BACKGROUND: Elderly people present alterations in body composition and physical fitness, compromising their quality of life. Chronic diseases, including HIV/AIDS, worsen this situation. Resistance exercises are prescribed to improve fitness and promote healthier and independent aging. Recovery of strength and physical fitness is the goal of exercise in AIDS wasting syndrome. OBJECTIVE: This study describes a case series of HIV-positive elderly patients who participated in a progressive resistance training program and evaluates their body composition, muscular strength, physical fitness and the evolution of CD4+ and CD8+ cell counts. METHODS: Subjects were prospectively recruited for nine months. The training program consisted of three sets of 8-12 repetitions of leg press, seated row, lumbar extension and chest press, performed with free weight machines hts, twice/week for one year. Infectious disease physicians followed patients and reported all relevant clinical data. Body composition was assessed by anthropometric measures and dual-energy x-ray absorptiometry before and after the training program. RESULTS: Fourteen patients, aged 62-71 years old, of both genders, without regular physical activity who had an average of nine years of HIV/AIDS history were enrolled. The strengths of major muscle groups increased (74%-122%, p=0.003-0.021) with a corresponding improvement in sit-standing and walking 2.4 m tests (p=0.003). There were no changes in clinical conditions and body composition measures, but triceps and thigh skinfolds were significantly reduced (p=0.037). In addition, there were significant increases in the CD4+ counts (N=151 cells; p=0.008) and the CD4+/CD8+ ratio (0.63 to 0.81, p=0.009). CONCLUSION: Resistance training increased strength, improved physical fitness, reduced upper and lower limb skinfolds, and were associated with an improvement in the CD4+ and CD4+/CD8+ counts in HIV positive elderly patients without significant side effects.

This study reported a case of rhinosinusitis for Respiratory Syncytial Virus in Intensive Care Unit patient. The settings were Intensive Care Unit at Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil. One female HIV-infected patient with respiratory failure and circulatory shock due to splenic and renal abscesses, who developed rhinosinusitis caused by RSV and bacteria. Respiratory viruses can play a pathogenic role in airways infection allowing secondary bacterial overgrowth.

Cytogenetic studies were performed on two sympatric species of Characidium, C. gomesi and C. cf. zebra, from the Grande River basin, Minas Gerais State, Brazil. Although both species had a chromosome number of 50 with a karyotype exclusively consisting of meta- and submetacentric chromosomes, interspecific diversity was detected concerning the size of the two first chromosome pairs of the karyotypes. Active nucleolus organizer regions (NORs) were located at the terminal position on the long arm of the 17th pair of C. gomesi and at subterminal position on the long arm of the 23rd pair of C. cf. zebra. For both species the fluorochrome CMA3 stained only the NOR-bearing pair of chromosomes. The heterochromatin pattern also showed some differentiation between these species restricted to the centromeric or pericentromeric region of C. cf. zebra and practically absent in C. gomesi. These data are discussed concerning chromosome diversification in this fish group.

Foi realizado estudo não controlado, de coorte histórica, com o objetivo de estabelecer marcos do desenvolvimento neurológico, definir o perfil clínico e epidemiológico de recém nascidos prematuros normais aos 3, 6, 9 e 12 meses de idade corrigida quanto à evolução dos reflexos primitivos. RESULTADOS: Aos 3 meses de idade corrigida, todos os reflexos primitivos estavam presentes em diferentes percentuais. Aos 6 meses de idade corrigida, 100% das crianças apresentavam preensão plantar e 2,7% apresentavam reflexo de Moro, apoio plantar e preensão palmar. A preensão plantar foi o único reflexo primitivo observado aos 9 e 12 meses de idade corrigida. CONCLUSÃO: Foi possível avaliar a ocorrência, assim como o desaparecimento dos reflexos primitivos de recém-nascidos prematuros normais. Estes resultados apontam para um atraso no desaparecimento dos reflexos primitivos mesmo com o uso da correção da idade.

A non-controlled, prognostic cohort study was performed with the aim of establishing markers of neurological development and defining a clinical and epidemiological profile of preterm newborns at 3, 6, 9, and 12 months of gestation-corrected age in terms of primitive reflexes evolution. RESULTS: At 3 months old of corrected age, all primitive reflexes were present. At 6 months old, all children showed plantar grasp and 2,7% still showed Moro and palmar grasp. Plantar grasp was the unique primitive reflex found at 9 and 12 months of corrected age. CONCLUSION: It was possible to evaluate the occurence, as well as the disappearing of primitive reflexes in preterm newborns. The results show delay in the disappearing of primitive reflexes even with the use of corrected age.

Este estudo comparou os resultados do exame do desenvolvimento neuropsicomotor aos seis meses de idade corrigida de lactentes prematuros com crises neonatais e/ou hemorragia intracraniana com lactentes prematuros sem estas intercorrências. Houve uma correlação estatisticamente significativa (p=0.000007) entre hemorragia intracraniana e crises neonatais no grupo de 68 lactentes prematuros vistos no ambulatório de neurodesenvolvimento do Hospital de Clínicas de Porto Alegre, Brasil. Hemorragia intracraniana foi significativamente associada com multiparidade (p=0.02). O exame do desenvolvimento neuropsicomotor aos 6 meses de idade corrigida mostrou que pacientes que sofreram hemorragia intracraniana neonatal e/ou crises neonatais tiveram tônus, forças e reflexos inapropriados, bem como atraso no controle do sustento cefálico. Conclusões: Comparamos os resultados dos exames de desenvolvimento neuropsicomotor dos dois grupos de lactentes prematuros aos 6 meses de idade corrigida. A diferença no desenvolvimento neurológico aos 6 meses de idade corrigida foi estatisticamente significativa quando comparado com lactentes prematuros que tiveram crises neonatais e/ou hemorragia periventricular.

This study compared the results of neurodevelopmental examination at 6 months' corrected age of premature infants with neonatal seizures and/or intracranial hemorrhage and normal premature infants. There was a statistically significant correlation (p=0.000007) between intracranial hemorrhage and seizures in the group of 68 premature infants seen in the neurodevelopmental outpatient service at Hospital de Clínicas de Porto Alegre, Brazil. Intracranial hemorrhage was significantly associated with multiparity (p=0.02). The neurodevelopmental examination at 6 months' corrected age revealed that patients who suffered neonatal intracranial hemorrhage and/or seizures had inappropriate muscle tone, strength and reflexes, as well as delay in head control. Conclusion: we compared the results of neurodevelopmental examinations of two groups of premature infants at 6 months' corrected age. The difference in neurological development at 6 months' corrected age was statistically significant when comparison was corrected for premature infants who had neonatal seizures and periventricular hemorrhage.

OBJETIVO: é relatar a eficácia da vigabatrina no controle das convulsões, bem como as alterações eletrencefalográficas em crianças com esclerose tuberosa e síndrome de West. MÉTODO: Estudo retrospectivo, com dados clínicos, de neuroimagem e de eletrencefalograma. RESULTADOS: Sete pacientes foram acompanhados e o tempo médio de seguimento foi 10 anos. Dos pacientes, quatro eram do sexo feminino e todos eram de cor branca. A média de idade de início das convulsões foi 3,4 meses. Todos usaram associações de vários anticonvulsivantes; no mínimo duas drogas por esquema terapêutico, e cada paciente utilizou pelo menos dois esquemas diferentes. O uso de vigabatrina como monoterapia ou em associação iniciou em média aos 7 anos de idade ou 4 anos após início dos sintomas. Cinco dos sete pacientes que iniciaram vigabatrina ficaram sem crise. CONCLUSÃO: Vigabatrina mostrou-se eficaz no controle das crises, levando a um melhor prognóstico.

PURPOSE: To report the efficacy of vigabatrin in seizures control, as well as the electroencephalographic abnormalities in children with tuberous sclerosis and West syndrome. METHOD: Retrospective study, with clinical, neuroimaging, and electroencephalographic data. RESULTS: Seven patients were followed, and the median time of follow-up was 10 years. Four of them were females and all were white. The mean age of seizures onset was 3.4 months. All patients used antiepileptic drugs associations, at least 2 drugs each therapeutic scheme, each one of the patients have used at least two different schemes. Vigabatrin as monotherapy or adjuvant was started in a mean age of seven years or 4 years after the onset of symptons. Five from seven patients on vigabatrin became seizure free. CONCLUSION: Vigabatrin was efficient in seizures control, leading to a better prognosis.

Doença cerebrovascular isquêmica (DCVI) é rara na infância, mas quando ocorre, o impacto pode ser muito sério. Pode ser a primeira manifestação de uma doença sistêmica. Relatamos a ocorrência de 12 casos de DCVI. Foram diagnosticados e tratados no Hospital de Clínicas de Porto Alegre (HCPA) na Unidade de Neuropediatria de março de 1997 a março de 2000. Todos os casos com suspeita clínica de DCVI foram confirmados por avaliação radiológica de recém-nascidos de termo (RNT) a crianças até 12 anos de idade, que internaram na Unidade de Pediatria do HCPA. Eles foram acompanhados de um a seis anos (média 3,4 anos). Os sintomas iniciais foram: hemiparesia em 9 pacientes, convulsões em 7, desvio da comissura labial em 3 e perda da consciência em um. O aumento do reconhecimento de DCVI em crianças, auxiliado pela confirmação do diagnóstico através de exames não invasivos, tem auxiliado na identificação da etiologia. As etiologias mais frequentes foram doenças hematológicas, cardíacas e genéticas. Contudo, nosso estudo mostrou 6 recém-nascidos com DCVI em que não foi identificada etiologia. Sete crianças com convulsões usaram fenobarbital. Em seis RNT com DCVI as convulsões estiveram restritas às primeiras 72 horas de vida.

Although rare in childhood, stroke may have a serious impact when it happens in this stage of life. Also, it may be the first sign of a systemic disease. We report 12 cases of patients with stroke treated in the Neuropediatrics Unit of Hospital de Clínicas de Porto Alegre (HCPA) from March 1997 to March 2000. All patients, from term infants to 12-year-old children hospitalized in the Pediatrics Unit of HCPA, had clinical suspicion of stroke, which was later confirmed by radiological studies. Patient follow up ranged from 1 to 6 years (mean = 3.4 years). Presenting symptoms were hemiparesis in 9 patients, seizures in 7, deviation of labial commissure in 3, and loss of consciousness in 1. The increase in the number of cases of childhood stroke identified and later confirmed by noninvasive methods had helped in the determination of different ethiologies of stroke: the most frequent being hematologic, cardiac and genetic diseases. However, our study included 6 newborns with stroke whose ethiology was not identified. Seven children with seizures received phenobarbital. Six term infants had neonatal seizures secondary to stroke and restricted to the first 72 hours of life.