Razão de prevalências: Alcoolismo nas diferentes regiões geográficas do Brasil segundo o sexo

The present study applies a method of prevalence analysis to data obtained in two nationwide household surveys on alcohol use during life and dependence, for each of the sexes. The ratios of prevalences (R), for the lifetime alcohol use and dependence rates, between the two genders in the various Brazilian macro-regions, were calculated together with their respective 95% confidence intervals. It was found that lifetime use, both in 2001 and in 2005, was significantly greater in Brazilian males in all geographical regions. In 2001, the population of the North (male and female) had a higher rate of alcohol consumption than that in the Brazilian population as a whole and that in the Southeast. Dependence on the consumption of alcoholic drinks in 2001 and in 2005 was greater in the male sex, but similar among the various regions studied. It can be concluded that this method of analyzing the data on alcoholism could be of great use in assessing its magnitude and importance in terms of public health.

Ocorrência de infecção urinária em pacientes de um hospital universitário

Infection in hospitals is a serious problem for the Public Health System. It is responsible for the increasing number of hospital deaths, as well as the longer time patients may have to stay in hospital, raising the costs of confinement more and more. The most common hospital infection is urinary tract infections (UTI), the use of the urinary catheter being the main risk factor. The aim of this study was to evaluate the profile of UTI among hospitalized patients in a University Hospital in Brazil, from October to December 2003. Out of 271 samples of urine checked, 51 were positive, 27 of these from patients having community-acquired UTI and 24 whose infection originated in the hospital. The community-acquired UTIs were more frequent in female patients (63%). The highest incidence of infection was caused by Escherichia coli (74%), especially in patients aged from 0 to 15 (37%). The episodes of hospital-acquired infection happened, in the main, in male patients aged above 50 (68%) who were using a lasting vesical catheter; in this group of patients the infection was frequently caused by E. coli (29.1%) and Klebsiella spp. (29.1%). E. coli and Klebsiella pneumoniae exhibited strong resistance (62.5%) to trimethoprim-sulfamethoxazole, as well as to ampicillin, showing that these drugs should not be used to cure UTIs in this institution.

Fatores de risco para doenças cardiovasculares em idosos com diabetes mellitus tipo 2

The aim of this study was to analyze the risk factors related to the cardiovascular diseases (CVRF) in elderly type 2 diabetics. A cross-sectional observational study was carried out on 100 elderly patients attending the Rehabilitation Center of Araraquara (CRRA), São Paulo State, Brazil, from March to December, 2004. The majority were married, female, white, with a low income and low educational level. Regarding habits and style of life, the subjects had an adequate diet, were sedentary, non-smoking and non-drinking. In the population of 100, 42% were overweight, 42% obese, 71% had above-normal waist measurements and 84% high waist-to-hip ratios. Concerning the CVRF, it was observed that more than half had hypertension, hypercholesterolaemia and hypertriglyceridaemia. 84% had high values of LDL-cholesterol and 59% HDL-cholesterol levels below the reference values, 78% high levels of fasting glycemia, 76% glycohemoglobin and 57% fibrinogen and thus subject to cardiovascular risk. The results showed a high frequency of cardiovascular risk factors, differing according to sex and the age.

Dental trauma involving root fracture and periodontal ligament injury: A 10-year retrospective study

The purpose of this retrospective study was to analyze the cases of traumatic dental injuries involving root fracture and/or periodontal ligament injury (except avulsion) treated at the Discipline of Integrated Clinic, School of Dentistry of Araçatuba, São Paulo State University (UNESP), Brazil, from January 1992 to December 2002. Clinical and radiographic records from 161 patients with 287 traumatized teeth that had sustained root fracture and/or injuries to the periodontal ligament were examined. The results of this survey revealed that subluxation (25.09%) was the most common type of periodontal ligament injury, followed by extrusive luxation (19.86%). There was a predominance of young male patients and most of them did not present systemic alterations. Among the etiologic factors, the most frequent causes were falls and bicycle accidents. Injuries on extraoral soft tissues were mostly laceration and abrasion, while gingival and lip mucosa lacerations prevailed on intraoral soft tissues injuries. Radiographically, the most common finding was an increase of the periodontal ligament space. The most commonly performed treatment was root canal therapy. Within the limits of this study, it can be concluded that traumatic dental injuries occur more frequently in young male individuals, due to falls and bicycle accidents. Subluxation was the most common type of periodontal ligament injury. Root canal therapy was the type of treatment most commonly planned and performed.

Incidência e evolução da polipose nasal em crianças e adolescentes com fibrose cística

Nasal polyps are a clinical sign of alert for investigating Cystic Fibrosis (CF). Aims: To study the incidence of nasal polyps in children and adolescents with cystic fibrosis, its possible association with age, gender, clinical manifestations, genotype and sweat chlorine level, and its evolution with topical steroid therapy. Methods: Clinical symptoms, sweat chlorine level and genotype were studied in 23 cystic fibrosis patients. Nasal polyps were diagnosed by nasal endoscopy and treated with topical steroids during 6 months, followed by a second nasal endoscopy. Fisher test was used for statistical analysis. Results: Nasal polyps were found in 39.1% of the patients (five bilateral, four unilateral), all older than six years, recurrent pneumonia in 82.6%, pancreatic insufficiency in 87% and malnutrition in 74%. No association was seen between nasal polyps and sweat chlorine level, genotype, clinical sings of severity and nasal symptoms. Seven patients improved in their nasal polyps with topical steroids, six showed complete resolution. Conclusion: The study showed a high incidence of nasal polyps in older children, who span the entire range of clinical severity, even in the absence of clinical nasal symptoms. Topical steroid therapy showed good results. An interaction among pediatricians and otolaryngologists is necessary for diagnosis and follow-up. 2008 © Revista Brasileira de Otorrinolaringologia. All Rights reserved.

Evaluation of children's behavior aged 0-3 years during dental care: A longitudinal analysis

Child temperament has been studied in various researches and may be useful to predict how a child responds to dental treatment, especially very young children. The purpose of the present longitudinal study was to evaluate the behavioral manifestation of children aged 0 to 3 years, considering different types of dental situation. A total of 169 children were selected and the following data were collected: the age of the child, gender, age of the mother, number of dental visits and their respective dates, stimuli offered to the child, and behavioral response to these stimuli. The children and their respective behaviors were divided into five groups according to the dental situation offered: control, missed visits, fluoride varnish, restoration, and dental trauma. The data were submitted to descriptive and inferential analysis using the chi-square test, with the level of significance set at 5%. Analysis of the different situation offered to infants during routine dental care revealed a predominance of collaborating and partially collaborating behavior, and age at the time of dental care influenced the behavior of the infants, irrespective of the stimulus group. The different types of dental situation provoked changes in the behavioral response of the children of certain age groups, especially in the dental trauma group.

Running behavior and its energy cost in mice selectively bred for high voluntary locomotor activity

Locomotion is central to behavior and intrinsic to many fitnesscritical activities (e.g., migration, foraging), and it competes with other life-history components for energy. However, detailed analyses of how changes in locomotor activity and running behavior affect energy budgets are scarce. We quantified these effects in four replicate lines of house mice that have been selectively bred for high voluntary wheel running (S lines) and in their four nonselected control lines (C lines). We monitored wheel speeds and oxygen consumption for 24-48 h to determine daily energy expenditure (DEE), resting metabolic rate (RMR), locomotor costs, and running behavior (bout characteristics). Daily running distances increased roughly 50%-90% in S lines in response to selection. After we controlled for body mass effects, selection resulted in a 23% increase in DEE in males and a 6% increase in females. Total activity costs (DEE - RMR) accounted for 50%-60% of DEE in both S and C lines and were 29% higher in S males and 5% higher in S females compared with their C counterparts. Energetic costs of increased daily running distances differed between sexes because S females evolved higher running distances by running faster with little change in time spent running, while S males also spent 40% more time running than C males. This increase in time spent running impinged on high energy costs because the majority of running costs stemmed from postural costs (the difference between RMR and the zero-speed intercept of the speed vs. metabolic rate relationship). No statistical differences in these traits were detected between S and C females, suggesting that large changes in locomotor behavior do not necessarily effect overall energy budgets. Running behavior also differed between sexes: within S lines, males ran with more but shorter bouts than females. Our results indicate that selection effects on energy budgets can differ dramatically between sexes and that energetic constraints in S males might partly explain the apparent selection limit for wheel running observed for over 15 generations. © 2009 by The University of Chicago. All rights reserved.

Lipid peroxidation and antioxidant capacity of G6PD-deficient patients with A-(202G>A) mutation

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an enzymopathy in which reduced NADPH concentrations are not maintained, resulting in oxidative damage. We evaluated G6PD activity, oxidative stress levels and Trolox equivalent antioxidant capacity in individuals with the A-(202G>A) mutation for G6PD deficiency. Five hundred and forty-four peripheral blood samples were screened for G6PD deficiency; we also analyzed lipid peroxidation products measured as thiobarbituric acid reactive species and Trolox equivalent antioxidant capacity. Men with the A-(202G>A) mutation had lower G6PD activity than women with the same mutation. Individuals with the A-(202G>A) mutation also differed in mean Trolox equivalent antioxidant capacity values but not for thiobarbituric acid reactive species values. We concluded that A-(202G>A) mutation is associated with reduced G6PD activity and increased Trolox equivalent antioxidant capacity. ©FUNPEC-RP.

Hemoglobin polymorphism and hematological profile of Geoffroy's side-necked turtle (Phrynops geoffroanus, Testudines) in the northwestern region of São Paulo State, Brazil

Complete blood counts and hemoglobin isoform data were gathered from 36 specimens of the turtle species Phrynops geoffroanus from the northwestern region of São Paulo State, Brazil. They were collected in an urban area. The hemoglobin profiles were obtained after red blood cell lysis and by electrophoretic migration in alkaline pH, acid pH, and neutral pH buffer. The hemoglobin components were confirmed using high-performance liquid chromatography (HPLC). Erythrogram analysis included hematocrit, total hemoglobin concentration, total red blood cell count, and red blood cell indices. The leukogram included a total white blood cell count and a calculation of the percent values of neutrophils, lymphocytes, monocytes, basophils, eosinophils, heterophils, and azurophils. HPLC analysis revealed three hemoglobin components; the first with a concentration of 5.5%, the second was a major component with an average concentration of 67.1%, and the third with a concentration of 28.5%. The hematological profile obtained for these specimens allowed us to establish a pattern for P. geoffroanus in São Paulo State Northwestern region. The average hematocrit values were 22.5% for females and 24.0% for males. For total hemoglobin, we found average values of 6.66 g/dL in females and 7.22 g/dL in males. The number of white blood cells was 2725 x 103/μL for females and 2775 x 103/μL for males. There was a predominance of heterophils, eosinophils, and monocytes in both sexes. No significant differences were found between males and females for hematological profile. The hematological results were compared to literature data for other Chelonia. They were similar to what is known for fresh water turtles. © FUNPEC-RP.

Preemptive dexamethasone and etoricoxib for pain and discomfort prevention after periodontal surgery: A double-masked, crossover, controlled clinical trial

Background: Several anti-inflammatory drugs have been used to reduce pain and discomfort after periodontal surgeries. This study evaluates the efficacy of using etoricoxib and dexamethasone for pain prevention after open-flap debridement surgery. Methods: For this prospective, double-masked, crossover, placebo-controlled, randomized clinical trial, open-flap debridement surgeries were performed on 15 patients (eight males and seven females, age range 20 to 56 years: mean age ± SD: 40 ± 9.7 years) who presented with chronic periodontitis after nonsurgical periodontal therapy at three quadrants. Each patient underwent three surgical procedures at intervals of 30 days and received one of the following premedication protocols 1-hour before surgery: group 1 = placebo, group 2 = 8 mg dexamethasone, and group 3 = 120 mg etoricoxib. Rescue medication (750 mg acetaminophen) was given to each patient who was instructed to take it when necessary. Pain intensity and discomfort were evaluated by a 101-point numeric rate scale and a four-point verbal rate scale, respectively, hourly for the first 8 hours after surgery and three times a day on the following 3 days. Results: The results demonstrate that groups 2 and 3 present reduced postoperative pain-intensity levels compared to group 1. There were statistically significant differences at the 4, 5, 6, 7, and 8 hour-periods after surgery (Friedman test; P<0.05). Furthermore, rescue-medication intake was significantly lower for groups 2 and 3 than for group 1 (analysis of variance; P<0.02). Conclusion: The adoption of a preemptive medication protocol using etoricoxib or dexamethasone may be considered effective for pain and discomfort prevention after open-flap debridement surgeries.

DNA repair gene polymorphism is associated with the genetic basis of atherosclerotic coronary artery disease

Background: Atherosclerotic coronary artery disease (CAD) is a multifactorial process that appears to be caused by the interaction of environmental risk factors with multiple predisposing genes. It is nowadays accepted that increased levels of DNA damage induced by xenobiotics play an important role in the early phases of atherogenesis. Therefore, in this study, we focus on determining whether genetic variations in xenobiotic-metabolizing [glutathione-S-transferase theta 1 (GSTT1), glutathione-S-transferase mu 1 (GSTM1), cytochrome P450 IIEI (CYP2E1)] and DNA repair [X-ray cross-complementing group 1 (XRCC1)] genes might be associated with increased risk for CAD. Methods: A case-control study was conducted with 400 individuals who underwent subjected to coronary angiography. A total of 299 were patients diagnosed with effective coronary atherosclerosis (case group; >20% obstructive lesion), and 101 (control group) were individuals diagnosed as negative for CAD (<20% obstructive lesions). The polymorphism identifications for GSTM1 and GSTT1, and for CYP2E1 and XRCC1 genes were performed by polymerase chain reaction (PCR) amplification and by PCR-RFLP, respectively. Results and conclusions: The XRCC1 homozygous wild-type genotype Arg/Arg for codon 399 was statistically less pronounced in the case subjects (21.4%) than in controls (38.5%); individuals with the variant XRCC1 genotype had a 2.3-fold increased risk for coronary atherosclerosis than individuals with the wild-type genotype (OR=2.3, 95% CI=1.13-4.69). Conversely, no association between GSTM1, GSTT1, and CYP2E1gene polymorphisms and coronary atherosclerosis was detected. The results provide evidence of the role of DNA damage and repair in cardiovascular disease. © 2011 Elsevier Inc. All rights reserved.

Serum ferritin and transferrin saturation levels in β0 and β + thalassemia patients

There have been few studies on the mutations that cause heterozygous beta-thalassemia and how they affect the iron profile. One hundred and thirty-eight individuals were analyzed, 90 thalasemic β0 and 48 thalasemic β+, identified by classical and molecular methods. Mutations in the hemochromatosis (HFE) gene, detected using PCR-RFLP, were found in 30.4% of these beta-thalassemic patients; heterozygosity for H63D (20.3%) was the most frequent. Ferritin levels and transferrin saturation were similar in beta-thalassemics with and without mutations in the HFE gene. Ferritin concentrations were significantly higher in men and in individuals over 40 years of age. Transferrin saturation also was significantly higher in men, but only in those without HFE gene mutations. There was no significant difference in the iron profile among the β0 and β+ thalassemics, with and without HFE gene mutations. The frequency of ferritin values above 200 ng/mL in women and 300 ng/mL in men was also similar in β0 and β+ thalassemics (P > 0.72). Our conclusion is that ferritin levels are variable in the beta-thalassemia, trait regardless of the type of beta-globin mutation. Furthermore, HFE gene polymorphisms do not change the iron profile in these individuals. ©FUNPEC-RP www.funpecrp.com.br.

Dimensional correlates of poor insight in obsessive-compulsive disorder

Background: Cross-sectional studies have associated poor insight in patients with obsessive-compulsive disorder (OCD) with increased OCD symptom severity, earlier age of onset, comorbid depression, and treatment response. The goal of this current study was to examine the relationship between dimensions of OCD symptomatology and insight in a large clinical cohort of Brazilian patients with OCD. We hypothesized that poor insight would be associated with total symptom severity as well as with hoarding symptoms severity, specifically. Methods: 824 outpatients underwent a detailed clinical assessment for OCD, including the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS), the Brown Assessment of Beliefs Scale (BABS), a socio-demographic questionnaire, and the Structured Clinical Interview for axis I DSM-IV disorders (SCID-P). Tobit regression models were used to examine the association between level of insight and clinical variables of interest. Results: Increased severity of current and worst-ever hoarding symptoms and higher rate of unemployment were associated with poor insight in OCD after controlling for current OCD severity, age and gender. Poor insight was also correlated with increased severity of current OCD symptoms. Conclusion: Hoarding and overall OCD severity were significantly but weakly associated with level of insight in OCD patients. Further studies should examine insight as a moderator and mediator of treatment response in OCD in both behavioral therapy and pharmacological trials. Behavioral techniques aimed at enhancing insight may be potentially beneficial in OCD, especially among patients with hoarding. © 2011.

Prevalence of chewing side preference in the deciduous, mixed and permanent dentitions

Aim: This study evaluated the prevalence of the chewing side preference (CSP) in the deciduous, mixed and permanent dentitions. Materials and methods: Three-hundred subjects were divided in three groups (n = 100): Group 1 - children with deciduous dentition; group 2-children with mixed dentition; group 3 - subjects with permanent dentition. The CSP was determined using a direct method (visual observation) developed by McDonnell et al. (2004). Descriptive statistic was used to observe the prevalence of CSP. The Pearson's Chi-square was used to investigate signicant associations between gender, presence of CSP and preferred side (right/left). Results and conclusion: Eighty-seven percent of group 1 had a CSP. Eighty-two percent of group 2 had a CSP. Seventy-six percent of group 3 had a CSP. There was no statistically significant association between presence of CSP and gender in all groups. There was no statistically significant association between preferred side (right/left) and gender in all groups. Clinical significance: There is a higher prevalence of subjects in deciduous, mixed and permanent dentition that presented chewing side preference. The early diagnosis of the presence of chewing side preference can prevent the unilateral chewing pattern with prophylactic therapy applied to the first teeth (deciduous).

Proprioceptive neuromuscular facilitation does not increase blood pressure of healthy elderly women

Proprioceptive neuromuscular facilitation (PNF) is an attractive method to increase strength and proprioception of elderly individuals. However, a major clinical concern about the prescription of PNF is the belief that it can cause a cardiovascular overload, because it involves close-to-maximal loads and isometric contractions. Yet the acute effect of a PNF training session on cardiovascular response in elderly individuals is still unknown. Hence, the objective of this study was to evaluate the effect of PNF on diastolic and systolic blood pressure of healthy elderly people. Fifteen older women (mean age 72.40±6.82 years) performed three sets (five repetitions each) of three different PNF techniques (rhythmic initiation, dynamic reversion, and isotonic combination), executing a single movement pattern. Diastolic and systolic blood pressure (DBP and SBP) were evaluated by means of a manual sphygmomanometer immediately before and during the last two repetitions (last set) of each technique. A two-way ANOVA test (time and technique) was performed to investigate the PNF effect on blood pressure. No time (preexercise to postexercise) (p=0.33 for DBP; p=0.06 for SBP) or PNF technique (p=0.75; p=0.81) effect were observed. In conclusion, we can state that the execution of these PNF techniques is safe for the cardiovascular system of healthy elderly women, because no blood pressure increases were found. Copyright © Informa Healthcare USA, Inc.