Fibromialgia: o que é, como diagnosticar e como acompanhar?

O objetivo deste artigo é rever as principais características clínicas, critérios diagnósticos e métodos de acompanhamento clínico da fibromialgia. O autor apresenta ainda um pequeno histórico do conhecimento desta síndrome e comenta a necessidade da divulgação do conhecimento adquirido para a partir de um diagnóstico precoce melhorar a qualidade de vida dos pacientes.The main objective of this article is to review the clinical characteristics, diagnóstic criteria and follow up methods of the fibromyalgia syndrome. The author also presents a brief historical review of the knowledge on this syndrome. It is also commented the necessity of this knowledge divulgation in order to obtain early diagnosis to improve the patients quality of life

Iron stores and coagulation parameters in patients with hypoxemic polycythemia secondary to chronic obstructive pulmonary disease: the effect of phlebotomies

This study was designed to determine the effects of phlebotomy on iron body contents and coagulation tests of COPD patients with polycythemia secondary to hypoxemia. Seventeen patients with COPD and hematocrits higher than 54 percent (mean Hct: 57 ± 0.49 percent ), who had not received anti-inflammatory or antiplatelet aggregation agents recently. Their mean forced expiratory volume at 1 second (FEV1) was 0.92 ± 0.11 L. Intervention: Blood work was collected to evaluate the following: serum iron and ferritin levels, total iron binding capacity, transferrin saturation index, fibrinogen plasma levels, activated partial thromboplastin time, platelet count, platelet aggregation measurements, and thromboelastography coagulation parameters. The blood samples were obtained before and about 7 days after the hematocrit correction by 300-400 ml phlebotomies done every other day. The mean number of phlebotomies done for each patient was 4.4. Postphlebotomy iron serum levels decreased from 90.1 ± 14.8 to 59.7 ± 9.9 mg/dl and the ferritin serum levels from 133.8 ± 37.9 to 70.8 ± 32.7 ng/ml (p< 0.05). Regarding the coagulation studies, there were significant increases in the platelet count, from 227,300 ± 13,900 to 312,500 ± 30,200 per mm³, and in the maximum clot amplitude (a) obtained by thromboelastography ( from 53.6 ± 1.4 percent to 60.4 ± 1.1 percent). The coagulation time (k) of the thromboelastography also decreased significantly, from 7.5 ± 0.7mm prephlebotomy to 4.5 ± 0.3mm postphlebotomy. Although the coagulation changes were small amount, the observed significant decrease in iron contents may have important clinical implications.Determinar os efeitos das sangrias nas reservas corporais de ferro e em testes da coagulação sanguínea de pacientes com policitemia secundária a hipoxemia por doença pulmonar obstrutiva crônica (DPOC). Dezesete pacientes portadores de DPOC, com hematócritos superiores a 54%, ( Hct médio: 57± 0,49%) que não tinham feito uso recente de agentes antinflamatórios ou antiadesivos plaquetários, e cujo volume expirado forçado no primeiro segundo (VEF1), médio foi de 0,92 ± 0,11 L. Determinação dos níveis de ferro, ferritina, capacidade de ligação do ferro, índice de saturação da transferrina, fibrinogênio, tempo de tromboplastina parcial ativada, número de plaquetas, agregação plaquetária e de parâmetros da coagulação medidos pela tromboelastografia. Tais dosagens foram realizadas antes e em torno de sete dias após a normalização dos hematócritos através de sangrias de 300-400ml cada, realizadas em dias alternados, resultando num número médio de 4,4 sangrias por paciente. Com as sangrias os níveis séricos do ferro caíram de 90,1± 14,8 mg/dl a 59,7 ± 9,9 mg/dl, e os níveis da ferritina sérica de 133,8 ± 37,9 ng/ml a 70,8 ± 32,7 ng/ml (p<0.05). Em relação aos estudos da coagulação, houve um aumento significante na contagem plaquetária de 227.300 ± 13.900 a 312.500 ± 30,200 elementos/mm³, e na amplitude máxima do coágulo obtida pela tromboelastografia (a), de 53,6 ± 1,4% para 60,4 1 ± 1,1%. O tempo de coagulação (k) da tromboelastografia, também diminuiu significantemente de 7,5 ± 0,7 mm pré-flebotomias para 4,5 ± 0,3 mm pós-flebotomias. Os autores concluem que embora as alterações da coagulação tenham sido de pequena monta, os decréscimos nas reservas de ferro foram significantes podendo ter implicações clínicas importantes.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Respiratory and Hematology DivisionsUNIFESP, EPM, Respiratory and Hematology DivisionsSciEL

Análisis de los sistemas de control de potencia en redes LTE

Este trabajo analiza el funcionamiento de los sistemas de control de potencia desarrollados para su implantación en redes móviles celulares. Desde el punto de vista medioambiental, estos sistemas pueden tener un impacto clave en temas como el ahorro en el consumo energético, el control de las potencias máximas de emisión, etc. El análisis se centrará en la tecnología LTE (Long Term Evolution), máximo exponente de la denominada cuarta generación de las comunicaciones móviles o 4G, por lo que previamente se realizará una breve descripción de sus principales características

Há correlação entre classe social e a prática de atividade física?

O exercício físico é recomendado para promover a saúde e melhorar a qualidade de vida. As condições para a realização de atividade física devem incluir local, roupas, supervisão e elaboração de antemão. O objetivo desta pesquisa verificar se existe influência da renda familiar na freqüência e na forma de se praticar exercícios físicos. Utilizou-se um questionário especialmente elaborado para os dados sociodemográficos, freqüência, tipo e condições da prática de exercícios. Setenta pacientes, divididos em dois grupos: assistidos por instituições públicas de saúde (A) e assistidos por organizações privadas (B). Em ambos os grupos se observou uma maioria de mulheres (A - 66%; B - 60%) e casados. Em relação ao status sócio-econômico, os membros do grupo A têm maior renda e escolaridade. Os resultados mostram maior freqüência de atividade física entre os conveniados. Ambos os grupos têm a maioria dos componentes que não praticam exercícios. Entre aqueles que praticam exercício regularmente, a maior parte o faz de 1-3 vezes por semana, com duração entre 30-50 minutos. A modalidade principal é caminhar sem supervisão ou preparação como aquecimento ou alongamento. Os níveis econômicos e educacionais não influenciam a freqüência, tipo e condições da prática de exercícios.Exercise is recommended in order to promote health and to improve quality of life. The conditions required for physical activity should include location, clothing, supervision and preparation beforehand. The objective of this research is to see if family income influences the frequency and manner of doing physical exercise. A questionnaire containing data on demographics, frequency, type and conditions of exercise practiced involving seventy subjects, divided into two groups: assisted by public health institutions (A) and private organizations (B) was used. Both groups consisted of primarily women (A – 66 %; B - 60%) and married persons. In relation to socioeconomic status, members of the B group have a higher income and educational level. There is greater frequency of physical activity among the members of group B. The majority of participants in both groups do not exercise. In both groups, among those who do exercise regularly, the majority does so around 1-3 times per week, for a length of between 30-50 minutes. The main modality is walking with-out supervision or preparation such as warm ups or stretching. The economic and educational levels do not influence the frequency, type and conditions of exercise practiced

Juvenile hormone downregulates vitellogenin production in Ectatomma tuberculatum (Hymenoptera: Formicidae) sterile workers

In the ant Ectatomma tuberculatum (Olivier 1792), workers have active ovaries and lay trophic eggs that are eaten by the queen and larvae. Vitellogenins are the main proteins found in the eggs of insects and are the source of nutrients for the embryo in the fertilized eggs and for adults in the trophic eggs. In social insects, vitellogenin titres vary between castes and affect reproductive social status, nursing, foraging, longevity, somatic maintenance, and immunity. In most insects, vitellogenin synthesis is mainly regulated by juvenile hormone. However, in non-reproductive worker ants, this relationship is poorly characterized. This study determined the effects of juvenile hormone on vitellogenin synthesis in non-reproductive E. tuberculatum workers. Juvenile hormone was topically applied onto workers, and the effect on vitellogenin synthesis in the fat body and vitellogenin titres in the haemolymph were analysed by ELISA and qPCR. Juvenile hormone downregulated protein synthesis and reduced vitellogenin titres in the haemolymph, suggesting that in workers of E. tuberculatum, juvenile hormone loses its gonadotrophic function

Conformation-independent QSPR approach for the soil sorption coefficient of heterogeneous compounds

We predict the soil sorption coefficient for a heterogeneous set of 643 organic non-ionic compounds by means of Quantitative Structure-Property Relationships (QSPR). A conformation-independent representation of the chemical structure is established. The 17,538molecular descriptors derived with PaDEL and EPI Suite softwares are simultaneously analyzed through linear regressions obtained with the Replacement Method variable subset selection technique. The best predictive three-descriptors QSPR is developed on a reduced training set of 93 chemicals, having an acceptable predictive capability on 550 test set compounds. We also establish a model with a single optimal descriptor derived from CORAL freeware. The present approach compares fairly well with a previously reported one that uses Dragon descriptors.Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicada

Iahris: New Software to Assess Hydrologic Alteration

Indicators of Hidrologic Alteration in RIverS (IAHRIS) is a software designed to fulfill: 1. Parameters for the characterization of the natural or regulated flow regime, in a section of the river. These parameters evaluate those aspects of the flow regime with the highest environmental meaning (magnitude, variability, seasonality and duration). Their definition has given priority to the consideration of the singular characteristics of the Mediterranean regimes. 2. If the user enters data of the natural flow regime and data for any other flow regime in the same section or reach (altered regime, environmental regime, management scenario, …) the software calculates, furthermore, a set of indicators that assess the degree of hydrologic alteration in comparison with the natural regime. These indicators of alteration have been defined attending to the CIS-WFD recommendations for the Ecological Quality Ratios. The software requires, at least, 15 entire years with data (daily average flows and/or monthly volumes). The type of data entered in IAHRIS determines, directly, the results accomplished. In particular, they depend on the data periodicity –daily or monthly-, and the simultaneous character of the data associated to the natural and the altered flow regimes. IAHRIS is free software, available at the website of the Spanish Ministry of the Environment

Immunomanipulation of appetite and body temperature through the functional mimicry of leptin.

Objective: Although current obesity therapies produce some benefits, there is a need for new strategies to treat obesity. A novel proposal is the use of anti-idiotypic antibodies as surrogate ligands or hormones. These anti-idiotypic antibodies carry an internal motif that imitates or mimics an epitope in the antigen (i.e., hormone or ligand). Thus, anti-idiotypic antibodies to several ligands may mimic them in transducing signals when binding to their receptors. Research Methods and Procedures: We developed an anti-idiotypic polyclonal antibody against the region of a leptin monoclonal antibody that competitively binds leptin, mimicking the active site structure of leptin. To test whether our anti-idiotype could also reproduce leptin functions, we examined food intake, body weight, and colonic temperature in male Wistar rats (n = 9) in response to intracerebroventricular administration of the leptin anti-idiotype. Results: Our leptin anti-idiotype induced a significant reduction in food intake coupled with an increase in body temperature comparable to that of leptin. That is, the intracerebroventricular administration of 8.0 microg of leptin anti-idiotype or 5.0 microg leptin significantly increased colonic temperature (Delta 1.9 plusminus 0.11 °C and Delta1.7 plusminus 0.12 °C, respectively). In addition, both decreased 24-hour food intake (-26.4 plusminus 2.4% and -21.9 plusminus 2.2%) compared with the control. The gain in body weight was also decreased by acute administration of the anti-idiotype (-1.4 plusminus 0.28%) and leptin (-1.1 plusminus 0.17%) vs. the phosphate-buffered saline control (1.3 plusminus 0.15%). Discussion: These studies revealed that the leptin anti-idiotype inhibited food intake and enhanced heat production, mimicking leptin's central actions