Botucatu - FMB - Faculdade de Medicina

URI Permanente para esta coleçãohttps://hdl.handle.net/11449/253819

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    Nerves injuries during rhytidoplasty: How to avoid and surgical reparation
    (2021-04-07) Viterbo, Fausto ; Universidade Estadual Paulista (UNESP)
    Nerve injury in facial aesthetic surgery is not rare. Specially in facial lifting, the injuries may occur in the sensory and motor nerves. In this chapter, we describe the most injured nerves during face-lifting and our approach in terms of clinical and surgical treatment.
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    History Taking and Assessment
    (2019-01-01) Forlenza, Orestes V. ; Pereira, Marta L.G.F. ; Canineu, Paulo R. ; Stella, Florindo ; Universidade de São Paulo (USP) ; Universidade Estadual Paulista (UNESP)
    The clinical history is a fundamental part of the medical semiology. It requires assessing the patient with a holistic approach and demands special attention to specific elements that may allow a deeper understanding of disease process and its progression over time. In the present text, we emphasize some of the most relevant aspects of history taking in geriatric psychiatry, including the characterization of premorbid features, personal and family history, and the establishment of an accurate estimate of cognitive/functional status and behavioral symptoms both in primary (functional) and secondary (organic) psychiatric disorders. The identification of risk factors for neuropsychiatric disorders associated to general medical conditions is another important element, for the modification of these factors (whenever possible) may be crucial for overall response and prognosis. We further propose that use of psychometric scales in clinical practice not only yields the objective measurement of baseline cognitive/functional state for diagnostic purposes but also enables the clinician to monitor changes during follow-up, particularly those related to treatment response.
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    Peritoneal Dialysis in Acute Kidney Injury: Prescribing Acute PD
    (2021-01-01) Ponce, Daniela ; Balbi, André Luís ; Universidade de São Paulo (USP) ; Universidade Estadual Paulista (UNESP)
    Decades ago, peritoneal dialysis was widely accepted as treatment for acute kidney injury (AKI); however, its usage declined in favor of other types of extracorporeal therapies. The interest in PD to manage AKI patients has been reignited, and PD now frequently is used in developing countries because of its lower cost and minimal requirements for infrastructure. Studies from Brazil, India, and Africa have shown that with careful thought and planning, critically ill patients can be successfully treated with PD. To overcome some of the classic limitations in the use of PD for AKI, such as increased risk of infectious and mechanical complications and poorer control of urea, potassium, and bicarbonate levels, the use of cyclers, flexible catheters, and a high volume of dialysis fluid has been proposed. However, in developing countries, the setup for quality research is often lacking, thereby resulting in limited evidence regarding standardized treatment regimens including indications, dosing, technical failure, and mortality. The recent publication of the International Society for Peritoneal Dialysis (ISPD) guidelines for PD in AKI has tried to address these issues and provide an evidence-based standard by which to provide therapy. In this chapter, the advances in technical aspects, advantages, and limitations of PD and the key prescriptions and strategies for PD use in AKI are discussed, and we will review recent literature on clinical experience with PD for the treatment of AKI.
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    Gluteal augmentation in post-massive weight loss patients
    (2021-04-29) Mendes, Flavio Henrique ; Viterbo, Fausto ; Universidade Estadual Paulista (UNESP)
    Surgical treatment of obesity and its comorbidities has not only been recognized as one of the greatest achievements of modern medicine, but it also has created new body contour deformities for which our specialty has been devoted to correct in the last decades. Massive weight loss patients usually present with body contour deformities that often affect gluteal aesthetics. The lack of volume and projection is related to a severe disarrangement of the buttocks' frame, which requires specific measures to restore anatomical landmarks and to enhance shape and contour of the gluteal region. In most cases, circumferential body lift will be the first step to readjust the gluteal frame. Augmentation techniques such as fat grafting, autologous flaps, and alloplastic implants can be associated to enhance buttocks projection. Fat grafting helps restore volume and projection to the massive weight loss (MWL) buttocks, targeting different aesthetic units and globally promoting a true refill of the deflated subcutaneous spaces. Besides volume restoration, other regenerative and angiogenic properties of adipose tissue may be responsible for metabolic turnover and improvement in skin quality. Dermal flaps and silicone implants also contribute to increase buttock projection in specific gluteal units. As we continue to advance in our understanding of the MWL deformities, surgical techniques for gluteal contour will certainly be refined toward improving aesthetic outcomes and fewer complications.
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    Type I interferons: History and perspectives as immunotherapeutic agents against cancer
    (2020-09-24) Gorgulho, Carolina Mendonça ; Romagnoli, Graziela Gorete ; Kaneno, Ramon ; Universidade Estadual Paulista (UNESP) ; UNOESTE ; BRA
    Interferons (IFNs) were first described in the context of viral infection as macromolecules capable of interfering with the ability of a viral particle to infect a host cell. Besides viral interference, since their discovery, IFNs have been further implicated in different processes linked to immunity and cancer. The family of IFNs has been divided into three categories according to biological properties and signaling pathways: type I IFNs (consisting of IFN-α and β), type II IFNs (IFN-γ, also known as the immune IFN), and type III IFNs (consisting of IFN-λ). This chapter focuses on type I IFNs, which are closely linked to key processes in cancer, such as malignant transformation, differentiation, tumor cell growth, and death. Within the immune system, type I IFNs communicate with several populations involved in the antitumor immune response, such as NK (natural killer) and dendritic cells, contributing to cancer immunoediting. Type I IFNs are approved for the treatment of a number of cancers, including melanoma, renal cell carcinoma, and Kaposi's sarcoma. However, currently the biggest challenge in the therapeutic use of type I IFNs, as well as other cytokines, is the toxic side effects, which can compromise the efficacy of the treatment and reduce patient's quality of life. In this chapter, we review the biology of type I IFNs along with many therapeutic approaches being currently explored in order to reduce toxicity and fully harness the antitumor potential of type I IFNs.
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    Dendritic cell vaccines for cancer therapy: Fundamentals and clinical trials
    (2020-09-24) Romagnoli, Graziela Gorete ; Kaneno, Ramon ; Universidade Estadual Paulista (UNESP) ; Oeste Paulista University - UNOESTE
    Since conventional chemo- and radiotherapy and surgery are not completely satisfactory to fight cancer, active and passive immunotherapeutic approaches have figured as effective agents of customized medicine. Dendritic cells (DCs) are key cells to trigger an effective antitumor response, being the only antigen-presenting cells (APCs) able to prime naïve T lymphocytes for tumor antigens. Therefore, several approaches have been proposed to use these cells as therapeutic antitumor vaccines. Different strategies of tumor antigen delivery, as well as the use of the best DC activators, are in constant search for the development of more immunogenic DC-based vaccines. In the present chapter, we reviewed the strategies for developing clinical-grade DC vaccines and the data of clinical trials with patients with selected types of cancer. Current studies show positive but not definitive results, indicating that the association with other immunotherapeutic agents, such as checkpoint blockers, or even chemotherapeutic agents may contribute to achieve the clinical regression of cancer.
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    Paracoccidioidomycosis: An Update from the Environment to Clinics
    (2022-01-01) de Oliveira, Haroldo Cesar ; de Paula e Silva, Ana Carolina Alves ; Marcos, Caroline Maria ; de Fátima da Silva, Julhiany ; Scorzoni, Liliana ; Assato, Patricia Akemi ; Rossi, Suélen Andreia ; Fundação Oswaldo Cruz (Fiocruz-PR) ; Universidade Estadual Paulista (UNESP) ; Guarulhos University (UNG) ; Universidade de São Paulo (USP)
    Paracoccidioidomycosis is an endemic mycosis of great importance in Latin America caused by dimorphic fungi of the genus Paracoccidioides. Recent advances in the study of this mycosis reveal the Paracoccidioides genus as fungi that are difficult to treat and diagnose, with a great capacity to adapt and evade the environment of host cells, causing an invasive disease that is neglected in areas where it is endemic. This chapter aims to provide an overview of the fungi of this genus and the disease, bringing historical aspects and also the most recent advances in the study of this important mycosis, which has a great impact on public health in many countries in Latin America. This chapter will address issues such as the diversity of species of the Paracoccidioides genus, the thermal dimorphism, that allows the fungus to survive in the environment and the host, and its impact on the infectious process, virulence factors, and their relationship with the evasion capacity of the host immune system, as well as aspects associated with the disease such as clinical forms, pathogenesis, epidemiology, diagnosis and treatment.
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    Interlinking dementia in Parkinson’s disease: Nutritional correlates of body composition
    (2020-01-01) Schelp, Arthur Oscar ; Komuro, Jéssica Emy ; Corrente, José Eduardo ; Papini, Silvia Justina ; Universidade Estadual Paulista (UNESP) ; Medicine School ; Bioscience Institute
    Little evidence showed that body composition has a primary role in the development of dementia in Parkinson’s disease (PD). However, several studies indicated that metabolic and nutritional dysfunctions have a relevant influence on disease outcome. The confluence of several disturbances, including disruption in fat and glucose metabolism, with nutritional component abnormalities, could be a crucial event when associated with dopamine depletion in the striatum of patients with PD. It was discussed that there may be a relationship between decreased insulin resistance and cholesterol lower levels as a possible risk factor to dementia associated with PD (PDD). The possibility that nutritional habits, metabolic disturbances, and dopamine depletion in the striatum could have a synergic action on PDD is taken into consideration. Thus, future studies should establish dietary measures for elderly patients with PD, associated or not with dementia.
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    Research and production of second-generation biofuels
    (2019-11-15) Raghavendra, H. L. ; Mishra, Shashank ; Upashe, Shivaleela P. ; Floriano, Juliana F. ; Wollega University ; Universidade Estadual Paulista (UNESP) ; Quality Control and Quality Assurance Laboratory ; Dayananda Sagar University
    The global demand for fossil fuels is very high, but their use is not sustainable since its reserves are declining. Additionally, fossil fuels are responsible for the generation and accumulation of greenhouse gases. Thus, renewable fuels capable of sequestering carbon dioxide are in high demand. The production of first-generation biofuels from conventional fuel crops competes with food for arable land while producing low yields. The use of food crops like sugarcane, grains, and vegetable oils as biofuels may cause a threat to the food security system. Thus, there has been a great demand for the production of second-generation biofuels, which require lignocellulosic biomass as nonedible feedstocks that can be converted to sugar from which bioethanol can be produced. The emission of greenhouse gases from the transport sector can be reduced by substituting fossil fuels by biofuels. Second-generation biofuels can utilize nonarable land and consume waste products. Research on second-generation biofuels has emerged mainly in the developed and some developing countries like India, China, and Brazil. This chapter describes research and production of second-generation biofuels. A mixture of many oxygenated hydrocarbons comprise the feedstocks. Thus, the removal of oxygen becomes a necessity for converting it to a high-quality fuel by different routes such as catalytic cracking and hydrodeoxygenation. The most significant issue of a green economy is the application of gaseous fuels obtained from lignocellulosic mass for sale, subject to the renewable fuel standard. Private industrial investments and research funds should merge for the commercial production of biofuels at a cheaper rate.
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    Oral Signs of Tropical, Fungal, and Parasitic Diseases
    (2019-01-01) Pérez-Alfonzo, Ricardo ; Alencar-Marques, Silvio ; Giansante, Elda ; Guzmán-Fawcett, Antonio ; Central University of Venezuela ; Universidade Estadual Paulista (UNESP) ; Autonomous University of Paraguay
    More than 50% of the world population live in the tropics mostly in developing countries, with great poverty and poor essential goods, services, and access. These conditions and environmental factors make the population high risk for a group of fungal, bacterial, and parasitic diseases, many of which affect the oral mucosa.
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    Tuberculosis
    (2014-01-01) Pereira, Paulo Camara Marques ; Corrêa, Camila Renata ; Calvi, Sueli Aparecida ; Universidade Estadual Paulista (UNESP)
    Tuberculosis (TB) has been present in man since pre-historic times. More than 100 yr after Robert Koch identified its causative agent in 1882, TB is still a chronic infection with one of the highest morbidity and mortality rates (Brasil-Ministerio da Saude 2002).
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    Congestive Heart Failure
    (2014-01-01) Azevedo, Paula Schmidt ; Santos, Priscila Portugal dos ; Fernandes, Ana Angélica Henrique ; Minicucci, Marcos Ferreira ; Zornoff, Leonardo Antonio Mamede ; de Paiva, Sergio Alberto Rupp ; Universidade Estadual Paulista (UNESP)
    Heart failure (HF) is an emerging epidemic disorder. As one of the most prevalent diseases in the world, HF has a significant impact on mortality. Before the 1990s, HF mortality rate in 5 yr was about 60-70 percent. Despite the improvements in treatment, heart disease-related mortality rate has decreased 20-30 percent, but is still considered high (Mc Murray 2010). Furthermore, decompensated HF is one of the most frequent causes of hospitalization (Mc Murray 2010). Therefore, it is necessary to elucidate the mechanisms involved in HF that could be potential sites of intervention.
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    What enzyme-modified proteins are able to do
    (2021-01-01) Fleuri, Luciana Francisco ; Zanutto-Elgui, Mirella Rossitto ; Barros, Margarida Maria ; Carvalho, Pedro Luiz Pucci Figueiredo de ; Koike, Meliane Akemi ; Bagagli, Marcela Pavan ; Oliveira, Deilson Elgui de ; Santos, Andressa Genezini dos ; Novelli, Paula Kern ; Universidade Estadual Paulista (UNESP) ; Science and Technology of São Paulo (IFSP)
    Enzymes are proteins specialized in the catalysis of chemical reactions, and they are applied in a wide variety of industrial sectors. In this scenario, proteases hydrolyze proteins, one of the first classes of enzymes used industrially, currently a 1.2 million dollars industry worldwide. Proteases are also present in all living organisms, playing a role in most metabolic processes. These enzymes can be isolated from various sources and can be applied to the production of different protein products due to their diverse hydrolytic capacities and biochemical properties. Proteolytic enzymes are used to obtain value-added products capable of improving human and animal health. This chapter focuses on sustainable protease production based on fermentation and its application in obtaining bioactive peptides from milk, hydrolyzed cricket flour, and fish feed.
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    Dysbiosis and probiotic applications in autoimmune diseases
    (2022-01-01) Salis, Larissa Vedovato Vilela de ; Martins, Luísa Sales ; Rodrigues, Guilherme Siqueira Pardo ; Oliveira, Gislane Lelis Vilela de ; Universidade Estadual Paulista (UNESP)
    Several evidence in animal models and humans pointed to the involvement of oral and intestinal dysbiosis in the development of autoimmune diseases. Dysbiosis is associated with decreased bacterial function and diversity, as well as decreased beneficial microbes, increased pathobionts, impaired barrier function, bacterial translocation, systemic inflammation, and decreased immune regulatory mechanisms in the gut mucosa. The mechanisms proposed to link dysbiosis with autoimmune diseases include molecular mimicry, bystander T-cell activation, T helper cell skewing, epitope spreading, dual T-cell receptors, posttranslational modification of luminal proteins by dysbiotic microbiota, and amplification by inflammatory cytokines. Studies suggest that probiotics influence systemic immune responses, ensure the homeostasis of the healthy microbiota in the intestinal mucosa, and therefore, could be used as adjuvant therapy to treat immune-mediated diseases. The mechanisms to achieve these effects include mucus secretion, antimicrobial peptide production, cross-feeding other resident microbes, production of organic acids and enzymes, gastrointestinal epithelial barrier maintenance, decreasing oxidative stress, competition with pathogens, and finally, modulation of the host immunity. Here, we described several reports concerning dysbiosis and probiotic applications in animal models of autoimmune diseases, human studies, and clinical trials concerning the applicability of probiotics in autoimmune diabetes, autoimmune thyroid diseases, rheumatoid arthritis, systemic lupus erythematosus, and Sjögren syndrome.
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    Ethics of Research Involving Human Subjects: The Brazilian Experience
    (2010-01-01) Hossne, William Saad ; de Freitas, Corina Bontempo Duca ; Universidade Estadual Paulista (UNESP) ; Fundação de Ensino e Pesquisa em Ciências da Saúde-FEPECS
    Human experimentation cannot be analyzed in isolation because many forces shape social interaction - man’s quest for knowledge and mastery, his willingness to risk human life, and his readiness to delegate authority and to rely on professional judgment (Katz 1972). It was man’s capacity for seeking justice that made ethics committees possible, while at the same time it was man’s capacity for deceiving people that made ethics committees necessary (Ramsey 1982, p. 533). As Raul Hilberg wrote in The Destruction of the European Jews, “If the world was so shocked at what it discovered to be the extremes to which experimental medicine would go, it has yet to condemn the method or find the means to control it” (Hilberg 2003). From our point of view, the right choice is to control experimentation on human beings.
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    Taurine and Oxidative Stress in HIV
    (2018-01-01) Burini, Roberto C. ; Borges-Santos, Maria D. ; Moreto, Fernando ; Ming-Yu, Yong ; Universidade Estadual Paulista (UNESP) ; Harvard Medical School
    Taurine (Tau) (2-aminoethanesulfonic acid) is an amino acid, lacking the carboxyl group and messenger ribonucleic acid. As a major intracellular free amino acid, Tau regulates the osmolality and cell membranes stabilization. Moreover, due to its ability to generate conjugates with bile acids, xenobiotics, retinoic acid, and chloramine, Tau is involved in a diverse array of physiological functions, including detoxification, osmoregulation, membrane stabilization, calcium modulation, neurotransmitter agonist, antioxidation, and immunomodulation. As antioxidant Tau scavenges the phagocyte microbicidal agent HOCl to form the more stable and less toxic taurine chloramine (Tau-Cl) therefore acting as cytoprotectant, in the attenuation of apoptosis. As antiinflammatory agent Tau-Cl suppresses superoxide anion and decreases both NO and proinflammatory cytokines secretion by the activated phagocytes, body Tau comes from diet or from its endogenous biosynthesis from methionine (Met) and cysteine (Cys). Tau occurs naturally in food, especially in seafood and meat. The main organs involved in Tau metabolism are the gut, liver, and kidneys. Usually, plasma Tau levels decrease in response to surgical injury, trauma, sepsis, and cancer. In our data with HIV+ patients the low plasma Tau followed the other thiol-antioxidant pattern. Cys supplementation and methionine loading in HIV+ resulted in higher production of glutathione (GSH) and Tau than non-HIV+ controls. Tau normalization was obtained by methionine loading and was found associatively to similar transmethylation and remethylation of Met and lower transsulfuration of homocysteine compared with controls. Thus, the increased flux of Cys into GSH and Tau pathways seems to be a host strategy to strengthen the cellular antioxidant capacity against the HIV progression.
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    Relationship between plasma hormones and anthropometric measures of muscle mass in postmenopausal women
    (2012-01-01) Orsatti, Fábio Lera ; De Oliveira, Erick Prado ; Burini, Roberto Carlos ; Federal University of Triângulo Mineiro (UFTM) ; Universidade Estadual Paulista (UNESP)
    The muscle undoubtedly pertains to a complex mechano-biological system that primarily enables efficient locomotion but is also involved in other vital physiological functions. Aging is accompanied by progressive reduction in muscle mass (sarcopenia). Sarcopenia is a progressive process that occurs in healthy individuals. Sarcopenia is usually associated with functional impairment and physical disability, especially in women, and is the direct cause of reduction in muscle strength. Muscle mass and strength start declining over the perimenopausal years and this phenomenon seems to be partly estrogen-dependent. The role of estrogen in sarcopenia remains unclear. Epidemiological studies suggest that as estrogen declines with age there is an increase in the levels of pro-inflammatory cytokines suspected to be involved in the sarcopenia process such as tumor necrosis factor alpha and interleukin-6 (IL-6). These cytokines cause an imbalance in muscle tissue synthesis in favor of excess protein breakdown. Epidemiological studies suggest a relationship between low levels of testosterone and loss of muscle mass, strength and function. In post-menopausal women testosterone increases muscle mass. Despite evidence that DHEA supplementation results in an increase of blood testosterone levels in women and increase of IGF-1 in men, few studies have reported an effect in muscle size, strength or function. Insulin-like growth factor-1 (IGF-1) and growth hormone (GH) decline with age. GH replacement therapy lowers fat mass and increases lean body mass. The aging muscle is capable of synthesizing IGF-1 but it may be less sensitive to IGF-1 and could have an attenuated ability to synthesize an isoform of IGF-1 promoting satellite cell proliferation. Exercise may reverse the resistance of aging muscle to IGF-1.
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    The meaning of muscle mass for health, disease, and strength exercises
    (2012-01-01) Burini, Roberto Carlos ; Maestá, Nailza ; Universidade Estadual Paulista (UNESP)
    Skeletal muscle is the largest organ of the mature body having major contributions to endogenous amino acid supply, insulin-dependent glucose removal and total body energy expenditure. Muscle mass is a determinant of metabolic homeostasis, physical strength and daily living activities. Higher lean mass equates to higher nutritional reserve and strength whereas lower muscle mass (sarcopenia) is a major contributor to disability and increased mortality. The definition of sarcopenia is arbitrary and its diagnosis is dependent on the methodology of muscle mass assessment, reference groups and cut off points. Methods used to assess muscle mass such as anthropometry, BIA or DXA are unable to distinguish aqueous and non aqueous components of the muscle mass whereas this is accomplished with the more expensive CT or MRI. Data are referred as kg of muscle mass, % of the body mass or correcting either appendicular or total muscle mass for height (kg/m2). The most used data comes from either DXA or BIA assessment in male and female populations of Rosseta, New Mexico (NM Elder Health Survey) and NHANES III studies with cut off points at - 2 SD for both genders. There is no cut off for hypertrophic-muscle mass. There are also no consensual criteria for defining sarcopenic-obesity or the fat frailty, the worse condition with regard to the difficulties of performing physical tasks. For this purpose muscle mass must be associated with some type of functional test (strength and power) to assess muscle quality. This chapter highlights the roles of muscle mass, its measurements and variations in health and diseases, and the lack of data for correctly interpreting muscle mass and function in the presence of obesity and strength exercises.
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    Ophthalmological assessment of preschool children: Eye blink and pupillary diameter
    (2012-12-01) Lavezzo, Marcelo Mendes ; Schellini, Silvana Artioli ; Universidade de São Paulo (USP) ; Universidade Estadual Paulista (UNESP)
    Introduction: Nevertheless the eyes have a fast development mainly in the early childhood, there are many difficulties in eyes examination, leading to late diagnosis to various conditions. Conventional ophthalmic tests are difficult to implement in preschool children. Digital image processing system might provide important informations about the eyeblink and pupil evaluation. Purpose: To investigate, using a digital image processing system, the eyelid dynamics and the pupillary areas and diameters of normal preschool children. Methods: 50 newborns and 200 preschool children were examined. Images were recorded using a digital camera during three minutes. Complete and incomplete blink rates, opening, closing and complete blink times were calculated. Moreover, pupil diameter and pupil area of the preschool children were evaluated during attentive and spontaneous gaze. Data were expressed in pixels and arithmetic means of each parameter were calculated. Results: The complete eye blink was more common and the blink rate increased with age. The incomplete blink rate was the same for all ages. The eyelid opening and closing times and the complete blink time were similar for both sexes. The closing eyelid time was slower. The mean pupil diameter and area were similar for both eyes, presenting values of 18.5 and 311.7 pixels during attentive and 15.4 and 237.6 pixels during spontaneous gaze, respectively. There were no differences between sexes. However, six-year-old children showed lower pupil diameter and area. Conclusion: The digital image processing system is a very good method to evaluate children and permitted to observe the complete blink rate increases with age. Pupil diameter and area were larger during attention and similar for both eyes. © 2011 by Nova Science Publishers, Inc. All rights reserved.
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    Behavioral risk factors and effects of lifestyle-modification on the metabolic syndrome in adults. A Brazilian community-based study
    (2012-11-01) Burini, Roberto Carlos ; Michelin, Edilaine ; Burini, Franz Homero Paganini ; Moreto, Fernando ; McLellan, Kátia Cristina Portero ; Universidade Estadual Paulista (UNESP)
    Metabolic syndrome (MetS) is a complex disorder with definition and prognostic significance still on dispute but representing a growing public health problem. In this chapter by adding personal data to the reviewed literature it is described that MetS is determined by aging, less education and lower income subjects characterized by their obesogenic-atherogenic diets and lower level of physical activity. Cross-sectional analysis showed MetS associated with overweight, insulin resistance, inflammation and pro-oxidative status. Lifestyle-changes interventions are clinically more effective than drugs. The effectiveness of the dietary changes is based on low-energy dense diets mainly providing high dietary fiber intake. Increased physical activity is more effective with aerobic exercises (and increased cardiorespiratory fitness) than strength exercises. The obtained beneficial effects seem independent of body weight loss. The combination of both exercises along with diet is recommended for restoring health in MetS patients mainly through body fat loss. Follow-up data showed MetS reversal higher than 10% with less than six months if used combined interventions.Metabolic syndrome (MetS) is a complex disorder with definition and prognostic significance still on dispute but representing a growing public health problem. In this chapter by adding personal data to the reviewed literature it is described that MetS is determined by aging, less education and lower income subjects characterized by their obesogenic-atherogenic diets and lower level of physical activity. Cross-sectional analysis showed MetS associated with overweight, insulin resistance, inflammation and pro-oxidative status. Lifestyle-changes interventions are clinically more effective than drugs. The effectiveness of the dietary changes is based on low-energy dense diets mainly providing high dietary fiber intake. Increased physical activity is more effective with aerobic exercises (and increased cardiorespiratory fitness) than strength exercises. The obtained beneficial effects seem independent of body weight loss. The combination of both exercises along with diet is recommended for restoring health in MetS patients mainly through body fat loss. Follow-up data showed MetS reversal higher than 10% with less than six months if used combined interventions. © 2012 by Nova Science Publishers, Inc. All rights reserved.