Ipsilesional line bisection bias in patients with chronic parietal lesions

The current study investigated whether an ipsilesional bias in line bisection, a conventional measure for diagnosing hemispatial neglect, persists even in the absence of this syndrome in patients with chronic lesions restricted to posterior association cortex or dorsolateral prefrontal cortex. Both left and right hemisphere parietal lesions produced ipsilesional bisection errors, and to a comparable degree. Patients with lesions in frontal cortex, on the other hand, did not show a consistent bias. We conclude that chronic parietal lesions produce an ipsilesional bias in line bisection, even in the absence of other clinical signs of neglect, and that left hemisphere lesions can affect line bisection to the same degree as right hemisphere lesions.     

Nitric oxide modulates Na+, K+-ATPase activity through cyclic GMP pathway in proximal rat trachea

The present work demonstrated that nitric oxide (NO) modulates Na+, K+-ATPase activity in the proximal rat trachea. Sodium nitroprusside induced concentration-dependent (10-100 microM) stimulation in proximal trachea Na+, K+-ATPase activity. The effect was specific for Na+, K+-ATPase since Mg-ATPase activity was unaffected. This NO-donor changed neither Na+, K+-ATPase nor Mg-ATPase activity in the distal segment. The modulatory action on Na+, K+-ATPase induced by sodium nitroprusside was linked to an increase in nitrates/nitrites and cyclic GMP levels in proximal segments. Modulation of proximal Na+, K+-ATPase activity by sodium nitroprusside was mimicked by S-nitroso-N-acetylpenicillamine (100 microM) and 8-bromo-cyclic GMP (100 microM). Both sodium nitroprusside and 8-bromo-cyclic GMP effects on Na+, K+-ATPase activity of proximal segments of trachea were blocked by 2 microM of KT 5823 (a cyclic GMP-dependent protein kinase inhibitor), but not by 0.5 microM of KT 5720 (a cyclic AMP-dependent protein kinase inhibitor). Both kinase inhibitors decreased proximal Na+, K+-ATPase activity, but did not change Mg-ATPase activity. Okadaic acid (1 microM), a phosphatase-1 inhibitor, increased proximal Na+, K+-ATPase but not Mg-ATPase activity. The effect of okadaic acid was non-additive with that of 8-bromo-cGMP on Na+, K+-ATPase activity. Our results suggest that NO modulates proximal rat trachea Na+, K+-ATPase activity through cyclic GMP and cyclic GMP-dependent protein kinase.     

Indicators and standards proposal for the evaluation of the quality of hospital care: the case for bronchial asthma

The objectives of this article are to propose indicators for evaluation of the quality of hospital management of bronchial asthma patients, based on explicit criteria from literature reviews. The central problem identified in the literature review is the erroneous evaluation of severity of asthma crises, either by patients and their relatives, or by health professionals at all levels of care, causing serious consequences not only for the patient, but for society as a whole. Mortality figures indicate that from 1980 to 1990, an average of 2000 deaths per year from asthma occurred in Brazil, of which 70% occurred in hospital. Asthma was the fourth cause of hospitalization (hospital admissions), in the state of Rio de Janeiro in 1993. Only 12% of the admissions that resulted in death made use of the ICU. The above information highlights the need for a thorough evaluation of hospital care of bronchial asthma in Brazil, including a review of all admissions resulting in death and reviews of a sample of all bronchial asthma admissions. Proposed criteria are for this evaluation include: severity of the crise, treatment prescribed, information given to the patient and their relatives, and follow-up appointments made after discharge from hospital.     

Methodology to prevent mercury exposure among adolescents from goldmine areas in Mariana, state of Minas Gerais, Brazil

The main objective of this study was to promote the evaluation of an educational method to identify health risks among adolescents exposed to mercury by their work in gold mining production.The project was carried out with adolescents from a public school from the District of Monsenhor Horta, Municipality of Mariana, state of Minas Gerais. Statistical evaluation of the results revealed a significant increase in the amount of correct answers between the first and fifth stage concerning the definition of work accidents and its importance in relation to work-related diseases, accidents on route to and from the work place and violence at work site itself.     

Double Outlet Right Ventricle with Intact Atrial Septum and Restrictive Ventricular Septal Defect: An Analysis of Two Cases

Two cases of double outlet right ventricle with restrictive ventricular septal defect are described. This is an uncommon presentation that causes left ventricular dysfunction because of left ventricular outflow tract obstruction. The presence of an intact atrial septum leads to severe pulmonary hypertension, which tends to aggravate the right ventricular output. In the presence of a normal left ventricle, the authors suggest the possibility of enlargement of the ventricular septal defect in order to perform a biventricular repair. The association of a supramitral valve ring in both cases, and the isolation of the left subclavian artery and an aortopulmonary fenestration in one of these cases, are also discussed. In addition we explore factors that cause restrictive ventricular septal defects as well as the mechanisms that may lead to spontaneous closure of ventricular septal defect in a double outlet right ventricle.