Avaliação audiológica pré-cirurgia otológica de indivíduos com fissura labiopalatina operada

OBJETIVO: descrever as características audiológicas de indivíduos com fissura labiopalatina operada (FLP) e indicação de cirurgia otológica, comparando os grupos quanto ao tipo e grau da perda auditiva, bem como a curva timpanométrica. MÉTODOS: análise de 150 prontuários, ambos os gêneros, idade igual ou superior a 4 anos, FLP e indicação de cirurgia otológica, divididos em 3 grupos: I - Tubo de ventilação (TV), II - Timpanoplastia e III - Timpanomastoidectomia, analisando aspectos quanto a entrevista audiológica, audiometria tonal limiar e imitanciometria. RESULTADOS: o grupo I apresentou porcentagem maior de cirurgia bilateral (86%), o que não ocorreu nos demais grupos. Na entrevista audiológica, 83% apresentou algum tipo de queixa auditiva, sendo a mais frequente a perda auditiva (64%) com p<0,05 entre os grupos I e II; I e III. O tipo de perda auditiva de maior ocorrência foi condutivo bilateral (56%) seguido de unilateral (35%), com p<0,05 entre os grupos I e II; I e III. A perda de grau leve unilateral foi a de maior ocorrência (41%), seguida de grau leve a moderada bilateral (20%), com p<0,05 entre os três grupos. A curva timpanométrica mais frequente foi a do tipo B bilateral (39%) com p<0,05 entre os três grupos. CONCLUSÃO: a maioria dos indivíduos apresentou algum tipo de queixa na entrevista audiológica e alterações na audiometria tonal limiar e imitanciometria. A maioria dessas alterações foi compatível com problemas de orelha média, com perda auditiva do tipo condutiva, de grau leve e bilateral, independentemente da indicação cirúrgica.

O uso de videogames, jogos de computador e internet por uma amostra de universitários da Universidade de São Paulo

OBJETIVO: Avaliar uso de jogos eletrônicos (videogames, jogos de computador e internet) em uma amostra de universitários. MÉTODO: Um questionário a respeito de comportamentos relacionados ao uso de jogos eletrônicos, contendo a escala Problem Videogame Playing (PVP), foi aplicado em 100 alunos da Universidade de São Paulo (USP). RESULTADOS: A maioria (83%) relatou ter jogado no último ano, dentre a qual 81,9% eram homens, 51,8% jogavam de 1 a 2 horas por sessão; 74,4% afirmaram que jogar não interfere em seus relacionamentos sociais e 60,5%, que o uso de jogos violentos não influencia sua agressividade. Os estudantes dividiram-se entre jogadores ocasionais e frequentes, diferenciando-se por duração de cada sessão, jogo preferido, motivação para jogar, e influência do jogo na vida social. Cerca de 5% relataram só parar de jogar quando interrompidos, normalmente jogar mais de 4 horas por sessão e se relacionar mais com amigos virtuais, sugerindo maior envolvimento com a atividade. Na escala PVP, 15,8% da amostra preencheu mais da metade dos itens, indicando consequências adversas associadas ao uso dos jogos eletrônicos. CONCLUSÃO: Observou-se que o uso de jogos eletrônicos é comum entre os estudantes da USP e que uma parcela apresenta problemas relacionados ao excesso de jogo.

A importância das quedas no mesmo nível entre idosos no estado de são paulo

OBJETIVO: Analisar as características das quedas no grupo etário com 60 anos ou mais, com ênfase nas quedas no mesmo nível, residentes no Estado de São Paulo, a partir da análise das diferentes fontes de informação oficiais. MÉTODOS: Foram analisadas as 1.328 mortes registradas no SIM em 2007, 20.726 internações no SIH/SUS em 2008 e os 359 atendimentos realizados em 24 UEs do Estado de São Paulo em 2007. Um teste de regressão logística foi utilizado para testar associações entre variáveis nos atendimentos em emergências. RESULTADOS: O sexo masculino preponderou nas mortes (51,2 %) enquanto o sexo feminino preponderou nas internações (61,1%) e atendimentos em emergências (60,4%). O coeficiente de mortalidade foi 31/100.000 habitantes, aumentando com a idade e atingindo o valor de 110,7/100.000 habitantes na faixa de 80 anos e mais. As quedas no mesmo nível foram responsáveis pela maior proporção de mortes definidas (35%), nas internações (47,5%) e também nas emergências (66%), crescendo de importância com o aumento das faixas etárias. A residência foi o local de ocorrência em 65,8% dos casos atendidos nas emergências. Os traumatismos de cabeça assumem importância nas mortes; as fraturas de fêmur foram as lesões mais frequentes nas internações e emergências. Nas emergências, as mulheres foram 1,55 vezes significativamente mais prováveis de serem atendidas por uma queda do que pelas outras causas externas que os homens. Comparativamente à faixa de 60 a 69 anos, os indivíduos na faixa de 70 a 79 anos foram 2,10 vezes e os indivíduos de 80 anos e mais foram 2,26 vezes significativamente mais prováveis de serem atendidos por uma queda do que pelas outras causas externas. Não houve diferença estatisticamente significante quanto ao sexo ou faixa etária quando se comparou os indivíduos que sofreram quedas no mesmo nível e outros tipos de queda. CONCLUSÃO: Recomenda-se que a prevenção das quedas entre idosos entre na pauta de discussão das políticas públicas sem mais demora.

Determinantes individuais da utilização de serviços odontológicos por adultos e idosos de baixa renda

A utilização de serviços odontológicos resulta da interação de determinantes biológicos com fatores socioculturais, familiares e comunitários, bem como de características dos sistemas de saúde. O objetivo deste estudo foi identificar os fatores individuais associados à utilização de serviços odontológicos por parte de adultos e idosos de baixa renda residentes na área de abrangência da Estratégia Saúde da Família, em Ponta Grossa, PR. A amostra constou de 246 indivíduos, com 35 anos de idade ou mais, que responderam a um questionário sobre condições socioeconômicas, necessidade percebida e acesso a serviços odontológicos. A análise dos dados foi realizada por meio de regressão logística, segundo referencial teórico baseado no Modelo Comportamental de Andersen, considerando a consulta odontológica não recente como variável dependente. Verificou-se elevada prevalência de problemas bucais auto-referidos e de perdas dentárias. Cerca de 40% dos adultos e 67% dos idosos não iam ao dentista há mais de três anos. Indivíduos que não residiam em domicílios próprios, realizavam higiene bucal com menor frequência e utilizavam próteses totais apresentaram maiores chances de haver utilizado os serviços odontológicos há mais tempo. O fato de possuir um dentista regular foi identificado como fator de proteção na análise. Concluindo, os determinantes individuais mostraram-se importantes indicadores de acesso aos serviços de saúde bucal. O modelo teórico confirmou a presença de desigualdades sociais e psicossociais na utilização de serviços odontológicos entre os adultos e idosos de baixa renda.

Methods and Participant Characteristics of a Randomized Intervention to Promote Physical Activity and Healthy Eating Among Brazilian High School Students: The Saude na Boa Project

Background: A cross-cultural, randomized study was proposed to observe the effects of a school-based intervention designed to promote physical activity and healthy eating among high school students in 2 cities from different regions in Brazil: Recife and Florianopolis. The objective of this article is to describe the methodology and subjects enrolled in the project. Methods: Ten schools from each region were matched and randomized into intervention and control conditions. A questionnaire and anthropometry were used to collect data in the first and last month of the 2006 school year. The sample (n = 2155 at baseline; 55.7% females; 49.1% in the experimental group) included students 15 to 24 years, attending nighttime classes. The intervention focused on simple environmental/organizational changes, diet and physical activity education, and personnel training. Results: The central aspects of the intervention have been implemented in all 10 intervention schools. Problems during the intervention included teachers' strikes in both sites and lack of involvement of the canteen owners in schools. Conclusions: The Saude no Boa study provides evidence that public high schools in Brazil represent an important environment for health promotion. Its design and simple measurements increase the chances of it being sustained and disseminated to similar schools in Brazil.

Viral mutation and its influence in the time evolution of the immunizations

In this paper, we study the behavior of immune memory against antigenic mutation. Using a dynamic model proposed by one of the authors in a previous study (A. de Castro [Phys. J. Appl. Phys. 33, 147 (2006) and Simul. Mod. Pract. Theory. 15, 831 (2007)]), we have performed simulations of several inoculations, where in each virtual sample the viral population undergoes mutations. Our results suggest that the sustainability of the immunizations is dependent on viral variability and that the memory lifetimes are not random, what contradicts what was suggested by Tarlinton et al. [Curr. Opin. Immunol. 20, 162 (2008)]. We show that what may cause an apparent random behavior of the immune memory is the antigenic variability.

In vivo bioavailability of selenium in enriched Pleurotus ostreatus mushrooms

The in vivo bioavailability of Se was investigated in enriched Pleurotus ostreatus mushrooms. A bioavailability study was performed using 64 Wistar male rats separated in 8 groups and fed with different diets: without Se, with mushrooms without Se, with enriched mushrooms containing 0.15, 0.30 or 0.45 mg kg(-1) Se and a normal diet containing 0.15 mg kg(-1) of Se using sodium selenate. The experiment was performed in two periods: depletion (14 days) and repletion (21 days), according to the Association of Official Analytical Chemists. After five weeks, the rats were sacrificed under carbon dioxide, and blood was drawn by heart puncture. Blood plasma was separated by centrifugation. The total Se concentration in the plasma of rats fed with enriched mushrooms was higher than in rats fed with a normal diet containing sodium selenate. The plasma protein profiles were obtained using size exclusion chromatography (SEC) and UV detectors. Aliquots of effluents (0.5 mL per minute) were collected throughout in the end of the chomatographic column. However, Se was determined by graphite furnace atomic absorption spectrometry (GF AAS) only in the aliquots where proteins were detected by SEC-UV. The plasma protein pro. le of rats fed with different diets was similar. The highest Se concentration was observed in a peptide presenting 8 kDa. Furthermore, the higher Se concentration in this peptide was obtained for rats fed with a diet using enriched mushrooms (7 mu g L(-1) Se) compared to other diets (2-5 mu g L(-1) Se). These results showed that Se-enriched mushrooms can be considered as an alternative Se food source for humans, due to their high bioavailability.

Use of blanks to determine in vitro net gas and methane production when using rumen fermentation modifiers

Blanks (flasks without substrate containing only inoculum and medium) are used in vitro to correct for gas. CH(4) and residual organic matter (OM) fermented in inoculum. However inclusion of rumen fermentation modifiers may affect fermentation of OM in the substrate and inoculum. Thus, data correction using blanks that lack additives may result in inaccurate adjustment for background fermentation. Our objective was to evaluate impacts of using blanks containing additive (i.e., specific blanks) or blanks without additive on estimation of in vitro net gas and CH(4) production. We used the semi-automatic in vitro gas production technique including monensin sodium at 2.08 mg/l of buffered rumen fluid (Experiment 1) or carvacrol, eugenol and 1,8-cineol at 667 mg/l (Experiment 2) in flasks with substrate and in blank flasks. At 16h of incubation, monensin reduced (P <= 0.02) total gas production in flasks containing substrate (162.0 ml versus 146.3 ml) and in blanks (84.4 ml versus 79.2 ml). Total methane production was also decreased (P <= 0.05) by adding monensin to flasks containing substrate (15.7 ml versus 11.9 ml) as well as in blanks (6.4 ml versus 5.0 ml). Inclusion of carvacrol or eugenol reduced (P <= 0.05) total gas and CH(4) production in flasks with substrate and in blanks, but in a more pronounced manner than monensin. For these three additives, correction for blank without additive resulted in lower net gas and CH(4) production than correction for a treatment specific blank. For instance, correcting carvacrol data using a blank without the additive resulted in negative net gas and CH(4) production (-6.5 and -1.5 ml. respectively). These biologically impossible results occurred because total gas and CH(4) production in blanks without carvacrol (46.1 and 2.1 ml, respectively) were higher than in flasks containing substrate plus carvacrol (39.7 and 0.6 ml, respectively). Results demonstrated that inclusion of rumen additives affected fermentation of OM in the substrate and the inoculum. Thus, correction of gas and CH(4) production using blanks without additives resulted in overestimation of these variables. Blanks containing the additive of interest should be included when rumen fermentation modifiers are evaluated in vitro. This paper is part of the special issue entitled: Greenhouse Gases in Animal Agriculture Finding a Balance between Food and Emissions, Guest Edited by T.A. McAllister, Section Guest Editors: K.A. Beauchemin, X. Hao, S. McGinn and Editor for Animal Feed Science and Technology, P.H. Robinson. (C) 2011 Elsevier B.V. All rights reserved.

The effect of Sao Paulo`s smoke-free legislation on carbon monoxide concentration in hospitality venues and their workers

Background Studies have shown that there is no safe level of secondhand smoke (SHS) exposure and there is a close link between SHS and the risk of coronary heart disease and stroke. Carbon monoxide (CO) is one of the most important components present in SHS. Objective To evaluate the impact of the smoking ban law in the city of Sao Paulo, Brazil, on the CO concentration in restaurants, bars, night clubs and similar venues and in their workers. Methods In the present study we measured CO concentration in 585 hospitality venues. CO concentration was measured in different environments (indoor, semi-open and open areas) from visited venues, as well as, in the exhaled air from approximately 627 workers of such venues. Measurements were performed twice, before and 12 weeks after the law implementation. In addition, the quality of the air in the city during the same period of our study was verified. Results The CO concentration pre-ban and pot-ban in hospitality venues was indoor area 4.57 (3.70) ppm vs 1.35 (1.66) ppm (p<0.0001); semi-open 3.79 (2.49) ppm vs 1.16 (1.14) ppm (p<0.0001); open area 3.31 (2.2) ppm vs 1.31 (1.39) ppm (p<0.0001); smoking employees 15.78 (9.76) ppm vs 11.50 (7.53) ppm (p<0.0001) and non-smoking employees 6.88 (5.32) ppm vs 3.50 (2.21) ppm (p<0.0001). The average CO concentration measured in the city was lower than 1 ppm during both pre-ban and post-ban periods. Conclusion Sao Paulos smoking-free legislation reduced significantly the CO concentration in hospitality venues and in their workers, whether they smoke or not.

The Influence of Initial Xylose Concentration, Agitation, and Aeration on Ethanol Production by Pichia stipitis from Rice Straw Hemicellulosic Hydrolysate

Rice straw hemicellulosic hydrolysate was used as fermentation medium for ethanol production by Pichia stipitis NRRL Y-7124. Shaking bath experiments were initially performed aiming to establish the best initial xylose concentration to be used in this bioconversion process. In the sequence, assays were carried out under different agitation (100 to 200 rpm) and aeration ((V) under bar (flask)/V(medium) ratio varying from 2.5 to 5.0) conditions, and the influence of these variables on the fermentative parameters values (ethanol yield factor, Y(P/S); cell yield factor, Y(X/S); and ethanol volumetric productivity, Q(P)) was investigated through a 2(2) full-factorial design. Initial xylose concentration of about 50 g/l was the most suitable for the development of this process, since the yeast was able to convert substrate in product with high efficiency. The factorial design assays showed a strong influence of both process variables in all the evaluated responses. The agitation and aeration increase caused a deviation in the yeast metabolism from ethanol to biomass production. The best results (Y(P/S) = 0.37 g/g and Q(P) = 0.39 g/l. h) were found when the lowest aeration (2.5 V(flask)/V(medium) ratio) and highest agitation (200 rpm) levels were employed. Under this condition, a process efficiency of 72.5% was achieved. These results demonstrated that the establishment of adequate conditions of aeration is of great relevance to improve the ethanol production from xylose by Pichia stipitis, using rice straw hemicellulosic hydrolysate as fermentation medium.

Contribution of Tris Buffer on Xylitol Enzymatic Production

Xylitol enzymatic production can be an alternative to chemical and microbial processes, because of advantages like higher conversion efficiency. However, for an adequate conversion, it is necessary to investigate the effect of many parameters, such as buffer initial concentration, pH, temperature, agitation, etc. In this context, the objective of this work was to evaluate xylitol enzymatic production under different Tris buffer initial concentrations in order to determine the best condition for this parameter to begin the reaction. The best results were obtained when Tris buffer initial concentration was 0.22 M, reaching 0.31 g L(-1) h(-1) xylitol volumetric productivity with 99% xylose-xylitol conversion efficiency. Although the increase in buffer concentration allowed better pH maintenance, it hindered the catalysis. The results demonstrate that this bioreaction is greatly influenced by involved ions concentrations.

Xylooligosaccharides Production from Alkali-Pretreated Sugarcane Bagasse Using Xylanases from Thermoascus aurantiacus

Sugarcane bagasse hemicellulose was isolated in a one-step chemical extraction using hydrogen peroxide in alkaline media. The polysaccharide containing 80.9% xylose and small amounts of L-arabinose, 4-O-methyl-D-glucuronic acid and glucose, was hydrolyzed by crude enzymatic extracts from Thermoascus aurantiacus at 50 degrees C. Conditions of enzymatic hydrolysis leading to the best yields of xylose and xylooligosaccharides (DP 2-5) were investigated using substrate concentration in the range 0.5-3.5% (w/v), enzyme load 40-80 U/g of the substrate, and reaction time from 3 to 96 h, applying a 22 factorial design. The maximum conversion to xylooligosaccharides (37.1%) was obtained with 2.6% of substrate and xylanase load of 60 U/g. The predicted maximum yield of xylobiose by a polynomial model was 41.6%. Crude enzymatic extract of T. aurantiacus generate from sugarcane bagasse hemicellulose 39% of xylose, 59% of xylobiose, and 2% of other xylooligosaccharides.

Limiting factors for phytoplankton growth in subtropical reservoirs: the effect of light and nutrient availability in different longitudinal compartments

Limited information is available on the interactions between environmental factors and algal growth in tropical and subtropical aquatic systems. We investigated the relationships between algal biomass (measured as chlorophyll, Chl-a) and light, total phosphorus (TP) and total nitrogen (TN) in longitudinal zones of subtropical reservoirs. We studied the seasonal variation of water variables in Itupararanga Reservoir (Brazil) and compared the results with 16 other subtropical lakes and reservoirs. The longitudinal zones in Itupararanga Reservoir were considered statistically different (p 0.05, MANOVA). From the riverine zone to the dam region of the reservoir, Spearman Correlation Test suggested that light limitation and TP limitation tended to decrease and increase, respectively. Although nitrate concentrations were high (400 g/L), the Spearman coefficients between Chl-a and TN and the TN:TP ratios (11:1 TN:TP 35:1) indicated that nitrogen may be co-limiting algal growth in the studied water body. Putting Itupararanga in a regional context allowed assessment of potential influences of land use on trophic state. Within the subtropical dataset, TP explained a greater percentage of variance in Chl-a (R2 = 0.70) than TN (R2 = 0.17). The main land use type within the reservoirs drainage area significantly influenced the concentrations of TP, TN, and Chl-a (p 0.05, MANOVA), with different relationships between nutrients and chlorophyll in forested (R2 = 0.12-0.33), agricultural (R2 = 0.50-0.68) and urban (R2 = 0.09-0.64) watersheds. Comparisons with literature values and those from reservoirs with less altered watersheds indicated that Itupararanga Reservoir is reaching the mesotrophic-eutrophic boundary, and further nutrient enrichment could cause water quality degradation.

AnSBBR Applied to the Treatment of Metalworking Fluid Wastewater: Effect of Organic and Shock Load

An investigation was performed regarding the application of a mechanically stirred anaerobic sequencing batch biofilm reactor containing immobilized biomass on inert polyurethane foam (AnSBBR) to the treatment of soluble metalworking fluids to remove organic matter and produce methane. The effect of increasing organic matter and reactor fill time, as well as shock load, on reactor stability and efficiency have been analyzed. The 5-L AnSBBR was operated at 30 A degrees C in 8-h cycles, agitation of 400 rpm, and treated 2.0 L effluent per cycle. Organic matter was increased by increasing the influent concentration (500, 1,000, 2,000, and 3,000 mg chemical oxygen demand (COD)/L). Fill times investigated were in the batch mode (fill time 10 min) and fed-batch followed by batch (fill time 4 h). In the batch mode, organic matter removal efficiencies were 87%, 86%, and 80% for influent concentrations of 500, 1,000, and 2,000 mgCOD/L (1.50, 3.12, and 6.08 gCOD/L.d), respectively. At 3,000 mgCOD/L (9.38 gCOD/L.d), operational stability could not be achieved. The reactor managed to maintain stability when a shock load twice as high the feed concentration was applied, evidencing the robustness of the reactor to potential concentration variations in the wastewater being treated. Increasing the fill time to 4 h did not improve removal efficiency, which was 72% for 2,000 mgCOD/L. Thus, gradual feeding did not improve organic matter removal. The concentration of methane formed at 6.08 gCOD/L was 5.20 mmolCH(4), which corresponded to 78% of the biogas composition. The behavior of the reactor during batch and fed-batch feeding could be explained by a kinetic model that considers organic matter consumption, production, and consumption of total volatile acids and methane production.

Effect of Fill Time on the Performance of Pilot-scale ASBR and AnSBBR Applied to Sanitary Wastewater Treatment

Many lab-scale studies have been carried out regarding the effect of feed strategy on the performance of anaerobic sequencing batch reactors (ASBR); however, more detailed pilot-scale studies should be performed to assess the real applicability of this type of operation. Therefore, the objective of this work was to assess the effect of feed strategy or fill time in a 1-m(3) mechanically stirred pilot-scale sequencing batch reactor, treating 0.65 m(3) sanitary wastewater in 8-h cycles at ambient temperature. Two reactor configurations were used: one containing granular biomass (denominated ASBR) and the other immobilized biomass on polyurethane foam as inert support (denominated anaerobic sequencing batch biofilm reactor (AnSBBR)). The reactors were operated under five distinct feed strategies, namely: typical batch and fed-batch for 25%, 50%, 75%, and 100% of the cycle length. Stirring frequency in the ASBR was 40 rpm with two flat-blade turbine impellers and 80 rpm in the AnSBBR with two helix impellers. The results showed that both the ASBR and AnSBBR when operated under typical batch, fed-batch for 50% and 75% of the cycle length, presented improved organic matter removal efficiencies, without significant differences in performance, thus showing important operational flexibility. In addition, the reactors presented operation stability under all conditions.