Project Pró-Natal: population-based study of perinatal and infant mortality in Natal, Northeast Brazil

RAMOS, Ana Maria de Oliveira et al. Project Pró-Natal: population-based study of perinatal and infant mortality in Natal, Northeast Brazil. Pediatric and Developmental Pathology, v.3, n.1, p.29-35, 2000

Surgical Site Infection in a University Hospital in Northeast Brazil

We examined prevention of surgical site infection (SSI) in a tertiary teaching hospital in northeast Brazil, from January 1994 to December 2003. The survey included 5,742 patients subjected to thoracic, urologic, vascular and general surgery. The criteria for diagnosing SSI were those of the Centers for Disease Control, USA, and the variables of the National Nosocomial Infection Surveillance risk index were used. Data analysis revealed that anesthetic risk scores, wound class and duration of surgery were significantly associated with SSI. A total of 296 SSIs were detected among the 5,742 patients (5.1%). The overall incidence of SSI was 8.8% in 1994; it decreased to 3.3% in 2003. In conclusion, the use of educational strategies, based on guidelines for SSI prevention reduced SSI incidence. Appropriate management of preoperative, intraoperative, and postoperative incision care, and a surveillance system based on international criteria, were useful in reducing SSI rates in our hospital

Impacts of the Madden-Julian oscillation on intraseasonal precipitation over northeast Brazil

Este estudo tem como objetivo investigar os impactos da oscilação de Madden-Julian (OMJ) na precipitação da região Nordeste do Brasil (NEB). Para tanto foram utilizados dados diários de precipitação baseados em 492 pluviômetros distribuídos na região e cobrindo um período de 30 anos (1981 − 2010). As análises através de composições de anomalias de precipitação, radiação de onda longa e fluxo de umidade, foram obtidas com base no índice da OMJ desenvolvido por Jones-Carvalho. Para distinguir o sinal da OMJ de outros padrões de variabilidade climática, todos os dados diários foram filtrados na escala de 20 − 90 dias; portanto somente dias classificados como eventos da OMJ foram considerados nas composições. Uma análise preliminar baseada apenas nos dados de precipitação foi feita para uma pequena área localizada no interior semiárido do NEB, conhecida como Seridó. Essa microrregião é uma das áreas mais secas do NEB e foi reconhecida pela Convenção das Nações Unidas para o Combate à Desertificação e Mitigação dos Efeitos das Secas como particularmente vulnerável à desertificação. Composições de anomalias de precipitação foram feitas para cada uma das oito fases da OMJ durante Fevereiro-Maio (principal período chuvoso da microrregião). Os resultados mostraram a existência de variações significativas nos padrões de precipitação (de precipitação excessiva à deficiente) associados à propagação da OMJ. A combinação dos sinais de precipitação obtidos durantes as fases úmidas e secas da OMJ mostrou que a diferença corresponde cerca de 50 − 150% de modulação das chuvas na microrregião. Em seguida, uma investigação abrangente sobre o papel da OMJ sobre toda a região Nordeste foi feita considerando-se as quatro estações do ano. Os resultados mostraram que os impactos da OMJ na precipitação intrassazonal do NEB apresentam forte sazonalidade. A maior coerência espacial dos sinais de precipitação ocorreram durante o verão austral, quando cerca de 80% das estações pluviométricas apresentaram anomalias positivas de precipitação durante as fases 1 − 2 da OMJ e anomalias negativas de precipitação nas fases 5 − 6 da oscilação. Embora impactos da OMJ na precipitação intrassazonal tenham sido encontrados na maioria das localidades e em todas as estações do ano, eles apresentaram variações na magnitude dos sinais e dependem da fase da oscilação. As anomalias de precipitação do NEB observadas são explicadas através da interação existente entre as ondas de Kelvin-Rossby acopladas convectivamente e as características climáticas predominantes sobre a região em cada estação do ano. O aumento de precipitação observado sobre a maior parte do NEB durante o verão e primavera austrais encontra-se associado com o fluxo de umidade de oeste (regime de oeste), o qual favorece a atividade convectiva em amplas áreas da América do Sul tropical. Por outro lado, as anomalias de precipitação durante o inverno e outono austrais apresentaram uma variabilidade espacial mais complexa. Durante estas estações, as anomalias de precipitação observadas nas estações localizadas na costa leste do NEB dependem da intensidade do anticiclone do Atlântico Sul, o qual é modulado em grande parte por ondas de Rossby. As características topográficas do NEB parecem desempenhar um papel importante na variabilidade observada na precipitação, principalmente nestas áreas costeiras. A intensificação do anticiclone aumenta a convergência dos ventos alísios na costa contribuindo para a ocorrência de precipitação observada à barlavento do planalto da Borborema. Por outro lado, o aumento da subsidência parece ser responsável pelos déficits de precipitação observados à sotavento. Tais condições mostraram-se típicas durante o predomínio do regime de leste sobre a região tropical da América do Sul e o NEB, durante o qual ocorre uma diminuição no fluxo de umidade proveniente da Amazônia.

Project Pró-Natal: population-based study of perinatal and infant mortality in Natal, Northeast Brazil

RAMOS, Ana Maria de Oliveira et al. Project Pró-Natal: population-based study of perinatal and infant mortality in Natal, Northeast Brazil. Pediatric and Developmental Pathology, v.3, n.1, p.29-35, 2000

Surgical Site Infection in a University Hospital in Northeast Brazil

We examined prevention of surgical site infection (SSI) in a tertiary teaching hospital in northeast Brazil, from January 1994 to December 2003. The survey included 5,742 patients subjected to thoracic, urologic, vascular and general surgery. The criteria for diagnosing SSI were those of the Centers for Disease Control, USA, and the variables of the National Nosocomial Infection Surveillance risk index were used. Data analysis revealed that anesthetic risk scores, wound class and duration of surgery were significantly associated with SSI. A total of 296 SSIs were detected among the 5,742 patients (5.1%). The overall incidence of SSI was 8.8% in 1994; it decreased to 3.3% in 2003. In conclusion, the use of educational strategies, based on guidelines for SSI prevention reduced SSI incidence. Appropriate management of preoperative, intraoperative, and postoperative incision care, and a surveillance system based on international criteria, were useful in reducing SSI rates in our hospital

Incidência de cárie dentária em adolescentes em município do Nordeste brasileiro, 2006

NORO, Luiz Roberto Augusto et al. Incidência de cárie dentária em adolescentes em município do Nordeste brasileiro, 2006, Cadernos de Saúde Pública, Rio de Janeiro, v. 25, n. 4, p. 783-790, abr. 2009.

A cultura de índio, seu menino, vem de longe aqui : formação histórica e territorialização dos Tremembé/CE

This dissertation is based on the ethnography of a strategic selection of three Tremembé ethnic situations, which are situated in the backlands of Acaraú and Itarema, municipalities located in Ceará State (Northeast Brazil). My main aims are the following. Firstly, I reconstitute the historical and social formation of three localities, called Lagoa dos Negros, Telhas, and Queimadas, related to a particular origin myth which refers to Almofala, an extinct colonial Aldeamento in the seashore, where the Tremembé indians and other native populations were converted and gathered under missionary administration. According to the origin myth, these three localities were set up after a strong drought which happened in 1888 (the so called three eights) when a group of Tremembé families moved to the countryside and established close to the Lagoa dos Negros and, later on, they were segmented into smaller groups which started to live in other areas and places not far from the former location. Notably, I develop an anthropological approach to understand the historical formation of these three localities. Secondly, I analyze some processes of territorialization, which were emerged from the 1980s and had important consequences to these indigenous families throughout the next two decades. This historical dimension is re-appropriated and ressignified in ethnic terms. A third point of my work is the analysis of the construction of territorialities and also the cultural and symbolic dimensions which are formulated by the Tremembé Indians who live in these localities. Therefore, I investigate some cultural traditions and rituals, such as the Torém dance, but I also examine their multiple semantics, which constitute a transversal direction throughout the history understood by the Tremembé of the different social situations I researched. To sum up, there is a process of cultural actualization, which is still going on and presents itself through the ludic sphere as well as their political and religions dimensions, which are usually associated to the ritual presentation of the Torém

O Litoral e a metrópole dinâmica imobiliária, turismo e expansão urbana na região metropolitana de Natal-RN

The metropolitan regions of Northeast Brazil are being gradually included in a scenario of international investments, which are motivated by the restructuring of both touristic and real-estate sectors. The new capital, real-estate developers and space configurations that result from this process indicate the need for the creation and implementation of public tools which should, at least, allow the mitigation of the urban impacts and environmental losses resulting from this situation. The effects on landscape and on the socio-spatial configuration result from the intensification caused by the dynamism of the "real estate-tourism" sector. There is a regional integration as an expression of the urban expansion of the metropolitan area of Natal. This study investigates the uniqueness of the restructuring and territorial integration of coastal areas and the strategies of the circuit of capital accumulation formed by linking the real estate to tourism. It is intended to increase the understanding about the strategies of tourism, real estate and public policy agents involved in this territorial reconfiguration and in the fund-raising needed for the investments, to understand the existing social and environmental effects and their future trends and also to understand the forms of spatial production as results from the practices of approaching the land transformation and the tourism valorization of the landscape, in a synchronous manner, first in the Northeast region and, as a focal study, in the Metropolitan Area of Natal. Likewise, it is intended to apprehend the current processes of metropolization of the eastern coast of Rio Grande do Norte, in addition to indicate its physical-territorial transformation and the types of projects/developments promoted by the market in the recent period. Based upon analysis undertaken for the Metropolitan Region of Natal RN, this piece of work presents some considerations on possible legal instruments that can be adjusted to the municipalities which are experiencing the impact of this peculiar and recent phenomenon in the region, caused by the arrival of the real estate-touristic capital. It is also intended to point out basic proposals to the forms of public intervention, in a speculative way, starting from a Metropolitan Planning project within a medium and long term

Arquitetura da (in)segurança: estudando relações entre configuração espacial, artifícios de segurança e violência urbana no bairro Manaíra, João Pessoa, Paraíba

João Pessoa, the capital city of the state of Paraíba (Northeast Brazil), is reputed throughout the country as a quiet place, although it has been acquiring, over the past years, an urban character with social implications similar to those of major metropolitan Brazilian areas. The new situation is evident by the social inequalities, with the creation of confined spaces, which segregate and cause enclosure of the inhabitants, leading to death the public space. This study correlates accessibility in spatial structure with two types of crime data, burglary and robbery, recorded in 2008 and 2009, by the Secretaria de Segurança da Paraíba (The government agency public in charge of safety), in the district of Manaíra, an upper middle class neighborhood, which has, in recent times, been considered one of the most violent areas in João Pessoa. Sought to understand connections between these events and morpho-social aspects of the built environment, where examined the spatial properties, such as accessibility of the urban net, the presence of control measures, the safety of buildings and their uses. Spatial properties were also validated by the observation of pedestrian flows at strategic points of the study area. It was concluded that the presence of intense flows helps to attract potential thieves, physical security and control offers little protection

Eutrofização do reservatório Engenheiro Armando Ribeiro Gonçalves, no Rio Grande do Norte: implicações para o abastecimento público e para a piscicultura intensiva em tanques-rede

This study aimed to describe the spatial and temporal patterns of variation in trophic state and its relation with the structure and dynamics of planktonic community of a large reservoir located in semi-arid tropical region of Northeast Brazil. The reservoir Armando Ribeiro Gonçalves is the biggest reservoir of the Rio Grande do Norte State and is responsible for about 53% of all surface water accumulated in the State. The samples of water and plankton were taken monthly in 10 points distributed throughout the longitudinal axis of the reservoir and over a full hydrological cycle. The samples were collected to determine concentrations of total phosphorus, total nitrogen, chlorophyll a and suspended solids (fixed and volatile) and for determining the composition and abundance of phytoplanktonic and zooplanktonic species. During the study period, the reservoir was characterized as eutrophic and there was no trend of increasing the trophic state of the reservoir in the period of drought. The concentrations of total phosphorus and suspended fixed solids decreased towards the dam while the N:P ratios increased in the same direction due to the reduction in the phosphorus concentrations and relative constancy in the nitrogen concentrations. The N:P ratios observed were indicative of greater limitation by phosphorus than by nitrogen. However, as concentrations of both nutrients were high and the water transparency was very low, with secchi depth usually lower than one meter, it seems likely that the planktonic primary production of the reservoir is more limited by the availability of light than the availability of nutrients. High nutrient concentrations coupled with low availability of light may explain the continuing dominance of filamentous cyanobacteria such as Cylindrospermopsis raciborskii in the plankton of the reservoir.These cyanobacteria are potentially toxic and pose a serious environmental problem because it compromises the water quality for public supply, recreation and fishing when present in high densities as in this study. The mesozooplankton of the reservoir was dominated by the calanoid Notodiaptomus cearensis and the cladoceran Diaphanosoma spinulosum. In general, the structure of zooplankton community seems to be particularly influenced by the spatial variation of cyanobacteria. The results of the regression analyses show that both the chlorophyll a concentrations and the cyanobacteria biovolume were more strongly correlated with the nitrogen than with phosphorus and that the water transparency was more strongly correlated with algal biomass than with other sources of turbidity. The maximum load of phosphorus to attain the maximum permissible concentration of total P in the reservoir was estimated in 63.2 tonnes P/ year. The current external P load to the reservoir is estimated in 324 tonnes P / year and must be severely reduced to improve the water quality for water supply and allow the implementation of aquaculture projects that could contribute to the socio-economic development of the region

Preferência alimentar e identificação das principais fontes de repasto sanguíneo de fêmeas Lutzomyia (Diptera: Psychodidae) em áreas endêmicas para leishmaniose visceral na grande Natal

Leishmaniasis are endemic diseases wild spread in the New and Old World, caused by the flagelated protozoan Leishmania. In the New World, the distribution of different forms of leishmaniasis is mostly in tropical regions. In the State of Rio Grande do Norte, Northeast Brazil, 85% of the captured sand flies fauna is Lutzomyia longipalpis. The distribution of the sand fly vector in the state overlaps with the disease distribution, where the presence of sand flies is associated with presence of animals shelters. The aim of this study was to analyse the blood meal preference of sand flies vector from the genus Lutzomyia spp. in laboratory conditions, to verify the vector life cicle at different temperatures sets and to identify the main blood meal source in endemic areas for visceral leishmaniasis (VL) at peri-urban regions of Natal. Sand flies samples were collected from the municipalities of São Gonçalo do Amarante and Nísia Floresta where female sand flies were grouped for the colony maintenance in the laboratory and for the analysis of the preferred source of sand fly blood meal in natural environment. The prevalence of blood meal preference and oviposition for the females sand flies was 97% for Cavia porcellus with oviposition of 19 eggs/female; 97% for Eqqus caballus with 19 eggs/female; 98% for human blood with 14 eggs/female; 71.3% for Didelphis albiventris with 8.4 eggs/female; 73% for Gallus gallus with 14 eggs/female; 86% for Canis familiaris with 10.3 eggs/female; 81.4% for Galea spixii with 26 eggs/female; 36% for Callithrix jachus with 15 eggs/female; 42.8% for Monodelphis domestica with 0% of oviposition. Female sand flies did not take a blood meal from Felis catus. Sand flies life cycle ranged from 32-40 days, with 21-50 oviposition rates approximately. This study also showed that at 32°C the life cycle had 31 days, at 28° C it had 50 days and at 22°C it increased to 79 days. Adjusting the temperature to 35°C the eggs did not hatch, thus blocking the life cycle. A total of 1540 sand flies were captured, among them, 1.310 were male and 230 were female. Whereas 86% of the sand flies captured were Lu. longipalpis as compared to 10.5% for Lu. evandroi and, 3.2% for L. lenti and 0.3% for Lu whitmani. The ratio between female and male sandfly was approximately 6 males to 1 female. In Nísia Floresta, 50.7% of the collected females took their blood meal from armadillo, 12.8% from human. Among the female sand flies captured in São Gonçalo do Amarante, 80 of them were tested for the Leishmania KDNA infectivity where 5% of them were infected with Leishmania chagasi. Female Lutzomyia spp. showed to have an opportunistic blood meal characteristic. The behavioral parameters seem to have a higher influence in the oviposition when compared to the level of total proteins detected in the host s bloodstream. A higher Lu. longipalpis life cycle viability was observed at 28°C. The increase of temperature dropped the life cycle time, which means that the life cycle is modified by temperature range, source of blood meal and humidity. Lu longipalpis was the most specie found in the inner and peridomiciliar environment. In Nísia Floresta, armadillos were the main source of blood meal for Lutzomyia spp. At São Gonçalo do Amarante, humans were the main source of blood meal due to CDC nets placed inside their houses

Mapeamento cromossômico de genes ribossomais em espécies estuarinas da família Gerreidae Identificação de uniformidade cariotípica e sua empregabilidade com fins biotecnológicos - REPROGEN

Perciformes are dominant in the marine environment, characterized as the largest and most diverse fish group. Some families, as Gerreidae, popularly known as silver jennies, carapebas, or mojarras have a high economic potential to marine fish farming, natural explotation and game fishing. Genetic information of these species are of fundamental importance for their management and production. Despite exist over 13,000 marine fish species described, only 2% were cytogenetically analyzed and less than 1% have some reproductive characteristics known. Induced breeding, cytogenetic characterization and cryopreservation of gametes, represent important areas in applied fish studies. In this project cytogenetic analyzes were performed to acess genetic aspects of Gerreidae species, distributed in coastal and estuarine regions of Northeast Brazil. Different methods for identifying chromosomal regions were employed using conventional techniques (Ag-NORs, C-banding), staining with base-specific fluorochromes (DAPI-CMA3), and physical mapping of ribosomal genes 18S and 5S rDNA, through hybridization in situ with fluorescent probes (FISH). The six species analyzed showed remarkable chromosome conservatism. The 18S and 5S ribosomal genes when analyzed in phylogenetic perspective demonstrate varied evolutionary dynamics, suggesting ocurrence of stasis process in some groups and greater dynamism in others. Double FISH with 18S and 5S probes showed both how efficient cytotaxonomic markers in the homogeneous karyotypes of this group of species. The karyotypic pattern identified in addition to the evolutionary aspects of karyotype, are suggestive of existence of low potential of post-zygotic barrier, prompting further research to prospect for artificial interspecific hybridization of these species of commercial importance

Atividade antimalárica de plantas medicinais da biorregião do Araripe-CE em modelo murino - Plasmodium berghei

Malaria, also popularly known as maleita , intermittent fever, paludism, impaludism, third fever or fourth fever, is an acute infectious febrile disease, which, in human beings, is caused by four species: Plasmodium falciparum, P. vivax, P. malariae and P. ovale. Malaria, one of the main infectious diseases in the world, is the most important parasitoses, with 250 million annual cases and more than 1 million deaths per year, mainly in children younger than live years of age. The prophylactic and therapeutic arsenal against malaria is quite restricted, since all the antimalarials currently in use have some limitation. Many plant species belonging to several families have been tested in vivo, using the murine experimental model Plasmodium berghei or in vitro against P. falciparum, and this search has been directed toward plants with antithermal, antimalarial or antiinflammatory properties used in popular Brazilian bolk medicine. Studies assessing the biological activity of medicinal plant essential oils have revealed activities of interest, such as insecticidal, spasmolytic and antiplasmodic action. It has also been scientifically established that around 60% of essential oils have antifungal properties and that 35% exhibit antibacterial properties. In our investigation, essential oils were obtained from the species Vanillosmopsis arborea, Lippia sidoides and Croton zethneri which are found in the bioregion of Araripe-Ceará. The chemical composition of these essential oils was partially characterized and the presence of monoterpenes and sesquiterpenes. The acute toxicity of these oils was assessed in healthy mice at different doses applied on a single day and on four consecutive days, and in vitro cytotoxicity in HeLa and Raw cell lines was determined at different concentrations. The in vivo tests obtained lethal dose values of 7,1 mg/Kg (doses administered on a single day) and 1,8 mg/Kg (doses administered over four days) for 50% of the animals. In the in vitro tests, the inhibitory concentration for 50% of cell growth in Hela cell lines was 588 μg/mL (essential oil from C. zethneri after 48 h), from 340-555 μg/mL (essential oil from L. sidoides, after 24 and 48 h). The essential oil from V. arborea showed no cytotoxicity and none of the essential oils were cytotoxic in Raw cell lines. These data suggest a moderate toxicity in the essential XVIII oils under study, a finding that does not impede their testing in in vivo antimalarial assays. Was shown the antimalarial activity of the essential oils in mice infected with P. berghei was assessed. The three species showed antimalarial activity from 36%-57% for the essential oil from the stem of V. arborea; from 32%-82% for the essential oil from the leaves of L. sidoides and from 40%-70% of reduction for the essential oil from the leaves of C. zethneri. This is the first study showing evidence of antimalarial activity with these species from northeast Brazil. Further studies to isolate the active ingredients of these oils are needed to determine if a single active ingredient accounts for the antimalarial activity or if a complex integration of all the compounds present occurs, a situation reflected in their biological activity

Associação entre as narrativas em saúde bucal e condições socioeconômico-culturais: a dentição como reflexo da desigualdade social

This anthropological study investigates the lived-experience of oral diseases in the context of poverty in Northeast Brazil. During six months in 2004???, ethnographic interviews, narratives and participant-observation with 31 residents of the low-income community, Dendê, located in Fortaleza, Ceará were conducted and analyzed utilizing a hermeneutic-dialetic method. It is revealed that precarious life conditions make prioritizing caretaking a difficult task. Despite suffering tooth pain, seeking a dentist's care is perceived as "a luxury" not a citzens' right. Difficulties in accessing services and poor quality restorations, favor tooth extractions as the most effective intervention. The deterioration of one's oral health is lamented by community members who seek help from popular clinics, politicians and traditional healers. The experience of dental disease differs according to social class, leaves oral scars of inequity, harms self-esteem and inhibits social inclusion. In this context, "treating" the Teeth of Inequity demands that we deepen our comprehension of the social determinants of health, reduce injustice in the access to quality care, remove demoralizing stigmas and empower the community to confront structural forces which affect its life

Determinação da idade dental de crianças brasileiras nordestinas: novos valores de conversão de maturidade dental para população específica

Since Demirjian's system of estimating dental maturity was first described, many researchers from different countries have tested its accuracy among diverse populations. Some of these studies have pointed out a need to determine population-specific standards. In Brazil, the Northeast region is the one that most suffers the negative impact of exodus, specially related to the increase of abandoned children in the cities. The aim of this study was to test the accuracy of Demirjian's system for assessing the dental maturity of northeastern Brazilian children, so as to present a scale for maturity score conversion into dental age developed specifically for this population. This could be used for forensic, anthropological and legal matters, and also as a model for other countries attempting to formulate their own conversion scales. Panoramic radiographs of 1,491 children (821 females and 670 males), aged 7 to 13 years, from Ceará state, northeast Brazil, were assessed by a single observer to determine dental age (DA) according to Demirjian's system. The mean percentage of intra-observer agreement was 86.6%, with a mean Cohen's Kappa coefficient of 0.67 (substantial agreement). The DA was compared by paired t-test to subjects' chronological age (CA). The differences between CA and DA in all age groups were statistically significant (p<0.0001), demonstrating a great advancement in DA among Brazilians. Scatter plots were drawn for both genders, and the data were fitted to a growth curve, y = 100/ (1 + e-a(x b)). Graphs corresponding to the 50th percentile curves were produced. A table with new values for the conversion of maturity score into dental age for northeastern Brazilian children is presented. The great advancement in DA, as obtained by Demirjian's system in this population, justified the determination of specific scores for dental maturity assessment