Prevalence of excessive daytime sleepiness and associated factors in women aged 35-49 years from the "Pindamonhangaba Health Project" (PROSAPIN)

OBJETIVO: Estimar a prevalência da sonolência diurna excessiva (SDE) e identificar os fatores associados em mulheres de 35 a 49 anos de idade do "Projeto de Saúde de Pindamonhangaba" (PROSAPIN). MÉTODOS: O estudo foi observacional transversal com 372 mulheres com idade entre 35 e 49 anos selecionadas aleatoriamente da Estratégia Saúde da Família (ESF) do município de Pindamonhangaba, São Paulo, onde é desenvolvido o "Projeto de Saúde de Pindamonhangaba" (PROSAPIN). A SDE foi avaliada por entrevista utilizando a Escala de Sonolência de Epworth e os fatores associados por meio de questões que investigaram as características sócio-demográficas, a história ginecológica, a presença de comorbidades, o estilo de vida, a rotina de sono e o uso de medicamentos capazes de alterar o estado de alerta, além de mensuradas as variáveis antropométricas. Estimou-se a prevalência da SDE com intervalo de confiança de 95% (IC 95%) e foram identificados os fatores associados por meio de um modelo de regressão logística múltipla realizado no Programa Stata, versão 10.0. RESULTADOS: A prevalência da SDE foi de 18,5% (IC 95%: 14,7- 22,9) e os fatores associados foram: profissão relacionada a serviços domésticos (OR = 2,2; IC 95%: 1,1-4,3), nível de atividade física acima da média da população estudada (OR = 1,9; IC 95%: 1,1-3,4); e a presença de características sugestivas de ansiedade (OR = 1,9; IC 95%: 1,1-3,4). CONCLUSÃO: A prevalência da SDE em mulheres de 35 a 49 anos do PROSAPIN foi elevada e associada à característica sociodemográfica, à presença de comorbidades e ao estilo de vida.

KRONBERGER 49: A NEW LOW-MASS GLOBULAR CLUSTER OR AN UNPRECEDENTED BULGE WINDOW?

We employ optical and near-infrared photometry to study the stars in the direction of the star cluster candidate Kronberger 49. The optical color-magnitude diagrams (V, I, and Gunn z photometry obtained with the Galileo Telescope) are tight and present evidence of a main-sequence turnoff. We may be dealing with a low-mass, metal-rich globular cluster located in the bulge at a distance from the Sun of d(circle dot) = 8 +/- 1 kpc. Alternatively, it may be a dust hole through which we are sampling the bulge stellar population affected by a very low amount of differential reddening.

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.

Proctocolectomy and ileal J-pouch anal anastomosis on the surgical treatment of familial adenomatous polyposis and ulcerative colitis: analysis of 49 cases

OBJECTIVE: To evaluate the results of ileal J-pouch anal anastomosis in ulcerative colitis and familial adenomatous polyposis. METHOD: Retrospective analysis of medical records of 49 patients submitted to ileal J-pouch anal anastomosis. RESULTS: Ulcerative colitis was diagnosed in 65% and familial adenomatous polyposis in 34%. Mean age was 39.5 years. 43% were male. Among familial adenomatous polyposis, 61% were diagnosed with colorectal cancer. Thirty-one percent of patients with ulcerative colitis was submitted to a previous surgical approach and 21% of these had toxic megacolon. Average hospital stay was 10 days. Post-operative complications occurred in 50% of patients with ulcerative colitis and 29.4% with familial adenomatous polyposis. Intestinal diversion was performed in 100% of ulcerative colitis and 88% of familial adenomatous polyposis. Pouchitis occurred in eight cases (seven ulcerative colitis and one FAP), requiring excision of the pouch in three ulcerative colitis. Mortality rate was 7.6%: two cases of carcinoma on the pouch and two post-operative complications. Late post-operative complications occurred in 22.4%: six familial adenomatous polyposis and five ulcerative colitis). Two patients had erectile dysfunction, and one retrograde ejaculation. One patient with severe perineal dermatitis was submitted to excision of the pouch. Incontinence occurred in four patients and two reported soil. Mean bowel movement was five times a day. CONCLUSION: Ileal J-pouch anal anastomosis is a safe surgery with acceptable morbidity and good functional results, if well indicated and performed in referral centers.