Showing papers by "Universidade de Pernambuco published in 2008"

NOTES transvaginal cholecystectomy: preliminary clinical application

Abstract: Background Natural orifice translumenal endoscopic surgery (NOTES) is an emerging concept in the recent literature that could lead to potential benefits in clinical applications. Restricted to animal experiments, however, human procedures have not yet been published. Because of the technical and ethical challenges involved in perforation and closure of a healthy organ—as is also seen in operating via the transgastric route—and because of the lack of understanding of the physiopathology and infection risk with these approaches, they have not been applied in the clinical setting. Thus the present study, based on previous animal experiments, describes preliminary clinical application in four cases of transvaginal NOTES cholecystectomy, and discusses safety, feasibility, and potential benefits of the method.

A novel search algorithm based on fish school behavior

Abstract: Search problems are sometimes hard to compute. This is mainly due to the high dimensionality of some search spaces. Unless suitable approaches are used, search processes can be time-consuming and ineffective. Nature has evolved many complex systems able to deal with such difficulties. Fish schools, for instance, benefit greatly from the large number of constituent individuals in order to increase mutual survivability. In this paper we introduce a novel approach for searching in high-dimensional spaces taking into account behaviors drawn from fish schools. The derived algorithm - fish-school search (FSS) - is mainly composed of three operators: feeding, swimming and breeding. Together these operators afford the evoked computation: (i) wide-ranging search abilities, (ii) automatic capability to switch between exploration and exploitation, and (iii) self-adaptable global guidance for the search process. This paper includes a detailed description of the novel algorithm. Finally, we present simulations where the FSS algorithm is compared with, and in some cases outperforms, well-known intelligent algorithms such as particle swarm optimization in high-dimensional searches.

Odontogenic tumors: clinical and pathology study of 238 cases

Abstract: Summary Odontogenic tumors are neoplasms that develops exclusively in the gnathic bones; they originate from odontogenic tissues, by epithelial or mesenchymal proliferation, or both. Aim To evaluate the incidence of odontogenic tumors in a specific institution, and to compare these findings with other studies in the literature. Study format A cross-sectional cohort retrospective study. Material and method The sample was obtained from the files of patients with odontogenic tumors diagnosed between January 1992 and March 2007 (15 years). Cases in which the diagnosis could be adapted to the new World Health Organization (WHO) of 2005 were included. Data such as gender, age, anatomical site, histological type and symptomatology were analyzed. Results Odontogenic tumors were 4.76% of all biopsied lesions within the studied period. The mean age was 30.7 years; 57% of the patients were male. The keratocystic odontogenic tumor was the most prevalent histological type (30%), followed by the ameloblastoma (23,7%). The rate of asymptomatic cases was 75.7%. Conclusion Odontogenic tumors occurred more frequently in females, in the second and third decades of life, and more commonly in the mandible; most cases were asymptomatic.

Smoking increases the risk of relapse after successful tuberculosis treatment

Abstract: Background Recent tobacco smoking has been identified as a risk factor for developing tuberculosis, and two studies which have investigated its association with relapse of tuberculosis after completion of treatment had conflicting results (and did not control for confounding). The objective of this study was to investigate risk factors for tuberculosis relapse, with emphasis on smoking. Methods A cohort of newly diagnosed TB cases was followed up from their discharge after completion of treatment (in 2001–2003) until October 2006 and relapses of tuberculosis ascertained during that period. A case of relapse was defined as a patient who started a second treatment during the follow up. Results Smoking (OR 2.53, 95% CI 1.23–5.21) and living in an area where the family health program was not implemented (OR 3.61, 95% CI 1.46–8.93) were found to be independently associated with relapse of tuberculosis. Conclusions Our results establish that smoking is associated with relapse of tuberculosis even after adjustment for the socioeconomic variables. Smoking cessation support should be incorporated in the strategies to improve effectiveness of Tuberculosis Control Programs.

Ranking and selecting clustering algorithms using a meta-learning approach

Abstract: We present a novel framework that applies a meta-learning approach to clustering algorithms. Given a dataset, our meta-learning approach provides a ranking for the candidate algorithms that could be used with that dataset. This ranking could, among other things, support non-expert users in the algorithm selection task. In order to evaluate the framework proposed, we implement a prototype that employs regression support vector machines as the meta-learner. Our case study is developed in the context of cancer gene expression micro-array datasets.

Comparação do acesso aos serviços de saúde bucal em áreas cobertas e não cobertas pela Estratégia Saúde da Família em Campina Grande, Paraíba, Brasil

Abstract: Although there are various studies on access to health studies, few have dealt specifically with access to oral health services. The aim of the current study was to evaluate factors associated with access to oral health services in Campina Grande, Paraiba State, Brazil, comparing the areas covered versus not covered by the Family Health Program (FHP). This was a cross-sectional, population-based study with a sample consisting of individuals over 18 years of age (n = 827) from urban census tracts that included health units of the Unified National Health System (SUS), stratified in areas covered versus not covered by the FHP. The statistical analysis used Pearson's chi-square and logistic regression. Individuals living in areas not covered by the FHP had 1.5 times greater odds of having access to oral health services (OR = 1.5; 95%CI: 1.1-1.9; p = 0.004) when compared to those living in areas covered by the FHP. However, this probability decreased, losing its significance (OR = 1.1; 95%CI: 0.8-1.6; p = 0.337), after adjusting for gender, age, individual income, schooling, and self-perceived health. Thus, no association was proven between coverage versus non-coverage by the FHP and access to oral health services.

Comparative study of health behavior among college students at the start and end of their courses

Abstract: OBJETIVO: Analisar as diferencas nas condutas de saude de estudantes da area de saude de universidades publicas no inicio e no final do curso. METODOS: Estudo realizado com amostra estratificada por curso e por universidade, de 735 estudantes de ciencias da saude de universidades publicas do estado de Pernambuco, em 2006. Os dados foram coletados com a aplicacao do questionario National College Health Risk Behavior Survey, validado previamente para utilizacao com estudantes universitarios. Para analise de associacao foi utilizado o teste qui-quadrado ou exato de Fisher. Os resultados foram considerados significantes para p<0,05. RESULTADOS: A maioria dos estudantes era do genero feminino (69,5%). Um menor percentual de estudantes ao final da graduacao informou morar com os pais ou responsaveis. As condutas de violencia, relacionadas ao peso e a atividade fisica nao apresentaram diferencas significativas, assim como a maioria das condutas de seguranca no trânsito e de alimentacao. O consumo de alcool (68,8% vs 83,3%), tabaco (40,7% vs 52,5%) e inalantes (10,2% vs 21,9%) e a pratica de relacao sexual (62,5% vs 85,0%) foram mais frequentes entre estudantes do final do curso, com diferencas estatisticamente significativas. CONCLUSOES: Em geral, as condutas de saude nao diferiram significativamente entre os estudantes do inicio e os do final do curso de graduacao na area de saude.

Impacts of dental pain on daily activities of adolescents aged 14-15 years and their families.

Abstract: Objective. To assess the prevalence and severity of dental pain on the daily lives of adolescents and their families in Brazil, and, in terms of socio-economic status, whether there are differences in the prevalence of impacts. Material and Methods. In a cross-sectional survey of a random sample of 14 to 15-year-olds in Brazil, the prevalence and severity of dental pain, and how dental pain affects daily functioning, were assessed using a child-related questionnaire. A family-related questionnaire included questions on a child pain inventory and the pain-related impacts on the daily lives of the child's family members. Results. 14.5% of children reported high impact levels on their daily lives related to dental pain, the more so among girls than among boys, i.e. 16.7% compared to 11.6%. Significantly more impacts occurred in lower socio-economic class children than in higher, i.e. 19.7% versus 7.8%. The prevalence of impacts among children who reported dental pain (n=354) was high; 64.7% reporting that co...

Guidelines for the prevention, diagnosis and treatment of compensatory hyperhidrosis.

Abstract: With the objective of establishing guidelines for the prevention, diagnosis and treatment of compensatory hyperhidrosis, consensus meetings were held. Attendees included a general surgeon and thoracic surgeons affiliated with the Brazilian Society of Thoracic Surgery. The topics addressed were those that would ostensibly broaden multidisciplinary knowledge. Based on recent guidelines for the prevention, diagnosis and (clinical and surgical) treatment of compensatory hyperhidrosis, as well as on a review of the medical literature, the participants prepared a preliminary text, whose recommendations were revised and subsequently approved by all of the participants. The consensus text was posted on the Internet, becoming the object of further corrections and revisions prior to taking on its present form.

Multilevel analysis of hepatitis A infection in children and adolescents: a household survey in the Northeast and Central-west regions of Brazil

Abstract: Background The objectives were to estimate the prevalence of hepatitis A among children and adolescents from the Northeast and Midwest regions and the Federal District of Brazil and to identify individual-, household- and area-levels factors associated with hepatitis A infection. Methods This population-based survey was conducted in 2004–2005 and covered individuals aged between 5 and 19 years. A stratified multistage cluster sampling technique with probability proportional to size was used to select 1937 individuals aged between 5 and 19 years living in the Federal capital and in the State capitals of 12 states in the study regions. The sample was stratified according to age (5–9 and 10- to 19-years-old) and capital within each region. Individual- and household-level data were collected by interview at the home of the individual. Variables related to the area were retrieved from census tract data. The outcome was total antibodies to hepatitis A virus detected using commercial EIA. The age distribution of the susceptible population was estimated using a simple catalytic model. The associations between HAV infection and independent variables were assessed using the odds ratio and corrected for the random design effect and sampling weight. Multilevel analysis was performed by GLLAMM using Stata 9.2. Results The prevalence of hepatitis A infection in the 5–9 and 10–19 age-group was 41.5 and 57.4%, respectively for the Northeast, 32.3 and 56.0%, respectively for the Midwest and 33.8 and 65.1% for the Federal District. A trend for the prevalence of HAV infection to increase according to age was detected in all sites. By the age of 5, 31.5% of the children had already been infected with HAV in the Northeast region compared with 20.0% in the other sites. By the age of 19 years, seropositivity was ∼70% in all areas. The curves of susceptible populations differed from one area to another. Multilevel modeling showed that variables relating to different levels of education were associated with HAV infection in all sites. Conclusion The study sites were classified as areas with intermediate endemicity area for hepatitis A infection. Differences in age trends of infection were detected among settings. This multilevel model allowed for quantification of contextual predictors of hepatitis A infection in urban areas.

Plankton trophic structure and particulate organic carbon production during a coastal downwelling-upwelling cycle

Abstract: We evaluated plankton trophic structure in a short-term temporal survey performed throughout a downwelling-upwelling cycle at the SE Brazilian coast. Size-fractioned phytoplankton biomass (PB), microzooplankton (MiZA) and mesozooplankton (MeZA) abundances along with pri- mary (PP) and bacterial production (BP) were estimated for 5 consecutive days at a fixed station in the Cabo Frio upwelling core area. During the downwelling period, the dominance of pico- and nanoplankton in PB, and higher BP (0.1 µg C l -1 h -1 ) and MiZA (170 ind. l -1 ), characterized a micro- bial food web structure. After the South Atlantic Central Water (SACW) upwelling, the decrease in BP (0.02 µg C l -1 h -1 ), MiZA (50 ind. l -1 ) and picoplankton contribution to PB, along with the appear- ance of microplankton in PB and the increase in opportunistic herbivorous copepods densities (Paracalanus parvus: 2.0 ind. l -1 ) indicated the establishment of a herbivorous food web structure. Particulate organic carbon (POC) production was mainly due to phytoplankton (98%) and did not differ between periods. However, the observed variability in plankton trophic interactions should affect the magnitude of POC export from this dynamic system.

EJFlow: taming exceptional control flows in aspect-oriented programming

Abstract: Many of the problems that stem from the use of exception handling are caused by the local way in which exceptions are handled. It demands that developers understand the source of an exception, the place where it is handled, and everything in between. As a consequence, exceptions easily get "out of control" and, as system development progresses, exceptional control flows become less well-understood, with potentially negative consequences for the program maintainability and reliability. This paper presents an innovative aspect-oriented model for exception handling implementation. In contrast to other exception handling mechanisms, our model provides abstractions to explicitly describe global views of exceptional control flows. As a result, this new model makes it possible to understand exception flows from an end-to-end perspective by looking at a single part of the program. Also, it leverages existing pointcut languages to make the association of handlers with normal code more flexible. The implementation of our proposed model, called EJFlow, extends the AspectJ programming language with the aim of promoting enhanced robustness and program modularization. We evaluate qualitatively and quantitatively the proposed exception handling model through a case study targeting a real mobile application.

Prevalence of oral mucosa lesions in diabetic patients: a preliminary study

Abstract: Summary Aim The present study aimed to evaluate the prevalence of superficial lesions in the oral cavity mucosa in diabetic patients. Methods The sample was made of 30 patients. To obtain these results we did rigorous clinical and complementary tests. Results Of the 30 patients, 9 (30%) were males and 21 (70%) females. Of the studied patients, 40% were below 60 years of age, and 60% were older than 60 years. Thirteen different types of mucosal alterations were diagnosed. Tongue varicose veins (36.6%) and candidiasis (27.02%) were the most prevalent. Such alterations can be associated with the fact that these conditions are commonly found in senile patients and are also associated with prolonged wear of dentures. Xerostomia was diagnosed in only 1 (3.33%) patient, disagreeing with most of the studies observed in the literature. Conclusion Most of the diabetic patients presented at least one type of oral mucosa lesion or alteration.

Tumores odontogênicos: estudo clínico-patológico de 238 casos

Abstract: Os tumores odontogenicos sao neoplasias que se desenvolvem exclusivamente nos ossos gnaticos, originando-se dos tecidos odontogenicos por proliferacao de tecido epitelial, mesenquimal ou ambos. OBJETIVO: Avaliar a incidencia de tumores odontogenicos em determinada instituicao e comparar com outros estudos da literatura mundial. FORMA DE ESTUDO: Estudo de coorte transversal. MATERIAL E METODO: O material do estudo foi levantado a partir dos registros de pacientes com tumores odontogenicos, no periodo de janeiro de 1992 a marco de 2007 (15 anos). Foram incluidos os casos de pacientes que se enquadravam na Classificacao Histologica da Organizacao Mundial de Saude (OMS) de 2005. Foram analisados os indicadores genero, faixa etaria, localizacao anatomica, tipo histologico e presenca de sintomatologia. RESULTADOS: Os tumores odontogenicos constituiram 4,76% dentre todas as lesoes biopsiadas dentro do periodo estudado. A idade media dos pacientes foi de 30,7 anos, 57% dos pacientes eram do genero masculino. O tumor odontogenico ceratocistico foi o tipo histologico mais prevalente (30%), seguido do ameloblastoma (23,7%). Quanto a presenca de sintomatologia, 75,7% dos casos apresentaram-se assintomaticos. CONCLUSAO: Os tumores odontogenicos parecem ter discreta predilecao pelo genero feminino, segunda e terceira decadas de vida, sendo mais frequentes na mandibula e, na maioria dos casos apresentam-se assintomaticos.

Submental intubation in oral maxillofacial surgery: review of the literature and analysis of 13 cases.

Abstract: Objectives: Various different methods of intubation are suitable for facial trauma cases. A choice often has to be made between orotracheal and nasotracheal when surgical access to the nasal or oral cavity is necessary. This work presents our current experience using submental intubation in the airway management of facial trauma patients. Study design: From July 2003 to February 2005, 13 sufferers from facial trauma benefited from submental intubation. All the patients were males and the ages ranged from 19 to 35 years (mean, 27 years). Results: In all the patients, the submental intubation permitted simultaneous reduction and fixation of all fractures and intraoperative control of the dental occlusion without interference from the tube during the operation. There was only one intra-operative complication, when the tracheal pressure increased as a result of deviation and compression of the tube. No post-operative complications were reported. Conclusion: Submental intubation is a simple, secure and effective procedure for operative airway control in major maxillofacial traumas.

Comparative study on normalization procedures for cluster analysis of gene expression datasets

Abstract: Normalization before clustering is often needed for proximity indices, such as Euclidian distance, which are sensitive to differences in the magnitude or scales of the attributes. The goal is to equalize the size or magnitude and the variability of these features. This can also be seen as a way to adjust the relative weighting of the attributes. In this context, we present a first large scale data driven comparative study of three normalization procedures applied to cancer gene expression data. The results are presented in terms of the recovering of the true cluster structure as found by five different clustering algorithms.

Self-perceived health and associated factors in industrial workers from Santa Catarina State, Brazil

Abstract: The purpose of this study was to determine the prevalence of negative self-perceived health and associated factors among industrial workers in Santa Catarina State, in southern Brazil A cross-sectional investigation was conducted with a representative sample of 2,574 subjects (625% men) Negative self-perceived health (fair or poor) was the outcome investigated in association with demographic, socioeconomic, and other health indicators Multivariate analysis was performed through logistic regression based on a hierarchical model Negative self-perceived health was exceptional (118%), but positively associated with age, leisure physical activity, perceived quality of sleeping, perceived stress, and sex Meanwhile, the outcome was negatively associated with family income and schooling Workers with higher physical demands and BMI 30 showed increased odds of negative self-perceived health No significant differences were found for marital status, binge drinking, or smoking Few associations were observed for females

The methodological quality of systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment

Abstract: Temporomandibular joint disorders (TMJD) are multifactor, complex clinical problems affecting approximately 60–70% of the general population, with considerable controversy about the most effective treatment. For example, reports claim success rates of 70% and 83% for non-surgical and surgical treatment, whereas other reports claim success rates of 40% to 70% for self-improvement without treatment. Therefore, the purpose of this study was to (1) identify systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment, (2) evaluate their methodological quality, and (3) evaluate the evidence grade within the systematic reviews. A search strategy was developed and implemented for MEDLINE, Cochrane Library, LILACS, and Brazilian Dentistry Bibliography databases. Inclusion criteria were: systematic reviews (± meta-analysis) comparing surgical and non-surgical TMJD treatment, published in English, Spanish, Portuguese, Italian, or German between the years 1966 and 2007(up to July). Exclusion criteria were: in vitro or animal studies; narrative reviews or editorials or editorial letters; and articles published in other languages. Two investigators independently selected and evaluated systematic reviews. Three different instruments (AMSTAR, OQAQ and CASP) were used to evaluate methodological quality, and the results averaged. The GRADE instrument was used to evaluate the evidence grade within the reviews. The search strategy identified 211 reports; of which 2 were systematic reviews meeting inclusion criteria. The first review met 23.5 ± 6.0% and the second met 77.5 ± 12.8% of the methodological quality criteria (mean ± sd). In these systematic reviews between 9 and 15% of the trials were graded as high quality, and 2 and 8% of the total number of patients were involved in these studies. The results indicate that in spite of the widespread impact of TMJD, and the multitude of potential interventions, clinicians have expended sparse attention to systematically implementing clinical trial methodology that would improve validity and reliability of outcome measures. With some 20 years of knowledge of evidence-based healthcare, the meager attention to these issues begins to raise ethical issues about TMJD trial conduct and clinical care.

Use of Time-location Sampling for Systematic Behavioral Surveillance of Truck Drivers in Brazil

Abstract: We assessed HIV-related risk behavior in a time-location sampling (TLS) interviewer administered survey of male truck drivers at the crossroads of two of the major highways used for trucking in Northeast Brazil (N = 686). Overall, 21.3% had sex while on the road (2.8% unprotected); 12.3% had sex with commercial sex workers (1.4% unprotected); 1.8% had sex with hitch-hikers (0.3% unprotected). Unprotected sex with non-wife partners while on the road was independently associated with stimulant use, lack of religious affiliation and being separated or divorced. Stimulant use may be a particular occupational hazard associated with risk for HIV among truck drivers in Brazil and should be considered as a point of intervention. The TLS sampling approach can form the basis of systematic behavioral surveillance in this highly mobile population.

Optimisation of osmotic dehydration of ‘Tommy Atkins’ mango fruit

Abstract: Summary Osmotic dehydration of mango in sucrose solution as influenced by temperature (30–50 °C), immersion time (60–150 min) and solution concentration (40–60% w/w) was studied through response surface methodology. Responses of water loss and solid gain were fitted to polynomials, with multiple correlation coefficients ranging from 0.72 to 0.95, respectively. The fitted functions were optimised for maximum water loss and minimised incorporation of solids in order to obtain a product resembling non-processed fruit. Optimum conditions to obtain water removal >25% with solid uptake lower than 6% could be obtained using a 44% (w/w) sucrose solution concentration, temperatures up to 38 °C and immersion times up to 80 min.

Prevalência de pé diabético e fatores associados nas unidades de saúde da família da cidade do Recife, Pernambuco, Brasil, em 2005

Abstract: One of the most important chronic complications of diabetes mellitus is diabetic foot. Severe progression of diabetes can lead to lower limb amputations. However, since evolution of the disease is slow, it is possible to implement prevention and control measures. The scope of the Family Health Program (in terms of the possibility of early diagnosis of diabetes mellitus and diabetic foot) favors epidemiological studies to determine the problem's magnitude. This article aimed to identify the proportion of individuals with diabetic foot treated at family health units in the city of Recife, Pernambuco State, Brazil. An epidemiological survey was conducted with a probabilistic sample of medical charts of diabetic patients (N = 1,374) enrolled in six health districts in the city, analyzing relations between socioeconomic variables, health conditions, and the occurrence of amputation. Diabetic foot was observed in 9% of the sample. There was a positive and statistically significant association with the variables alcoholism and amputation (p < 0.001). The prevalence of lower limb amputations was 25.6% among individuals with complications and 2.3% of the total sample.

Clan Particle Swarm Optimization

Abstract: Particle swarm optimization (PSO) has been used to solve many different types of optimization problems. By applying PSO to problems where the feasible solutions are too much difficult to find, new ways of solving the problems are required. Many variations on the basic PSO form have been explored, targeting the velocity update equation. Other approaches attempt to change the structure of the swarm. In this paper a Clan PSO topology is proposed for improving the PSO degree of convergence focusing on the distribution of the particles in the search space. A comparison with star, ring, and four clusters topologies was performed. Our simulation results have shown that the proposed topology achieves better degrees of convergence than the cluster-based one.

Mapping SysML State Machine Diagram to Time Petri Net for Analysis and Verification of Embedded Real-Time Systems with Energy Constraints

Abstract: The main objective of this paper is to propose a solution for modeling, analysis and verification of embedded real-time systems with energy constraints. For that, we combine functionalities of the SysML models and annotation from MARTE with the advantages of using time Petri net. This formalism allows analysis and verification of functional, timing and energy requirements in early phases of the development lifecycle. In order to depict the practically usability of the proposed method, a real-world case study is presented, namely, pulse-oximeter. Experimental results have demonstrated an accuracy of 96% using the proposed formal method in comparison with the values obtained with the hardware platform.

Avaliação da qualidade de vida em adolescentes: revisão da literatura

Abstract: OBJETIVO: Revisar criticamente a disponibilidade de instrumentos de satisfacao com a vida utilizados para avaliar a qualidade de vida em adolescentes. METODO: Nesta revisao foram selecionados estudos que utilizavam escalas de satisfacao com a vida em adolescentes, exclusivamente. Foram excluidos estudos dirigidos a populacao em geral, ou que investigassem satisfacao na relacao com os pais, com cuidadores e com servicos de saude. Foram consultadas as bases eletronicas MedLine, Lilacs, PsycINFO, PubMed e Adolec, sendo incluida checagem manual das referencias bibliograficas dos artigos selecionados. RESULTADOS: Foram encontrados 22 estudos conforme os criterios de inclusao, verificando-se a existencia de nove escalas de satisfacao com a vida, sendo duas variacoes (abreviada e versao adolescente) da escala de um mesmo autor. Foi adicionada a selecao uma escala de qualidade de vida que continha avaliacoes de dominios de satisfacao com a vida. CONCLUSAO: As validacoes das principais escalas sao descritas, observando-se o reduzido numero de estudos transculturais disponiveis. O uso do conceito de qualidade de vida por meio de instrumentos de satisfacao com a vida e relativamente novo, e necessita de estudos mais abrangentes no que diz respeito a cultura e as diferentes realidades economicas.