Coping by relatives of critical care patients

OBJECTIVE: To describe the coping strategies used by the relatives of patients hospitalized in an intensive care unit. METHODS: This is a descriptive study that uses a convenience sample and both qualitative and quantitative methods. The study was conducted at a tertiary university hospital in Brazil. Participants included 41 relatives who were selected during the first 96 hours of patient hospitalization in the intensive care unit. RESULTS: The participants reported that they more frequently used Coping Strategies Based on the Stressor, followed by Religiosity/Fantasy Thinking and Seeking for Social Support. There was a statistically significant relationship (P <.01) between the use of the strategy Seeking for Social Support and elevated Acute Physiology, Age, and Chronic Health Evaluation 11 scores. Qualitative analysis allowed a clearer understanding of the relation between the patient`s condition and changes in the coping strategies used by the patient`s relatives. CONCLUSION: This study describes the coping strategies used by patients` relatives during the early hospitalization period. This investigation allowed for a better understanding of the relatives` psychologic aspects and their relation with the patient`s clinical condition. The results shall assist the design of specific interventions directed at facilitating positive coping responses on the part of relatives. (Heart Lung (R) 200 38:217-227.)

The impact of perinatal and socioeconomic factors on mental health problems of children from a poor Brazilian city: a longitudinal study

Low birth weight and preterm birth, and social disadvantage may negatively affect mental health of children, but findings have been inconsistent. To assess the influence of perinatal and social factors on mental health problems in children aged 7-9 years. A random sample of 805 births in So Luis, Brazil was studied in 1997/1998 and again in 2005/2006. Perinatal, socioeconomic and demographic variables were assessed within 24 h after delivery. The Strengths and Difficulties Questionnaire (SDQ) was used to assess mental health problems in the children. Simple and multiple Poisson regressions were used for statistical analysis. The overall prevalence of mental health problems in the total sample was 47.7%. The prevalences of emotional and conduct problems were 58.2 and 48.8%, respectively. Only paternal age (< 20 years) was associated with mental health problems as measured by the full SDQ scale (prevalence ratio PR = 1.27). Children born to single mothers (PR = 1.31) and those with birth weight from 1,500 to 2,499 g (PR = 1.18) and from 2,500 to 2,999 g (PR = 1.17) had a higher risk of emotional problems, but those from low income families had a lower risk (PR = 0.80). Children with a father of less than 20 years had a higher risk of having problems with their peers (PR = 1.75). A maternal education of 9 years or over was inversely associated with peer (PR = 0.70) and conduct problems (PR = 0.73). Girls had a lower risk of conduct (PR = 0.77) and hyperactivity problems (PR = 0.68). A maternal education of 4 years or less increased the risk of hyperactivity (PR = 1.48). Socioeconomic and demographic conditions were better predictors of mental health problems in children than birth weight or preterm birth. However, since most effect sizes were small most mental health problems were, unexplained by the variables in the study.

Juvenile idiopathic arthritis with involvement of the temporomandibular joint: the role of image examinations

PURPOSE: Juvenile idiopathic arthritis (JIA) has unknown etiology, and the involvement of the temporomandibular joint (TMJ) is rare in the early phase of the disease. The present article describes the use of computed tomography (CT) and magnetic resonance (MRI) images for the diagnosis of affected TMJ in JIA. CASE DESCRIPTION: A 12-year-old, female, Caucasian patient, with systemic rheumathoid arthritis and involvement of multiple joints was referred to the Imaging Center for TMJ assessment. The patient reported TMJ pain and limited opening of the mouth. The helical CT examination of the TMJ region showed asymmetric mandibular condyles, erosion of the right condyle and osteophyte-like formation. The MRI examination showed erosion of the right mandibular condyle, osteophytes, displacement without reduction and disruption of the articular disc. CONCLUSION: The disorders of the TMJ as a consequence of JIA must be carefully assessed by modern imaging methods such as CT and MRI. CT is very useful for the evaluation of discrete bone changes, which are not identified by conventional radiographs in the early phase of JIA. MRI allows the evaluation of soft tissues, the identification of acute articular inflammation and the differentiation between pannus and synovial hypertrophy.

Minas-type fresh cheese developed from buffalo milk with addition of L. acidophilus

Effective incorporation of a probiotic into foods requires the culture to remain viable all along processing and storage, without adverse alterations to sensory characteristics. The objective of this work was developing Minas-type fresh cheese with probiotic properties from buffalo milk. Four batches of Minas-type fresh cheese were prepared using buffalo milk: batch T1 in which neither culture nor lactic acid added; batch T3 in which only lactic acid added; batches T2 and T4 , both added of Lactobacillus acidophilus LAC 4, but T4 was also acidified. Resulting cheeses were evaluated for probiotic culture stability, texture profile, sensory acceptance, and changes in pH. The T4 probiotic cheese presented hardness, gumminess, and chewiness significantly lower than the other treatments. However, values for springiness and cohesiveness did not differ between all cheeses, and no sensory differences (p > 0.05) were found between treatments for texture, taste, and overall acceptance. The addition of probiotic to the acidified cheese (T4) yielded best aroma. The populations of L. acidophilus were greater than 10(6) CFU g-1 after 28 days of storage all products. Minas-type fresh cheese from buffalo milk is a suitable food for the delivery of L. acidophilus, since the culture remained viable during the shelf life of the products and did not negative affect analysed parameters.

Quality and sensorial characteristics of osmotically dehydrated mango with syrups of inverted sugar and sucrose

Osmotic dehydration is becoming more popular as a complementary treatment in the processing of dehydrated foods, since it presents some advantages such as minimising heat damage to the colour and flavour, inhibiting enzymatic browning and thus dispensing the addition of sulphite and, mainly, reducing energy costs. The objective of the present study was to evaluate the effect of using inverted sugar and sucrose syrups as osmotic agents in the dehydration of mango. The conditions used in the dehydration process were: syrup/fruit ratio of 3:1 (v/w); temperature of 45ºC and constant stirring. The in natura and osmo-dehydrated fruits were evaluated in relation to pH, moisture content, water activity (a w) and soluble solids (ºBrix). Solids incorporation and loss in mass after the dehydration process were also determined. The sensory acceptance of the in natura and osmo-dehydrated fruits was determined for the attributes of aroma, flavour, texture and overall acceptance using a hedonic scale. Osmotic dehydration resulted in a reduction in moisture content and water activity, an increase in Brix and maintenance of the pH. The treatment with inverted sugar syrup resulted in more significant alterations in moisture content, a w, Brix, solids incorporation and loss in mass than the treatment with sucrose syrup. Mangos osmo-dehydrated with inverted sugar (55.3% inversion rate) syrup obtained acceptance similar to in natura mangos, this treatment being considered the most adequate for dehydration purposes.

A systematic review of diapoma (teleostei: characiformes: characidae: stevardiinae: diapomini) with descriptions of two new species from southern Brazil

Diapoma is reviewed and four species are recognized: (1) Diapoma thauma, new species, from streams of the rio Jacuí basin, state of Rio Grande do Sul; (2) D. pyrrhopteryx, new species collected from the rio Canoas and streams flowing into this basin in the states of Rio Grande do Sul and Santa Catarina, Brazil; (3) Diapoma terofali, from streams flowing into rio Uruguay in Uruguay and Rio Grande do Sul, Brazil and streams flowing into rio de la Plata, Argentina; and (4) Diapoma speculiferum, from lowland coastal streams in Rio Grande do Sul, Brazil and Uruguay. Diapoma pyrrhopteryx possess the posteroventral opercular elongation typical of D. speculiferum, type species of the genus, but which is absent in D. thauma and D. terofali. Nonetheless, all the diapomin species have the caudal pouch organ about equally developed in both sexes and the dorsal portion of the pouch opening bordered by a series of 3 to 8 elongated scales, the two derived features that characterize the group. The two previously described species, D. speculiferum and D. terofali, are redescribed. Previous hypotheses of relationships among the diapomin genera Planaltina, Diapoma and Acrobrycon are discussed on the basis of preliminary morphological information. It is proposed that the Diapomini is a monophyletic group. An identification key, information on sexual dimorphism, gonad anatomy, reproductive mode and distribution of the species of Diapoma are provided.

Immature stages of the moth Lobeza dentilinea (Lepidoptera: Notodontidae), with redescription of the species based on male and female morphology

Egg and pupa of Lobeza dentilinea Schaus, 1901 are described and illustrated for the first time. Eggs are smooth, dome-shaped, and greenish at oviposition. Last instar larvae have an aposematic coloration and the chaetotaxy is very similar to other notodontines, except for the number of lateral setae: L. dentilinea has three instead of four lateral setae on abdominal segments A3-A6. Pupae are light brown and typical of the family, with the last abdominal segments broadly round. Evidence from the adult morphology supporting the placement of the genus in Notodontinae includes proboscis smaller than the length of the head, epiphysis with more than half the length of tibia, tarsal claws simple, and labial palpi short. Male and female are confidently associated, and a redescription of the species is presented based on both sexes. Larvae of L. dentilinea are here recorded feeding on a Melastomataceae.

Cladistic analysis of Hemirhipini with establishment of Propalaus gen. nov. (Coleoptera, Elateridae, agrypninae)

This article includes a cladistic analysis of the tribe Hemirhipini. Are included 20 Hemirhipini genera (sensu Casari-Chen 1994), Saltamartinus Casari (1996b) (Hemirhipini), 6 genera excluded from Hemirhipini and kept in Agrypninae (formerly Pyrophorinae) (Casari-Chen 1993) and also, Aphileus Candèze (1857), Pyrophorus Billberg (1820) and Thoramus Sharp (1877). The type-species of the majority of genera and all species of the American genera (except Saltamartinus viduus (Chevrolat 1867)) are included. This analysis demonstrates that 30 genera belong to Hemirhipini: Abiphis Fleutiaux (1926), Alaolacon Candèze (1865), Alaomorphus Hauser (1900), Alaus Eschscholtz (1829), Aliteus Candèze (1857), Anthracalaus Fairmaire (1888), Aphileus Candèze (1857), Austrocalais Neboiss (1967), Calais Castelnau (1836), Catelanus Fleutiaux (1942), Chalcolepidius Eschscholtz (1829), Chalcolepis Candèze (1857), Conobajulus Van Zwaluwenburg (1940), Coryleus Fleutiaux (1942), Cryptalaus Ôhira (1967), Eleuphemus Hyslop (1921), Eumoeus Candèze (1874), Fusimorphus Fleutiaux (1942), Hemirhipus Latreille (1829), Lacais Fleutiaux (1942), Lycoreus Candèze (1857), Mocquerysia Fleutiaux (1899), Neocalais Girard (1971), Pherhimius Fleutiaux (1942), Phibisa Fleutiaux (1942), Propalaus gen. nov., Pseudocalais Girard (1971), Saltamartinus Casari (1996), Tetrigus Candèze (1857) and Thoramus Sharp (1877). The species included in Alaus do not make a monophyletic group and Propalaus gen. nov. is established to include Alaus alicii (Pjatakowa 1941) and A. haroldi (Candèze 1878). A description of Propalaus gen. nov. (type-species: Chalcolepidius haroldi Candèze, 1878) and a new key to Hemirhipini genera are also presented.

Revision of the species of the genus Cathorops (Siluriformes: Ariidae) from Mesoamerica and the Central American Caribbean, with description of three new species

The ariid genus Cathorops includes species that occur mainly in estuarine and freshwater habitats of the eastern and western coasts of southern Mexico, Central and South America. The species of Cathorops from the Mesoamerica (Atlantic slope) and Caribbean Central America are revised, and three new species are described: C. belizensis from mangrove areas in Belize; C. higuchii from shallow coastal areas and coastal rivers in the Central American Caribbean, from Honduras to Panama; and C. kailolae from río Usumacinta and lago Izabal basins in Mexico and Guatemala. Additionally, C. aguadulce, from the río Papaloapan basin in Mexico, and C. melanopus from the río Motagua basin in Guatemala and Honduras, are redescribed and their geographic distributions are revised.

Trichopeltariidae (Crustacea, Decapoda, Brachyura), a new family and superfamily of eubrachyuran crabs with description of one new genus and five new species

A new family, Trichopeltariidae, is proposed to accommodate Sphaeropeltarion edentatum, new genus and species, and four additional genera traditionally placed in the family Atelecyclidae: Trichopeltarion A. Milne-Edwards, 1880 (type genus); Peltarion Hombron & Jacquinot, 1846; Podocatactes Ortmann, 1893; and Pteropeltarion Dell, 1972. Additionally, four new species of Trichopeltarion are described and illustrated. The new family exhibits characters of neither superfamilies of the Section Eubrachyura and is assigned to its own superfamily, Trichopeltarioidea nov. Keys to the genera of Trichopeltariidae fam. nov. and to all species in the family are presented (species of Trichopeltarion excepted). Six new combinations are proposed or confirmed. The genus Krunopeltarion Števčić, 1993, is merged into the synonymy of Trichopeltarion. A lectotype is selected for Trichopeltarion corallinum (Faxon, 1893).

Revision of the genus Physoclypeus Hendel, 1907 (Diptera, Lauxaniidae), with description of seven new species

The genus Physoclypeus Hendel, 1907 has its distribution restricted to the Neotropical region. In this study, its species have been redescribed, three new combinations have been proposed, three lectotypes have been designated, seven new species have been described, and an identification key to the species is presented. An updated list of species of Physoclypeus is presented as: P. annulatus Hendel, 1925; P. coquilletti (Hendel, 1908); P. farinosus (Hendel, 1925); P. flavus (Wiedemann, 1830); P. hendeli sp. nov. (Type locality, Jamaica, N. Irish Town); P. lineatus (Williston, 1896) new comb.; P. montanus (Becker, 1919) new comb.; P. plaumanni sp. nov. (Type locality, Brazil, Santa Catarina); P. risaraldensis sp. nov. (Type locality, Colombia, Risaralda); P. saltensis sp. nov. (Type locality, Argentina, Salta); P. scutellatus (Curran, 1926) new comb.; P. unimaculatus sp. nov. (Type locality, Mexico, Vera Cruz); P. vitattus sp. nov. (Type locality, Brazil, Santa Catarina) and P. zebrinus sp. nov. (Type locality, Costa Rica, Limón).

Revision of the Neotropical trahiras of the Hoplias lacerdae species-group (Ostariophysi: Characiformes: Erythrinidae) with descriptions of two new species

Hoplias lacerdae was originally described from the rio Ribeira de Iguape, Iporanga, São Paulo State. The Hoplias lacerdae group is defined as containing generally large trahiras with the medial margins of dentaries running parallel to each other and lacking teeth on the basihyal compared to the H. malabaricus group in which the medial margins of the dentaries converge towards the mandibular symphysis and which have teeth on the basihyal. A taxonomic revision of the group based on meristic and morphometric data identified five distinct species: H. lacerdae distributed in the rio Ribeira de Iguape and rio Uruguai; H. intermedius from the rio São Francisco, upper rio Paraná basin, and rio Doce; H. brasiliensis from rivers of the Atlantic Coastal drainage from the rio Paraguaçu to the rio Jequitinhonha; H. australis new species, endemic to the rio Uruguai; and H. curupira new species present in northern South America, including the rios Negro, Trombetas, Tapajós, Xingu, Tocantins and Capim in the Amazon basin, upper rio Orinoco near the rio Casiquiare (Venezuela), and coastal rivers of Guyana and Suriname. A lectotype for Hoplias intermedius and a neotype for H. brasiliensis are designated.

Factors associated with stages of change for red meat and vegetable intake by Japanese-Brazilians

Stages of change assess individual motivation for lifestyle changes, contributing to the development of more effective intervention strategies. The objective of the present study was to identify factors associated with stages of change for lower intake of red meat and higher intake of vegetables in a cross-sectional analysis of 578 Japanese-Brazilians aged 30-90 years. In adjusted logistic regression models, the odds ratios for women (OR = 1.89; 95%CI: 1.154; 3.103) and physically active individuals (OR = 1.00; 95%CI: 1.000; 1.001) were positively associated with stage of "action" for the higher intake of vegetables. Inverse associations were observed between central obesity (OR = 0.5; 95%CI: 0.351; 0.887) and highest tertile of red meat intake (OR = 0.50; 95%CI: 0.302; 0.817), as well as a positive association between age (OR = 1.04; 95%CI: 1.020; 1.070) and the stage of "action" to the lower intake of meat were verified. Motivation for Japanese-Brazilians to change their food intake was linked to lifestyle. Stage of change is an important factor in mediating food intake behavior change.

Menopausal status: a possible predictive factor for recurrence in women with cancer of the uterine cervix without pelvic lymph node metastasis

Abstract Objectives to evaluate risk factors for recurrence of carcinoma of the uterine cervix among women who had undergone radical hysterectomy without pelvic lymph node metastasis, while taking into consideration not only the classical histopathological factors but also sociodemographic, clinical and treatment-related factors. Study desin This was an exploratory analysis on 233 women with carcinoma of the uterine cervix (stages IB and IIA) who were treated by means of radical hysterectomy and pelvic lymphadenectomy, with free surgical margins and without lymph node metastases on conventional histopathological examination. Women with histologically normal lymph nodes but with micrometastases in the immunohistochemical analysis (AE1/AE3) were excluded. Disease-free survival for sociodemographic, clinical and histopathological variables was calculated using the Kaplan-Meier method. The Cox proportional hazards model was used to identify the independent risk factors for recurrence. Twenty-seven recurrences were recorded (11.6%), of which 18 were pelvic, four were distant, four were pelvic + distant and one was of unknown location. The five-year disease-free survival rate among the study population was 88.4%. The independent risk factors for recurrence in the multivariate analysis were: postmenopausal status (HR 14.1; 95% CI: 3.7-53.6; P < 0.001), absence of or slight inflammatory reaction (HR 7.9; 95% CI: 1.7-36.5; P = 0.008) and invasion of the deepest third of the cervix (HR 6.1; 95% CI: 1.3-29.1; P = 0.021). Postoperative radiotherapy was identified as a protective factor against recurrence (HR 0.02; 95% CI: 0.001-0.25; P = 0.003). (To continue) Postmenopausal status is a possible independent risk factor for recurrence even when adjusted for classical prognostic factors (such as tumour size, depth of tumour invasion, capillary embolisation) and treatment-related factors (period of treatment and postoperative radiotherapy status)