (GDM) is associated to increased rates of large for gestational age newborns and macrosomia. Several charts are used to classify birth weight. Is there an ideal chart to classify newborns of GDM mothers? Methods : We evaluated adequacy of birth weight of 332 neonates born to GDM mothers at Hospital de Clinicas de Porto Alegre, Brazil. Newborns were classified according to gestational age as small (SGA), adequate or large (LGA) based on four charts: Alexander, Pedreira, INTERGROWTH 21 st Project and SINASC-2012. The latter was built using data from a large national registry of 2012, the Born Alive National Surveillance System ( Sistema de Informacoes de Nascidos Vivos – SINASC), which included 2.905,789 birth certificates. Frequencies of SGA and LGA and Kappa agreement were calculated. Results : In non-gender adjusted curves, SGA rates (95% confidence interval) varied from 8% (5-11) to 9% (6-13); LGA rates, from 11% (8-15) to 17% (13-21). For males, SGA rates varied from 3% (1-6%) to 6% (3-11%), and LGA rates, from 18% (13-24%) to 31% (24-38%); for female, SGA rates were from 3% (1-7%) to 10% (6-16%) and LGA rates, from 11% (6-16%) to 19% (13-26%). Kappa results were: ALEXANDER vs. SINASC-2012: 0.80 (0.73-0.88); INTERGROWTH 21 st vs. SINASC-2012 (adjusted by sex): 0.62 (0.53-0.71); INTERGROWTH 21 st vs. PEDREIRA: 0.71 (0.62-0.79); SINASC-2012 (by sex) vs. PEDREIRA: 0.86 (0.79-0.93). Conclusions : Misclassification has to be taken into account when evaluating newborns of GDM mothers, as LGA rates can almost double depending on the chart used to classify birth weight.

Yes, I believe in the CBR!

Two years ago The Clinical and Biomedical Research entered in a new era. I am honored to be the second Editor-in-Chief of what has become known as the ‘CBR Journal’. I aim to follow Alexandre Zavascki successes and his hard work and accomplishments as the first Editor-in-Chief. Those of you who remember the former Revista Hospital de Clinicas de Porto Alegre have seen many changes in the last 2 years. The number of articles has now risen to around 65 articles annually and the Journal received an increased number of papers for consideration.

Effect of 6-minute walk test on neuromuscular properties of patients with chronic obstructive pulmonary disease.

The objective of this study was to evaluate the neuromechanical properties of the knee extensor muscles before and after the 6-minute walk test (6MWT) in chronic obstructive pulmonary disease (COPD) patients and control subjects. COPD patients from the Department of Pulmonology of the Hospital de Clinicas de Porto Alegre and age- and sex-matched control volunteers without COPD were included in this study. Body composition and lower limb strength assessed by maximal voluntary isometric contraction (MVIC) of the knee extensors) were assessed before and after the 6MWT. The total reaction time (TRT), premotor time (PMT) and motor time (MT) were assessed using surface electromyography of the rectus femoris and vastus lateralis knee extensor muscles. Eighteen patients COPD patients (10 men, FEV1 36 ± 12% of predicted) and 8 control subjects (5 men, FEV1 82 ± 7% of predicted) were included. COPD patients had lower muscle strength before (21.77 ± 7.86 kg) and after the 6MWT (11.16 ± 4.70 kg) compared with control subjects (33.50 ± 14.01 kg before; 29.25 ± 16.66 kg after). After the 6MWT, COPD patients showed a significant reduction in the MVIC and a significant increase in the TRT and PMT, which did not occur in control subjects. The reaction time parameters were higher in COPD patients after the 6MWT compared with control subjects. The TRT (r = -0.535, P < 0.005) and PMT (r = -0.549, P < 0.005) were inversely correlated with the MVIC after the 6MWT. Neuromuscular changes associated with upper motor neuron activation contribute to MVIC impairment in COPD patients after performing a functional test.

Cirurgia aberta e endovascular no tratamento de aneurisma de artéria poplítea: experiência de cinco anos do HCRP-FMRP-USP

Resumo Contexto Aneurismas de artéria poplítea (AAPs) correspondem a 70,00% dos aneurismas periféricos. A indicação cirúrgica é para aneurismas com diâmetros maiores que 2,0 cm ou sintomáticos. O tratamento é feito por técnicas cirúrgicas convencionais ou endovasculares. Esta última tem ganho muitos adeptos, mas ainda não há consenso estabelecido sobre sua indicação. Objetivo Apresentar a experiência da Divisão de Cirurgia Vascular e Endovascular do Hospital das Clínicas de Ribeirão Preto da Universidade de São Paulo no tratamento dos AAPs. Método Foram revisados casos de reparo convencional e endovascular de AAPs tratados nos últimos cinco anos, avaliando dados demográficos, comorbidades, indicação cirúrgica, complicações pré e pós-operatórias precoces e tardias, tempo de internação e de perviedade em até um ano. Resultados Foram realizadas no período dez cirurgias endovasculares (CE) e 21 cirurgias abertas (CA). O grupo CE teve maior frequência de comorbidades. Houve maior frequência de pacientes sintomáticos no grupo CA (85,00%) do que no grupo CE (40,00%). O Grupo CE apresentou menor número de complicações clínicas e cirúrgicas. A idade entre os grupos e o tempo de internação de cada grupo não apresentaram diferença estatística. A perviedade primária em um ano no Grupo CE foi de 80,00%, enquanto no Grupo CA foi de 75,00%. Conclusão O tratamento endovascular para AAPs apresenta bons resultados, em termos de perviedade com taxas de complicações aceitáveis, em pacientes com risco cirúrgico elevado e anatomia favorável, justificando, assim, a necessidade de mais estudos controlados para modificar a posição da técnica endovascular como uma terapia alternativa para casos selecionados.

Cannabis users show increased susceptibility to false memories

Drug and Alcohol Dependence 156 (2015) e183–e245 e189 areas of sexual risk reduction, prevention and treatment for substanceabuseandmental health. Publichealthprogramsprioritizing the different populations are necessary. Financial support: Fogarty International Center; Grant 1R03TW007612; Fundo de Incentivo e Auxilio a Pesquisa (FIPE) from Hospital de Clinicas de Porto Alegre, Brazil (GPPGHCPA – No. 07-391). http://dx.doi.org/10.1016/j.drugalcdep.2015.07.507 Crack, powdered cocaine, both or neither: A generalized logit analysis of a community-based sample Grace L. Reynolds1,2,∗, Dennis G. Fisher1, Erlyana Erlyana2 1 Center for Behavioral Research and Services, California State University, Long Beach, Long Beach, CA, United States 2 Health Care Administration, California State University, Long Beach, Long Beach, CA, United States Aims: To understand factors associated with use of both crack cocaine and non-injected powered cocaine. Methods: The Risk Behavior Assessment (RBA; 1993) was used to elicit information on past month, past 48-hours and drugs used before/during sex drug use in a sample of out-of-treatment drug users (N=8538). Past 30 day, past 48h, and before/during sex drug use were coded into (1) use of crack (smokable cocaine) only, (2) powdered cocaine use only, (3) both drugs used during the timeframe and (4) neither drug used. Generalized logit analysis was used to develop models for each timeframe (48-hour and 30-day). For all models the reference group was using neither drug. Results: Respondents who reported use of both crack and powdered cocaine (N=306) included both men (n=207) and women (n=99). The 48-hour, 30-day, and before/during sex models were almost identical. Those who reported using both crack and cocaine were more likely to: be Black (OR=1.65, CI 1.27, 2.14); bisexual (OR=1.85, CI 1.39, 2.47); trade sex fordrugs (OR=4.88CI 3.73, 6.39); tobehomeless (OR=3.50, CI 2.66, 4.62), havehighernumberof days used alcohol in the pastmonth (OR=1.09, CI 1.08, 1.10); and to have had gonorrhea (OR=1.42, CI 1.07, 1.88). Conclusions: The general logit model highlights factors associated with use of both crack and powdered cocaine within the same timeframe, includinghomelessness, andbeingamemberof anethic or sexual minority, and sex trading. Financial support: Funding was provided in part by grant R01 DA030234 from the National Institute on Drug Abuse, P20MD003942 from the National Institute of Minority Health and Health Disparities. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse, the National Institute ofMinority Health and Health Disparities or the National Institutes of Health. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.508 Cannabis users show increased susceptibility to false memories Jordi Riba1,∗, Frederic Sampedro2, Aina Rodriguez-Pujadas2, Saul Martinez-Horta1, Jaime Kulisevsky1, Jose-Carlos Perez-de-los-Cobos1, Antoni Rodriguez-Fornells1, Marta Valle1 1 Hospital Sant Pau, Barcelona, Spain 2 University of Barcelona, Barcelona, Spain Aims: Previous studies on the neurocognitive impact of cannabis use have found working and declarative memory deficits that tend to normalize with abstinence. An unexplored aspect of cognitive function in chronic cannabis users is the ability to distinguish between veridical and illusory events; a crucial aspect of reality monitoring that relies on adequate memory function and cognitive control. Methods: Sixteen heavy cannabis users not seeking treatment for their cannabis consumptionwerematched to a group of healthy controls taking into account sex, age, years of education, verbal intelligence and fluid intelligence. All participants performed a modified version of the Deese–Roediger–McDermott paradigm in an MRI scanner. Following a study phase, subjects were presented with 75 old words, 40 semantically unrelated new words and 40 semantically related new words or lures. They were required to judge whether a word had been presented in the study phase and make an old vs. new decision by button press. Results: Cannabis users showed an increased susceptibility to false memories, failing to identify lure stimuli as events that never occurred. In addition to impaired performance, they displayed reduced activation in areas associated with memory processing within the medial temporal lobe (MTL), and in parietal and frontal brain regions involved in attention and performance monitoring. Reduced activity in the MTL was associated with greater cannabis consumption. Conclusions: These findings indicate that cannabis users have an increased susceptibility to memory distortions even when abstinent and drug-free, suggesting a long-lasting compromise of memory and cognitive control mechanisms involved in reality monitoring. Financial support: This research was supported by the “Plan Nacional Sobre Drogas” of the Spanish Government. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.509 CaMKII inhibition affects cocaine-cue memory processes to attenuate reinstatement Matthew T. Rich1,∗, Mary M. Torregrossa2 1 University of Pittsburgh, Pittsburgh, PA, United States 2 Psychiatry, University of Pittsburgh, Pittsburgh, PA,

Correlates between Brazilian club drug users men who have sex with men, psychiatric vulnerabilities and multiple sexual partners

Drug and Alcohol Dependence 156 (2015) e183–e245 e189 areas of sexual risk reduction, prevention and treatment for substanceabuseandmental health. Publichealthprogramsprioritizing the different populations are necessary. Financial support: Fogarty International Center; Grant 1R03TW007612; Fundo de Incentivo e Auxilio a Pesquisa (FIPE) from Hospital de Clinicas de Porto Alegre, Brazil (GPPGHCPA – No. 07-391). http://dx.doi.org/10.1016/j.drugalcdep.2015.07.507 Crack, powdered cocaine, both or neither: A generalized logit analysis of a community-based sample Grace L. Reynolds1,2,∗, Dennis G. Fisher1, Erlyana Erlyana2 1 Center for Behavioral Research and Services, California State University, Long Beach, Long Beach, CA, United States 2 Health Care Administration, California State University, Long Beach, Long Beach, CA, United States Aims: To understand factors associated with use of both crack cocaine and non-injected powered cocaine. Methods: The Risk Behavior Assessment (RBA; 1993) was used to elicit information on past month, past 48-hours and drugs used before/during sex drug use in a sample of out-of-treatment drug users (N=8538). Past 30 day, past 48h, and before/during sex drug use were coded into (1) use of crack (smokable cocaine) only, (2) powdered cocaine use only, (3) both drugs used during the timeframe and (4) neither drug used. Generalized logit analysis was used to develop models for each timeframe (48-hour and 30-day). For all models the reference group was using neither drug. Results: Respondents who reported use of both crack and powdered cocaine (N=306) included both men (n=207) and women (n=99). The 48-hour, 30-day, and before/during sex models were almost identical. Those who reported using both crack and cocaine were more likely to: be Black (OR=1.65, CI 1.27, 2.14); bisexual (OR=1.85, CI 1.39, 2.47); trade sex fordrugs (OR=4.88CI 3.73, 6.39); tobehomeless (OR=3.50, CI 2.66, 4.62), havehighernumberof days used alcohol in the pastmonth (OR=1.09, CI 1.08, 1.10); and to have had gonorrhea (OR=1.42, CI 1.07, 1.88). Conclusions: The general logit model highlights factors associated with use of both crack and powdered cocaine within the same timeframe, includinghomelessness, andbeingamemberof anethic or sexual minority, and sex trading. Financial support: Funding was provided in part by grant R01 DA030234 from the National Institute on Drug Abuse, P20MD003942 from the National Institute of Minority Health and Health Disparities. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse, the National Institute ofMinority Health and Health Disparities or the National Institutes of Health. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.508 Cannabis users show increased susceptibility to false memories Jordi Riba1,∗, Frederic Sampedro2, Aina Rodriguez-Pujadas2, Saul Martinez-Horta1, Jaime Kulisevsky1, Jose-Carlos Perez-de-los-Cobos1, Antoni Rodriguez-Fornells1, Marta Valle1 1 Hospital Sant Pau, Barcelona, Spain 2 University of Barcelona, Barcelona, Spain Aims: Previous studies on the neurocognitive impact of cannabis use have found working and declarative memory deficits that tend to normalize with abstinence. An unexplored aspect of cognitive function in chronic cannabis users is the ability to distinguish between veridical and illusory events; a crucial aspect of reality monitoring that relies on adequate memory function and cognitive control. Methods: Sixteen heavy cannabis users not seeking treatment for their cannabis consumptionwerematched to a group of healthy controls taking into account sex, age, years of education, verbal intelligence and fluid intelligence. All participants performed a modified version of the Deese–Roediger–McDermott paradigm in an MRI scanner. Following a study phase, subjects were presented with 75 old words, 40 semantically unrelated new words and 40 semantically related new words or lures. They were required to judge whether a word had been presented in the study phase and make an old vs. new decision by button press. Results: Cannabis users showed an increased susceptibility to false memories, failing to identify lure stimuli as events that never occurred. In addition to impaired performance, they displayed reduced activation in areas associated with memory processing within the medial temporal lobe (MTL), and in parietal and frontal brain regions involved in attention and performance monitoring. Reduced activity in the MTL was associated with greater cannabis consumption. Conclusions: These findings indicate that cannabis users have an increased susceptibility to memory distortions even when abstinent and drug-free, suggesting a long-lasting compromise of memory and cognitive control mechanisms involved in reality monitoring. Financial support: This research was supported by the “Plan Nacional Sobre Drogas” of the Spanish Government. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.509 CaMKII inhibition affects cocaine-cue memory processes to attenuate reinstatement Matthew T. Rich1,∗, Mary M. Torregrossa2 1 University of Pittsburgh, Pittsburgh, PA, United States 2 Psychiatry, University of Pittsburgh, Pittsburgh, PA,

Prevalence of dermatoses in dermatologic evaluation requests from patients admitted to a tertiary hospital for 10 years.

Skin diseases are common in hospitalized patients. However, there is a lack of data concerning their frequency. The objective of this study is to evaluate the prevalence of dermatological diagnoses in hospitalized patients after consultation requested by nondermatologist physicians to the Department of Dermatology, Hospital de Clinicas de Porto Alegre period of 10 years. A total of 5685 patients were evaluated, representing an average of 48.2 patients per month. The five most frequent groups were infectious dermatoses(33.25%), eczematous dermatoses (11.49%), drug reactions (11.43%), vascular dermatoses (6.81%) and group of pruritus, prurigo nodularis and urticaria (hives) (4.71%).

Computed tomography imaging study of the superior attachment of the uncinate process.

The superior attachment of the uncinate process (SAUP) is an important landmark in the nasofrontal recess, but its anatomical distribution is still unclear. The objective of this study was to assess the location and number of superior attachments of the uncinate process on computed tomography (CT) images. A cross-sectional, retrospective study conducted at the Department of Radiology, Hospital de Clinicas de Porto Alegre, Brazil. Sinus CT scans of adult patients with no history of sinonasal surgery, craniofacial fractures, malignant neoplasms, or malformations were examined for identification of the site of SAUP. 152 CT scans (304 sides) were assessed. The SAUP was appropriately identified in 292 sides (96%). Six distinct SAUP patterns were identified: to the lamina papyracea or anterior ethmoidal cells (193, 63.48%); to the middle turbinate (19, 6.25%); to the skull base (19, 6.25%); to the lamina papyracea and middle turbinate (29, 9.53%); to the lamina papyracea and skull base (29, 9.53%); and to the skull base and middle turbinate (3, 0.98%). The site of superior attachment of the uncinate process is highly variable, but is in contact with the lateral nasal wall in 82.5% of the cases.

The role of MRI in Clinically Suspected Appendicitis During Pregnancy

A 31 years female with approximately 20 weeks of gestation attends the emergency department of the Hospital de Clinicas de Porto Alegre (HCPA) reporting pain in the lower abdomen radiating to the right iliac fossa. After clinical and laboratory examination, the clinical diagnosis of appendicitis was suspected, and then performed magnetic resonance imaging (MRI) of the abdomen for diagnostic reasons. The MRI of the abdomen was performed and revealed signs of appendicitis. The intraoperative findings were purulent fluid in the right iliac fossa and appendix with necrotic appearance without signs of perforation. The pathological diagnosis was acute suppurative appendicitis, with periviscerite signals. In pregnant women the enlarged uterus can alter the position of the abdominal contentes and thus make sonography and clinical diagnosis more difficult. CT can be performed in such cases, but it involves a considerable amount of radiation. A typical dose for an abdominal CT examination is on the order of 10 mSv. The routine use of diagnostic CT for benign diseases, as in appendicitis, raises the question whether the diagnosis can be obtained by other radiologic means, especially in pregnant women and even more when the fetus is in the direct beam. The International Commission on Radiological Protection recently published a report on radiation and pregnancy. They recommended that if the expected dose for the fetus is high, one should question whether the diagnosis could be obtained without using ionizing radiation. MRI has been described as a valuable technique for the evaluation of patients with suspected acute appendicitis.

Major bleeding risk assessment in atrial fibrillation patients taking vitamin K antagonists

Background. The use of risk scores for the assessment of major bleeding and stroke in patients with atrial fibrillation (AF) helps evaluate the risks and benefits of oral anticoagulation therapy. The aim of this study was to describe the percentage of patients receiving anticoagulants for non-valvular AF with a high risk of major bleeding based on the HAS-BLED score, as well as identify potential modifiable risk factors of bleeding and compare the risk of major bleeding with the risk of stroke. Methods. Retrospective cohort study involving patients of the anticoagulation outpatient clinic of the Division of Internal Medicine at Hospital de Clinicas de Porto Alegre. Major bleeding risk was estimated based on the HAS-BLED score and stroke risk was determined using the CHADS 2 and CHA 2 DS 2 -VASc scores. Results. Sixty-three patients were investigated (mean age 74.3±10.9 years). The median HAS-BLED score was 2 points, 19 (30.2%) patients had a score ≥ 3 (high risk). The most prevalent modifiable risk factors were labile TP/INR (36.5%) and concomitant use of drugs (30.2%). The absolute risk of major bleeding based on the HAS-BLED score was higher than the risk of stroke in three (4.8%) and four (6.3%) patients in comparison with the CHADS 2 and CHA 2 DS 2 -VASc score, respectively. Conclusions. We concluded that the percentage of patients with high risk of major bleeding is similar to the rate found in the national literature (30.2%). In addition, the most prevalent modifiable risk factors in our cohort were labile TP/INR and concomitant drug use.

Mild Decrease in Renal Function in HIV-Infected Patients on Antiretroviral Therapy: A Neglected Diagnosis

Background: Renal impairment is increasingly reported among HIV-Infected patients and has been associated to an increased chance of cardiovascular disease and death. Therefore, early identification of this problem could help to reduce morbidity and mortality among these individuals. The objective of the study was to determine the prevalence and associated factors with mild decrease in renal function of HIV-infected patients on highly-active antiretroviral therapy (HAART) and undetectable viral load in Brazil. Methods: Individuals between 18-70 years of age with time on HAART ≥ 12 months, viral load < 50 copies/mm3, and CD4 ≥ 200 cells/mm3, were consecutively enrolled at the outpatient clinic of Hospital de Clinicas de Porto Alegre, Brazil. Exclusion criteria were chronic kidney disease, pregnancy and known hepatic disease. Renal function was assessed by the Chronic Kidney Disease Epidemiology Collaboration equation. Mild decrease in renal function was defined as an estimated glomerular filtration rate between 89-60 mL/min/1.73m2, for a period of at least 3 months. Results: From the total of 213 enrolled volunteers, 193 were included in the final analysis. The mean age was 41.5 years, 102 were men (52.6%), and 156 (80.4%) were euro-descendants. Mild renal decline was diagnosed in 33.5% of the patients. Every other year of life (RR=1.05, 95%CI 1.03-1.06, p<0.001) and being euro-descendant (RR=1.94; 95%CI 1.07-3.78; p=0.049) were associated to mild decreases, whereas high body mass index (BMI) (RR=1.04, 95% CI 1.013-1007, p<0,001) was associated to normal function. Conclusions: Mild decrease in renal function was extremely common and more than expected in our cohort (33.5%) which deserves further attention while assisting HIV-positive individuals.

Quality of Life in Patients with Dohlman-Doane Type 1 Keratoprosthesis(Boston Kpro)

Introduction: The aim of this study was to assess quality of life in patients undergoing implantation of a Dohlman keratoprosthesis. Materials and methods: Cross-sectional controlled, with patients undergoing implant Dohlman keratoprosthesis type I at the Hospital de Clinicas de Porto Alegre between September 2005 and May 2013. Two questionnaires of quality of life were administered in these patients SF-36 and VF-14. Furthermore, a retrospective patient charts analysis was performed. Results: Keratoprosthesis implant surgery was performed in 33 eyes of 26 patients. A statistically significant difference was found between groups (separated by visual acuity) for the questionnaire of visual acuity (p=0.01). In SF-36 domains, there were difference in general health (p=0.036), vitality (p=0.028) and mental health (p=0.037). On the Spearman correlation analysis, 5 of the 8 domains of the SF-36, correlated with visual questionnaire (VF-14), when analyzed for the entire sample. When we separated the analysis by subgroups (according to visual acuity), in the group of lowest visual acuity had only one domain correlation (mental health). In the group of best vision, the 5 domains remained with a positive association. Conclusion: Patients with greater visual acuity showed better results in the VF-14 responses, with a statistically significant difference between groups.

209-POS

Objectives To verify the behavior of glycosylated hemoglobin (HbA1c) and homeostasis model assessment (HOMA), which assesses insulin resistance from insulin and fasting glucose levels in pregnant women with GDM after an aerobic training on a cycle ergometer. Methods Randomized clinical trial where mothers with GDM are randomly allocated to the intervention group (IG), which is part of a program of regular aerobic exercise with 50-min sessions, three times a week for 10 weeks, or the control group (CG), which makes stretching and relaxation sessions with 50 min once a week for 10 week. The groups are selected from prenatal clinics in the Hospital de Clinicas de Porto Alegre. Results At this moment, six patients completed the proposed trainings, two in the intervention group and four in the control group. We will only describe the data, since the present study is still in progress, under recruitment of pregnant women. The average age of IG is 30.5 ± 9.2 years and in CG 27.5 ± 8.7 years. Four are primiparous and two are pregnant for the fourth time. At baseline, the overall mean HbA1c is 5.2 ± 0.5 and 6.1 ± 2.0 HOMA. After the intervention of 10 weeks, the overall mean HbA1c is 5.5 ± 0.4 and 6.3 ± 4.0 HOMA. The mean gestational age at IG and CG is the same, 38 weeks and 5 days ± 1 day. Weight and height of the newborn IG was 3620.0 ± 714.2 g and 49.5 ± 2.1 cm, respectively, and in controls was 4037.5 ± 180.5 g and 50.8 ± 2.2 cm, respectively. Conclusions After 10 weeks of training we noticed an increase in mean HbA1c and HOMA, compared to baseline, and that the intervention group delivered lighter and smaller babies. Disclosures J.G. Ramos: None. R. Bgeginski: None. M.L. Opperman: None. S. Martins-Costa: None. R. Delevatti: None. R. Schuch: None. L.F. Kruel: None.

Computed tomography imaging study of the superior attachment of the uncinate process

The superior attachment of the uncinate process (SAUP) is an important landmark in the nasofrontal recess, but its anatomical distribution is still unclear. The objective of this study was to assess the location and number of superior attachments of the uncinate process on computed tomography (CT) images. A cross-sectional, retrospective study conducted at the Department of Radiology, Hospital de Clinicas de Porto Alegre, Brazil. Sinus CT scans of adult patients with no history of sinonasal surgery, craniofacial fractures, malignant neoplasms, or malformations were examined for identification of the site of SAUP. 152 CT scans (304 sides) were assessed. The SAUP was appropriately identified in 292 sides (96%). Six distinct SAUP patterns were identified: to the lamina papyracea or anterior ethmoidal cells (193, 63.48%); to the middle turbinate (19, 6.25%); to the skull base (19, 6.25%); to the lamina papyracea and middle turbinate (29, 9.53%); to the lamina papyracea and skull base (29, 9.53%); and to the skull base and middle turbinate (3, 0.98%). The site of superior attachment of the uncinate process is highly variable, but is in contact with the lateral nasal wall in 82.5% of the cases.

Impacto do DSM-5 no diagnóstico de transtornos de aprendizagem em crianças e adolescentes com TDAH: um estudo de prevalência

Estudos de prevalencia de Transtornos de Aprendizagem (TA) em criancas e adolescentes com TDAH apresentam resultados nao conclusivos, apesar da frequente comorbidade entre as sindromes. Esse artigo descreve e analisa a prevalencia de TA em uma amostra referida de 270 criancas e adolescentes com TDAH atendidas no Programa de Transtornos de Deficit de Atencao/Hiperatividade/Hospital de Clinicas de Porto Alegre - Universidade Federal do Rio Grande do Sul (ProDAH/HCPA-UFRGS), de acordo com os criterios diagnosticos do Manual Diagnostico e Estatistico de Transtornos Mentais IV - versao revisada (DSM-IV-TR). Verificou-se que 46,7% dos estudantes apresentam, pelo menos, um TA, sendo o Transtorno da Expressao Escrita o mais frequente (32,6%). Discutiu-se o potencial impacto das mudancas nos criterios diagnosticos para os TA, propostas pelo DSM-5 na prevalencia desses transtornos. Embora seja possivel afirmar que ocorrerao alteracoes nas taxas de prevalencia de TA, o impacto do DSM-5 sobre a prevalencia, especificidade e comorbidade do TA permanece incerto, ja que ha mudancas que ampliarao a abrangencia dos criterios de inclusao e outras que a reduzirao.

Accuracy of a probabilistic record-linkage methodology used to track blood donors in the Mortality Information System database.

The probabilistic record linkage (PRL) is based on a likelihood score that measures the degree of similarity of several matching variables. Screening test results for different diseases are available for the blood donor population. In this paper, we describe the accuracy of a PRL process used to track blood donors from the Fundação Pró-Sangue (FPS) in the Mortality Information System (SIM), in order that future studies might determine the blood donor's cause of death. The databases used for linkage were SIM and the database made up of individuals that were living (200 blood donors in 2007) and dead (196 from the Hospital das Clinicas de São Paulo that died in 2001-2005). The method consists of cleaning and linking the databases using three blocking steps comparing the variables "Name/Mother's Name/ Date of Birth" to determine a cut-off score. For a cut-off score of 7.06, the sensitivity and specificity of the method is 94.4% (95%CI: 90.0-97.0) and 100% (95%CI: 98.0-100.0), respectively. This method can be used in studies that aim to track blood donors from the FPS database in SIM.

AB0072 Vitamin D Levels and Cytokine Profile in SLE Patients

BackgroundSystemic lupus erythematosus (SLE) is a systemic autoimmune inflammatory disease which presents heterogeneous clinical manifestations. Patients with SLE develop autoimmune response mediated by T and B cells that are manifested...

Incidence of uterine post abortion infection at Hospital de Clínicas de Porto Alegre. Is prophylactic antibiotic necessary?

To identify the incidence of pelvic infection after miscarriage undergoing uterine evacuation in a tertiary hospital in southern Brazil and to compare with the international literature. we reviewed electronic medical records of the Hospital de Clinicas de Porto Alegre of all patients who underwent uterine evacuation for miscarriage between August 2008 and January 2012 were reviewed. We included all patients submitted to uterine curettage due to abortion and who had outpatient visits for review after the procedure. We calculated emographic and laboratory data of the study population, number needed for treatment (NNT) and number needed to harm (NNH). of the 857 revised electronic medical records, 377 patients were subjected to uterine evacuation for miscarriage; 55 cases were lost to follow-up, leaving 322 cases that were classified as not infected abortion on admission. The majority of the population was white (79%); HIV prevalence and positive VDRL was 0.3% and 2%, respectively. By following these 322 cases for a minimum of seven days, it was found that the incidence of post-procedure infection was 1.8% (95% CI 0.8 to 4). The NNT and NNH calculated for 42 months were 63 and 39, respectively. The incidence of post-abortion infection between August 2008 to January 2012 was 1.8% (0.8 to 4).

Avaliação nutricional dos profissionais do serviço de nutrição e dietética de um hospital terciário de Porto Alegre

Este estudo objetivou identificar o perfil antropométrico e bioquímico e analisar a evolução do ganho de peso dos profissionais do Serviço de Nutrição e Dietética (SND) do Hospital de Clínicas de Porto Alegre (HCPA). Estudo de caráter longitudinal retrospectivo, com 190 funcionários. Aplicou-se questionário estruturado e foram realizadas análises bioquímicas e avaliação antropométrica. Observou-se excesso de peso em 60,8% dos funcionários. O ganho de peso encontrou-se associado ao tempo de serviço, turno de trabalho e prática de atividade física. O estudo demonstrou que 1 ano a mais de trabalho esteve associado ao ganho de peso médio de 500 g, o turno de trabalho com ganho de peso médio de 4 kg e a prática de atividade física com perda de peso médio de 3,3 kg. A associação entre ganho de peso, tempo e turno de trabalho em colaboradores de serviços de nutrição remete à necessidade de criação de programas de educação nutricional que promovam hábitos alimentares saudáveis.

One-time Exposure to General Anesthetics Alters Nociceptive Response and Nucleotide Hydrolysis in Infant Rats

Aims: The objective was to evaluate the single exposure of general a nesthetics with or without a surgical procedure at postnatal day 14 (P14) on nociceptive behavioral responses. Furthermore, we evaluated ectonucleotidase activities at P14 and P30. Place of Study:All experiments were performed at the Animal Experimentatio n Unit of Hospital de ClInicas de Porto Alegre. The Institutional Committee approved the OriginalResearch Article