Showing papers by "Universidade de Pernambuco published in 2003"

Participação social nos serviços de saúde: concepções dos usuários e líderes comunitários em dois municípios do Nordeste do Brasil

Abstract: Social participation in management of the health care system at different levels of government is one of the key policies promoted by the Unified National Health System (SUS) in Brazil. As with any new policy, success hinges on several factors such as stakeholders' interests and opinions, which have not always been considered in the past. This paper analyzes the underlying concepts of two groups of stakeholders with respect to social participation in health and the potential influence of these concepts on the effectiveness of policy implementation. A case study of two municipalities in Northeast Brazil was conducted using a combination of qualitative and quantitative social science research methods. Health services users and community leaders were interviewed. Various concepts were found in which the participatory approach to health policies was only partially reflected. Likely influences on stakeholders' concepts of social participation in health are the evolution of the broader Brazilian social context and the traditional performance of health services. Particular attention should be paid to stakeholders' opinions and concepts if policy effectiveness is to be improved.

Chromosomal relationships among cultivars of Citrus reticulata Blanco, its hybrids and related species

Abstract: Karyotypes of 93 individuals belonging to 18 accessions of mandarins, mandarin hybrids and two related species were analysed with the fluorochromes CMA and DAPI, to identify marker chromosomes. The karyotypes revealed highly differentiated banding patterns and could be classified in four groups (I–IV) according to the presence/absence of chromosomes with three bands (type A) or with two bands (one proximal and one terminal, type B, or both terminal, type C). The accessions of group I exhibited the simplest and homozygous karyotypes (lacking chromosome types A, B and C), represented by `Sunki' and `Cleopatra'. Group II (lacking chromosome types A and B) included three accessions of Mediterranean mandarins and `Cravo' mandarin, all of them with very similar and almost completely homozygous karyotypes. All other karyotypes of groups II and III (lacking chromosome type A) were heterozygous for one or more chromosome pairs and most of them seemed to be hybrid derivatives from non-mandarin accessions. Group IV (with chromosome types A and B) was represented only by two heterozygous hybrids (`Murcott' and `King'). The karyotype of most hybrids agrees with one of the possible combinations resulting from chromosome types segregation from their putative ancestor karyotypes, but at least `Orlando' seemed to be a more complex hybrid. Comparing with banding patterns of other Citrus species, those of group I and the Mediterranean mandarins (group II) are the best candidates to represent C. reticulata (sensu Swingle) as a true species.

The effect of collagen removal and the use of a low-viscosity resin liner on marginal adaptation of resin composite restorations with margins in dentin.

Abstract: This study evaluated the influence of collagen removal and the use of a low-viscosity liner on the marginal quality of composite restorations for the total-etch system, Prime & Bond 2.1 (PB) and the self-etching primer system, Clearfil SE Bond (CSEB), in high C-factor cavities with margins in dentin. High C-factor cavities were made on dentin exposed from ground labial surfaces of 100 bovine lower incisors, randomly assigned to 10 treatment groups and restored with composite Z 250, placed in bulk. In Group 1 (PB), control group, PB was applied according to the manufacturer's directions; in Group 2 (PB/PLF), an intermediate layer of low-viscosity composite Protect Liner F (PLF) was applied on the bonding resin surface; in Group 3 (PB/SH) following acid-etching, the surfaces were treated with 10% sodium hypochlorite (SH) for one minute and in Group 4 (PB/SH/PLF), the same procedure was conducted as for Group 3, plus an intermediate layer of PLF was applied as for Group 2. In Group 5 (CSEB), the control group, CSEB was applied according to the manufacturer's directions; in Group 6 (CSEB/PLF), an intermediate layer of PLF was applied; in Group 7 (SH/CSEB), the cavity surface was pre-treated with SH; in Group 8 (SH/CSEB/PLF), SH pre-treatment was conducted as for Group 7, then an intermediate layer of PLF was applied; in Group 9 (CSEB/SH), after CSEB-primer application, the surface was treated with SH, followed by CSEB-adhesive application and in Group 10 (CSEB/SH/PLF), the same was conducted as for Group 9, then an intermediate layer of PLF was applied. The specimens were stored at 37 degrees C for 24 hours, polished, molded and replicas were obtained in epoxy resin. The replicas were gold-sputter coated and observed by SEM (300x) for marginal quality classification. The Kruskal-Wallis non-parametrical multi-comparison Test (p<0.05) was used to obtain statistical analysis of the data. Results demonstrated that both adhesive systems in the control groups presented low marginal quality and a high variability. The use of an intermediate layer of PLF significantly improved the marginal quality with the CSEB system but had no effect with the PB system. Collagen depletion with SH enhanced marginal quality for the PB system and did not influence the CSEB system results.

PCA feature extraction for protein structure prediction

Abstract: The PCA linear transformation method is used for feature extraction to the secondary structure prediction problem. The method of dimensionality reduction is applied on PSI-Blast profiles built on NCBI's Nonredundant Protein database. Different numbers of components extracted are used as input to three artificial neural networks with 30, 35 or 40 nodes in the hidden layer. Those classifiers are trained with the RPROP algorithm. To estimate the accuracy of the predictor the sevenfold cross-validation method is applied to CB396, a database used previously to evaluate the performance of several predictors. Aiming to increase the efficiency of the predictor presented here, the outputs of the classifiers are combined through five simple rules: product, average, voting, minimum and maximum. This original application for the PCA method derives relevant results. Even with a drastic reduction from 260 to 80 components, the accuracy obtained is at least 1% superior to the best one published for another predictor, the CONSENSUS, a combination of four other predictors. With a reduction from 260 to 180 components the performance is even better, achieving an Q/sub 3/ accuracy of 74.5%. The results flag the PCA as a promising method for feature extraction in the secondary structure prediction problem.

Currículos de enfermagem do Brasil e as diretrizes: novas perspectivas

Abstract: Este recorte bibliografico objetivou realizar uma retrospectiva dos curriculos existentes para o curso de graduacao em enfermagem, desde a sua primeira escola, Escola Profissional de Enfermeiros e Enfermeiras, do Rio de Janeiro, em 1890 ate a Resolucao CNE/CES 3/2001, documento que estabelece o novo curriculo de enfermagem em nosso pais. Percebi que as mudancas de curriculos foram obrigatorias e agora observo mais participacao dos enfermeiros e mais interesse coletivo deles, que estao engajados em formar futuros enfermeiros mais humanistas, reflexivos e criticos.

Inflation inertia and inliers: the case of Brazil

Abstract: This paper addresses the issue of measuring the degree of inertia in inflation in the presence of potential 'inliers'. It shows that by using robust unit root tests one reaches the same inference on the order of integration of the series as what is revealed by the modified procedure proposed by Cati et al. (1999). The results also suggest that, contrary to previous findings, the degree of inertia in inflation is rather small. Finally, the paper presents simulation results on the finite-sample behavior of unit root tests and of a persistence measure when the data contain inliers.

The impact of restorative treatment on tooth loss prevention.

Abstract: A cross-sectional study was carried out to analyze tooth loss resulting from caries in relation to the number of times the extracted tooth had been restored, the type of caries diagnosed (primary or secondary), and socioeconomic indicators of patients from the city of Recife, Brazil. Ten public health centres and ten centres associated with health insurance companies were randomly selected. The size of the sample was calculated using a standard error of 2.5%. A confidence interval of 95% and a 50% prevalence of reasons for extractions were used for calculating the sample. The minimum size of the sample for meeting these requirements was 381 patients. Patients were randomly selected from the list of adults registered at each centre. A total of 410 patients were invited to take part in the study. The response rate was 100%, but 6 patients were excluded due to incompleteness of data in the questionnaire applied. An assessment was made to obtain the number of decayed, missing or filled teeth (DMFT index) and the reasons for extraction. The results showed a highly significant (p < 0.001) relationship between the number of times the tooth indicated for extraction had been restored and the reason for extraction being caries. Furthermore, the majority of teeth extracted due to caries had been restored two or more times. A highly statistically significant association was also observed between one indicator of use of dental services (F/DMFT) and extraction due to caries (p < 0.001). The findings questioned the belief that tooth loss can be prevented in the general population by merely providing restorative treatment.

Cohort study of endodontic therapy success

Abstract: A retrospective cohort study was carried out aiming to assess the success rate of endodontic treatment of patients from the Faculty of Dentistry, University of Pernambuco, Brazil. The dental records of the sampling comprised all patients treated in 1998 and 1999. Trials were standardized and a pilot study was carried out to determine the feasibility of the proposed study. Chi-square and Fisher's exact tests were used to calculate the level of significance that was set at 5%. Logistic regression models were used to confirm significant effect of some variables on the endodontic outcome. The final sample size comprised 311 (75.9%) women and 99 (21.1%) men. The majority of cases (82.9%) were considered successful. Success was less frequent for patients with up to primary school education (55.6%) than for those with a higher degree of education (89.7%). The vital condition of the pulp showed a statistically significant relationship with the success of endodontic therapy (p < 0.05). These results suggest that it is possible to attain very high success rates for endodontic treatment when both the intraradicular andthe extraradicular causes of failure of endodontic treatment are well managed.

Hepatitis C virus infection in a Brazilian population with sickle-cell anemia

Abstract: Patients with sickle-cell anemia submitted to frequent blood transfusions are at risk of contamination with hepatitis C virus (HCV). Determination of HCV RNA and genotype characterization are parameters that are relevant for the treatment of the viral infection. The objective of the present study was to determine the frequency of HCV infection and the positivity for HCV RNA and to identify the HCV genotype in patients with sickle-cell anemia with a history of blood transfusion who had been treated at the Hospital of the HEMOPE Foundation. Sera from 291 patients were tested for anti-HCV antibodies by ELISA 3.0 and RIBA 3.0 Chiron and for the presence of HCV RNA by RT-PCR. HCV genotyping was performed in 19 serum samples. Forty-one of 291 patients (14.1%) were anti-HCV positive by ELISA and RIBA. Both univariate and multivariate analysis showed a greater risk of anti-HCV positivity in those who had started a transfusion regime before 1992 and received more than 10 units of blood. Thirty-four of the anti-HCV-positive patients (34/41, 82.9%) were also HCV RNA positive. Univariate analysis, used to compare HCV RNA-negative and -positive patients, did not indicate a higher risk of HCV RNA positivity for any of the variables evaluated. The genotypes identified were 1b (63%), 1a (21%) and 3a (16%). A high prevalence of HCV infection was observed in our patients with sickle-cell anemia (14.1%) compared to the population in general (3%). In the literature, the frequency of HCV infection in sickle-cell anemia ranges from 2 to 30%. The serological screening for anti-HCV at blood banks after 1992 has contributed to a better control of the dissemination of HCV infection. Because of the predominance of genotype 1, these patients belong to a group requiring special treatment, with a probable indication of new therapeutic options against HCV.

As necessidades comunicacionais das práticas educativas na prevenção da transmissão materno-fetal do HIV

Abstract: OBJETIVOS: elucidar a fecundidade da pratica educativa centrada na prevencao da transmissao materno-fetal da AIDS para promover a comunicacao usuarias-servicos. METODOS: Estudo exploratorio, parte de uma pesquisa sobre atencao pre-natal, realizado em 19 centros de saude, duas maternidades e seis unidades de saude da familia da Secretaria de Saude da cidade do Recife, de maio a julho de 1998. O processo de trabalho foi observado, equipes tecnicas entrevistadas e um questionario foi aplicado as 355 mulheres em atendimento; dessas, 81 foram submetidas a sondagem. RESULTADOS: nenhum servico faz aconselhamento, mesmo quando informam sobre o teste anti-HIV (48,1%). O trabalho educativo esta focalizado no fornecimento de informacoes durante a consulta, pois, as atividades coletivas, nas unidades que realizam-nas (48,1%), nao ocorrem em todos os horarios do pre-natal. A pratica educativa baseada na racionalidade estrategica subestima a importância da aproximacao as decisoes valorativas das mulheres, das quais somente 11,1% utilizam camisinha de modo sistematico. CONCLUSOES: a pequena oferta de atividades educativas no pre-natal e o "monologo tecnocratico" que predomina nas relacoes entre usuarias e servicos de saude tem repercussoes negativas na vulnerabilidade da populacao feminina e de seus filhos.

Exploring memory hierarchy with ArchC

Abstract: We present the cache configuration exploration of a programmable system, in order to find the best matching between the architecture and a given application. Here, programmable systems composed by processor and memories may be rapidly simulated making use of ArchC, an architecture description language (ADL) based on SystemC. Initially designed to model processor architectures, ArchC was extended to support a more detailed description of the memory subsystem, allowing the design space exploration of the whole programmable system. As an example, it is shown an image processing application, running on a SPARC-V8 processor-based architecture, which had its memory organization adjusted to minimize cache misses.

The occurrence and distribution of lymphatic filariasis in Greater Metropolitan Recife: the case of an endemic area in Jaboatão dos Guararapes, Pernambuco, Brazil

Abstract: This article analyzes the results of an epidemiological survey on the occurrence and distribution of lymphatic filariasis in Cavaleiro, a district in the city of Jaboatao dos Guararapes in Greater Metropolitan Recife, Pernambuco State, Brazil. The district was divided into 12 areas, and a cross-sectional technique was used to examine 9,520 individuals, of whom 2.2% were found to be infected. There were positive cases in 11 of the areas. The prevalence rate ranged from 0% to 5.15%. The majority (64.3%) of infected individuals were males (p < 0.05). Infected individuals were identified in all age groups. The results show that lymphatic filariasis is still an important public health problem in the Cavaleiro district and that it deserves attention by municipal authorities and health planners.

Efetividade da aplicação do sulfato ferroso em doses semanais no Programa Saúde da Família em Caruaru, Pernambuco, Brasil

Abstract: Descreve-se, neste artigo, a avaliacao da efetividade de um projeto experimental de enfrentamento da anemia em criancas de 6 a 23 meses de idade, utilizando doses semanais de sulfato ferroso, atraves do Programa Saude da Familia em Caruaru, Pernambuco, Brasil. O Ministerio da Saude iniciou, em 1999, um programa de combate a anemia em cerca de 300 mil criancas de 512 municipios do Nordeste. Foram aplicados as criancas 50mg de ferro elementar por semana durante cerca de 24 semanas. Avaliaram-se, nesse estudo, 293 criancas de 6 a 23 meses de idade em zonas rural e urbana do Municipio de Caruaru. Antes do inicio da intervencao, a media da concentracao de hemoglobina (dosada pelo metodo da cianometahemoglobina) era de 10,1 (±0,98) g/dl e existiam 77,5% de criancas anemicas. Apos o tratamento, a media de hemoglobina elevou-se para 11,1 (±0,87) g/dl, enquanto ocorreu uma reducao da anemia para 40,3%. A estrategia representa um instrumento promissor na reducao da prevalencia e no controle das formas graves de anemia em criancas.

Idade materna como fator de risco para a hipertensão induzida pela gravidez: análise multivariada

Abstract: PURPOSE: to evaluate maternal age of 40 and older as an independent risk factor for pregnancy-induced hypertension (PIH). METHOD: we conducted a retrospective cohort study involving analysis of medical records of 2047 women in labor, divided into groups of 298 aged 40 and older and 1749 aged under 40. A multiple logistic regression was done to evaluate the association of maternal age with the occurrence of PIH adjusted by parity, chronic arterial hypertension, diabetes and twin pregnancy. RESULTS: the incidence of PIH in patients aged 40 and over was 22.1% (66/298), higher than in patients aged under 40 (16%, 286/1463). PIH was diagnosed in 27.2% of primiparous (174/640), 47.6% of chronic hypertensive (30/66) and 27.1% of diabetic patients (13/48). Advancing maternal age, primiparity and chronic arterial hypertension were associated with the occurrence of PIH in univariate analysis (OR = 1.46, 2.58 and 4.69, respectively). There was no significant association with diabetes. After the adjustment we observed an increase in the strength of the association between maternal age and PIH (adjusted OR = 1.69), as well as parity and chronic arterial hypertension. CONCLUSION: maternal age of 40 and older was a risk factor for the occurrence of PIH independent of parity, chronic arterial hypertension and diabetes.

Conduction velocity of the rabbit facial nerve: a noninvasive functional evaluation

Abstract: The aim of this study was to evaluate standardized conduction velocity data for uninjured facial nerve and facial nerve repaired with autologous graft nerves and synthetic materials An evaluation was made measuring the preoperative differences in the facial nerve conduction velocities on either side, and ascertaining the existence of a positive correlation between facial nerve conduction velocity and the number of axons regenerated postoperatively In 17 rabbits, bilateral facial nerve motor action potentials were recorded pre- and postoperatively The stimulation surface electrodes were placed on the auricular pavilion (facial nerve trunk) and the recording surface electrodes were placed on the quadratus labii inferior muscle The facial nerves were isolated, transected and separated 10 mm apart The gap between the two nerve ends was repaired with autologous nerve grafts and PTFE-e (polytetrafluoroethylene) or collagen tubes The mean of maximal conduction velocity of the facial nerve was 4110 m/s After 15 days no nerve conduction was evoked in the evaluated group For the period of 2 and 4 months the mean conduction velocity was approximately 50% of the normal value in the subgroups assessed A significant correlation was observed between the conduction velocity and the number of regenerated axons Noninvasive functional evaluation with surface electrodes can be useful for stimulating and recording muscle action potentials and for assessing the functional state of the facial nerve

Nightmares without atonia as an early symptom of diffuse Lewy bodies disease.

Abstract: A male 70 years old patient with diffuse or "pure" Lewy body disease is described. The diagnosis was made based on clinical features of nightmares with no atonia, attention deficits with fluctuation in cognitive function, incapacity to find his way around the neighbourhood and other formerly familiar environments and mild neuropsychiatric symptoms. Neuropsychological assessment showed memory deficits, visuospatial and visuo-constructive disturbances. He had neither parkinsonism nor recurrent visual hallucinations typically well formed and detailed. Neuroimaging (computed tomography and magnetic resonance spectroscopy) showed mild diffuse cortical atrophy, mostly on the left temporal lobe and a decrease of N-acetyl-aspartate levels. A cholinesterase inhibitor was prescribed to this patient during 6 months with clinically relevant behavioral effect. Diagnosis confirmation was made by post-mortem neuropathological findings. Macroscopical features were mild atrophy on the frontal, parietal and temporal lobes, notedly on the frontal lobes. Microscopically, there was neuronal loss and diffuse classic Lewy bodies. Brainstem (substantia nigra, raphe nucleus, locus coeruleus, pedunculopontine nucleus), limbic cortex, and neocortex (frontal, parietal and temporal) were the areas of predilection for Lewy bodies. Hematoxylin-eosin and Bielschowsky staining did not show neuronal swelling (ballooned cell), argyrophilic inclusion (Pick's bodies), neurofibrillary tangles nor senile plaques. Immunohistochemical staining for anti-tau, anti-beta-amyloid, and anti-prion protein were negative. Antiubiquitine reaction was positive for Lewy body in the cerebral cortex and brainstem.

On the computation of weight enumerators for convolutional codes

Abstract: Performance bounds for maximum-likelihood decoding of convolutional codes over memoryless channels are commonly measured using the distance weight enumerator T(x,y), also referred to as the transfer function, of the code. This paper presents an efficient iterative method to obtain T(x,y) called the state reduction algorithm. The algorithm is a systematic technique to simplify signal flow graphs that algebraically manipulate the symbolic adjacency matrix associated with the convolutional code. Next, the algorithm is modified to compute the first few terms of the series expansion of T(1,y) and {/spl part/T(x,y)//spl part/x}/sub x=1/ (the distance spectra) without first computing the complete T(x,y).

A combinatorial approach to finding the capacity of the discrete noiseless channel

Abstract: Shannon defined the capacity of the discrete noiseless channel (DNC) and considered a finite-state model from which the capacity can be calculated. Alternatively, the DNC may be (and often is) represented by a finite list of forbidden strings. In this correspondence, we demonstrate the application of combinatorial techniques to finding the Shannon capacity of the DNC directly from the forbidden list. In our derivations, the case of noninteger symbol durations, as introduced by Csiszar, is considered.

Como será o amanhã? responda quem puder! perspectivas de enfermeirandos quanto ao seu futuro profissional

Abstract: Estudo qualitativo que teve como objetivos: Identificar os fatores significativos na formacao do enfermeiro; descortinar o perfil do enfermeiro na percepcao do graduando; conhecer as perspectivas dos enfermeirandos quanto ao seu amanha profissional. Teve como sujeitos 12 alunos concluintes do Curso de Graduacao em Enfermagem de tres Universidades de Pernambuco. Foram realizadas entrevistas gravadas e observacao assistematica, nos meses de marco e abril de 2003. Como resultados foram construidas as seguintes categorias: Escolha pela profissao de enfermagem; envolvimento com a formacao profissional; reflexoes quanto a formacao academica e perspectivas em relacao ao futuro profissional.

Transplante de fígado em hospital universitário do Recife: resultados iniciais

Abstract: OBJETIVO: Apresentar a experiencia e enfatizar o aprendizado obtido em um programa incipiente de transplante hepatico desenvolvido em Hospital Universitario de Recife-PE. METODO: Foram estudados os primeiros 20 pacientes submetidos a transplante ortotopico de figado, de maneira simplificada, no periodo de agosto de 1999 a marco de 2002. Foram analisadas as indicacoes, a reserva funcional hepatica pre-operatoria, o volume de sangue transfundido, o tempo de isquemia, o tempo de permanencia em UTI, a morbidade e a mortalidade. A cirrose por virus C foi a indicacao de transplante em 9 pacientes (45%), seguida de cirrose alcoolica em 7 (35%). Quarenta e cinco por cento dos pacientes foram classificados como CHILD-PUGH A, 35% como B, e apenas 20% como C. RESULTADOS: O tempo de isquemia medio foi de 9h 09' (+ 2h 33'). Foram utilizadas em media 2,88 (+ 2,11) unidades de hemacias. A tecnica empregada foi a convencional sem bypass em 90% dos casos e piggyback nos restantes. No pos-operatorio, houve um caso de trombose de arteria hepatica e outro de veia porta. Oito pacientes apresentaram complicacoes biliares, todas resolvidas por via endoscopica ou percutânea. A sobrevida global e de 100%, no periodo de seguimento de 2 a 32 meses. CONCLUSAO: Conclui-se que e possivel realizar transplantes de figado, com bons resultados, em hospital universitario do Nordeste do Brasil, desde que se reunam as minimas condicoes de estrutura fisica e recursos humanos.

O desempenho na pre-escola de criancas portadoras de carie severa

Abstract: School performance of pre-school children with severe caries. The study evaluated and compared school performance of caries-free and severe caries of 4-year- old children by their teachers' perception. The selected group consisted of 101 preschoolers from 4 randomly chosen municipal schools in the city of Recife, state of Pernambuco, Brazil, in 2002. All the study data was collected by 3 examiners by applying validated questionnaires to the teachers. Forty-one children were selected from the initial sample of 101. Thirty-two were caries-free and 9 had severe caries (31.7% and 8.9%, respectively). The caries-free group presented more attention to teachers' explanation and less difficulty in school tasks than the severe caries group. They also did not have absences in school caused by their teeth, but this happened with children from group B. The teachers did not observe differences between the 2 groups in oral school participation and word pronunciation. Neither of children from caries-free group received constrained nickname related to their teeth, although 11% from severe caries group have received it. The teachers considered that 22% from severe caries group presented damage in their school performance caused by their teeth. Severe caries group school performance can be affected by their oral health. Researches have to be developed to better evaluate the impact of severe

Petri net based interface analysis for fast IP-core integration

Abstract: An interface process generation methodology, based on Petri nets, is described for fast integrating point-to-point communicating modules. Formal basis of this methodology ease behavioral property-checking and consistent execution of the generated interface process. The exposed technique allows fast incorporation of third-party cores into SoPC systems design where integration task is often a barrier for reusability.

Pesquisa em enfermagem à luz da complexidade de Edgar Morin

Abstract: O objetivo deste artigo foi apresentar a Complexidade, mostrando sua importância na pesquisa em enfermagem Trata-se de uma reflexao em duas partes: os principios da Complexidade, de Edgar Morin; a pesquisa em enfermagem a partir da Complexidade Considerando a complexidade que envolve os objetos de estudo da enfermagem, torna-se desejavel escolher um caminho metodologico mais apropriado a sua apreensao, ou seja optar por um metodo que apresente maior possibilidade de retratar esta realidade E entendendo o metodo como caminho da investigacao acoplado a/e originario da teoria e nao amarra do fazer cientifico, a Complexidade, de Edgar Morin, quando utilizado como escolha teorica termina sendo um guia para o caminho metodologico