Inequalities in access and utilization of dental services: a cross-sectional study in an area covered by the Family Health Strategy

This cross-sectional study aimed to investigate the presence of inequalities in the access and use of dental services for people living in the coverage area of the Family Health Strategy (FHS) in Ponta Grossa, Paraná State, Brazil, and to assess individual determinants related to them. The sample consisted of 747 individuals who answered a pre-tested questionnaire. Data analysis was performed by chi-square test and Poisson regression analysis, obtaining explanatory models for recent use and, by limiting the analysis to those who sought dental care, for effective access. Results showed that 41% of the sample had recent dental visits. The lowest visit rates were observed among preschoolers and elderly people. The subjects who most identified the FHS as a regular source of dental care were children. Besides age, better socioeconomic conditions and the presence of a regular source of dental care were positively associated to recent dental visits. We identified inequalities in use and access to dental care, reinforcing the need to promote incentives to improve access for underserved populations.

Domestic use of a disclosing solution for denture hygiene: a randomised trial

Objectives: The purpose of this study was to investigate the effect of the domestic use of a disclosing agent for denture hygiene. Materials and methods: Completely edentulous participants wearing maxillary dentures were randomly assigned to one of the three intervention groups: (1) Follow-up only (control; n = 12); (2) Oral and denture hygiene instructions (n = 10); (3) Instructions associated with the home use of a disclosing agent (1% neutral red; n = 10). Biofilm coverage area (%) over internal and external surfaces of the maxillary denture was assessed at baseline and after 14 and 90 days. Data were evaluated by generalised estimating equations based on score tests (alpha = 0.05). Results: The participants presented low changes for areas of biofilm coverage (14 days (%): internal: GI = 1.4 +/- 0.9; GII = 1.5 +/- 1.3; GIII = -0.4 +/- 0.9; external: GI = 1.4 +/- 1.5; GII = 1.5 +/- 1.4; GIII = -0.4 +/- 0.9; 90 days (%): internal: GI = 2.0 +/- 0.9; GII = 2.2 +/- 1.4; GIII = 0.3 +/- 1.0; external: GI = 2.1 +/- 1.4; GII = 2.2 +/- 1.5; GIII = 0.3 +/- 0.9). Changes were similar for the three groups (p = 0.293) and were not influenced by the test time (p = 0.218). Conclusion: It can be concluded that the home use of a disclosing agent for denture hygiene does not improve the removal of the biofilm, particularly for patients with adequate oral hygiene habits.

Skin Coverage of the Middle-Distal Segment of the Leg With a Pedicled Perforator Flap

Objective: This is a clinical study of our experience using pedicle perforator flaps to cover skin defects in the middle and distal segment of the leg. Design: Prospective study. Setting: University hospital. Patients/Intervention: Twenty-four patients underwent treatment of a skin defect in the middle or distal segment of the leg by means of pedicled flaps based on perforating arteries. The perforating arteries were located before the operation by means of echo-Doppler examination. The flaps were planned in propeller fashion (21 cases) and as advancement (three cases). Main Outcome Measurements: The results were evaluated according the origin of perforator flap, size of the flap, and donor area and viability of the flap. The success rate of the echo-Doppler to identify the location of perforator vessel was also evaluated. Results: In nine cases, the perforating vessels originated from the fibular artery, in 10 the posterior tibial artery, and in five the anterior tibial artery. The mean size of the flaps was 5 cm in width by 12 cm in length. The success rate using an echo-Doppler was 87%. The flaps were fully viable in 20 cases and partially viable in four cases. Conclusion: On the basis of these results, it is concluded that perforating flaps are a good choice of treatment for skin losses, especially in the distal segment of the leg, and could be an alternative option for the use of free microsurgical flaps.

Comparison between two surgical techniques for root coverage with an acellular dermal matrix graft

Aim: The aim of this randomized, controlled, clinical study was to compare two surgical techniques with the acellular dermal matrix graft (ADMG) to evaluate which technique could provide better root coverage. Material and Methods: Fifteen patients with bilateral Miller Class I gingival recession areas were selected. In each patient, one recession area was randomly assigned to the control group, while the contra-lateral recession area was assigned to the test group. The ADMG was used in both groups. The control group was treated with a broader flap and vertical-releasing incisions, and the test group was treated with the proposed surgical technique, without releasing incisions. The clinical parameters evaluated before the surgeries and after 12 months were: gingival recession height, probing depth, relative clinical attachment level and the width and thickness of keratinized tissue. Results: There were no statistically significant differences between the groups for all parameters at baseline. After 12 months, there was a statistically significant reduction in recession height in both groups, and there was no statistically significant difference between the techniques with regard to root coverage. Conclusions: Both surgical techniques provided significant reduction in gingival recession height after 12 months, and similar results in relation to root coverage.

Weekend/weekday differences in concentrations of ozone, nox, and non-methane hydrocarbon in the metropolitan area of São Paulo

Ozone and inhalable particulate matter are the major air pollutants in the Metropolitan Area of São Paulo, Brazil, a region that has more than 19 million inhabitants and approximately 7 million registered vehicles. Proximity of roadways, adjacent land use, and local circulation are just some of the factors that can affect the results of monitoring of pollutant concentrations. The so-called weekend effect (higher ozone concentrations on weekends than on weekdays) might be related to the fact that concentrations of ozone precursors, such as nitrogen oxides (NOx) and Non Methane-Hydrocarbon (NMHC), are relatively lower on weekends. This phenomenon has been reported in some areas of the United States since the 1970s. The differences between the concentrations of ozone in period of weekend and weekday, were obtained from analysis of data hourly average of CETESB for 2004, studied the precursors to the formation of troposphere ozone, the meteorological variables and traffic profile for RMSP. Because of the proximity to sources of emissions from the station Pinheiros showed higher concentrations of NO and NO² and greater variations to the periods weekend and weekday. With fewer vehicles circulating during the weekend, and consequently less emission of pollutants, it has cleaner air and less concentration of NO and NO², there is the ideal setting to the formation of troposphere ozone, despite the lower concentration of NO². The proximity with the source emissions, aided by the increased availability of solar radiation and the presence of ozone precursors, were factors conditions for the occurrence of weekend effect.

Fitossociologia de um Cerrado denso em área de influência de torre de fluxo de carbono, Pé-de-Gigante, Parque Estadual de Vassununga, SP

O domínio do Cerrado compreende uma área contínua nos estados centrais do Brasil e áreas disjuntas em outros estados, incluindo São Paulo. Essa vegetação ocupava originalmente 21% do território brasileiro, restando atualmente apenas 21,6% de sua extensão original. A área recoberta por essa vegetação em São Paulo cobria 14% de sua área total e seus remanescentes recobrem menos de 1% da ocorrência original dessa vegetação. Estudos recentes indicam que o valor da produtividade líquida no Cerrado Pé-de-Gigante (SP) constitui um pequeno dreno de carbono e indicou que a sazonalidade foi o fator determinante do valor observado. Os estudos dos fluxos de carbono em ecossistemas terrestres são raramente acompanhados de abordagens ecofisiológicas de modo a explorar a relação funcional das espécies que compõem o ecossistema e os valores líquidos obtidos para o mesmo. Assim, o objetivo deste trabalho foi caracterizar estruturalmente a vegetação presente na área de maior influência da torre de fluxo instalada no Cerrado Pé-de-Gigante, visando possibilitar estudos relacionados à quantificação em longo prazo da dinâmica dos fluxos de água, energia e CO2 na vegetação de Cerrado. Para isso foram levantadas 20 parcelas (10 x 10 m) em 0,2 ha de Cerrado, e amostraram-se todas as plantas com perímetro ao nível do solo >6 cm (exceto lianas e árvores mortas). A distribuição das classes de diâmetro e estrutura vertical, assim como os parâmetros fitossociológicos foram analisados. Encontramos 1451 indivíduos, distribuídos em 85 espécies, 52 gêneros e 31 famílias. A densidade absoluta e área basal foram de 7255 ind. ha-1 e de 7,9 m².ha-1, respectivamente. A família Leguminosae apresentou o maior número de espécies (13). O Índice de diversidade de Shannon (H') foi 3,27 nats.ind-1. A distribuição em classes de diâmetro mostrou uma curva de "J" invertido, estando a maioria dos indivíduos na primeira classe. Concluímos que a área deve ser classificada como Cerrado denso, devido principalmente à dominância pela espécie arbórea Anadenanthera falcata, cuja ocorrência no estado foi relatada apenas em locais com solos ricos em saturação de bases na região das Cuestas Basálticas, devido também à maior área basal dos indivíduos, comparando com outros fragmentos de Cerrado. Além da espécie citada, Myrcia lingua e Xylopia aromatica, apresentaram os maiores IVI (Valor de importância).

Allometric models for estimating the phytomass of a secondary Atlantic Forest area of southeastern Brazil

The purpose of this study was to develop and validate equations to estimate the aboveground phytomass of a 30 years old plot of Atlantic Forest. In two plots of 100 m², a total of 82 trees were cut down at ground level. For each tree, height and diameter were measured. Leaves and woody material were separated in order to determine their fresh weights in field conditions. Samples of each fraction were oven dried at 80 °C to constant weight to determine their dry weight. Tree data were divided into two random samples. One sample was used for the development of the regression equations, and the other for validation. The models were developed using single linear regression analysis, where the dependent variable was the dry mass, and the independent variables were height (h), diameter (d) and d²h. The validation was carried out using Pearson correlation coefficient, paired t-Student test and standard error of estimation. The best equations to estimate aboveground phytomass were: lnDW = -3.068+2.522lnd (r² = 0.91; s y/x = 0.67) and lnDW = -3.676+0.951ln d²h (r² = 0.94; s y/x = 0.56).

Modelos preditores da fitomassa aérea da Floresta Baixa de Restinga

Este estudo teve como objetivo desenvolver modelos preditores de fitomassa epigéa da vegetação arbórea da Floresta Baixa de Restinga. Foram selecionadas 102 árvores de 29 espécies ocorrentes na área de estudo e 102 indivíduos de jerivá (Syagrus romanzoffiana (Cham.) Glassman), distribuídos proporcionalmente entre as classes de diâmetro da vegetação arbórea. As árvores foram cortadas, ao nível do solo e foram medidos a altura total e o diâmetro à altura do peito (DAP) de cada árvore. As folhas foram separadas do lenho e a massa fresca da porção lenhosa e foliar medidas separadamente. Amostras de cada fração foram secas a 70 °C, até peso constante, para determinação da massa seca das árvores. Os modelos foram desenvolvidos através de análise de regressão linear, sendo a variável dependente a massa seca (MS) das árvores e as variáveis independentes a altura (h), o diâmetro a altura do peito (d) e as relações d² h e d² h multiplicada pela densidade da madeira (ρ d² h). Os modelos desenvolvidos indicam que o diâmetro explica grande parte da variabilidade da fitomassa das árvores da restinga e a altura é a variável explanatória da equação específica para o jerivá. Os modelos selecionados foram: ln MS (kg) = -1,352 + 2,009 ln d (R² = 0,96; s yx = 0,34) para a comunidade vegetal sem jerivá, ln MS (kg) = -2,052 + 0,801 ln d² h (R² = 0,94; s yx = 0,38) para a comunidade incluindo o jerivá, e ln MS (kg) = -0,884 + 2,40 ln h (R² = 0,92; s yx = 0,49) para o jerivá.

A cave population of Isbrueckerichthys alipionis (Gosline, 1947) in the Upper Ribeira karst area, southeastern Brazil (Siluriformes: Loricariidae)

A cave population of the armored catfish Isbrueckerichthys alipionis is reported from the Santana Cave, in the rio Betari watershed, Upper Ribeira karst area, Iporanga, São Paulo State, southeastern Brazil. The cave population was compared to an epigean population of I. alipionis and no significant differences where found in morphology or degree of pigmentation. As the cave population is known for at least 30 years and is apparently isolated from epigean streams, it is classified as troglophilic. The discovery of this troglophilic species in the Santana Cave is an additional strong argument for the conservation of that cave.

Ituglanis mambai, a new subterranean catfish from a karst area of Central Brazil, rio Tocantins basin (Siluriformes: Trichomycteridae)

Ituglanis mambai, new species, is described from a cave in the Mambaí karst area, State of Goiás, Central Brazil. The new species distinguishes from epigean and cave congeners by the combination of the following characteristics: posterior supraoccipital fontanel absent; pectoral-fin rays usually i,7; six pleural ribs; total vertebrae 37-38 behind Weberian apparatus; shorter predorsal length (65.1-70.8% SL); shorter caudal peduncle length (8.4-11.9% SL); shorter dorsal-fin base length (7.7-11.3% SL); wider interobital width (29.2-36.5% HL); larger mouth width (43.4-64.0% HL); intermediate between epigean and other cave Ituglanis species as regards to both eyes (diameter varying from 0.5 to1.0 mm in adults, 7.8-10.1 % HL) and pigmentation, composed by irregular light brown spots along the body. The latter indicate the troglobitic status for I. mambai. In addition, this species has the maxillae with a discrete medial-posterior projection; fronto-lacrimal one half-length of the maxillae and pointed backwards; posterior process of palatine half its length, with a tenuous medial concavity; 14 dorsal and 12 ventral procurrent rays. In the natural habitat, I. mambai displayed cryptobiotic habits, trying to hide in the graveled bottom or under boulders when disturbed, apparently showing a negative response to light. It was observed a preference to slow-moving waters. Recent flood marks were observed in the stream conduit in March/April 2007 (end of the rainy season) when less individuals were observed on 300 m of the subterranean stream compared to September 2004 (end of the dry season).

Epigean and subterranean ichthyofauna in Cordisburgo karst area, eastern Brazil

After an ichthyofaunistic survey conducted in May 2007 on surface (epigean) water bodies of Cordisburgo karst area, State of Minas Gerais, 13 species were recorded, mostly characiforms; in addition three non-troglomorphic (normally eyed and pigmented) and one troglomorphic catfish (siluriforms) species were recorded in two caves surveyed at different occasions, totaling 17 fish species for the area. All the nominal species herein reported for Cordisburgo area have been previously reported for the Rio das Velhas basin. None of the species observed in caves were found in epigean habitats and vice-versa. The four cave species are distributed throughout subterranean stream reaches, with individuals at different size/age classes. This, associated to the lack of conspicuous morphological differences in relation to epigean congeners, indicate that Trichomycterus brasiliensis, Gymnotus cf. carapo and Pimelodella cf. vittata are troglophiles (species encompassing individuals able to live and complete their life cycle either in the surface or in the subterranean environment) in the Morena Cave; the latter forms a large population and may be at the beginning of a differentiation process due to isolation in the subterranean habitat, as indicated by a slight reduction in eye size. Topographic isolation may be the cause for the incipient, but unmistakable troglomorphism of the Rhamdiopsis population found in the Salitre Cave, allowing for its classification as troglobite (exclusively subterranean species). The Cordisburgo area is subject to significant anthropic pressure, mainly represented by deforestation for agriculture, cattle raising and timbering. Tourism is an additional important threat for cave communities, calling for urgent protection measures.

Natural history and population data of fishes in caves of the Serra do Ramalho karst area, Middle São Francisco basin, northeastern Brazil

During the exploration and mapping of new caves in Serra do Ramalho karst area, southern Bahia state, cavers from the Grupo Bambuí de Pesquisas Espeleológicas - GBPE (Belo Horizonte) noticed the presence of troglomorphic catfishes (species with reduced eyes and/or melanic pigmentation), which we intensively investigated with regards to their ecology and behavior since 2005. Non-troglomorphic fishes regularly found in the studied caves were included in this investigation. We present here data on the natural history of two troglobitic (exclusively subterranean troglomorphic species) fishes - Rhamdia enfurnada Bichuette & Trajano, 2005 (Heptapteridae; Gruna do Enfurnado) and Trichomycterus undescribed species (Trichomycteridae; Lapa dos Peixes and Gruna da Água Clara), and non-troglomorphic Hoplias cf. malabaricus, probably a troglophile (able to form populations both in epigean and subterranean habitats) in the Gruna do Enfurnado, and Pimelodella sp., a species with a sink population in the Lapa dos Peixes.

Surface and subterranean ichthyofauna in the Serra do Ramalho karst area, northeastern Brazil, with updated lists of Brazilian troglobitic and troglophilic fishes

After an ichthyofaunistic survey in several epigean (surface) water bodies of the Serra do Ramalho, southern Bahia, conducted in May 2007, 44 species were recorded; in addition, three non-troglomorphic (normally eyed and pigmented) and two troglomorphic species were recorded only in caves, totaling 49 species of fishes for the area, which represents a little more than one fourth of the total registered in the literature for the entire Rio São Francisco basin. In these caves, which have been studied since 2005, eight non-troglomorphic species were sampled and their presence in both epigean and subterranean habitats, associated to the lack of morphological differences, indicate that they may be either troglophiles (species encompassing individuals able to live and complete their life cycle either in the surface or in the subterranean environment), trogloxenes (individuals regularly found in subterranean habitats, but which must return periodically to the surface in order to complete their life cycle) or even accidental in caves. In addition, two troglomorphic species (with reduced eyes and melanic pigmentation when compared to close epigean relatives), belonging respectively to the genera Rhamdia and Trichomycterus, were recorded exclusively in caves, thus classified as troglobites. Interestingly, no epigean representative of the genus Trichomycterus was collected. The new data are integrated into updated lists of Brazilian troglobitic and troglophilic fishes, based on published data and new records recently confirmed.

Benthic macrofauna structure in the northeast area of Todos os Santos Bay, Bahia State, Brazil: patterns of spatial and seasonal distribution

Structure of intertidal and subtidal benthic macrofauna in the northeastern region of Todos os Santos Bay (TSB), northeast Brazil, was investigated during a period of two years. Relationships with environmental parameters were studied through uni-and multivariate statistical analyses, and the main distributional patterns shown to be especially related to sediment type and content of organic fractions (Carbon, Nitrogen, Phosphorus), on both temporal and spatial scales. Polychaete annelids accounted for more than 70% of the total fauna and showed low densities, species richness and diversity, except for the area situated on the reef banks. These banks constitute a peculiar environment in relation to the rest of the region by having coarse sediments poor in organic matter and rich in biodetritic carbonates besides an abundant and diverse fauna. The intertidal region and the shallower area nearer to the oil refinery RLAM, with sediments composed mainly of fine sand, seem to constitute an unstable system with few highly dominant species, such as Armandia polyophthalma and Laeonereis acuta. In the other regions of TSB, where muddy bottoms predominated, densities and diversity were low, especially in the stations near the refinery. Here the lowest values of the biological indicators occurred together with the highest organic compound content. In addition, the nearest sites (stations 4 and 7) were sometimes azoic. The adjacent Caboto, considered as a control area at first, presented low density but intermediate values of species diversity, which indicates a less disturbed environment in relation to the pelitic infralittoral in front of the refinery. The results of the ordination analyses evidenced five homogeneous groups of stations (intertidal; reef banks; pelitic infralittoral; mixed sediments; Caboto) with different specific patterns, a fact which seems to be mainly related to granulometry and chemical sediment characteristics.

Ichthyofauna in an estuary of the Mataripe area, Todos os Santos Bay, Bahia, Brazil

The community structure and dynamics as well as some biological parameters of selected species of the ichthyofauna of the Mataripe estuarine region affected by the Landulfo Alves Oil Refinery (RLAM) were analyzed. Twenty stations were sampled with a gillnet in five different periods: August and December 2003, March and July/August 2004 and January 2005. Thirty-five actinopterygian species and one elasmobranch species were recorded, Oligoplites saurus, Diapterus rhombeus, Lutjanus synagris and Scomberomorus brasiliensis among them, on all the campaigns. A total of 1368 specimens, weighing 36.10 kg, were caught. The ichthyofauna total biomass was greater, in weight, on the eastern side of the study region, especially at the stations close to the shoals/reefs and the rocky bottom. A similar pattern was also observed for the diversity values. In general, low evenness and diversity were observed in the area studied, possibly as a result of the fishing gear used. D. rhombeus juveniles dominated in all but one of the samplings (July 2004), in which latter Cyclichthys spinosus was dominant. Carangids and species associated with consolidated bottoms were observed, although in small numbers, throughout the study period. In spite of the limitations imposed by the gear used for sampling, the estuarine area influenced by the RLAM was seen to play a role as a growth area for the great majority of species, especially the mojarra (D. rhombeus), but it offers no fishing potential due to the prevalence of young and small individuals. Evidence of imminent spawning was recorded for Pomadasys corvinaeformis in August 2003, and recent spawning in March 2004 for Oligoplites saurus. Further, mature individuals occurred in insufficient numbers to permit population level evaluation.