Showing papers by "Universidade de Pernambuco published in 2005"

Geographic distribution of hepatitis C virus genotypes in Brazil

Abstract: Brazil is a country of continental dimension with a population of different ethnic backgrounds. Thus, a wide variation in the frequencies of hepatitis C virus (HCV) genotypes is expected to occur. To address this point, 1,688 sequential samples from chronic HCV patients were analyzed. HCV-RNA was amplified by the RT-PCR from blood samples collected from 1995 to 2000 at different laboratories located in different cities from all Brazilian States. Samples were collected in tubes containing a gel separator, centrifuged in the site of collection and sent by express mail in a refrigerated container to Laboratorio Bioquimico Jardim Paulista, Sao Paulo, SP, Brazil. HCVRNA was extracted from serum and submitted to RT and nested PCR using standard procedures. Nested PCR products were submitted to cycle sequencing reactions without prior purification. Sequences were analyzed for genotype determination and the following frequencies were found: 64.9% (1,095) for genotype 1, 4.6% (78) for genotype 2, 30.2% (510) for genotype 3, 0.2% (3) for genotype 4, and 0.1% (2) for genotype 5. The frequencies of HCV genotypes were statistically different among Brazilian regions (P = 0.00017). In all regions, genotype 1 was the most frequent (51.7 to 74.1%), reaching the highest value in the North; genotype 2 was more prevalent in the Center-West region (11.4%), especially in Mato Grosso State (25.8%), while genotype 3 was more common in the South (43.2%). Genotypes 4 and 5 were rarely found and only in the Southeast, in Sao Paulo State. The present data indicate the need for careful epidemiological surveys throughout Brazil since knowing the frequency and distribution of the genotypes would provide key information for understanding the spread of HCV.

The psychosocial effects of severe caries in 4-year-old children in Recife, Pernambuco, Brazil

Abstract: The aim of this study was to analyze the psychosocial effects of severe caries in 4-year-old children in Recife, Pernambuco, Brazil. The clinical examination was conducted by a single examiner in order to select children with severe caries and caries-free (kappa = 1). Of the 861 children examined, 77 (8.1%) had severe caries and 225 (23.6%) were caries-free. Data were collected by applying validated questionnaires answered by the parents or guardians. Most of the parents or guardians of children with severe caries reported that their children complained of toothache (72.7%), and a significant portion stated that their children had problems eating certain kinds of food (49.4%) and missed school (26.0%) because of their teeth. Most of the parents or guardians of children with severe caries (68.8%) stated that oral health affects their children's life, while the same was stated by 9.8% of the parents or guardians of the caries-free children. Severe caries was found to have a negative impact on children's oral health-related quality of life.

The influence of cryotherapy on reduction of swelling, pain and trismus after third-molar extraction: A preliminary study

Abstract: Background Swelling, pain and trismus are undesirable consequences of impacted mandibular third molar extraction. The authors conducted a study to evaluate the effectiveness of cryotherapy, the therapeutic use of cold, in reducing undesirable consequences after surgery. Methods Fourteen patients aged 20 to 28 years comprised the sample. The authors extracted two impacted mandibular third molars at different times from each patient. Immediately after surgery, the patient underwent cryotherapy on one side for 30 minutes every one and one-half hours for 48 hours when he or she was awake. The patient did not receive cryotherapy on the other side. The authors performed clinical examinations to measure trismus and swelling before surgery, immediately after surgery and 24 and 48 hours after surgery. Results The authors compared both sides for differences in swelling, pain and trismus in each patient. The results showed significant statistical differences in two of the five points that were used to measure the swelling (Wilcoxon nonparametric signed rank test of linear distances between the angle of the mandible to the pogonion and to the tragus). They found statistical differences between the two sides in relation to the pain; however, they found no significant differences in relation to trismus. Conclusions Cryotherapy was effective in reducing swelling and pain in this sample. Despite playing no role in the reduction of trismus, cryotherapy was effective in reducing swelling and pain in this sample, and the authors still recommend it be used. Clinical Implications Cryotherapy is helpful after third-molar extraction. Further studies need to be conducted that use larger samples of patients and other types of therapy, such as low-level laser therapy.

Influence of cervical preflaring on determination of apical file size in maxillary molars: SEM analysis

Abstract: This study investigated the influence of cervical preflaring with different rotary instruments on determination of the initial apical file (IAF) in mesiobuccal roots of mandibular molars. Fifty human mandibular molars whose mesial roots presented two clearly separated apical foramens (mesiobuccal and mesiolingual) were used. After standard access opening and removal of pulp tissue, the working length (WL) was determined at 1 mm short of the root apex. Five groups (n=10) were formed at random, according to the type of instrument used for cervical preflaring. In group 1, the size of the IAF was determined without preflaring of the cervical and middle root canal thirds. In groups 2 to 5, preflaring was performed with Gates-Glidden drills, ProTaper instruments, EndoFlare instruments and LA Axxes burs, respectively. Canals were sized manually with K-files, starting with size 08 K-files, inserted passively up to the WL. File sizes were increased until a binding sensation was felt at the WL and the size of the file was recorded. The instrument corresponding to the IAF was fixed into the canal at the WL with methylcyanoacrylate. The teeth were then sectioned transversally 1 mm short of the apex, with the IAF in position. Cross-sections of the WL region were examined under scanning electron microscopy and the discrepancies between canal diameter and the diameter of IAF were calculated using the tool "rule" (FEG) of the microscope's proprietary software. The measurements (microm) were analyzed statistically by Kruskal-Wallis and Dunn's tests at 5% significance level. There were statistically significant differences among the groups (p 0.05) were found among the rotary instruments. In conclusion, cervical preflaring improved IAF fitting to the canals at the WL in mesiobuccal roots of maxillary first molars. The rotary instruments evaluated in this study did not differ from each other regarding the discrepancies produced between the IAF size and canal diameter at the WL.

Access to basic care for children seen at emergency departments

Abstract: OBJETIVO: Conhecer a acessibilidade as acoes basicas entre criancas atendidas em servicos de pronto-socorro, reconstruindo trajetoria de contatos com unidades de saude no evento atual e caracterizando vinculos com atencao basica e adequacao da morbidade ao perfil organizacional dos servicos. METODOS: Estudo descritivo, transversal, realizado em novembro de 2002 e de fevereiro a maio de 2003, nos cinco servicos publicos de urgencia/emergencia pediatrica, em amostra de 383 criancas menores de 5 anos, residentes no Recife, calculada com 20% de adequacao da morbidade, erro de 5% e perda de 10%. Utilizou-se instrumento padronizado aplicado por oito entrevistadores, devidamente treinados. RESULTADOS: Na trajetoria ate contato atual, 38,5% das criancas procuraram os seguintes servicos: pronto-socorro (48,3%), Saude da Familia (19,7%) e centro de saude (17%), com 18,4% tendo dificuldades na atencao primaria; 39,4% utilizaram apenas pronto-socorro e 54,4% recorreram em algum momento a esse tipo de servico. Cerca de 88% sao cadastradas numa unidade: 34,5% na Saude da Familia (56,8% nao utilizaram servicos e 25,6% utilizaram) e 42% no centro de saude (59,1% nao usaram servicos e 18,2% recorreram ao proprio). Apenas 18,9% preferem unidade basica quando a crianca adoece. Assim, no contato atual, a maior parte foi trazida ao servico preferido (gosta/confia nos profissionais, acessibilidade geografica, qualidade do atendimento). A demanda de 36,5% foi considerada adequada. CONCLUSOES: Apesar das dificuldades da rede basica para garantir acesso e resolubilidade, parte substancial dessa demanda espontânea decorre da enorme legitimidade dos servicos de urgencia perante a populacao.

Análise espacial dos determinantes socioeconômicos dos homicídios no Estado de Pernambuco

Abstract: OBJETIVO: Investigar a associacao entre variaveis socioeconomicas e taxas de homicidio, considerando a localizacao espacial dos indicadores. METODOS: Utilizou-se o metodo de estudo ecologico. A variavel dependente foi taxa de homicidio da populacao masculina de 15 a 49 anos, residente nos municipios do Estado de Pernambuco, em 1995 a 1998. As variaveis independentes referem-se a: indice de condicoes de vida, renda familiar per capita, desigualdade de Theil, indice de Gini, renda media do chefe de familia, indice de pobreza, taxa de analfabetismo, densidade demografica.Utilizou-se teste de correlacao espacial determinado pelo Indice de Moran, regressao multipla, Conditional Auto Regressive (CAR) e a funcao Loess, como modelo de deteccao de tendencia especial. RESULTADOS: Os indicadores taxa de analfabetismo e indice de pobreza explicaram 24,6% da variabilidade total das taxas de homicidio, cuja associacao foi inversa. O indice de Moran revelou autocorrelacao espacial entre os municipios. O modelo de regressao espacial que melhor se adequou ao estudo foi o CAR, que confirmou a associacao entre indice de pobreza, analfabetismo e homicidio. CONCLUSOES: A relacao inversa observada entre os indicadores socioeconomicos e homicidios pode expressar determinado processo que propicia melhoria das condicoes de vida, e esta atrelado predominantemente a condicoes geradoras de violencia, como a do trafico de drogas.

Regional patterns of the temporal evolution of the AIDS epidemic in Brazil following the introduction of antiretroviral therapy

Abstract: We examined the characteristics of the AIDS epidemic in the northeastern region of Brazil, comparing it to the epidemic in Brazil as a whole, and to the state of Sao Paulo, with respect to the temporal evolution of morbidity and mortality during the period 1990 to 1999, using information from communicable disease reports and mortality records. Since 1996, the incidence rate of AIDS in adults in Brazil as a whole and in Sao Paulo has been showing a trend towards stability, whereas in the Brazilian northeast the incidence rates of the disease continue to grow. In the northeast, sexual transmission is responsible for more than 80% of cases, injectable drug users (IDU) comprising only a small percentage of cases. There is a greater incidence of AIDS among groups with lower educational levels throughout the country. The comparative analysis of cases of AIDS and of deaths from AIDS shows growth, both in the number of cases and in the number of deaths; however, from 1996 onwards there has been a progressive reduction in the number of deaths in all regions analyzed. With respect to the incidence of cases of the disease acquired by vertical transmission, a significant growth trend can be seen in all regions for cases born in the period 1990-6, but in 1997 temporal analysis showed evidence of a reduction in this growth. In conclusion, temporal changes have occurred in the AIDS epidemic in Brazil, which has been showing a trend towards stability since 1996, when potent ARV therapy was introduced. However, this deceleration is not homogenous throughout all the regions.

Prática de esportes durante a adolescência e atividade física de lazer na vida adulta

Abstract: FUNDAMENTOS E OBJETIVOS: Inatividade fisica e importante fator de risco para as doencas cronicas. Os resultados da literatura sao controvertidos em relacao a pratica de atividades esportivas na infância e adolescencia e atividade fisica na vida adulta. O objetivo deste estudo foi verificar em adultos jovens a frequencia de atividade fisica de lazer (AFL) e determinar se a pratica de esportes durante a adolescencia influenciou esta atividade. METODOS: Foi realizado um estudo transversal, tipo inquerito, no periodo de novembro de 2003 a abril de 2004, em 170 alunos do curso medico que realizaram o estagio de internato em pediatria e tocoginecologia no Instituto Materno Infantil de Pernambuco (IMIP). Foram considerados como atletas aqueles que afirmaram terem praticado algum tipo de esporte durante pelo menos dois anos consecutivos, entre a faixa etaria dos 10 aos 19 anos. Atividade fisica desenvolvida atualmente foi aferida atraves da informacao sobre AFL, na ultima semana que antecedeu a aplicacao do questionario, para a pratica de algum tipo de atividade fisica que provocasse sudorese e respiracao acelerada. Foram considerados como fisicamente ativos aqueles que despenderam um minimo de 150 minutos de atividade fisica por semana. RESULTADOS: Apenas 22,5% (35/155) dos internos desenvolviam AFL. Entre aqueles que foram atletas durante a adolescencia, a pratica de AFL na vida adulta foi maior; 26,8% (33/123), do que aqueles nao atletas, 6,2% (2/32); p < 0,03 (tabela 1). Entretanto, a presenca de excesso de peso ou obesidade, hipertensao arterial, tabagismo e antecedentes familiares de doenca aterosclerotica precoce nao diferiu entre os grupos com maior e menor AFL. CONCLUSAO: Praticas de atividades esportivas durante a adolescencia contribuem para AFL na vida adulta.

The in vitro morphological effects of some current pre-treatments on dentin surface: a SEM evaluation.

Abstract: This in vitro study morphologically evaluated the effect of some current surface pre-treatments on dentin, using scanning electron microscopy, and related these morphological alterations to clinical implications. The labial surfaces of 30 bovine lower incisors were ground to obtain a flat dentin surface and were finished with 600-grit SiC paper to produce standardized smear layers. The teeth were randomly divided into six groups of five each. Group 1 was the control group, smear layer covered dentin; Group 2 was etched with 37% phosphoric acid (PA) for 15 seconds; Group 3, 37% PA for 15 seconds, followed by 10% NaOCl for 60 seconds; Group 4, 10% NaOCl for 60 seconds; Group 5, a self-etching primer (Clearfil SE Bond, CSEB-primer) was applied for 20 seconds; Group 6, CSEB-primer for 20 seconds, followed by NaOCl for 60 seconds. The specimens were fixed, dehydrated, dried and analyzed by SEM. Treatment with 37% PA removed the smear layer, funneled the tubules and resulted in a collagen-rich surface which appeared to have collapsed in its outermost part, producing a dense surface layer covered with silica particles. When 37% PA treatment was followed by 10% NaOCl, the collagen network was removed to reveal an eroded, rough mineral surface with numerous lateral branches and larger than normal tubular orifices. The action of 10% NaOCl on the smear layer-covered dentin showed no significant alteration in surface morphology. The treatment with CSEB-primer dissolved the smear layer but only partially dissolved the smear plugs. The tubules did not present the typical funnel shape seen following PA treatment. These morphological aspects on dentin surface must influence bonding results. The dentin surface alterations produced by PA appeared to be a very severe demineralization pattern, quite irregular and less permeable to monomer infiltration, while the surface provided by the self-etching primer appeared to be a more uniform, less porous surface, and the association with simultaneous monomer infiltration may reduce the occurrence of mistakes in clinical bonding procedures.

Prevalence of Staphylococcus aureus introduced into intensive care units of a University Hospital

Abstract: Staphylococcus aureus is one of the principal human pathogens that colonize healthy individuals in the community in general, and it is responsible for severe infections in hospitalized patients. Due to an increase in the prevalence of strains of methicillin-resistant S. aureus (MRSA), combating these microorganisms has become increasingly difficult. A descriptive study was carried out on 231 patients in intensive care at the Oswaldo Cruz University Hospital (HUOC) in Recife, Brazil between January and April 2003 to determine the prevalence of S. aureus and MRSA and to evaluate risk factors for colonization by these bacteria when introduced into Intensive Care Units (ICUs). Body secretions were collected from the nostrils, axillary and perineal regions, and from broken skin lesions, of all patients during the first 48 hours following admission to the ICU. Samples were inoculated into blood agar and mannitol-salt-agar culture medium and identified by Gram staining, and by coagulase, DNAse and agglutination (Slidex Staph Test) tests. Growth in Mueller-Hinton agar with 4% sodium chloride and 6 mg/L oxacillin was used to identify MRSA. In addition, the latex agglutination test was performed to identify penicillin-binding protein, PBP 2A. The prevalence of S. aureus and MRSA was 87/231 (37.7%) and 30/231 (12.98%), respectively. There was no association between any risk factor studied (age, sex, origin of the patient--whether hospital or community, previous hospitalization, use of current or previous antibiotic therapy, corticotherapy and/or immunotherapy, reason for hospitalization and place of hospitalization) and the presence of S. aureus. However, a significant association was established between previous hospitalization and the presence of MRSA (RR:1.85; CI:1.00-3.41; p=0.041). The nostrils were the principal site of colonization by both S. aureus (80.4%) and MRSA (26.4%), followed by the perineal area, with rates of 27.6% and 12.6%, respectively. If only the nostrils had been investigated, the study would have failed to diagnose 17 patients (19.5%) as carriers of the pathogen into the ICU, thus contributing towards cross-dissemination.

Resposta fisiológica de sementes de feijão caupi ao estresse salino

Abstract: This work aimed to evoluate physiological response of cowpea (Vigna unguiculata L. Walp) seeds submitted to salt stress. Seeds of cultivars 'Epace-10'; 'Canapu' and 'Pitiuba' of cowpea, were submitted to germination test in germinator at 250C, in "germitest" papers imbibed in distilled water or in 0, 10, 50, 100 and 200mol m-3 NaCl solutions. At the first and second counting of the germination test, normal seedlings were accounted, weighted and dried, obtaining data for vigor, total germination, fresh matter weight and dry matter weight. The seedlings hypocotyls, root and total length were measured total proteins content in cotyledons were obtained from germinating seeds. The presence of salt at concentrations higher than 50mol m-3 NaCl affect the germination, seedlings growth and cotyledons total protein synthesis of all cowpea cultivars. The seeds of cultivar pitiuba were is more tolerant to salinity, than the cultivars Canapu and Epace-10.

Early childhood caries: prevalence and risk factors in 4-year-old preschoolers in João Pessoa, Paraíba, Brasil

Abstract: The purpose of the present study was to evaluate the prevalence of early childhood caries (ECC), in a cohort of children of low socioeconomic status at 48 months of age in Joao Pessoa, Paraiba, Brazil, in relation to feeding practices, oral health behaviors, fluoride exposure, and enamel defects. 224 children were clinically examined in the Knee-Knee position at the children's home under natural light. Teeth were dried and cleaned with gauze, and caries (WHO index) and defect (DDE Index) were determined. Questionnaires on children's oral hygiene and dietary history were completed by parents or guardians. The SAS statistical program was used with the Mantel-Haenszel tests. The results showed a prevalence of 10.7% and 33.0% for ECC and SECC, respectively. Of all the children examined, 79.9% had at least one tooth with enamel defects, which was the only statistically significant factor (p < 0.001) for ECC. The association between enamel defects and ECC indicates that alterations in the enamel surface may cause progression of dental caries.

Sentimentos de profissionais dos serviços de pronto-socorro pediátrico: reflexões sobre o burnout

Abstract: OBJETIVOS: conhecer os sentimentos de profissionais dos servicos de pronto-socorro infantil diante das situacoes de trabalho, focalizando os componentes do burnout: exaustao emocional, falta de envolvimento pessoal e despersonalizacao. METODOS: pesquisa qualitativa realizada, na cidade do Recife, de marco a julho de 2003, em cinco unidades publicas de referencia, utilizando analise de conteudo para compreender os "nucleos de sentido" das mensagens de 40 entrevistas semi-estruturadas com pediatras e sete enfermeiras da urgencia/emergencia. RESULTADOS: nesses relatos convivem sentimentos dispares: cansaco, esgotamento, angustia e revolta pela sobrecarga e limitacoes dos recursos frente as situacoes que envolvem risco de vida, permeados pela satisfacao de gostar do que fazem e reconhecimento da propria utilidade; temor de cometer enganos fatais; desqualificacao profissional quando comparam remuneracao com responsabilidade e esforco empregado; exposicao ao risco de agressao e indiciamento judicial alimentando desesperanca e vulnerabilidade; e vinculo afetivo com trabalho. Esbocam-se, sobretudo entre medicos com menor tempo de formados, o descredito nas possibilidades de mudancas e a vontade de desistir. CONCLUSOES: apesar do estresse laboral cronico, os profissionais entrevistados mantem o compromisso de contribuir na solucao dos problemas cotidianos. Existe tendencia para exaustao emocional, desânimo e sentimentos de inadequacao e fracasso, reforcando a importância da promocao e prevencao em saude no ambiente de trabalho.

Karyotype, C-and fluorescence banding pattern, NOR location and FISH study of five Scarabaeidae (Coleoptera) species

Abstract: Meiotic chromosomes obtained from members of the coleopteran subfamilies Rutelinae and Dynastinae were studied using standard and silver nitrate staining, C-banding, base-specific fluorochromes and fluorescent in situ hybridization (FISH). The study presents detailed karyotipic descripitions of three Rutelinae species (Geniates borelli, Macraspis festiva and Pelidnota pallidipennis), and two Dynastinae species (Lygirus ebenus and Strategus surinamensis hirtus) with special emphasis on the distribution and variability of constitutive heterochromatin and the nucleolar organizer region (NOR). We found that for G. borelli, P. pallidipennis, L. ebenus and S. s hirtus the karyotype was 2n = 20 (9II + Xyp), with G. borelli, P. pallidipennis and L. ebenus showed meta-submetacentric chromosomes which gradually decreased in size. For Macraspis festiva the karyotype was 2n = 18 (8II + Xyp). In L. ebenus we found that the NOR was located on an autosome, but in the other four species it occurred on the sex bivalents. In all five species the constitutive heterochromatin (CH) was predominantly pericentromeric while the X chromosomes were almost completely heterochomatic, although CMA3/DA/DAPI staining showed intra and interspecific variation in the bright fluorescence of the constitutive heterochromatin. The FISH technique showed rDNA sites on the X chromosome of the Rutelinae species.

Comparative study of eminectomy and use of bone miniplate in the articular eminence for the treatment of recurrent temporomandibular joint dislocation.

Abstract: Summary Dislocation of the temporomandibular joint occurs when the mandibular condyle exits the glenoidal cavity and remains anteriorly locked to the articular eminence. It is repetitive (recurrent dislocation), usually associated with mandibular hypermobility and inclination of the articular eminence. Aim This study intended to clinically and radiologically assess the technique of eminectomy and the use of a miniplate on the articular eminence for the treatment of recurrent dislocation of the temporomandibular joint of patients operated on at Oswaldo Cruz University Hospital from January to September 2003. Study design Retrospective cohort. Material and Method The sample consisted of 11 patients. Eminectomy was performed on nine joints of five patients and the placement of a miniplate on the articular eminence was performed on 11 joints of six patients. Data collection was carried out through analysis of patient's medical charts and new postoperative visit. Results The results showed that there were no major postoperative complications with either technique. Maximum mouth opening was greater with eminectomy procedure and none of the patients operated on presented any recurrence of dislocation. Conclusion It is concluded that both techniques were effective in the treatment of recurrent dislocation of the temporomandibular joint.

Software component certification: a survey

Abstract: Component-based software engineering, the process of building software systems from reusable parts, offers the potential to radically improve the way in which software is developed. It promises increased reuse leading to higher quality and reduced time to market. "Higher quality" means that the components must have a quality stamp in terms of what level of reliability can be expected from them. Thus, the certification stands out as an essential area to evaluate the component reliability level. In this sense, this paper presents a survey of software component certification research.

Prevalence and associations of symptoms of upper extremities, repetitive strain injuries (RSI) and 'RSI-like condition'. A cross sectional study of bank workers in Northeast Brazil

Abstract: The repetitive strain injury syndrome (RSI) is a worldwide occupational health problem affecting all types of economic activities. We investigated the prevalence and some risk factors for RSI and related conditions, namely 'symptoms of upper limbs' and 'RSI-like condition'. We conducted a cross-sectional study with 395 bank workers in Recife, Northeast Brazil. Symptoms of upper limbs and 'RSI-like condition' were assessed by a simple questionnaire, which was used to screen probable cases of RSI. The diagnosis of RSI was confirmed by clinical examination. The associations of potential risk factors and the outcomes were assessed by multiple logistic regression analysis. We found prevalence rates of 56% for symptoms of the upper limbs and 30% for 'RSI-like condition'. The estimated prevalence of clinically confirmed cases of RSI was 22%. Female sex and occupation (as cashier or clerk) increased the risk of all conditions, but the associations were stronger for cases of RSI than for less specific diagnoses of 'RSI-like condition' and symptoms of upper limbs. Age was inversely related to the risk of symptoms of upper limbs but not to 'RSI-like' or RSI. The variation in the magnitude of risk according to the outcome assessed suggests that previous studies using different definitions may not be immediately comparable. We propose the use of a simple instrument to screen cases of RSI in population based studies, which still needs to be validated in other populations. The high prevalence of RSI and related conditions in this population suggests the need for urgent interventions to tackle the problem, which could be directed to individuals at higher risk and to changes in the work organization and environment of the general population.

Estratégias para prevenção de erros de medicação no setor de emergência

Abstract: O estudo identificou as situacoes indicativas de erro ou quase erro na medicacao atraves da analise das prescricoes de medicamentos e evolucoes de enfermagem. A partir dos dados obtidos foram implementados um ciclo de palestras e um curso sobre a seguranca na administracao de medicamentos para profissionais do setor de emergencia de um hospital do nordeste. Os resultados revelaram que das 1.585 prescricoes analisadas, 83,9% nao explicitava a apresentacao do medicamento e 84,6% a dose do medicamento. Dos medicamentos prescritos 34,2% apresentaram horarios em que nao havia registro da administracao de medicamentos e 22,5% tinham o horario circulado. Dentre os medicamentos nao-administrados 26% eram antibioticos e anticoagulantes; 15% analgesicos. As estrategias implementadas tiveram participacao dos profissionais com bons indices de frequencia.

Treatment of invasive cervical resorption with MTA: case report.

Abstract: This paper presents a case report of a maxillary lateral incisor affected by invasive cervical resorption. The tooth was submitted to a 21-day treatment with calcium hydroxide followed by root canal filling. The area of resorption was sealed with MTA followed by glass ionomer cement and restored with composite resin. Two-year radiographic follow-up showed stability of the resorption site and normal coronal colour and depth of gingival sulcus.

Influence of age and schooling on the performance in a modified Mini-Mental State Examination version: a study in Brazil northeast.

Abstract: Performance in cognitive tests can be influenced by age and education level. In developing countries, formal education is limited for most people. Application of the Mini-Mental State Examination (MMSE) test, in its original version could have an adverse effect on the evaluation of low educated and elderly individuals. OBJECTIVE: To assess the cognitive performance of low and middle educated old people in a modified version of the adapted to portuguese language MMSE. METHOD: A study was carried out enrolling 253 individuals, aged 60 to 90 years included in different schooling levels. Four educational groups were studied: illiterate;1-4 schooling years; 5-8 schooling years and over 8 schooling years. Besides, the sample was also studied according to six classes: 60-65, 66-70, 71-75, 76-80, 81-85 and 86-90 years. The modified version (mo-MMSE) included modifications in copy and calculation items from the adapted MMSE (ad-MMSE) to Portuguese language. The maximum possible score was the same in the two versions: total, 30; copy, 1 and calculation, 5. RESULTS: mo-MMSE scores were significantly higher than ad-MMSE for every age classes. A negative correlation was observed between age and scores in individuals of 1-4 and in individuals over eight schooling years, both in ad-MMSE and mo-MMSE. However, there was not a significant correlation between age and scores in illiterate group and in individuals of 5-8 schooling years. CONCLUSION: The modification of copy and calculation items of ad-MMSE, are responsible by the best performance in mo-MMSE. Cultural background could have influenced this result. Individuals with more than eight years of formal instruction are protected against a reduction of their capacity to solve cognitive tests. However, low instructed individuals have not this capacity and so they present signals of intellectual aging before they become elderly people.

Anestesia e paralisia cerebral

Abstract: JUSTIFICATIVA E OBJETIVOS: A paralisia cerebral (PC) e uma doenca nao progressiva decorrente de lesao no sistema nervoso central, levando a um comprometimento motor do paciente. O portador de PC frequentemente e submetido a procedimentos cirurgicos devido a doencas usuais e situacoes particulares decorrentes da paralisia cerebral. Foi objetivo deste artigo revisar aspectos da paralisia cerebral de interesse para o anestesiologista, permitindo um adequado manuseio pre, intra e pos-operatorio neste tipo de paciente. CONTEUDO: O artigo aborda aspectos da paralisia cerebral como etiologia, classificacao, fatores de risco, fisiopatologia, quadro clinico, diagnostico, terapeuticas utilizadas bem como avaliacao pre-operatoria, medicacao pre-anestesica, manuseio intra e pos-operatorio, analgesia pos-operatoria e dor cronica. CONCLUSOES: O anestesiologista desempenha um papel importante na diminuicao da morbidade e mortalidade anestesico-cirurgica em pacientes portadores de paralisia cerebral. O conhecimento da fisiopatologia dos diferentes tipos de paralisia cerebral bem como das doencas associadas e suas terapeuticas e imprescindivel, pois permite ao anestesiologista antecipar e prevenir complicacoes intra e pos-operatorias neste tipo de paciente.

Phlebotomine sandflies (Diptera: Psychodidae) of the Atlantic forest in Recife, Pernambuco state, Brazil: the species coming to human bait, and their seasonal and monthly variations over a 2-year period.

Abstract: In a study of the phlebotomine sandflies (Diptera: Psychodidae) in a forest reserve in Recife, Pernambuco state, north–eastern Brazil, the sandflies landing on human bait between 1.00 and 1.42 h after sunset were collected weekly for 2 years. Although 10,287 sandflies of 10 Lutzomyia species were collected, almost all (96.5%) of the sandflies caught were Lu. umbratilis. This species and several others caught are potential vectors of some of the Leishmania parasites that cause human disease. The recorded landing rate for Lu. umbratilis peaked, at the high level of 333.3 flies/person-hour, during the collections made in May 2003.The relative rarity in the collections of males of some of the species caught probably indicates that these species do not lek on their bloodmeal sources.It is likely that the sizes of the local populations of species that are not very anthrophilic, such as Lu. flaviscutellata, are much larger than indicated by the collections made on human bait.

Misoprostol sublingual versus vaginal para indução do parto a termo

Abstract: OBJETIVO: comparar efetividade e seguranca de uso de comprimido sublingual de 25 µg de misoprostol com o comprimido vaginal de 25 µg do misoprostol na inducao do parto com idade gestacional e > 37 semanas e colo uterino desfavoravel. METODOS: realizou-se ensaio clinico controlado e aleatorizado, nao cego, na Maternidade Monteiro de Morais (CISAM-UPE), em Recife, no periodo de outubro de 2003 a fevereiro de 2004. Participaram do estudo 123 gestantes com idade gestacional e > 37 semanas, indice de Bishop <8 e fora de trabalho de parto, que apresentavam indicacao para interrupcao da gravidez. As gestantes aleatoriamente receberam 25 µg de misoprostol sublingual ou 25 µg de misoprostol vaginal a cada seis horas, ate uma dose maxima de oito comprimidos (200 µg). Para verificar diferencas entre os grupos foram utilizados media, desvio padrao, teste t de Student, c2 para tendencia e teste de Mann-Whitney. O valor de significacao estatistica adotado foi de 5%. RESULTADOS: nao houve diferenca significativa entre o numero de mulheres que tiveram parto por via vaginal no grupo do misoprostol sublingual e no vaginal (65,5% vs 75,8%, p=0,22). Tambem nao foi significativa a diferenca do intervalo de tempo entre o inicio da inducao e o parto (24 horas e 42 minutos vs 20 horas e 37 minutos, respectivamente, p=0,11) entre os grupos. Os grupos, sublingual e vaginal, nao mostraram tambem diferencas significativas em relacao a sindrome de hiperestimulacao (1,7% vs 3,2%, p=0,95), as incidencias de meconio (5,2% vs 4,8%, p=0,74), ao indice de Apgar <7 no quinto minuto (3,4% vs 4,8%, p=0,98) e a outros efeitos adversos. CONCLUSAO: o misoprostol na dose de 25 mg por via sublingual apresentou a mesma efetividade e seguranca quando comparado com a mesma dose vaginal para inducao do parto. O misoprostol por via sublingual parece representar mais uma opcao a ser considerada na inducao do parto.

Estudo comparativo da eminectomia e do uso de miniplaca na eminência articular para tratamento da luxação recidivante da articulação temporomandibular

Abstract: Dislocation of the temporomandibular joint occurs when the mandibular condyle exits the glenoidal cavity and remains anteriorly locked to the articular eminence. It is repetitive (recurrent dislocation), usually associated with mandibular hypermobility and inclination of the articular eminence. AIM: This study intended to clinically and radiologically assess the technique of eminectomy and the use of a miniplate on the articular eminence for the treatment of recurrent dislocation of the temporomandibular joint of patients operated on at Oswaldo Cruz University Hospital from January to September 2003. STUDY DESIGN: Retrospective cohort. MATERIAL AND METHOD: The sample consisted of 11 patients. Eminectomy was performed on nine joints of five patients and the placement of a miniplate on the articular eminence was performed on 11 joints of six patients. Data collection was carried out through analysis of patient's medical charts and new postoperative visit. RESULTS: The results showed that there were no major postoperative complications with either technique. Maximum mouth opening was greater with eminectomy procedure and none of the patients operated on presented any recurrence of dislocation. CONCLUSION: It is concluded that both techniques were effective in the treatment of recurrent dislocation of the temporomandibular joint.

Revascularização miocárdica em pacientes octogenários: estudo retrospectivo e comparativo entre pacientes operados com e sem circulação extracorpórea

Abstract: OBJECTIVE: The purpose of the present study is to compare and analyze the benefits of this operation with and without cardiopulmonary bypass in octogenarian patients. METHOD: Retrospective data of the patients aged eighty years or more from December 1995 to December 2003 were analyzed. During this period 73 patients were submitted to coronary artery bypass grafting (CABG), 26 (35.6%) on-pump and 47 (64.4%) off-pump. A comparison was made of the demographic data, preoperative risks, concurrent morbid conditions, types of angina, postoperative complications and surgical outcomes between the on-pump and off-pump groups. The Student t-test was used to compare the groups and the level of significance was set at p-value < 0.05. RESULTS: Both groups showed a high preoperative risk, although the off-pump group presented less surgical mortality (11.5% vs 2.1%, p < 0.05). No strokes were observed in the patients operated on off-pump (11.5% vs 0.0%, p < 0.005). Atrial fibrillation (AF) in the immediate postoperative period was present less often in the off-pump group (30.8% vs 12.8%, p < 0.005). The postoperative mechanical ventilation time and the presence of respiratory failure were less in the off-pump group (p < 0.005). The presence of acute renal insufficiency (ARI) was 19.2% in the on-pump group and 0% in the off-pump group (p < 0.05). There was less need for transfusion of blood or blood derivatives in the off-pump group (69.2% vs 31.9%, p < 0.005). The mean sojourn in the intensive care unit (ICU) was shorter in the off-pump group (p < 0.05). The percentage of patients with no postoperative complications was higher in the off-pump group than in the on-pump group (89.4% vs 61.5%, p <0.001). CONCLUSIONS: The present study suggests that patients aged eighty years and over benefit when submitted to off-pump CABG and that this procedure is associated with low rates of postoperative complications such as stroke, AF, ARI and respiratory insufficiency, and with less time in the ICU, a shorter hospital sojourn, less use of blood derivatives and lower mortality. In octogenarian patients off-pump CABG surgery is a safe and effective technique, and may be the operation of choice when correctly indicated.