Showing papers by "Universidade Federal de Pelotas published in 2002"
TL;DR: In this paper, the authors investigate why some women prefer caesarean sections and how decisions to medicalise birthing are influenced by patients, doctors, and the sociomedical environment.
Abstract: Objectives: To investigate why some women prefer caesarean sections and how decisions to medicalise birthing are influenced by patients, doctors, and the sociomedical environment. Design: Population based birth cohort study, using ethnographic and epidemiological methods. Setting: Epidemiological study: women living in the urban area of Pelotas, Brazil who gave birth in hospital during the study. Ethnographic study: subsample of 80 women selected at random from the birth cohort. Nineteen medical staff were interviewed. Participants: 5304 women who gave birth in any of the city9s hospitals in 1993. Main outcome measures: Birth by caesarean section or vaginal delivery. Results: In both samples women from families with higher incomes and higher levels of education had caesarean sections more often than other women. Many lower to middle class women sought caesarean sections to avoid what they considered poor quality care and medical neglect, resulting from social prejudice. These women used medicalised prenatal and birthing health care to increase their chance of acquiring a caesarean section, particularly if they had social power in the home. Both social power and women9s behaviour towards seeking medicalised health care remained significantly associated with type of birth after controlling for family income and maternal education. Conclusions: Fear of substandard care is behind many poor women9s preferences for a caesarean section. Variables pertaining to women9s role in the process of redefining and negotiating medical risks were much stronger correlates of caesarean section rates than income or education. The unequal distribution of medical technology has altered concepts of good and normal birthing. Arguments supporting interventionist birthing for all on the basis of equal access to health care must be reviewed. What is already known on this topic Women9s preferences for caesarean sections are understood to result from lack of knowledge and psychological aptitude to handle vaginal delivery and its consequences Efforts to reduce the demand for caesarean sections have focused on providing consumers with correct information on the relative risks associated with vaginal and operative deliveries What this study adds In Brazil, many women prefer caesarean sections because they consider it good quality care Rich women are more likely to have caesarean sections, supporting the notion that medical intervention represents superior care Poor women may implement a series of medicalised practices that justifies the need for greater medical intervention during birth Interventions for reducing caesarean sections by educating physicians and patients about risk factors associated with birthing procedures are not sufficient
351 citations
TL;DR: Examining whether self-controlled feedback schedules enhance learning, because they are more tailored to the performers' needs than externally controlled feedback schedules, revealed that self-control learners asked for feedback primarily after good Trials and yoked learners preferred to receive feedback after good trials.
Abstract: This paper examines whether self-controlled feedback schedules enhance learning, because they are more tailored to the performers' needs than externally controlled feedback schedules. Participants practiced a sequential timing task. One group of learners (self-control) was provided with feedback whenever they requested it, whereas another group (yoked) had no influence on the feedback schedule. The self-control group showed learning benefits on a delayed transfer test. Questionnaire results revealed that self-control learners asked for feedback primarily after good trials and yoked learners preferred to receive feedback after good trials. Analyses demonstrated that errors were lower on feedback than no-feedback trials for the self-control group but not for the yoked group. Thus, self-control participants appeared to use a strategy for requesting feedback. This might explain learning advantages of self-controlled practice.
324 citations
TL;DR: Para avaliar a situacao de utilizacao e acesso aos servicos de odontologia no Brasil e estudar diferenciais entre os estratos socioeconomicos, utilizaram-se dados da Pesquisa Nacional por Amostragem de Domicilios (PNAD) de 1998.
Abstract: Para avaliar a situacao de utilizacao e acesso aos servicos de odontologia no Brasil e estudar diferenciais entre os estratos socioeconomicos, utilizaram-se dados da Pesquisa Nacional por Amostragem de Domicilios (PNAD) de 1998, realizada pelo IBGE. A analise, que levou em conta o desenho amostral, indicou um nivel baixo de utilizacao de servicos odontologicos. Setenta e sete por cento das criancas de 0-6 anos e 4% dos adultos de 20-49 anos nunca haviam consultado um dentista. Entre estes adultos, comparando-se os 20% mais pobres com os 20% mais ricos, observou-se que o numero de desassistidos era 16 vezes maior entre os primeiros. No grupo de 0-6 anos, as criancas ricas consultaram o dentista cinco vezes mais do que as pobres no ano anterior a entrevista. Cerca de 4% dos que procuraram atendimento odontologico nao o obtiveram, 8% dos quais entre os mais pobres e 1% entre os mais ricos. A maioria (68%) dos atendimentos do grupo mais pobre foi financiada pelo SUS, enquanto 63% deles foram pagos pelos mais ricos. As maiores desigualdades no acesso e na utilizacao de servicos odontologicos foram encontradas, exatamente, nos grupos de menor acesso ou utilizacao. A participacao do SUS nos atendimentos odontologicos e muito mais baixa do que na atencao medica.
248 citations
TL;DR: In this paper, the authors investigated the risk factors and prevalence of suspected cases of developmental delay in a cohort of children born in Pelotas, Brazil, in 1993, and found that they were more likely to have delayed development.
Abstract: Objective. To investigate the risk factors and prevalence of suspected cases of developmental delay in a cohort of children born in Pelotas, Brazil, in 1993.
210 citations
TL;DR: Long-term intermittent treatment with trimethoprim/sulfamethoxazole can reduce the rate of recurrent toxoplasmic retinochoroiditis.
201 citations
TL;DR: There is no current evidence supporting the clinical use of CBZ, antidepressants, dopamine agonists, disulfiram, mazindol, phenytoin, nimodipine, lithium and NeuRecover-SA in the treatment of cocaine dependence.
Abstract: Aims Cocaine dependence is a common and serious condition, associated with severe medical, psychological and social problems, including the spread of infectious diseases This systematic review assesses critically the efficacy of pharmacotherapy for treating cocaine dependence
Methods The literature search strategy included: electronic searches of Cochrane Library holdings, EMBASE, MEDLINE, PsycLIT, Biological Abstracts and LILACS; scans of reference lists of relevant articles, personal communications, conference abstracts, unpublished trials from the pharmaceutical industry and book chapters on the treatment of cocaine dependence Randomized controlled trials (RCTs) focusing on the use of antidepressants (ADs), carbamazepine (CBZ), dopamine agonists (DAs) and other drugs used in the treatment of cocaine dependence were included The reviewers extracted data independently, and relative risks (RR) with 95% confidence interval (CI) were estimated Qualitative assessments were carried out using a Cochrane validated checklist Where possible, analysis was carried out according to ‘intention-to-treat’ principles
Findings The search strategy generated 45 different trials Most studied drugs were ADs (20 studies), DAs and CBZ Data were very heterogeneous, with dropout rates within the studies between 0 and 84% A non-significant trend favoring CBZ was found in terms of dropouts (RR 088; 95% CI 075–103) and results from one trial suggest that fluoxetine patients are less likely to drop out The main efficacy outcome reported in the studies was the presence of cocaine metabolites in the urine No significant results were found, regardless the type of drug or dose used for all relevant outcomes assessed
Conclusions There is no current evidence supporting the clinical use of CBZ, antidepressants, dopamine agonists, disulfiram, mazindol, phenytoin, nimodipine, lithium and NeuRecover-SA in the treatment of cocaine dependence Larger randomized investigation must be considered, while taking into account that these time-consuming efforts should be reserved for medications showing more relevant and promising evidence Given the high dropout rate among the test population, clinicians may wish to consider adding psychotherapeutic supportive measures aimed at keeping patients in treatment programs
170 citations
TL;DR: Self-efficacy was the most important predictor of adherence, followed by number of times antiretroviral medication was taken per day, among sociodemographic and clinical variables, only the number of years of schooling was associated with adherence.
Abstract: A cross-sectional study was conducted on HIV-infected adults being treated with antiretroviral drugs at a reference service in Southern Brazil. Participants answered a sociodemographic questionnaire and were tested by scales assessing sociocognitive variables. Adherence to treatment was assessed by a self-report inventory developed for the study. Clinical information was obtained from the patients' records. Significance tests were conducted using univariate logistic regressions followed by multivariate logistic regression analysis. A total of 195 patients participated in the study and 56.9% of them reported > or = 95% adherence on the previous two days. In univariate analysis, the odds of adherence increased with self-efficacy (a person's conviction that he/she can successfully execute the behavior required to produce a certain desired outcome) in taking medications as prescribed (OR = 3.50, 95% CI 1.90-6.55), and decreased with perception of negative affect and physical concerns (OR = 0.71, 95% CI 0.53-0.95). The odds were lower for taking antiretroviral medications >4 times a day (OR = 0.44, 95% CI 0.20-0.94) and higher for patients with 8 years of schooling (OR = 2.28, 95% CI 1.12-4.66). In the multivariate analysis, self-efficacy (OR = 3.33, 95% CI 1.69-6.56) and taking medication >4 times a day (OR = 0.34, 95% CI 0.14-0.80) were independently associated with adherence. Self-efficacy was the most important predictor of adherence, followed by number of times antiretroviral medication was taken per day. Among sociodemographic and clinical variables, only the number of years of schooling was associated with adherence. Motivational interventions based on self-efficacy may be useful for increasing treatment adherence.
108 citations
TL;DR: Farrowing room management to minimize stillborn risk should target higher-parity females, large litters and optimization of practices of obstetric interventions.
98 citations
TL;DR: In this paper, the authors investigate comportamentos de risco e autopercepcao de vulnerabilidade as doencas sexualmente transmissiveis (DST) and a Sindrome de imunodeficiencia adquirida (Aids) em mulheres.
Abstract: OBJETIVO: Investigar comportamentos de risco e autopercepcao de vulnerabilidade as doencas sexualmente transmissiveis (DST) e a Sindrome de imunodeficiencia adquirida (Aids) em mulheres. METODOS: Dos 281 setores censitarios existentes na cidade de Pelotas, RS, foram selecionados 48 a partir de amostragem sistematica. Foi entrevistada uma amostra de 1.543 mulheres, de 15 a 49 anos, por meio de questionario composto de tres partes (informacoes socioeconomicas, perguntas aplicadas em entrevista, questionario auto-aplicado). Para tabulacao dos dados, foi utilizado o programa Epi-Info, versao 6.0. Para analise estatistica dos dados foram usados o teste de Kappa e a razao de odds. RESULTADOS: Na amostra, 64% das mulheres achavam impossivel ou quase impossivel adquirir DST/Aids. Os principais comportamentos de risco foram o nao uso de preservativo na ultima relacao antes do depoimento (72%); inicio das relacoes sexuais com menos de 18 anos (47%); uso de alcool ou drogas pelo parceiro (14%) ou pela mulher (7%) antes da ultima relacao; dois ou mais parceiros nos tres meses que antecederam o depoimento (7%) e sexo anal na ultima relacao (3%); 44% das mulheres apresentaram dois ou mais comportamentos de risco. A sensibilidade da autopercepcao, usando como padrao o escore de risco igual ou superior a dois, foi de 41 %. Sua especificidade de 67%. CONCLUSOES: A autopercepcao de vulnerabilidade nao e um bom indicador, pois as mulheres nao identificam corretamente seu nivel de risco.
75 citations
TL;DR: Results indicate that BCG was able to express antigens of PRRSV and elicit an immune response against the viral proteins in mice.
73 citations
TL;DR: Sera of tick-infested bovines suggested that this protein may not be able to induce an IgG-based humoral response in its natural host, so cloning, sequence characterization and expression analysis of a calreticulin coding cDNA of Boophilus microplus are reported.
TL;DR: An identification key for the main 33 species of Muscidae, Anthomyiidae and Fanniidae occurring in association to human habitats in Brazil is presented and most of the characters used for identification of the species are illustrated.
Abstract: Key to adult flies of dipterous species (Muscidae, Fanniidae, Anthomyiidae) associated to human habitats in Brazil. An identification key for the main 33 species of Muscidae, Anthomyiidae and Fanniidae occurring in association to human habitats in Brazil is presented. Most of the characters used for identification of the species are illustrated. Based on literature records, a list of the 65 anthropic species known to Brazil is also included.
TL;DR: Subjective global assessment was validated by convergent validity, when this method was compared to other objective nutritional assessment methods, and by predictive validity, showing that subjective global assessment could identify patients who were at high risk for developing postoperative complications.
Abstract: RACIONAL: A avaliacao nutricional subjetiva e metodo clinico de avaliacao do estado nutricional, que considera nao apenas alteracoes da composicao corporal, mas tambem alteracoes funcionais do paciente. E metodo simples, de baixo custo e nao-invasivo, podendo ser realizado a beira do leito. Seu uso foi descrito pela primeira vez ha quase duas decadas. OBJETIVOS: Revisar os estudos de validacao da avaliacao nutricional subjetiva descritos na literatura nas ultimas duas decadas de seu uso. METODOS: Foi realizada uma revisao sistematica no MEDLINE utilizando o descritor "subjective global assessment" e selecionados os trabalhos mais relevantes. RESULTADOS: Por se tratar de metodo subjetivo, sua precisao depende da experiencia do observador. Porem, quando usado por observadores experientes, apresenta boa precisao diagnostica. A avaliacao nutricional subjetiva foi legitimada atraves da validacao convergente, onde o metodo foi comparado com outros metodos objetivos de avaliacao nutricional, e da validacao preditiva, mostrando que a tecnica identificou pacientes de alto risco para desenvolver complicacoes pos-operatorias. CONCLUSAO: A avaliacao nutricional subjetiva tem se mostrado boa opcao na avaliacao nutricional de pacientes cirurgicos e algumas modificacoes tem sido sugeridas para o uso do metodo tambem em outras especialidades. A experiencia do observador e de extrema importância, uma vez que dela depende a precisao do metodo.
TL;DR: The authors conclude that due to the different patterns of economic gradients among different age groups and among males and females, the practice of standardization used in constructing concentration curves and in computing concentration indices should be avoided.
Abstract: Objective. To explore and describe inequalities in health and use of health care as revealed by self-report in 12 countries of Latin America and the Caribbean. Methods. A descriptive and exploratory study was performed based on the responses to questions on health and health care utilization that were included in general purpose household surveys. Inequalities are described by quintile of household expenditures (or income) per capita, sex, age group (children, adults, and older adults), and place of residence (urban vs. rural area). For those who sought health care, median polishing was performed by economic status and sex, for the three age groups. Results. Although the study is exploratory and descriptive, its findings show large economic gradients in health care utilization in these countries, with generally small differences between males and females and higher percentages of women seeking health care than men, although there were some exceptions among the lower economic strata in urban areas. Conclusions. Inequalities in self-reported health problems among the different economic strata were small, and such problems were usually more common among women than men. The presence of small inequalities may be due to cultural and social differences in the perception of health. However, in most countries included in the study, large inequalities were found in the use of health care for the self-reported health problems. It is important to develop regional projects aimed at improving the questions on self-reported health in household interview surveys so that the determinants of the inequalities in health can be studied in depth. The authors conclude that due to the different patterns of economic gradients among different age groups and among males and females, the practice of standardization used in constructing concentration curves and in computing concentration indices should be avoided. At the end is a set of recommendations on how to improve these sources of data. Despite their shortcomings, household interview surveys are very useful in understanding the dimensions of health inequalities in these countries.
TL;DR: Amisulpride was as effective as typical antipsychotics as compared with placebo, typical and atypical antipsychotic drugs for schizophrenia and was shown to be more likely to cause extrapyramidal symptoms than placebo in two studies.
Abstract: Background The treatment of schizophrenia with old, 'typical' antipsychotic drugs such as haloperidol can be problematic, because many people treated with these drugs will suffer from movement disorders Amisulpride is said to be an "atypical" antipsychotic which induces less movement disorder and which is effective for the negative symptoms of schizophrenia Objectives To evaluate the effects of amisulpride as compared with placebo, typical and atypical antipsychotic drugs for schizophrenia Search strategy The authors carried out electronic searches of Biological Abstracts (1982-1999), CINAHL (1982-1999), Cochrane Library (Issue 4, 1999), Cochrane Schizophrenia Group's Register (November 2000), EMBASE (1980-1999), LILACS(1982-1999), MEDLINE (1966-1999) and PsycLIT (1974-1999) They checked all identified studies for further trial citations, and sought these studies in the Science Citation Index They also contacted authors of trials and the manufacturer of amisulpride Selection criteria All randomised controlled trials comparing amisulpride to placebo, typical or atypical antipsychotic drugs for schizophrenia or other non-affective serious mental illnesses Data collection and analysis Data were independently extracted and analysed on an intention-to-treat basis The relative risk (RR) and 95% confidence intervals (CI) of dichotomous data were calculated using a random effects model, and, where possible, the number needed to treat was calculated Weighted mean differences (WMD) were calculated for continuous data Main results This review currently includes 19 randomised studies with a total of 2443 participants Most trials were of short duration Data from 4 trials with 514 participants with predominantly negative symptoms suggest that low-dose (up to 300mg/day) amisulpride was a more acceptable treatment than placebo (n=514, RR 06 CI 05 to 08, NNT 3 CI 3 to 7), the improvement of the participants' global state (n=242, RR 06 CI 05 to 08, NNT 3 CI 2 to 6) and the treatment of negative symptoms (n=177, WMD -101 CI -166 to -35) Amisulpride was shown to be more likely to cause extrapyramidal symptoms than placebo in two studies (n=269, RR 22 CI 12 to 42), but this result did not hold calculating the risk reduction so that an NNT-statistic could not be indicated Compared to typical antipsychotics, the pooled results of a total of fourteen trials suggest that amisulpride was more effective in improving global state (n=651, RR 07 CI 05 to 09, NNT 6 CI 4 to 11), the general mental state (n=695, WMD -42 CI -65 to -19) and the negative symptoms of schizophrenia (n=506, WMD -28 CI -43 to -13) Regarding positive symptoms, amisulpride was as effective as typical antipsychotics Amisulpride was less prone to cause at least one general adverse event (n=751, RR 09 CI 08 to 097, NNH 9 CI 6 to 18), one extrapyramidal symptom (n=771, RR 07 CI 06 to 09, NNH 5 CI 4 to 9) or to require the use of antiparkinson medication (n=851, RR 06 CI 05 to 08, NNH 4 CI 3 to 6) No clear differences in other adverse events compared to typical drugs were found Amisulpride also seemed to be more acceptable than conventional drugs as measured by the outcome 'leaving the studies early' (n=1512, RR 08 CI 07 to 09, NNT 16 CI 9 to 69) than conventional drugs, but this result might have been overestimated due to a publication bias which could not be excluded with certainty A single trial compared amisulpride to another 'atypical' antipsychotic, risperidone With the exception of agitation, which was more frequent in the amisulpride group (n=228, RR 34 CI 12 to 101, NNH 11 CI 6 to 50) no significant differences were recorded on efficacy or acceptability Reviewer's conclusions This systematic review confirms that amisulpride is an effective 'atypical' antipsychotic drug for those with schizophrenia Amisulpride may offer a good general profile, at least compared to high-potency 'typical' antipsychotics It may also yield better results in some specific outcomes related to efficacy, such as improvement of global state and general negative symptoms It might be more acceptable and more tolerable than high-potency conventional antipsychotics, especially regarding extrapyramidal side-effects Longer term randomised trials are needed to evaluate the comparative value of amisulpride, particularly compared to other expensive atypical antipsychotics These should focus on important outcomes which have not been sufficiently monitored such as service use, family burden and quality of life
TL;DR: Os resultados indicam that as prevalencias of DPM foram semelhantes a outros estudos realizados no municipio e atingem principalmente as camadas sociais mais baixas, sugerindo that esses resultados possam orientar a formacao de profissionais de saude e o planejamento das acoes of saude.
Abstract: Foi realizado um estudo transversal, de base populacional, com o objetivo de determinar a prevalencia de disturbios psiquiatricos menores (DPM) e verificar sua associacao com fatores de risco. A amostragem por conglomerados foi definida em estagios multiplos, incluindo 1967 pessoas com idade entre 20 e 69 anos, identificadas em 40 setores censitarios da zona urbana da cidade de Pelotas. As entrevistas foram realizadas nos domicilios, utilizando-se um questionario pre-codificado, contendo SRQ-20, informacoes socioeconomicas e demograficas, presenca de doencas cronicas, utilizacao de servicos de saude, consumo de alcool, habito de tabagismo e coleta de medidas antropometricas. A presenca de DPM foi definida a partir de 6 e 7 respostas positivas no SRQ-20, para homens e mulheres, respectivamente. A prevalencia de DPM foi de 28,5%, com intervalo de confianca de 95% entre 26,5% e 30,5%. A prevalencia foi maior nas pessoas inseridas nas classes sociais mais baixas, de menor renda, acima de 40 anos e do sexo feminino. Na analise ajustada, os disturbios psiquiatricos menores mantiveram-se associados com habito de tabagismo, presenca de doenca cronica nao transmissivel e frequencia de consultas medicas. Os resultados indicam que as prevalencias de DPM foram semelhantes a outros estudos realizados no municipio e atingem principalmente as camadas sociais mais baixas. Embora nao tenham sido diferentes em relacao ao tipo de servico de saude utilizado, mostraram associacao com a frequencia de utilizacao de assistencia medica, sugerindo que esses resultados possam orientar a formacao de profissionais de saude e o planejamento das acoes de saude.
TL;DR: The subjective global assessment has been a good option in nutritional assessment in surgical patients and some modifications have been suggested to adjust the method to other clinical situations.
Abstract: RACIONAL: A avaliacao nutricional subjetiva e metodo clinico de avaliacao do estado nutricional, que considera nao apenas alteracoes da composicao corporal, mas tambem alteracoes funcionais do paciente. E processo simples, de baixo custo e nao-invasivo, podendo ser realizado a beira do leito. Embora tenha sido desenvolvida para avaliar pacientes cirurgicos, varios estudos mostram seu uso em outras situacoes clinicas, como pacientes com insuficiencia renal, pacientes oncologicos, hepatopatas, geriatricos e HIV positivos. OBJETIVO: Revisar o uso da avaliacao nutricional subjetiva em outras situacoes clinicas e estudos de intervencao. METODOS: Foi realizada revisao sistematica no MEDLINE utilizando o descritor "subjective global assessment" e selecionados os trabalhos mais relevantes. RESULTADOS: Foram encontradas adaptacoes da avaliacao nutricional subjetiva para seu uso em pacientes com insuficiencia renal, pacientes oncologicos e hepatopatas, com bons resultados neste grupo de pacientes. Em estudos de intervencao em pacientes oncologicos, a avaliacao nutricional subjetiva tem sido utilizada para identificar pacientes de maior risco nutricional e que necessitam de terapia nutricional agressiva. Poucos estudos de intervencao de pacientes cirurgicos utilizaram a avaliacao nutricional subjetiva como metodo para identificacao do paciente de risco nutricional. CONCLUSAO: A avaliacao nutricional subjetiva tem se mostrado boa opcao na avaliacao nutricional de pacientes cirurgicos e algumas modificacoes tem sido sugeridas para o uso do metodo tambem em outras especialidades. A experiencia do observador e de extrema importância, uma vez que dela depende a precisao do metodo.
TL;DR: The antifungal drugs are classified in classic and current chemical agents and in antibiotics and the discretion of each antIFungal drug will be presented in the work.
Abstract: The antifungal drugs are classified in classic and current chemical agents and in antibiotics. The chemists classic agents are those medicines that present in a general way reduced action spectrum against fungi, having a fungistatic effect in an indirect way when modifying the local conditions, as for instance the iodine, acids fat and derived, acid salicilic, tolnaftate and tolciclate. The current chemical agents are represented by imidazole and triazole, flucytosine and allylamines and the antibiotics represented by the polyene (amphotericin B, nystatin and natamycin) and the griseofulvin. The discretion of each antifungal drug will be presented in the work.
TL;DR: In this article, a pesquisa baseou-se em tres estudos de caso-controle em cidade de medio porte do Brazil, with a goal of avaliar o risco populacional atribuivel ao fumo nesses tipos de câncer.
Abstract: OBJETIVO: Os tipos de câncer de pulmao, laringe e esofago tem como um de seus principais fatores de risco o fumo. O objetivo do estudo foi avaliar o risco populacional atribuivel ao fumo nesses tipos de câncer. METODOS: A pesquisa baseou-se em tres estudos de caso-controle em cidade de medio porte do Brasil. Analisaram-se casos incidentes hospitalares de câncer de pulmao, de laringe e de esofago diagnosticados por biopsias; os controles foram pacientes hospitalizados por outros motivos, sem ser câncer ou doencas altamente relacionadas ao fumo. O fator de exposicao foi o tabagismo medido em tres niveis: nao-fumantes, ex-fumantes e fumantes atuais, definidos por meio de questionarios aplicados por entrevistadores treinados. Para a medida de efeito, foi utilizado o odds ratio obtendo-se, dessa forma, o "risco populacional atribuivel" ao fumo com IC de 95%. RESULTADOS: Foram estudados 122 casos e 244 controles de câncer de pulmao, 50 casos de câncer de laringe e 48 casos de câncer de esofago, com um grupo de 96 controles comum a ambos. A prevalencia da exposicao ao fumo utilizada para a analise foi de 34%, que corresponde a prevalencia de fumo na populacao adulta da cidade. Os odds ratios para o calculo do risco populacional atribuivel foram obtidos por analises ajustadas para os fatores de confusao de cada um dos estudos. Para ex-fumantes com câncer de pulmao, o risco populacional atribuivel foi de 63% (IC95%, 0,58-0,68) e, para fumantes, de 71% (IC95%, 0,65-0,77). Para câncer de laringe, o RPA foi de 74% (IC95%, 0,70-0,78) para ex-fumantes e de 86% (IC95%, 0,81-0,85) para fumantes. O câncer de esofago mostrou um risco de 54% (IC95%, 0,46-0,62) para fumantes. CONCLUSAO: Conclui-se que o fumo e um importante fator de risco e que a cessacao do mesmo contribuiria para reducoes significativas na incidencia de câncer nesses tres sitios.
TL;DR: Treatment of hypertension with diuretics or beta blockers was more cost-effective than treatment with ACE inhibitors and calcium channel blockers, and the costs of hypertension care are mainly dependent on the expenditure on blood pressure-lowering drugs.
Abstract: CONTEXT: The cost-effectiveness of the treatment of hypertension has scarcely been investigated in population-based studies. Most data come from secondary analysis of clinical trials and administrative sources. OBJECTIVE: To describe the healthcare costs for outpatient hypertension treatment in comparison with diabetes mellitus and chronic bronchitis, and to examine the cost-effectiveness of different classes of antihypertensive drugs. DESIGN: Cross-sectional population-based study. SETTING: Urban area of Pelotas, southern Brazil. PARTICIPANTS: Individuals aged 20-69 years, identified through multi-stage probability sampling. METHODS: Participants were interviewed at home. Demographic data, education, income, smoking, previous morbidity, use of medicine and other characteristics were assessed via a pre-tested questionnaire, and blood pressure while seated was measured in a standardized way. RESULTS: Approximately 24% of the participants had high blood pressure or were taking antihypertensive drugs, and among these, 33% had had a physician consultation during the month preceding the interview. The monthly mean costs of care for hypertension (R$ 89.90), diabetes (R$ 80.64) and bronchitis (R$ 92.63) were similar. Treatment of hypertension consumed 22.9% of the per-capita income, corresponding to R$ 392.76 spent per year exclusively on antihypertensive drugs. Most of the direct costs associated with hypertension and diabetes were spent on drugs, while patients with bronchitis had greater expenditure on appointments. The cost-effectiveness relationship was more favorable for diuretics (116.3) and beta blockers (228.5) than for ACE inhibitors (608.5) or calcium channel blockers (762.0). CONCLUSION: The costs of hypertension care are mainly dependent on the expenditure on blood pressure-lowering drugs. Treatment of hypertension with diuretics or beta blockers was more cost-effective than treatment with ACE inhibitors and calcium channel blockers.
TL;DR: Low birth weight, stunting, and lack or breastfeeding acted simultaneously as risk and prognostic factors for diarrhea and risk factors for mild diarrhea were identified.
Abstract: The aim of this study was to examine the effect of demographic, socioeconomic, environmental, maternal reproductive, dietary, and nutritional variables on diarrhea risk and prognosis using a hierarchical framework A case-control study of children aged 0-23 months in Greater Metropolitan Porto Alegre was conducted during the peak season for diarrhea in 1987-1988 Three groups were investigated, with 192 children each The first group included hospitalized children with an episode of acute diarrhea complicated by moderate to severe dehydration The second group included children with acute mild diarrhea without signs of dehydration who were identified in the same neighborhood as hospitalized cases The third group consisted of controls without diarrhea Mothers were interviewed by trained interviewers using a standardized questionnaire Data analysis included a hierarchical approach to control for confounding, using conditional logistic regression Comparison of the three groups aimed to identify risk factors for diarrhea complicated by dehydration, prognostic factors for dehydration, and risk factors for mild diarrhea Low birth weight, stunting, and lack or breastfeeding acted simultaneously as risk and prognostic factors for diarrhea
TL;DR: Discutiu-se a necessidade de qualificar a aderencia dos profissionais de saude as recomendacoes de manejo do diabetes, mês que foram entrevistados na zona urbana de Pelotas, Rio Grande do Sul, Brasil.
Abstract: Com objetivo de avaliar a adequacao do manejo de pacientes diabeticos, durante o ano de 1998 foram entrevistados, em domicilio, pacientes atendidos nos postos de saude da zona urbana de Pelotas, Rio Grande do Sul, Brasil. Coletaram-se informacoes relativas a caracteristicas da doenca e do tratamento dos mesmos. Analisou-se o tratamento do diabetes mellitus em tres componentes: realizacao de dieta, atividade fisica e tratamento medicamentoso. Verificou-se que 76% dos entrevistados receberam orientacoes dieteticas; porem, apenas metade desses as seguiram nos ultimos quinze dias. Dos 75% dos pacientes que receberam orientacoes sobre exercicios fisicos, apenas um terco praticou algum tipo de atividade no ultimo mes. Dos 377 entrevistados, 289 (77%) utilizavam algum tipo de medicamento. Grande parte dos usuarios de hipoglicemiantes orais apresentavam alguma contra-indicacao ao seu uso. Discutiu-se a necessidade de qualificar a aderencia dos profissionais de saude as recomendacoes de manejo do diabetes.
TL;DR: A 21-item scale of efficacy-expectation for adhesion to antiretroviral therapy in high-risk situations was developed by content analysis of interviews with HIV/AIDS patients undergoing and dropouts from therapy and demonstrated construct validity and reliability as a measure of self-efficacy for antireT virus therapy in these patients.
Abstract: A 21-item scale of efficacy-expectation for adhesion to antiretroviral therapy in high-risk situations was developed by content analysis of interviews with HIV/AIDS patients undergoing and dropouts from therapy. Internal consistency and construct validity were examined in 60 patients attending at an ambulatory for patients in advanced stages of the disease (day-hospital). A score of self-efficacy for treatment adhesion was derived from the first component of the principal component analysis. The mean score was 0.25 among adherent patients and n0.33 among those who were non-adherent (t test, p < 0.046). The odds of treatment adhesion increased 2,07 times when the efficacy-expectation score increased by one unit (OR = 2,07; IC95% = 1,002 a 4,26). The internal consistency was high (Cronbach-alpha = 0.96). The scale demonstrated construct validity and reliability as a measure of self-efficacy for antiretroviral therapy in these patients.
TL;DR: Few risk factors were associated with an increased frequency of injuries, and the most amenable to intervention seems to be the presence of younger siblings, which should be aware of childrens needs for increased attention when a younger sibling is born.
Abstract: Objective: to measure the main risk factors associated with the occurrence of accidental injuries in children aged 4-5 years.Methods: the study included a prospective cohort of children whose parents filled in a diary recording accidents and injuries during a period of one-month. The children represented a systematic subsample from a population-based birth cohort in southern Brazil. The outcome was the number of reported injuries per child during one month. Multivariate analysis (Poisson regression) was used to assess confounding factors.Results: the monthly frequency of accidents was 53.8%, and 48.4% of the children suffered at least one injury. Boys had 30% more injuries than girls, and white children had 70% higher incidence than non-white. Family income, parental education and maternal employment were not associated with the frequency of injuries. After adjustment of socioeconomic and environmental factors, having younger siblings was associated with a 30% higher injury rate, and living in a home made of bricks was associated with a 35% increase. The incidence of injuries appeared to be higher among children attending day-care centers and those living in periurban areas.Conclusions: few risk factors were associated with an increased frequency of injuries. Among them, the most amenable to intervention seems to be the presence of younger siblings. Parents should become aware of childrens needs for increased attention when a younger sibling is born.
TL;DR: IAA induced higher rooting percentage, plants with better root system and leaves in the highest concentrations, but when it was used IBA and NAA these characteristics were observed in the lowest concentrations.
Abstract: The utilization of trees with desirable characteristics, genetics and sanitary, is an important factor for the success in plant propagation. The micropropagation, in comparison with the traditional vegetative propagation methods, helps to increase the production and to get trees with higher sanitary quality. In this technique rooting is a crucial stage to the development of the plants propagated in vitro. In such context, it was aimed to test cultivation conditions and types and concentrations of auxin for the rooting in vitro of the cv. M-9 apple tree root-stook. Shoots (1cm) were used, and they were cultivated in half MS. medium, with the addition of gelrite for their solidification. The auxins used were IAA, NAA and IBA, in 0.5; 1.0; 5.0; 10.0; 20.0; 50.0 and 100.0 mM concentrations. Two different incubation conditions were tested. In the first one, the explants were kept into the light (30 days), and in the second one, the explants were kept for 5 days in the dark with further transfer to light (25 days). In both conditions, the explants were exposed to plant growth regulators during all the time, or just for ten days, with further transfer to a medium without plant growth regulator. The variables analysed were as follows: rooting percentage; number, length and kind of root, while in the shoot test, apart from these, the survival percentage in the stage of aclimatization was evaluated. IAA induced higher rooting percentage, plants with better root system and leaves in the highest concentrations, but when it was used IBA and NAA these characteristics were observed in the lowest concentrations. When the explants were cultivated for just ten days in medium added writh auxins, they presented, in general, better results.
TL;DR: In this article, the short-range properties of the kaon-nucleon ( KN) interaction are studied within the meson-exchange model of the Julich group, and dynamical explanations for the phenomenological shortrange repul- sion, required in this model for achieving agreement with the empirical KN data are explored.
Abstract: The short-range properties of the kaon-nucleon ( KN) interaction are studied within the meson-exchange model of the Julich group. Specifically, dynamical explanations for the phenomenological short-range repul- sion, required in this model for achieving agreement with the empirical KN data, are explored. Evidence is found that contributions from the exchange of a heavy scalar-isovector meson @a0(980)# as well as from genuine quark-gluon exchange processes are needed. Taking both mechanisms into account, a satisfactory description of the KN phase shifts can be obtained without resorting to phenomenological pieces.
TL;DR: In this paper, the effect of inclusion of an enzymatic cocktail, containing proteases, amilases and cellulases (Vegpro) in broiler diets was evaluated, and the results indicate that Vegpro was not effective in growth performance improvement.
Abstract: This study was run to evaluate the effect of inclusion of an enzymatic cocktail, containing proteases, amilases and cellulases (Vegpro) in broiler diets. The cocktail was added with the ration of 1 kg per 200 kg of soybean meal. Two thousand and forty female Ross chicks were distributed in eight treatments with seven replicates each. A split-plot experimental design was used. Treatments consisted of T1 ¾ control (no enzyme added), T2 ¾ diet five percent lower in energy, protein and amino acids, without enzyme addition. T3 ¾ control (no enzyme added up to 28 days and with enzyme from 29 to 35 days of age), T4 ¾ control (without enzyme up to 21 days and with enzyme from 22 to 35 days of age), T5 ¾ control (plus enzyme addition), T6 ¾ control (plus enzyme addition up to 28 days of age, and five percent lower in energy, protein and amino acids, with enzyme addition from 29 to 35 days of age). T7 ¾ control (with enzyme addition up 21 days of age and five percent lower in energy, protein and amino acids, with enzyme from 22 to 35 days of age), and T8 ¾ five percent lower in energy, protein and amino acids. During the first experimental period, except for T2, body weight, body weight gain and feed intake were not influenced by dietary treatments. Feed conversion and factor of production differed statistically. During the fourth week of experimental period, birds fed T2 were the only ones to differ in body weight and body weight gain. Feed intake, feed conversion and factor of production were not statistically different. During the last week of experimental period, most differences among treatments were observed. The results indicate that Vegpro enzymatic cocktail was not effective in growth performance improvement.
TL;DR: In this paper, a delineamento experimental inteiramente casualizado with seis repeticoes, constando de seis niveis of acido acetico: 0, 0, 2,5, 5,0; 7,5; 10,0, 15,0 mM.
Abstract: Com o objetivo de avaliar o efeito de diferentes concentracoes de acido acetico, em solucao nutritiva, no crescimento de plantas de arroz (Oryza sativa L.) e na absorcao de nutrientes, foi desenvolvido um experimento em uma bancada com iluminacao artificial no Laboratorio de Nutricao de Plantas da UFPel/FAEM/DS. Utilizou-se um delineamento experimental inteiramente casualizado com seis repeticoes, constando de seis niveis de acido acetico: 0,0; 2,5; 5,0; 7,5; 10,0; 15,0 mM. Plântulas de arroz da cultivar BRS-7 “Taim” com dois dias de germinacao, foram cultivadas durante treze dias em tubos de ensaio contendo solucao nutritiva completa e diferentes doses de acido acetico. O crescimento da raiz e da parte aerea diminuiu com a utilizacao de doses crescentes de acido acetico ate 15,0 mM. Houve, tambem, reducao no peso de materia seca da parte aerea. O crescimento da raiz foi mais afetado do que o crescimento da parte aerea, porem nao houve efeito significativo do acido acetico sobre o peso de materia seca da raiz. O acido acetico diminuiu a absorcao de N, P, K, Ca e Mg pelo arroz.
TL;DR: The results allowed to conclude that the studied individuals belong to a risk group and should periodically undergo biological monitoring and proper care.
Abstract: In this study, the micronuclei test (MNT) was applied in exfoliated cells of buccal mucosa, in order to evaluate the genotoxic risk associated with occupational exposure of mechanics, storage battery renovation workers, and car painters. For each individual, 3000 exfoliated buccal cells were analyzed. There was a significantly higher frequency of micronucleated cells (MNC) in the exposed workers than in controls. Smoking and drinking habits, age, and working time did not represent significant factors in terms of increasing the production of micronuclei (MN), when the control and the exposed groups were compared. These results allowed to conclude that the studied individuals belong to a risk group and should periodically undergo biological monitoring and proper care.