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Inclusive design (ID) is one of the innovative strategies contributing to understanding public spaces designed for occupants' diversity and needs. This paper aims to provide an overview of the importance, procedure, and future scope for evaluating multisensory interactions while applying ID principles. Through this work, it is possible to move the knowledge forward to participate and fill the scientific gap related to the two concepts of multisensory perception and inclusive design in public spaces for all the people with special needs concentrating on visually impaired people. The focus of this paper is organized into three parts discussing both concepts: (1) a thorough review of the literature from 2002 to 2022; (2) a review of data collection and processing techniques; and (3) a review of the research studies motivations, implications, and its future scopes and applications.

The symptoms associated to the occurrence of typical faults in a heating, ventilation and air-conditioning (HVAC) system, including a single duct dual fan constant air volume air-handling unit, have been experimentally characterized. The operation of the HVAC unit with 3 artificially forced faults ((1) reduced velocity of the supply air fan, (2) reduced velocity of the return air fan, (3) the valve supplying the humidifier kept always closed) has been analysed and compared with that of healthy operation of the same plant under very similar boundary conditions (outside air temperature and initial indoor air temperature) during Italian summer and winter in order to preliminarily assess (i) the effects on the main operating parameters, and (ii) generate preliminary operation data to assist further research in fault detection and diagnosis of HVAC systems.

Made available in DSpace on 2018-11-12T17:28:16Z (GMT). No. of bitstreams: 0 Previous issue date: 2018. Added 1 bitstream(s) on 2018-11-12T17:36:22Z : No. of bitstreams: 1 S0004-28032018005004102.pdf: 365089 bytes, checksum: 2705248f09535897df1500d443e0ce57 (MD5) RESUMOCONTEXTO:O emprego dos prevalecentes critérios de Roma para constipação em pediatria, no atendimento primário de saúde, ainda é baixo. Mesmo com finalidade de pesquisa, estes critérios não têm sido adotados universalmente. Assim, tem sido indicado que seria bem-vinda alguma revisão de tais critérios.OBJETIVO:Avaliar criticamente o ‘timing’ do diagnóstico e as recomendações dietéticas dos critérios, a fim de apresentar propostas que os aproximem da prática clínica diária.MÉTODOS:Foi revisada a literatura citada nos critérios de Roma e foram incluídas as publicações pertinentes ao assunto pesquisadas pela Medline até janeiro 2018.RESULTADOS:Diagnóstico precoce é fundamental, a fim de evitar evolução para complicações indesejáveis e possivelmente para constipação dita intratável, mas a necessidade de inclusão de dois itens - segundo os critérios - pode inviabilizá-lo. Assim, um sinal/sintoma seria suficiente, em geral a presença de ‘evacuações dolorosas e/ou duras’, facilmente observáveis. Ademais, nos critérios faltam detalhes quanto à recomendação sobre fibra alimentar, embora o seu incremento seja usualmente a primeira abordagem no atendimento primário, e no geral os dados sobre suplementos de fibra alimentar apontem para efeitos benéficos.CONCLUSÃO:Para diagnóstico de constipação em pediatria no atendimento primário, um sinal/sintoma de constipação deve ser suficiente. A ingestão diária de fibra alimentar, conforme a American Health Foundation, deve ser detalhada para o tratamento da constipação e também como medida preventiva desde o desmame. ABSTRACTBACKGROUND:Acceptance of the prevailing pediatric Rome constipation criteria, by primary care physician, is still low. Even for research purposes they have not been universally adopted. Thus, it has been indicated that some re-evaluation of these criteria would be welcome.OBJECTIVE:The authors aimed to look at the timing of diagnosis and the dietary treatment recommendations in the criteria, to make proposals trying to approximate them to everyday practice.METHODS:The literature cited in the Rome criteria was reviewed and the publications pertinent to the subject, searched by Medline up to January 2018, were included.RESULTS:An early diagnosis is fundamental to avoid evolution to bothersome complications and possibly to ’intractable’ constipation, but the inclusion of two items of the criteria might hamper it. Thus, one constipation sign/symptom should suffice, usually the easily observable ‘painful or hard bowel movements’. Details about dietary fiber recommendations are missing in the criteria, although its increase is usually the first approach in primary care, and overall the data about dietary fiber supplements point to beneficial effects.CONCLUSION:For diagnosis and treatment of pediatric constipation in primary care, one constipation sign/symptom should suffice. The recommended daily dietary fiber intake, according to the American Health Foundation, should be detailed as a treatment measure, and also for prevention, from weaning on. Universidade Estadual Paulista Faculdade de Medicina de Botucatu Departamento de Pediatria Universidade Federal de São Paulo Escola Paulista de Medicina Divisão de Gastroenterologia Pediátrica Universidade Estadual Paulista Faculdade de Medicina de Botucatu Departamento de Pediatria

This paper presents the results of a research conducted to assess the effects a 2D seismic survey may have had on medium and large mammals living in the Lower Urubamba basin (Cuzco, Peru), performed in the frame of the Camisea Project Biodiversity Monitoring Program (PMB). The research was conducted over an area of 900 ha, characterized by dense amazon rain forest and rich biodiversity, representing one of the 35 world biodiversity hotspots identified by Conservation International. Thirty four camera traps were installed along the seismic lines. Results yielded significant information regarding the effects diverse anthropogenic disturbances had on medium and large mammals in the course of the survey, concluding that, although some limited impact in time and space were identified, most of the species recorded remained in the surroundings, with little and only temporary drive away. In addition, the survey allowed the identification of 23 mammal species, many of them indicators of good conservation conditions.

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Alprazolam (ALP), a benzodiazepine activating GABAergic receptors, is involved in ACTH secretion. WHAT THIS STUDY ADDS • This study demonstrates a partial opioid influence in the inhibitory effect of ALP on the release of ACTH/cortisol during physical exercise. AIMS To establish the possible involvement of alprazolam (ALP) and/or opiates in the mechanism underlying the ACTH/cortisol response to physical exercise. METHODS Tests were carried out under basal conditions (exercise control test), exercise plus ALP (50 µg at time −90 min), naloxone (10 mg at time 0) or ALP plus naloxone. Plasma ACTH and serum cortisol concentrations were evaluated in blood samples taken before, during and after the bicycle ergometer tests. RESULTS ACTH and cortisol concentrations rose significantly after physical exercise. Maximum peak at time 15 min (P ≤ 0.01 vs. baseline) for ACTH and at time 30 min (P ≤ 0.01 vs. baseline) for cortisol. In the presence of naloxone, the ACTH and cortisol responses were significantly increased (maximum peak at time 20 min, P ≤ 0.02 vs. control test for ACTH, and at time 30 min (P ≤ 0.01 vs. baseline) for cortisol) whereas they were abolished by ALP. When ALP and naloxone were given together, the inhibitory effect of ALP was partial. CONCLUSIONS These data demonstrate an inhibitory effect of ALP in the regulation of the ACTH/cortisol response to physical exercise in man and suggest that GABAergic receptor activating benzodiazepines and opioids interact in the neuroendocrine secretion of ACTH/cortisol.

Amblyopia is a neurodevelopmental disorder characterized by visual acuity and contrast sensitivity loss, refractory to pharmacological and optical treatments in adulthood. We studied the response of the visual cortex to transcranial Direct Current Stimulation (tDCS) applied over the primary visual area (V1) contralateral to the “lazy eye”. Visual acuity (logMAR) was assessed before (T0), immediately after (T1) and 60′ following the application of cathodal tDCS (2.0 mA, 20′). At each time point, Visual Evoked Potentials (VEPs) triggered by grating stimuli of different contrasts (K90%, K20%) were recorded in both hemispheres and compared to those obtained in healthy volunteers. Cathodal tDCS improved visual acuity (Holm–Sidak, p

Objective To evaluate whether prolonged physical activity (25 km/week running for 8 years) modifies GH decline. Design The GH response to maximal exercise on bicycle-ergometer was tested in younger (26–30 years) and older (42–46 years) healthy women. Each age group included 2 subgroups of 10 sedentary and 10 runners, which were compared. The workload was increased at 3 min intervals from time 0 until exhaustion. Subjects with a low maximal capacity (as established in a preliminary test) pedalled for 3–4 min against no workload at the beginning of the test, so that exercises lasted about 15 min in all individuals. Results At exhaustion, heart rate and systolic pressure were significantly higher in sedentary than in trained subjects, whereas V O 2 max , blood glucose and plasma lactate levels were similar in all groups. Exercise induced similar GH responses in younger sedentary and exercise-trained subjects and in older exercise-trained subjects, with mean peak levels 7.5 times higher than baseline. In contrast, in older sedentary women peak GH level was only 4.4 times higher than baseline and was significantly lower than in the other groups. Conclusion These data suggest that in women prolonged physical training exerts protective effects against age-dependent decline in GH secretion.

To establish whether ethanol and/or endogenous opioids play a role in the control of arginine-vasopressin (AVP) response to physical exercise, six healthy men underwent six bicycle-ergometer tests until exhaustion [exercise control test; exercise plus ethanol (50 of 110 ml proof whiskey orally), exercise plus naloxone (2 mg injected plus 5 mg infused or 4 mg injected plus 10 mg infused intravenously] or exercise plus ethanol plus naloxone). Plasma AVP levels, physiological and biochemical variables were measured during tests. Physiological and biochemical variables were similar in all tests. During the control test, exercise significantly increased plasma AVP levels, with a peak value five times higher than baseline. The AVP response to exercise was similar in the presence of naloxone, whereas it was abolished by ethanol. When ethanol tests were repeated in the presence of naloxone, at both lower and higher dose, ethanol inhibition on AVP secretion was only partial, with mean peak responses 2.5 times higher than basal values. Results indicate an ethanol involvement in regulation of the AVP response to physical exercise. Furthermore, naloxone-sensitive endogenous opioids appear to play a role in the mechanism underlying ethanol inhibitory action, but not in mediation of the AVP response to physical exercise.

To establish whether somatostatin (SRIH) and/or endogenous opioids play a role in the control of arginine-vasopressin (AVP) response to physical exercise, eight healthy men underwent four bicycle-ergometer tests until exhaustion: exercise control test; exercise plus SRIH, naloxone or SRIH plus naloxone. Serum AVP levels, physiological and biochemical variables were measured during tests. Physiological and biochemical variables were similar in all tests. During control test exercise significantly increased serum AVP levels, with a peak value 4.1 times higher than baseline. The AVP response to exercise was similar in the presence of naloxone, whereas it was significantly reduced by SRIH (AVP peak was only 2.8 times higher than baseline). When SRIH and naloxone were given together, the exercise-induced AVP rise was comparable to that observed in the control test. Results indicate a somatostatinergic involvement in the regulation of the AVP response to physical exercise. Furthermore, naloxone-sensitive endogenous opioids appear to play a role in the mechanism underlying SRIH inhibitory action, but not in mediation of the AVP response to physical exercise.

Background: Alterations in the hypothalamic–pituitary–adrenal (HPA) axis in alcoholic patients have been reported in various experimental conditions. Methods: To establish whether alcoholism affects the HPA axis activation during physical exercise, 10 recent abstinent alcoholic patients (age range: 33–45 years; duration of alcohol dependence: range 4–6 years) were tested by exercising on a bicycle ergometer. Ten age-matched healthy nonalcoholic men participated as controls. The workload was gradually increased at 3-minute intervals until exhaustion and lasted about 15 minutes for all subjects. Alcoholic patients were tested at 3 time points, at 4, 6, and 8 weeks after alcohol withdrawal, whereas controls were tested only once. Main outcome measurements were circulating levels of adrenocorticotropic hormone (ACTH) and cortisol and physiological variables during physical exercise [heart rate, blood pressure, ventilation, frequency of breathing, tidal volume, oxygen consumption (VO2), carbon oxide production (VCO2), and respiratory exchange ratio (R)]. Results: Similar basal and exercise-induced changes in physiological variables were observed in controls and alcoholic patients in all tests. Basal levels of ACTH and cortisol were similar in all tests performed on alcoholic patients and on normal controls. In normal subjects, exercise induced a significant increase in plasma ACTH and serum cortisol levels, with peak levels at 20 minutes for ACTH (84% higher than baseline) and at 30 minutes for cortisol (70% higher than baseline). After 4 weeks of abstinence, slight but not significant ACTH/cortisol responses to physical exercise were observed in alcoholic patients (mean peaks were 10 and 18% higher than baseline, respectively, for ACTH and cortisol). By contrast, when the exercise test was repeated after 6 weeks abstinence, ACTH/cortisol levels rose significantly versus baseline (mean peak levels of ACTH and cortisol were 48 and 38% higher than baseline, respectively, for ACTH and cortisol). However, the hormonal responses were significantly lower than in the normal controls. At 8 weeks of abstinence, ACTH/cortisol responses were significantly higher than 2 weeks previously, and were not distinguishable from the increments observed in the normal controls (76 and 68% higher than baseline, respectively, for ACTH and cortisol). Conclusions: In concurrence with previous reports showing alterations of the HPA axis in the central nervous system in alcohol-dependent subjects, these data show a defect of the neuroendocrine mechanism(s) underlying the ACTH/cortisol response to physical exercise for at least a month after alcohol withdrawal, with reconstitution of a normal hormonal response at 8 weeks.

The immune events that take place in the central nervous system (CNS) during cryptococcal infection are incompletely understood. We used competitive reverse transcription-PCR to delineate the time course of the local expression of mRNAs encoding a variety of cytokines and inducible nitric oxide synthase (iNOS) during progressive murine cryptococcal meningoencephalitis and assessed the CNS inflammatory response using immunohistochemistry. Interleukin 18 (IL-18), transforming growth factor β1, and IL-12p40mRNAs were constitutively expressed in the brains of infected and uninfected mice; IL-2 mRNA was not detected at any time. Increased levels of transcripts corresponding to IL-1α, tumor necrosis factor alpha (TNF-α), and iNOS were detected as early as day 1 postinfection, with TNF-α rising by ∼30-fold and iNOS increasing by ∼5-fold by day 7. Each remained at these levels thereafter. IL-4, IL-6, and gamma interferon transcripts were detected on day 5, and IL-1β and IL-10 transcripts were detected beginning on day 7. Once detected, each remained at a relatively constant level through 28 days of infection. This cytokine profile does not suggest a polarized Th1 or Th2 response. Immunohistochemistry did not reveal inflammatory infiltrates before day 7, despite the presence of cryptococci. Intraparenchymal abscesses with inflammatory cells in their peripheries were found beginning on day 10. The infiltrates were comprised primarily of cells expressing CD4, CD8, or CD11b; low numbers of cells expressing CD45R/B220 were also present. The persistence ofCryptococcusobserved in the CNS may result from an ineffective immune response, perhaps owing to an insufficient anticryptococcal effector function of endogenous glial cells resulting from competing pro- and anti-inflammatory cytokines. These data detail the immune response in the brain and could be important for the future design of specific immunomodulatory therapies for this important opportunistic infection.

Background: Congenital haemolytic anaemia may be associated with pseudoxanthoma elasticum (PXE)-like clinical manifestations. Methods: The cardiovascular system of 14 homozygous and double heterozygous I²-thalassaemia patients with skin and retinal vessel alterations similar to those in genetic PXE was analysed over a period of 12 years and compared with that of 13 relatives (five sets of parents, one single parent, two thalassaemic brothers), and that of the control group composed of 16, age- and sex-matched, thalassaemic patients. Results: All patients with clinical PXE-like skin lesions exhibited, by light and electron microscopy, dermal alterations and mineralization of elastic fibres identical to those typical of inherited PXE. None of the relatives and none of the control group showed clinical or structural findings of PXE. The follow-up started in 1988. After 12 years of clinical observation, six patients showed dramatic progression of skin involvement, angioid streaks had progressed in two subjects. One patient had recurrent gastrointestinal bleeding and underwent partial stomach removal for gastric artery aneurysm, one underwent colon resection for intestinal infarct, one patient had a transitory ischaemic attack, one died after an intracranial haemorrhage, two patients died from cardiovascular disease and one from neoplasia. Conclusions: Thalassaemic patients with PXE-like skin lesions also manifest PXE-like vessel alterations that progress with time. Considering the severe outcome of these lesions, accurate monitoring should be routinely performed on the cardiovascular system of thalassaemic patients with PXE-like skin manifestations.

To establish whether glucocorticoids inhibit the arginine-vasopressin (AVP) response to physical exercise, 10 healthy men underwent bicycle ergometer tests until exhaustion (exercise control test, exercise plus dexamethasone [2 or 4 mg in an intravenous bolus]). Physiological and biochemical variables were similar in all tests. Pretreatment with dexamethasone (2 or 4 mg) partially but significantly decreased the AVP response induced by physical exercise. Our results demonstrate a partial inhibition induced by glucocorticoids of AVP neurosecretion during cycle ergometer tests.

In this paper the authors report on a simplified procedure, developed in a Geographical Information System (GIS) environment, for the localization of school buildings characterized by high indoor background noise levels due to the outside noise sources. The noise sources include road, rail, and air traffic and other human activities (playgrounds, commercial activities, etc). Starting with the knowledge of noise pollution levels in the urban areas where the educational premises are sited, indoor background noise levels are obtained by adding two corrective terms; the first term takes into account for road configuration sound attenuation and the second one for façade sound insulation. For each educational building, a priority index is assigned on the basis of fixed objective parameters. The developed procedure has been applied to case studies of school buildings in Naples. The procedure promises a practical, low cost tool for municipal administrations to assess critical educational buildings and to plan noise reduction measures.

Chronic childhood functional constipation is highly prevalent and a public health problem. Prevention should begin early, since its onset after weaning is frequent. This chapter discusses breastfeeding, other preventive measures, and dietary fiber (DF) recommendations. Population surveys show that DF intake is mostly below what is recommended. An adequate DF intake from weaning onwards seems fundamental, but recommendations concerning complementary foods/DF for premature weaning, and DF for 6- to 12-month-olds, are lacking. The relationship between DF intake and constipation is presented, along with a detailed account of the factors possibly involved in the conflicting data. A vicious circle maintains and aggravates constipation; thus, treatment should not be postponed. A DF-dense diet is recommended, but little emphasis is placed on this in the guidelines. The chapter provides a dietary treatment schedule, proposals to implement its acceptance, and a summary of studies in adults and children evaluating dietary treatment of constipation with emphasis on supplements with DF/wheat bran. More studies are necessary to recommend DF supplements. Nevertheless, DF treatment of constipation should not be neglected, since, in general, studies show its beneficial effects.

OBJECTIVE To obtain the prevalence of constipation in school children, as chronic constipation is frequent among children attending our outpatient unit but only scarce data about community prevalence are available. METHODS 1145 children of the two first school years (52.5% males, median age 8y 4mo) of 5 schools in underprivileged areas were evaluated. They answered a previously validated questionnaire, applied by specially trained students of a practical nurse school. Defecation of scybalous stools and/or straining / pain, usually, were used to characterize constipation, by a strict criterium. Soiling or fecal blood occurring as isolated symptoms were not included in the strict criterium, but were included in two other criteria. RESULTS The prevalence of constipation was 25.1% for boys and 32.9% for girls, by the strict criterium, and was more frequent among girls (p

In order to estimate the nutritional rehabilitation (NR) during admission of malnourished children with persistent diarrhea (PD) receiving standardized nutritional support (NS), we prospectively evaluated the weight, height, head circumference and arm measurements (AM) of 20 children, 19 below 1 year, admitted to the ward with weigh/age -2.89 to -5.21 standard deviation. Four infants comprised the death group (DG) and 16 survived (SG). The SG was separated, according to initial weight behavior, into weight gain (WG) or weight loss (WL). Compared to SG at admission, DG only had lower AM and more metabolic-infectious alterations (p

The researches on soundscape have clearly addressed the need to transfer their outcomes into the practice of soundscape design. In this process, the numerical models are useful tools to assist urban planner and designers in estimating the potential users' ratings of a designed soundscape and to tailor it to match the subjective expectation. To develop such models, experimental data on both descriptors of the sonic environment and subjective ratings of the soundscape are necessary, hopefully including data on other factors that may affect the perception of the environment, such us the visual aspect. The experiments carried out by IDASC and RiAS in the framework of the COST Action TD0804 ''Soundscape of European Cities and Landscapes'' have provided data suitable to develop the above models. In particular, descriptors of the sonic environments binaurally recorded during soundwalks in 8 urban squares (2 in Naples and 6 in Rome, with different use, lay-out and sonic environment) were available, as well as subjective ratings of these recordings played back in laboratory. The paper describes preliminary models obtained from the collected data that may be applied in urban open spaces with similar physical and social environments.

Aim: In the present study, we have evaluated whether physical exercise affect low osteocalcin concentrations observed in patients with subclinical hypercortisolism. Subjects and methods: Sixteen patients (10 men and 6 women, age 38–55 yr) with adrenal incidentaloma were studied. Fifteen healthy volunteers matched for age (range 35–47 yr) were used as controls. Subjects were submitted to a 8-week exercise-training program with cycle-ergometer for 1 h/day 3–4 days/week at 60% of their individual VO2 max. Before and after this period, resting venous serum osteocalcin and GH concentrations were measured in the same batch. The blood sampling after 8 weeks of the training program were performed after resting for one day. All patients and controls underwent also the following endocrine evaluation: serum cortisol, plasma ACTH. Results: Our results demonstrate a significant increase of osteocalcin after physical exercise and a positive correlation between osteocalcin and GH. This later might suggest a role of GH in the increased osteocalcin secretion. Conclusions: The data of the present study suggest a positive effect of physical exercise on bone metabolism in patients with adrenal incidentaloma.

The effect of an i. v. infusion of somatostatin (SRIH) 4.1 μg/min×90 min on the basal secretion of NPY and on the NPY response to physical exercise was studied in normal men. Basal NPY secretion was not modified by SRIH infusion, whereas the NPY response to physical exercise was significantly lower in the presence of SRIH. These data suggest the involvement of a somatostatinergic mechanism in the regulation of NPY response to physical exercise.

The present study was undertaken in order to establish the possible involvement of GABAergic and/or opioid pathways in the mechanism underlying the arginine-vasopressin (AVP) response to physical exercise. After fasting overnight, seven subjects were tested on four mornings at least 1 week apart. Exercise was performed on a bicycle ergometer. The workload was gradually increased at 3 min intervals until exhaustion and lasted about 15 min in all subjects. Tests were carried out under administration of placebo, the opioid antagonist naloxone (10 mg as an i.v. bolus injection), the GABAergic agonist sodium valproate (600 mg in three divided doses orally) or naloxone plus sodium valproate. Plasma AVP levels rose 4-fold during exercise. The administration of naloxone did not modify, whereas sodium valproate completely abolished the plasma AVP rise during exercise. When naloxone was given together with sodium valproate, AVP rose 3-fold in response to exercise. These data suggest the involvement of a GABAergic mechanism in regulation of the AVP response to physical exercise in men. Furthermore, the data argue against a role of naloxone sensitive endogenous opioids in the control of AVP during exercise, whereas they suggest a partial opioid mediation of the GABAergic inhibitory action.

The aim of the study was to evaluate, over 24 months, the intake of dietary fiber (DF) and the bowel habit (BH) of constipated children advised a DF-rich diet containing wheat bran.BH and dietary data of 28 children with functional constipation defined by the "Boston criteria" were obtained at visit 1 (V1, n = 28) and at 4 follow-up visits (V2-V5, n = 80). At each visit the BH was rated BAD (worse/unaltered; improved but still complications) or RECOVERY (REC) (improved, no complications; asymptomatic), and a food intake questionnaire was applied. DF intake was calculated according to age (year) + 5 to 10 g/day and bran intake according to international tables. Nonparametric statistics were used.Median age (range) was 7.25 years (0.25-15.6 years); 21 children underwent bowel washout (most before V1/V2), and 14 had the last visit at V3/V4. DF intake, bran intake, and the BH rate significantly increased at V2 and remained higher than at V1 through V2 to V5. At V1, median DF intake was 29.9% below the minimum recommended and at the last visit 49.9% above it. Twenty-four children accepted bran at 60 visits, at which median bran intake was 20 g/day and median proportion of DF due to bran 26.9%. Children had significantly higher DF and higher bran intake at V2 to V5 at which they had REC than at those at which they presented BAD BH. DF intakeage +10 g/day was associated with bran acceptance and REC. At the last visit 21 children presented REC (75%); 20 of them were asymptomatic and 18 were off washout/laxatives.High DF and bran intake are feasible in constipated children and contribute to amelioration of constipation.

The present study was undertaken in order to establish the possible involvement of serotonergic receptors in the control of physical exercise-stimulated vasopressin secretion. Twenty-one healthy men (divided in three groups of seven) underwent bicycle-ergometer tests until exhaustion: exercise control test (n = 21), exercise plus ondansetron, selective 5-HT3 antagonist (n = 7), exercise plus buspirone, selective 5-HT1A receptor agonist (n = 7), exercise plus sumatriptan, selective 5-HT1D receptor agonist (n = 7). AVP levels, physiological and biochemical variables were measured and compared during tests. Results showed that exercise-induced AVP rise did not change after the administration of buspirone and sumatriptan. In contrast, the administration of ondansetron significantly reduced physical exercise-induced AVP rise. Mean peak levels during physical exercise were 4.9 times higher than basal values in the control test and 2.6 times higher than basal values in the ondansetron plus exercise test. These data demonstrate that 5-HT3 serotonergic receptors at least partially mediate the AVP response to physical exercise. On the other hand, 5-HT1A and 5-HT1D serotonergic receptors do not appear to be involved in the control of AVP secretion during exercise.

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:47:13Z No. of bitstreams: 1 S0004-28032009000200013.pdf: 174540 bytes, checksum: 47df8b84a08540d119f4b4f7a226c472 (MD5) Made available in DSpace on 2013-08-22T18:47:13Z (GMT). No. of bitstreams: 1 S0004-28032009000200013.pdf: 174540 bytes, checksum: 47df8b84a08540d119f4b4f7a226c472 (MD5) Previous issue date: 2009-06-01 Made available in DSpace on 2013-09-30T18:17:57Z (GMT). No. of bitstreams: 2 S0004-28032009000200013.pdf: 174540 bytes, checksum: 47df8b84a08540d119f4b4f7a226c472 (MD5) S0004-28032009000200013.pdf.txt: 39928 bytes, checksum: 3cb006e8785fff00befcd49032c4803b (MD5) Previous issue date: 2009-06-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:33:45Z No. of bitstreams: 2 S0004-28032009000200013.pdf: 174540 bytes, checksum: 47df8b84a08540d119f4b4f7a226c472 (MD5) S0004-28032009000200013.pdf.txt: 39928 bytes, checksum: 3cb006e8785fff00befcd49032c4803b (MD5) Made available in DSpace on 2014-05-20T13:33:45Z (GMT). No. of bitstreams: 2 S0004-28032009000200013.pdf: 174540 bytes, checksum: 47df8b84a08540d119f4b4f7a226c472 (MD5) S0004-28032009000200013.pdf.txt: 39928 bytes, checksum: 3cb006e8785fff00befcd49032c4803b (MD5) Previous issue date: 2009-06-01 CONTEXTO: Mães relatam início precoce de constipação em crianças atendidas em clínicas de gastroenterologia. OBJETIVOS: Estudar o hábito intestinal em crianças de baixa idade na comunidade, para avaliar se início precoce da constipação é confirmado neste contexto e se há concordância entre o hábito intestinal relatado e o registrado prospectivamente. MÉTODOS: Obtiveram-se dados sobre evacuações de 57 crianças com idade 6.0-40.7 meses, mediante relato materno (questionário sobre características fecais predominantes) e, a seguir, foram registradas 1.934 evacuações em casa e na creche. O hábito intestinal foi classificado como adequado, constipação, diarréia funcional, outro hábito intestinal, conforme frequência evacuatória e proporção das características fecais (macias, duras e/ou que escorrem). Usaram-se dois critérios para classificar o hábito intestinal registrado, devido indefinição no ponto de corte para fezes duras na identificação de constipação em crianças: critério predominante e critério adulto, respectivamente com >50% e >25% de evacuações com consistência alterada. Usou-se estatística não-paramétrica e, para concordância entre hábito intestinal relatado e registrado, o índice Kappa. RESULTADOS: Constipação ocorreu em 17.5%, 10.5%, 19.3% das crianças, respectivamente pelo relato e pelo registro segundo critérios predominante e adulto. Constipação foi o hábito intestinal mais frequentemente relatado, versus 12.3% outro hábito intestinal. Só uma criança se classificou como tendo diarréia funcional (pelo critério adulto). Concordância entre o hábito intestinal relatado e o registrado foi razoável (fair) para constipação, pelos critérios predominante e adulto (K=0.28 e 0.24, respectivamente), mas apenas leve (slight) para os demais hábito intestinal (K 50% and >25% of stools with altered consistency. Bowel habit categories were: adequate, constipation, functional diarrhea and other bowel habit. Nonparametric statistics, and the Kappa index for agreement between recalled and recorded bowel habit, were used. RESULTS: Constipation occurred in 17.5%, 10.5%, 19.3% of the children by recall, the predominant and the adult criteria, respectively. Constipation was the main recalled alteration, vs 12.3% other bowel habit. Only one child classified as having functional diarrhea (by the adult criterion). Agreement between recalled and recorded bowel habit was fair for constipation, by the predominant and the adult criteria (K = 0.28 and 0.24, respectively), but only slight (K

The nutritional management of infants admitted with diarrhoea to the University Hospital of Botucatu includes a change from bolus feeding of a modulated minced-chicken formula to a continuous nasogastric drip (NGD) feeding, whenever the required calorie intake is not achieved or the diarrhoea does not subside. To evaluate this approach, the clinical course and weight changes of 63 children, aged 1-20 months, were reviewed; most (81 per cent) were below the third percentile for weight at admission and 76 per cent had a total duration of diarrhoea greater than or equal to 10 days. Associated infections, mainly systemic, were present at or after admission in 70 per cent of them. Twenty-five survivors needed nutritional support (NS), predominantly NGD, for a median duration of 30 per cent of their admission time, and were compared to 31 survivors managed without NS. Those who necessitated NS lost weight for a significantly longer median time (12 x 4 days, p less than 0.005), but their total weight loss was similar (5 x 4 per cent) as well as diarrhoea's duration (8 x 7 days). There was a tendency for a longer hospitalization (21 x 16 days 0.05 less than P less than 0.10) and a longer span to begin weight gain after diarrhoea's end for the group with NS (p less than 0.05), but subsequent growth quotient and daily weight gain during admission were similar for both groups. Both groups of survivors received similar amounts of energy, although the initial increase was delayed for those who needed the NGD.(ABSTRACT TRUNCATED AT 250 WORDS)

The present study was performed to establish whether the mechanism by which the cholinergic system influences growth hormone (GH) release was altered in type I diabetic patients. Therefore, we investigated in a dose-response fashion the inhibitory effect of the muscarinic cholinergic receptor antagonist pirenzepine on the GH responses to arginine infusion (30 g infused intravenously (IV) in 30 minutes), exercise (bicycle ergometer test at an intensity of 75 W for 30 minutes), or 1-44 GH-releasing hormone (GHRH) (1 μg/kg in an IV bolus). In a preliminary study, IV injection of 17.5 mg pirenzepine failed to produce modification in the GH response to arginine infusion in both diabetic (N = 4) and normal subjects (N = 4), and to exercise (diabetics, N = 4; normals, N = 4). Therefore, other subjects were tested without and with 20, 25, and 30 mg pirenzepine during arginine (diabetics, N = 7; normals, N = 7) or exercise (diabetics, N = 7; normals, N = 7) tests. Each subject was tested four times. Diabetic patients presented higher GH responses to stimulation with arginine or exercise than normal controls. In both groups, pirenzepine administered at doses ranging from 20 to 30 mg produced a dose-related inhibition of the GH response to arginine and exercise, which was almost complete when 30 mg pirenzepine was administered. However, the percent inhibition produced by 20 or 25 mg pirenzepine in the arginine test and by 20 mg in the exercise test was significantly lower in the diabetic patients than in the normal controls. Since these results might reflect hyperresponsiveness toward the stimuli for GH release rather than hyporesponsiveness toward the blocking agent, further experiments with GHRH plus pirenzepine (0, 20, 25, or 30 mg) were performed in additional groups of normal (N = 7) and type I diabetic (N = 7) subjects. Results showed similar GH responses to GHRH in controls and diabetics in the absence of pirenzepine. Again, treatment with 20 or 25 mg pirenzepine produced a significantly lower inhibition of the GHRH-induced GH release in diabetics than in normal men, whereas 30 mg pirenzepine almost completely abolished the GH response to GHRH in both groups. These data show a decreased sensitivity to muscarinic cholinergic receptor blockade in the mechanisms underlying the GH responses to arginine, exercise, and GHRH in type I diabetic patients. An increased cholinergic activity at hypothalamic and/or pituitary level might explain this phenomenon and might be, at least in part, responsible for the hyperresponsiveness to arginine and exercise in type I diabetic patients.

Summary Background The basal circulating levels of ACTH and cortisol, but not the ACTH/cortisol response to hCRH, are significantly reduced by free fatty acid (FFA) infusion. Objective To verify whether FFA infusion modifies the ACTH/cortisol response to physical exercise, a well-known activator of the HPA axis at suprapituitary level. Design Exercise tests on a bicycle ergometer during infusion of a lipid-heparin emulsion (LHE) (experimental test) or normal saline (NaCl 0·9%) (control test). Setting Department of Cardiology at the University-Hospital. Subjects Seven healthy male subjects aged 25–33 years. Interventions On two mornings, at weekly intervals, LHE or saline were infused for 60 min; infusion started 10 min before exercise test on a bicycle ergometer, which lasted about 15 min. Main outcome measures Circulating ACTH/cortisol levels and physiological variables during physical exercise. Results FFA levels (0·4 ± 0·1 mEq/l) remained constant during control test, whereas they progressively rose (peak at 60 min, 2·7 ± 1·0 mEq/l) during LHE infusion. Neither basal nor exercise-induced changes in physiological variables were modified by LHE infusion. Both ACTH and cortisol increased during exercise, with peak levels at 20 min and 30 min (control test: 103% and 42%, P