Central serous chorioretinopathy (CSCR) is an idiopathic serous detachment of the macula caused by focal leakage of choroidal interstitial fluid through the retinal pigment epithelium. Since von Graefe first described central serous chorioretinopathy in 1866' dozens of papers have reported its demographic characteristics, presenting visual symptoms, and ophthalmological signs. Patients usually report the sudden onset of central blurring, metamorphopsia, and relative scotoma. Serous detachment usually lasts about three months. Focal photocoagulation of the leak site significantly decreases the duration of detachment to about one month, but has no significant effect on visual acuity.2-5 Indirect photocoagulation, which has been employed to avoid direct coagulation ofsubretinal foveal leaks, has no effect on the duration of detachment.56We found in the literature 12 series that included CSCR patients with follow-up of one or more years.2-5 7-13 Seven are retrospective follow-up studies, four are prospective randomised studies, and one is a prospective, nonrandomised study. The studies by Klein et al.'0 Dellaporta," and Nanjiani'2 are most comparable with our study. In our retrospective long-term follow-up study of CSCR patients we studied visual acuity outcome, recurrence tendency, and pigment epithelial leakage pattern and mottling features. We searched for possible prognostic indicators and attempted to determine the long-term effects of focal argon laser photocoagulation. Patients and methodsWe reviewed 157 cases of CSCR with classic focal retinal pigment epithelial dye leakage and macular detachment that were identified from the Wilmer Retinal Vascular Center files. Cases with coexisting ocular disease were not included. Of these 157 cases of active central serous retinopathy 105 (67%) were not treated and 52 (33%) were treated with focal argon laser photocoagulation. We performed a follow-up examination on approximately half of each group: 47 untreated, 26 treated. We obtained followup for an additional 45 patients from their local ophthalmologists or by detailed questionnaire.The initial and interim examinations were performed by the Wilmer Retinal Vascular Center staff. All initial examinations included visual acuity measurement (existing correction plus pinhole) by a technician, direct and indirect ophthalmoscopy, contact lens biomicroscopy, and stereoscopic colour 815 on 12 May 2018 by guest. Protected by copyright.

A B S T R A C T Membrane metabolism was studied during the initiation of compensatory growth after acute reduction in renal mass. The rate of [14C]choline incorporation into phospholipid in renal cortical slices was increased by 37% at 5 min of compensatory growth in mice. The rate increased to the maximal value of 68% by 20 min and remained there for 3 h. The rate then remained increased at 28-34% above normal for 2 days and returned to normal by the 6th day.The increase in rate of choline incorporation into renal phospholipid was independent of choline uptake. r"C]Choline was found to be a specific precursor of the three renal phospholipids, phosphatidylcholine, lysophosphatidylcholine, and sphingomyelin, which comprise over half the amount of the phospholipids. The relative distribution of the label in each of the three phospholipid classes did not change with compensatory growth. An increased rate of choline incorporation was also observed in kidneys of rats during compensatory growth and in the compensating kidneys of mice treated with indomethacin before uninephrectomy. The rate was increased 24% at 3 h after uninephrectomy in vivo. The increase appeared to be specific for the kidney, since it did not occur in the livers of these mice.The results indicate that the onset of renal compensatory growth is associated with a specific enhancement of the synthesis of renal choline-containing phospholipids. Since the phospholipids largely occur in the cell membrane, early alterations in cell membrane metabolism may thus play a role in the initiation of cell growth.A preliminary report of this work has been published in abstract form: 1973. American Society of Nephrology. 6: 105.

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o fato de que o idoso não tolera bem os extremos de temperatura e umidade, devendo ser evitados exercícios intensos sob tais condições climáticas, devido à possibilidade de hipertermia ou hipotermia.Documentos institucionais previamente publicados traçaram recomendações quanto à prática de exercícios competitivos em portadores de doenças cardiovasculares; quanto aos critérios de afastamento e elegibilidade para competição desportiva; e quanto aos critérios para detecção de doenças cardiovasculares em uma população aparentemente saudável. Entretanto, esses documentos se concentraram, principalmente, em atletas jovens ou indivíduos idosos praticantes de atividade física de caráter não-competitivo.As competições para veteranos, organizadas pelas confederações nacionais, federações regionais ou por associações de atletas apresentam com freqüência bom nível téc-nico. Alguns atletas com idades para serem considerados veteranos (master) ainda mantêm carreiras competitivas em algumas modalidades, participando de campeonatos mundiais absolutos ou mesmo dos Jogos Olímpicos, com bons resultados.O objetivo deste Posicionamento Oficial da Sociedade Brasileira de Medicina do Esporte (SBME) é fornecer recomendações médicas para uma maior segurança na prática de exercícios de caráter competitivo por atletas veteranos. INTRODUÇÃONas últimas décadas tem sido observada uma tendência ao aumento da expectativa de vida, ao lado de uma maior participação de indivíduos acima de 35 anos em atividade física de caráter competitivo e não-competitivo.A medicina preventiva reconhece a importância do exercício, como meio de desacelerar o processo de envelhecimento e diminuir as diversas enfermidades associadas. No entanto, o aumento da participação em atividades competitivas traz como conseqüência uma maior incidência de complicações.Os problemas médicos principais entre os idosos que praticam exercícios são de natureza cardiovascular, mús-culo-esquelética e termorreguladora. É importante lembrar

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