-Background: Hemodialysis (HD)-related headaches are a common complaint of patients undergoing this procedure. Objective: To determine the frequency and clinical characteristics of headache in patients undergoing HD and to discuss their diagnostic criteria. Method: The present study assessed, in a prospective manner, a series of patients consulting at a HD center in Aracaju, Sergipe, Brazil, from November 2007 to January 2008. Only patients with HD-related headaches without previous history of primary headache were diagnosed as isolated HD headache (HDH). Results: Headache was reported by 76.1% of the patients studied. Prior to beginning dialysis, 47.9% had migraine without aura, 6.7% migraine with aura, 0.6% hemiplegic migraine, 5% episodic tension-type headache, and 2.5% migraine and tension-type headache. HDH was diagnosed in 6.7% of the patients, the most prevalent features being diffuse or temporal region location, bilateral headache, throbbing nature, and moderate severity. Seven patients with headaches between the sessions were not classified. Conclusion: While the pathophysiology of HDH is unknown, to diagnose patients with HDH or other possible HD-related headaches remains a challenge.Key WOrDS: hemodialysis headache, end-stage renal, clinical description, diagnostic criteria. Caracterização clínica da cefaléia da diálise em pacientes renais crônicosResumo -Cefaléias relacionadas ao programa de hemodiálise é uma queixa comum. Objetivo: Determinar freqüência e características clínicas das cefaléias em pacientes em regime de hemodiálise e discutir critérios diagnósticos. Método: Foi feita uma avaliação clínica prospectiva de pacientes cefalêicos em um serviço de hemodiálise em Aracaju, Sergipe, Brasil, de novembro de 2007 a janeiro de 2008. Apenas pacientes sem antecedente de cefaléia primária receberam diagnóstico de cefaléia da diálise isolada. Resultados: Cefaléia esteve presente em 76,1% dos pacientes estudados. Como antecedente de cefaléia, 47,9% tinham migrânea sem aura, 6,7% migrânea com aura, 0,6% migrânea hemiplégica, 5,5% cefaléia tensional episódica, e 2,5% associação de migrânea e cefaléia tensional. A cefaléia da diálise isolada foi diagnosticada em 6,7% dos pacientes e as localizações difusas e temporais, cefaléia bilateral, pulsátil, e intensidade moderada foram as características mais prevalentes. Conclusão: enquanto a fisiopatologia da cefaléia da diálise for desconhecida, o diagnostico da cefaléia da diálise ou de outras possíveis cefaléias relacionadas à diálise permanecerá um desafio.PAlAvrAS-CHAve: cefaléia da diálise, insuficiência renal terminal, características clínicas, critérios diagnósticos.

No abstract

Objective: Somatotrophs represent the majority of cells in the anterior pituitary, and their numeric reduction can cause anterior pituitary hypoplasia (APH). Small numbers of patients with familial isolated GH deficiency (IGHD) due to bi-allelic mutations in the GHRH receptor (GHRHR) gene (GHRHR) have been reported to have APH. We tested if APH was present in a large cohort of patients homozygous and heterozygous for a GHRHR mutation. Design: We studied pituitary morphology in adult and pediatric age subjects (8 years of age and older) belonging to a large extended Brazilian kindred with a high prevalence of IGHD due to a null GHRHR mutation. Methods: We performed brain magnetic resonance imaging (MRI) in 38 subjects, divided into four groups: group I: normal adults (five males, four females, age 38^11:7 years); group II: heterozygous adults (six males, seven females, age 42:23^8:8 years); group III: homozygous GH-naive affected adults (three males, five females, age 41:4^15:0 years); group IV: homozygous affected children (three males, five females, age 11:9^2:5 years). Results are expressed as means^s:d: Results: Pituitary height (mm) was not different between groups II and I (4:61^1:55 and 4:41^0:62 respectively), but it was significantly reduced in groups III ð2:67^0:87; P , 0:001Þ and IV ð2:87^0:79; P , 0:001Þ compared with group I. Pituitary volume (mm 3 ) was normal in group II ð417:12^140:86Þ; but it was significantly reduced in groups III and IV ð124:06^64:27 and 155:68^39:79 respectively vs 414:56^71:57; both P , 0:001Þ: The volume ratio (calculated by multiplying the pituitary volume by 1000 and dividing it by cranial volume) was significantly lower in the affected subjects (groups III and IV) ð0:06^0:02Þ than in unaffected (groups I and II) ð0:15^0:04; P , 0:0001Þ; demonstrating that APH is not due to reduction of cranial volume. Conclusions: APH is present from childhood in patients homozygous for an inactivating GHRHR mutation, but it does not occur in heterozygous subjects. In our cohort, the presence of normal anterior pituitary size by MRI rules out homozygosity for a GHRHR mutation in subjects who are 8 years of age or older.

Resumo O presente trabalho tem por objetivo caracterizar quatro argilas diferentes utilizadas na produção de revestimento cerâmico do tipo BIIb no Estado de Sergipe, Brasil. As argilas foram caracterizadas por difração de raios X, fluorescência de raios X, análise termogravimétrica, análise térmica diferencial, distribuição de tamanho de partículas, limites de Atterberg e dilatometria. A partir dos resultados obtidos foi possível detectar concentrações de calcita entre 1,1 e 13,7%, a depender da origem da argila. Esta informação é determinante para ajustes no ciclo de queima e previsão da energia mínima para que a sinterização ocorra. Foram produzidos corpos de prova por prensagem uniaxial em matriz retangular de 120 mm x 56 mm x 6 mm a uma pressão de 28 MPa, os quais foram queimados a 1130 oC com ciclo de queima de 23 min e patamar de 3 min. Os corpos de prova foram caracterizados quanto à absorção de água e módulo de ruptura à flexão, e sua microestrutura foi investigada por microscopia eletrônica de varredura. Através dos resultados, foi possível confirmar a correlação entre a formação de fase líquida e redução de porosidade nos corpos cerâmicos sinterizados a 1150 oC. As energias de ativação para o processo de sinterização foram determinadas a partir dos ensaios dilatométricos e os resultados mostraram que, à medida que se diminui o teor de calcário combinado com o aumento do teor de materiais fundentes, a sinterização ocorre em temperaturas mais baixas, resultando em menores gastos energéticos no processo de produção.

Breast MRI is effective in detecting residual lesions after RFA in patients with IDC.

Conventional processes for heavy metal removal are costly. Natural and modified clay with quaternary ammonium salt were used as adsorbent for the removal of Cr (VI) from aqueous solutions. Clays were characterized using Fourier transform infrared spectroscopy FTIR, thermal analysis (TG/DTA) and X-ray diffraction (XRD). Cr (VI) determination was conducted by ultraviolet-visible spectrophotometry, using complexation with 1,5-diphenylcarbazide. Absorbance was measured at the wavelength of 540 nm. The experiments were conducted at 25 ± 1 °C; initial Cr (VI) concentration of 4 to 25 mg L-1; initial pH of 2, agitation of 150 rpm; contact time of 120 minutes and clay mass of 0.1 g. Natural and modified clays exhibited a maximum adsorption capacity of 2.548 mg g-1 and 17.24 mg g-1, respectively, in accordance with the Langmuir isotherm model. X-ray diffraction analysis of clay indicated that the sample consists mainly of kaolinite and montmorillonite.

-Spinal cord compressing syndrome due to synovial cyst (SC) of the thoracic spine is a rare clinic condition. We report a case of SC located in the thoracic spine causing spastic paraparesis in a 14 yearold female patient. The SC was removed thoroughly by laminectomy. The patient had an excellent recovery. The etiological and therapeutic aspects are discussed.Key WoRdS: myelopathy, synovial cyst, spinal cord compressing, thoracic spine.Cisto sinovial da coluna torácica: relato de caso ReSUMo -Síndrome de compressão medular causada por cisto sinovial (CS) da coluna torácica é patologia rara e pouco descrita na literatura. descrevemos um caso de CS da coluna torácica causando paraparesia espástica em uma paciente de 14 anos de idade. o cisto foi removido através de laminectomia e a paciente apresentou uma excelente recuperação. discutimos os aspectos etiológicos e terapêuticos.PAlAvRAS-ChAve: mielopatia, cisto sinovial, compressão medular, coluna torácica. Synovial cysts (SC) of the spine are cystic dilatations of the synovial sheaths commonly found in the lumbar spine [1][2][3][4][5][6][7] , following by the cervical [8][9][10][11][12][13] and rarely in the thoracic spine 14-16 usually affecting patients over the fifth decade. These can cause myeloradiculopathy, depending on the level of occurrence due to compression of the spinal cord structure or the peripherical roots 2,3 . These cysts have intraspinal and extradural location and originate from the facet capsules caused by degeneration of the facet joints, being therefore known as synovial, juxtafacet, ganglion or ligamentum flavum cysts 14 . Incidentally, can be diagnosed during pain investigation located in the spine and/or myeloradicular symptoms; now they are more easily diagnosed through magnetic resonance imaging (MRI) 1 and by computerized tomography (CT) 18. The SC of the thoracic spine is infrequent and the world literature shows a shortage of documented cases.This fact collaborates with the aim of this study: presentation of a case of SC in a young patient, occurring in the thoracic spine and developing progressively compressive spine symptoms. CASEA 14 years-old girl was admitted with a chief complain of weakness in the lower limbs which had started four months earlier. In the beginning she felt an intermittent weakness, mainly in the right, that interfered in the dance classe development. The weakness was progressive, followed by cramps, tingling and interfering in the gait. Moderate alteration of anal and vesical sphincter function was presented. The general examination showed good overall state. The patient was alert, lucid and guided, but with depressed humor. vital signs were normal. Absence of palpable ganglions was noticed. The cardio-respiratory system and the abdomen did not show any alteration during exam. Neurological exam presented: asymmetrical paraparesis (R>l); moderate hypertonia (R>l); increased deep tendon reflexes with clonus in the lower limbs. Bilateral Babinski sign being more evident in the right. Superficial hypoesth...

The Fisher revised scale (FRS) presents an alternative for evaluating patients with subarachnoid hemorrhage (SAH). In this study, we compared the prognosis of patients with SAH and vasospasms (VSP). Method: This was a prospective study on patients with a diagnosis of aneurysmal SAH, 72 hours after the initial event. Sequential neurological examinations and Hunt and Hess (HaH) score were performed on the 1 st , 7 th and 14 th days. Transcranial Doppler was used to assess vasospasms. Results: Out of the 24 patients studied, ten (41.66%) presented a delayed neurological deficit, such as diminished consciousness, decreased HaH score or death. The single patient classified as FS-1 did not have any delayed neurological deficit, while such deficits evolved in one patient out of five with FS-2 (20%); two out of seven with FS-3 (28.57%) and seven out of 11 with FS-4 (63.63%). Conclusion: Level three of the FS and FRS seemed to be compatible with regard to predicting the likelihood of progression to severe VSP.