Electroconvulsive Therapy in Brazil After the "Psychiatric Reform" A Public Health Problem-Example From a University Service

Objectives: The Brazilian public health system does not provide electroconvulsive therapy (ECT), which is limited to a few academic services. National mental health policies are against ECT. Our objectives were to analyze critically the public policies toward ECT and present the current situation using statistics from the Institute of Psychiatry of the University of Sao Paulo (IPq-HCFMUSP) and summary data from the other 13 ECT services identified in the country. Methods: Data regarding ECT treatment at the IPq-HCFMUSP were collected from January 2009 to June 2010 (demographical, number of sessions, and diagnoses). All the data were analyzed using SPSS 19, Epic Info 2000, and Excel. Results: During this period, 331 patients were treated at IPq-HCFMUSP: 221 (67%) were from Sao Paulo city, 50 (15.2%) from Sao Paulo's metropolitan area, 39 (11.8%) from Sao Paulo's countryside, and 20 (6.1%) from other states; 7352 ECT treatments were delivered-63.0% (4629) devoted entirely via the public health system (although not funded by the federal government); the main diagnoses were a mood disorder in 86.4% and schizophrenia in 7.3% of the cases. Conclusions: There is an important lack of public assistance for ECT, affecting mainly the poor and severely ill patients. The university services are overcrowded and cannot handle all the referrals. The authors press for changes in the mental health policies.

The young stellar cluster [DBS2003] 157 associated with the H ii region GAL 331.31-00.34

We report a study of the stellar content of the near-infrared (NIR) cluster [DBS2003] 157 embedded in the extended H ii region GAL 331.31-00.34, which is associated with the IRAS source 16085-5138. JHK photometry was carried out in order to identify potential ionizing candidates, and the follow-up NIR spectroscopy allowed the spectral classification of some sources, including two O-type stars. A combination of NIR photometry and spectroscopy data was used to obtain the distance of these two stars, with the method of spectroscopic parallax: IRS 298 (O6 V, 3.35 +/- 0.61 kpc) and IRS 339 (O9 V, 3.24 +/- 0.56 kpc). Adopting the average distance of 3.29 +/- 0.58 kpc and comparing the Lyman continuum luminosity of these stars with that required to account for the radio continuum flux of the H ii region, we conclude that these two stars are the ionizing sources of GAL 331.31-00.34. Young stellar objects (YSOs) were searched by using our NIR photometry and mid-infrared (MIR) data from the Galactic Legacy Infrared Mid-Plane Survey Extraordinaire (GLIMPSE) survey. The analysis of NIR and MIR colourcolour diagrams resulted in 47 YSO candidates. The GLIMPSE counterpart of IRAS 16085-5138, which presents IRAS colour indices compatible with an ultracompact H ii region, has been identified. The analysis of its spectral energy distribution between 2 and m revealed that this source shows a spectral index a= 3.6 between 2 and m, which is typical of a YSO immersed in a protostellar envelope. Lower limits to the bolometric luminosity and the mass of the embedded protostar have been estimated as L= 7.7 x 10(3) L? and M= 10 M?, respectively, which correspond to a B0B1 V zero-age main sequence star.

Distribution of major elements in Atlantic surface sediments (36 degrees N-49 degrees S): Imprint of terrigenous input and continental weathering

Numerous studies use major element concentrations measured on continental margin sediments to reconstruct terrestrial climate variations. The choice and interpretation of climate proxies however differ from site to site. Here we map the concentrations of major elements (Ca, Fe, Al, Si, Ti, K) in Atlantic surface sediments (36 degrees N-49 degrees S) to assess the factors influencing the geochemistry of Atlantic hemipelagic sediments and the potential of elemental ratios to reconstruct different terrestrial climate regimes. High concentrations of terrigenous elements and low Ca concentrations along the African and South American margins reflect the dominance of terrigenous input in these regions. Single element concentrations and elemental ratios including Ca (e. g., Fe/Ca) are too sensitive to dilution effects (enhanced biological productivity, carbonate dissolution) to allow reliable reconstructions of terrestrial climate. Other elemental ratios reflect the composition of terrigenous material and mirror the climatic conditions within the continental catchment areas. The Atlantic distribution of Ti/Al supports its use as a proxy for eolian versus fluvial input in regions of dust deposition that are not affected by the input of mafic rock material. The spatial distributions of Al/Si and Fe/K reflect the relative input of intensively weathered material from humid regions versus slightly weathered particles from drier areas. High biogenic opal input however influences the Al/Si ratio. Fe/K is sensitive to the input of mafic material and the topography of Andean river drainage basins. Both ratios are suitable to reconstruct African and South American climatic zones characterized by different intensities of chemical weathering in well-understood environmental settings.

The impact of dental caries and trauma in children on family quality of life

Objectives: To assess the impact of childrens dental caries (DC) and traumatic dental injuries (TDI) on parents quality of life (QoL), adjusted by family income. Methods: Parents of 219 children aged 5 and 6 years answered the Family Impact Scale (FIS) on their perception of QoL and data about income. Three calibrated dentists examined the severity of DC according to decayed, missing and filled permanent teeth index, and children were categorized into: 0 = caries free; 15 = low severity; and =6 = high severity. TDI were classified into uncomplicated and complicated injuries. QoL was measured through FIS items and total score, and Poisson regression was used to associate the variables with the outcome. Results: Severity of DC showed a negative impact on the total score and subscales on parental/family activities, parental emotions and financial burden (P < 0.001). TDI showed a negative impact on total score and in some FIS items. The multivariate-adjusted model showed that only the increase in the severity of childrens DC (RR = 3.19; 95% CI = 2.36, 4.31; P < 0.001) was associated with a greater negative impact on parents QoL, while high family income was a protective factor (RR = 0.68; 95% CI = 0.48, 0.95; P < 0.001). Conclusions: The severity of childrens DC has a negative impact on parents QoL, whereas TDI do not. A lower family income might have a negative impact on parents QoL.

Corte foliar e tempo de transplantio para o uso de plântulas do sub-bosque na restauração florestal

O uso de plântulas da regeneração natural tem sido recomendado como estratégia para produção de mudas visando à restauração florestal, contudo muitos aspectos técnicos desse método ainda carecem de investigação científica. O objetivo deste trabalho foi avaliar o efeito da redução da área foliar e do transplantio imediato na sobrevivência e crescimento de mudas de espécies arbóreas produzidas a partir de plântulas obtidas da regeneração natural. Plântulas de Esenbeckia leiocarpa (Rutaceae), Eugenia ligustrina (Myrtaceae) e Maytenus salicifolia (Celastraceae), obtidas em remanescente de vegetação secundária de Floresta Estacional Semidecidual em Bofete, SP, foram extraídas do solo e submetidas aos tratamentos: I) redução de 50% da área de cada folha e transplantio imediato; II) nenhuma redução de área das folhas e transplantio imediato; III) redução de 50% da área de cada folha, manutenção das plântulas em água e transplantio 24 h após a coleta; e IV) nenhuma redução de área das folhas, manutenção das plântulas em água e transplantio 24 h após a coleta. As mudas foram avaliadas com relação à sobrevivência e ao crescimento em altura, ao longo de oito meses. Os resultados evidenciaram que nem o corte das folhas ou a manutenção das plântulas dentro de recipientes com água por 24 h antes do transplantio afetaram os parâmetros avaliados. Assim, para as espécies estudadas a redução da área foliar e o transplantio imediato são desnecessários para a produção de mudas em viveiro a partir de plântulas obtidas da regeneração natural.

Importância dos vírus respiratórios na febre sem sinais localizatórios em crianças menores de 36 meses

INTRODUÇÃO Cerca de 20% das crianças menores de 36 meses trazidas ao setor de emergência por febre apresentam febre sem sinais localizatórios (FSSL). Nos últimos anos, vários estudos estabeleceram critérios para a identificação dos pacientes com risco de infecção bacteriana grave (IBG), além de demonstrarem a aplicabilidade da pesquisa de vírus respiratórios (PVR) na avaliação destes pacientes. Entretanto, não existem estudos abordando a identificação de vírus respiratórios em crianças menores de 36 meses com FSSL no nosso meio. OBJETIVOS Descrever a frequência dos vírus respiratórios na febre sem sinais localizatórios (FSSL) em crianças menores de 36 meses de idade CASUÍSTICA E MÉTODOS Estudo prospectivo e observacional de crianças menores de 36 meses no setor de emergência pediátrico, durante o período de abril de 2011 a abril de 2013, com diagnóstico de FSSL. Foram excluídas crianças portadoras de doenças de base que implicavam em alteração da imunidade e uso de antibiótico até 14 dias antes da consulta. Os pacientes foram avaliados laboratorialmente de acordo com o protocolo institucional para avaliação de FSSL. Além de hemograma completo, análise do sedimento urinário e culturas de sangue e urina, foi coletada amostra de secreção de nasofaringe para pesquisa de vírus respiratórios por imunoflourescência indireta. Resultados Foram estudados 232 crianças menores de 36 meses com diagnóstico de FSSL, sendo 53% do sexo masculino, com idade mediana de 10,7 meses (5,4 - 16,1). Em 57 (24,6%) destes pacientes, foi identificado vírus respiratórios, sendo o adenovírus (33 casos - 57,9%) o agente mais identificado, seguido do parainfluenza 3 (17,5%) e do influenza A (12,3%). CONCLUSÃO Em torno de 25% dos casos de FSSL do nosso meio foram identificados vírus respiratórios, mostrando que a PVR é uma ferramenta útil na avaliação do paciente com FSSL, possibilitando a redução do número de retornos hospitalares e uso de antibioticoterapia empírica.