Health in Brazil 2 Maternal and child health in Brazil: progress and challenges

In the past three decades, Brazil has undergone rapid changes in major social determinants of health and in the organisation of health services. In this report, we examine how these changes have affected indicators of maternal health, child health, and child nutrition. We use data from vital statistics, population censuses, demographic and health surveys, and published reports. In the past three decades, infant mortality rates have reduced substantially, decreasing by 5.5% a year in the 1980s and 1990s, and by 4.4% a year since 2000 to reach 20 deaths per 1000 livebirths in 2008. Neonatal deaths account for 68% of infant deaths. Stunting prevalence among children younger than 5 years decreased from 37% in 1974-75 to 7% in 2006-07. Regional differences in stunting and child mortality also decreased. Access to most maternal-health and child-health interventions increased sharply to almost universal coverage, and regional and socioeconomic inequalities in access to such interventions were notably reduced. The median duration of breastfeeding increased from 2.5 months in the 1970s to 14 months by 2006-07. Official statistics show stable maternal mortality ratios during the past 10 years, but modelled data indicate a yearly decrease of 4%, a trend which might not have been noticeable in official reports because of improvements in death registration and the increased number of investigations into deaths of women of reproductive age. The reasons behind Brazil`s progress include: socioeconomic and demographic changes (economic growth, reduction in income disparities between the poorest and wealthiest populations, urbanisation, improved education of women, and decreased fertility rates), interventions outside the health sector (a conditional cash transfer programme and improvements in water and sanitation), vertical health programmes in the 1980s (promotion of breastfeeding, oral rehydration, and immunisations), creation of a tax-funded national health service in 1988 (coverage of which expanded to reach the poorest areas of the country through the Family Health Program in the mid-1990s); and implementation of many national and state-wide programmes to improve child health and child nutrition and, to a lesser extent, to promote women`s health. Nevertheless, substantial challenges remain, including overmedicalisation of childbirth (nearly 50% of babies are delivered by caesarean section), maternal deaths caused by illegal abortions, and a high frequency of preterm deliveries.

Serum oxytocin concentrations in elective caesarean delivery: a randomized comparison of three infusion regimens

Background: The aim of this study was to determine serum oxytocin concentrations following different regimens of prophylactic oxytocin administration in women undergoing elective caesarean delivery. Methods: Thirty healthy pregnant patients were randomized, after clamping of the umbilical cord, to receive intravenous oxytocin in one of the following groups: G1 (n = 9), 10 IU of oxytocin infused over 30 min (0.33 IU/min); G2 (n = 11), 10 IU of oxytocin infused over 3 min and 45 s (2.67 IU/min); and G3 (n = 10), 80 IU of oxytocin infused over 30 min (2.67 IU/min). Both patient and surgeon were blinded to allocation. Uterine tone was assessed by surgical palpation. Serum oxytocin concentration was determined by enzyme immunoassay before anaesthesia (T0) and at 5 (T5), 30 (T30) and 60 (T60) min after the start of oxytocin infusion. Results: Serum oxytocin concentrations (mean standard error, ng/mL) were not significantly different in the groups at T0 (0.06 +/- 0.02, 0.04 +/- 0.02 and 0.07 +/- 0.04, respectively, P = 0.76), and T60 (0.65 +/- 0.26, 0.36 +/- 0.26 and 0.69 +/- 0.26, respectively, P = 0.58). G3 showed higher concentrations than G1 at 15 (3.65 +/- 0.74 versus 0.71 +/- 0.27, P = 0.01) and at T30 (6.19 +/- 1.19 versus 1.17 +/- 0.37, P < 0.01), and were higher than G2 at T30 (6.19 +/- 1.19 versus 0.41 +/- 0.2, P < 0.01). Haemodynamic data and uterine tone were considered satisfactory and similar in all groups. No additional uterotonic agents were needed. Conclusion: Serum oxytocin measurements made using enzyme immunoassay in healthy pregnant women undergoing elective caesarean delivery showed that administration of 80 IU oxytocin over 30 min resulted in higher serum oxytocin levels after 5 and 30 min than the two other regimens. The concentrations did not differ between groups at 60 min. (C) 2011 Elsevier Ltd. All rights reserved.

An Alternative Section Method for Casting and Posterior Laser Welding of Metallic Frameworks for an Implant-Supported Prosthesis

Purpose: The aim of this study was to compare the accuracy of fit of three types of implant-supported frameworks cast in Ni-Cr alloy: specifically, a framework cast as one piece compared to frameworks cast separately in sections to the transverse or the diagonal axis, and later laser welded. Materials and Methods: Three sets of similar implant-supported frameworks were constructed. The first group of six 3-unit implant-supported frameworks were cast as one piece, the second group of six were sectioned in the transverse axis of the pontic region prior to casting, and the last group of six were sectioned in the diagonal axis of the pontic region prior to casting. The sectioned frameworks were positioned in the matrix (10 N(.)cm torque) and laser welded. To evaluate passive fit, readings were made with an optical microscope with both screws tightened and with only one-screw tightened. Data were submitted to ANOVA and Tukey-Kramer`s test (p < 0.05). Results: When both screws were tightened, no differences were found between the three groups (p > 0.05). In the single-screw-tightened test, with readings made opposite to the tightened side, the group cast as one piece (57.02 +/- 33.48 mu m) was significantly different (p < 0.05) from the group sectioned diagonally (18.92 +/- 4.75 mu m) but no different (p > 0.05) from the group transversally sectioned (31.42 +/- 20.68 mu m). On the tightened side, no significant differences were found between the groups (p > 0.05). Conclusions: Results of this study showed that casting diagonally sectioned frameworks lowers misfit levels of prosthetic implant-supported frameworks and also improves the levels of passivity to the same frameworks when compared to structures cast as one piece.

Modified section method for laser-welding of ill-fitting cp Ti and Ni-Cr alloy one-piece cast implant-supported frameworks

P>This study aimed to verify the effect of modified section method and laser-welding on the accuracy of fit of ill-fitting commercially pure titanium (cp Ti) and Ni-Cr alloy one-piece cast frameworks. Two sets of similar implant-supported frameworks were constructed. Both groups of six 3-unit implant-supported fixed partial dentures were cast as one-piece [I: Ni-Cr (control) and II: cp Ti] and evaluated for passive fitting in an optical microscope with both screws tightened and with only one screw tightened. All frameworks were then sectioned in the diagonal axis at the pontic region (III: Ni-Cr and IV: cp Ti). Sectioned frameworks were positioned in the matrix (10-Ncm torque) and laser-welded. Passive fitting was evaluated for the second time. Data were submitted to anova and Tukey-Kramer honestly significant difference tests (P < 0 center dot 05). With both screws tightened, one-piece cp Ti group II showed significantly higher misfit values (27 center dot 57 +/- 5 center dot 06 mu m) than other groups (I: 11 center dot 19 +/- 2 center dot 54 mu m, III: 12 center dot 88 +/- 2 center dot 93 mu m, IV: 13 center dot 77 +/- 1 center dot 51 mu m) (P < 0 center dot 05). In the single-screw-tightened test, with readings on the opposite side to the tightened side, Ni-Cr cast as one-piece (I: 58 center dot 66 +/- 14 center dot 30 mu m) was significantly different from cp Ti group after diagonal section (IV: 27 center dot 51 +/- 8 center dot 28 mu m) (P < 0 center dot 05). On the tightened side, no significant differences were found between groups (P > 0 center dot 05). Results showed that diagonally sectioning ill-fitting cp Ti frameworks lowers misfit levels of prosthetic implant-supported frameworks and also improves passivity levels of the same frameworks when compared to one-piece cast structures.

Taxonomic survey of Paepalanthus section Diphyomene (Eriocaulaceae)

Paepalanthus is the largest genus in Eriocaulaceae, comprising about 400 species distributed mainly throughout the Neotropics. Through phylogenetic studies it has been demonstrated that the genus is polyphyletic, although many of its infrageneric categories are monophyletic. In an attempt to clarify the nomenclature and classification of Paepalanthus, we present a taxonomic survey of Paepalanthus section Diphyomene. This group consists of 10 species restricted to South America and is defined by inflorescences being arranged in the form of a tribotryum with terminal dibotryum, a terminal basic unit and pherophylls subtending the lateral dibotrya. Further important distinguishing characteristics are dimerous flowers, pistillate flowers with dolabriform sepals, bifid stigmatic branches and absent staminodes, and staminate flowers with an elongated anthophore. We hereby propose 19 new synonyms, six lectotypifications, one new status, one neotypification and one epitypification.

Five New and Narrowly Distributed Species of Paepalanthus Section Diphyomene (Eriocaulaceae) from Central Brazil

Five new species of Paepalanthus section Diphyomene are described and illustrated: P. brevis, P. flexuosus, P. longiciliatus, P. macer, and P. stellatus. Paepalanthus brevis, similar to P. decussus, is easily distinguished by its short reproductive axis, and pilose and mucronate leaves. Paepalanthus flexuosus, morphologically related to P. urbanianus, possesses a distinctive short and tortuous reproductive axis. Paepalanthus longiciliatus, morphologically similar to P. weddellianus, possesses long trichomes on the margins of the reproductive axis bracts, considered a diagnostic feature. Paepalanthus macer shares similarities with P. amoenus, differing by its sulfurous capitula and adpressed reproductive axis bracts. Paepalanthus stellatus also has affinity with P. decussus, but possesses unique, membranaceous, reproductive-axis bracts and a punctual inner-capitulum arrangement of pistillate flowers. Four of the described species are narrowly distributed in the state of Goias, whereas P. brevis is endemic to Distrito Federal. All are considered critically endangered. Detailed comparisons of these species are presented in tables. Comments on phenology, distribution, habitat and etymology, along with an identification key, are provided.

Baccharis scopulorum, a new species of section Caulopterae (Asteraceae: Astereae) from rocky cliffs of southern Brazil

A new species of Baccharis sect. Caulopterae endemic to rocky cliffs in southern Brazil, is here described as Baccharis scopulorum. This new species is characterized by the general presence of basal and persistent leaves, mostly solitary capitula born at the tips of the branches, and many flowered capitula, the pistillate capitula with an urceolate to campanulate involucres. The new species is morphologically most similar to B. altimontana and B. opuntioides, both inhabiting mountain summits in eastern Brazil. A description of B. scopulorum, together with illustrations, a distribution map, habitat description, conservation assessment and diagnostic comparison with B. altimontana and B. opuntioides is presented.

A new species of Croton section Cleodora (Euphorbiaceae s.s.) from Minas Gerais, Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Molecular phylogenetics and character evolution of the ""sacaca"" clade: Novel relationships of Croton section Cleodora (Euphorbiaceae)

Phylogenetic relationships of Croton section Cleodora (Klotzsch) Baill. were evaluated using the nuclear ribosomal ITS and the chloroplast trnl-F and trnH-psbA regions. Our results show a strongly supported clade containing most previously recognized section Cleodora species, plus some other species morphologically similar to them. Two morphological synapomorphies that support section Cleodora as a clade include pistillate flowers in which the sepals overlap to some degree, and styles that are connate at the base to varying degrees. The evolution of vegetative and floral characters that have previously been relied on for taxonomic decisions within this group are evaluated in light of the phylogenetic hypotheses. Within section Cleodora there are two well-supported clades, which are proposed here as subsections (subsection Sphaerogyni and subsection Spruceani). The resulting phylogenetic hypothesis identifies the closest relatives of the medicinally important and essential oil-rich Croton cajucara Benth. as candidates for future screening in phytochemical and pharmacological studies. (C) 2011 Elsevier Inc. All rights reserved.

Measurement of thermal neutron cross section and resonance integral for the (165)Ho(n, gamma)(166g)Ho reaction

The ground state thermal neutron cross section and the resonance integral for the (165)Ho(n, gamma)(166)Ho reaction in thermal and 1/E regions, respectively, of a thermal reactor neutron spectrum have been measured experimentally by activation technique. The reaction product, (166)Ho in the ground state, is gaining considerable importance as a therapeutic radionuclide and precisely measured data of the reaction are of significance from the fundamental point of view as well as for application. In this work, the spectrographically pure holmium oxide (Ho(2)O(3)) powder samples were irradiated with and without cadmium covers at the IEA-RI reactor (IPEN, Sao Paulo), Brazil. The deviation of the neutron spectrum shape from 1/E law was measured by co-irradiating Co, Zn, Zr and Au activation detectors with thermal and epithermal neutrons followed by regression and iterative procedures. The magnitudes of the discrepancies that can occur in measurements made with the ideal 1/E law considerations in the epithermal range were studied. The measured thermal neutron cross section at the Maxwellian averaged thermal energy of 0.0253 eV is 59.0 +/- 2.1 b and for the resonance integral 657 +/- 36b. The results are measured with good precision and indicated a consistency trend to resolve the discrepant status of the literature data. The results are compared with the values in main libraries such as ENDF/B-VII, JEF-2.2 and JENDL-3.2, and with other measurements in the literature.

GLUON SATURATION AND THE TOTAL PROTON-AIR CROSS SECTION

In this work we propose a simple model for the total proton-air cross section, which is an improvement of the minijet model with the inclusion of a window in the p(T)-spectrum associated to the saturation physics. Our approach introduces a natural cutoff for the perturbative calculations which modifies the energy behavior of this component. The saturated component is calculated with a dipole model. The results are compared with experimental cross sections measured in cosmic ray experiments.