Motile sperm organelle morphology examination is stricter than Tygerberg criteria

The present study aimed to evaluate the correlation between the motile sperm organelle morphology examination (MSOME) and a well-known sperm morphology classification (Tygerberg criteria). For MSOME, spermatozoa were analysed at x8400 magnification by inverted microscope equipped with Nomarski differential interference contrast optics, Uplan Apo x 100 oil/1.35 objective lens and variable zoom lens. By Tygerberg criteria, the semen underwent morphological evaluation as described in the literature. Regression analysis demonstrated significant positive correlation between percentage of normal sperm forms by Tygerberg criteria and by MSOME (r = 0.83, P < 0.0001). However, the incidence of normal spermatozoa by Tygerberg criteria (9.4%) was significantly higher (P < 0.0001) than under MSOME (3.3%). Despite the highly positive correlation, MSOME is a much stricter criterion of sperm morphology classification, since it identifies vacuoles and chromatin abnormalities that are not evaluated with the same precision by the analysis of Tygerberg criteria. MSOME should be included among the routine criteria for semen analysis. In addition, MSOME should be used for selection of spermatozoa for intracytoplasmic sperm injection based on the already published literature, as this is a good selection tool.

Critical analysis of the international classification of headache disorders diagnostic criteria (ICHD I-1988) and (ICHD II-2004), for migraine in children and adolescents

The present study analyzed the (ICHD I-1988) and ( ICHD II-2004) diagnostic criteria in children and adolescents. Our population consisted of 496 patients of the Headache Outpatient Ward for Children and Adolescents retrospectively studied from 1992 to 2002. Individuals were classified according to three diagnostic groups: Intuitive Clinical Diagnosis ( Gold Standard), ICHD I-1988 and ICHD II-2004. They were statistically compared using the variables: Sensitivity ( S), Specificity (Sp), Positive Predictive Value (PPV), Negative Predictive Value (NPV). When ICHD I-1988 was used, the sensitivity of migraine without and with aura was 21% and 27%, respectively, whereas in ICHD II-2004 it changed to 53% and 71% without affecting specificity. As a conclusion, the current classification criteria ( ICHD II-2004) showed greater sensitivity and high specificity for migraine than ICHD I-1988, although it improved migraine diagnosis in children and adolescents, the sensitivity remains poor.

Metabolic syndrome in overweight children from the city of Botucatu - São Paulo State - Brazil: agreement among six diagnostic criteria

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Prospective Evaluation of Dietary Treatment in Childhood Constipation: High Dietary Fiber and Wheat Bran Intake Are Associated With Constipation Amelioration

Objectives: The aim of the study was to evaluate, over 24 months, the intake of dietary fiber (DF) and the bowel habit (BH) of constipated children advised a DF-rich diet containing wheat bran.Patients and Methods: BH and dietary data of 28 children with functional constipation defined by the Boston criteria were obtained at visit 1 (V1, n = 28) and at 4 follow-up visits (V2-V5, n = 80). At each visit the BH was rated BAD (worse/unaltered; improved but still complications) or RECOVERY (REC) (improved, no complications; asymptomatic), and a food intake questionnaire was applied. DF intake was calculated according to age (year)+5 to 10 g/day and bran intake according to international tables. Nonparametric statistics were used.Results: Median age (range) was 7.25 years (0.25-15.6 years); 21 children underwent bowel washout (most before V1/V2), and 14 had the last visit at V3/V4. DF intake, bran intake, and the BH rate significantly increased at V2 and remained higher than at V1 through V2 to V5. At V1, median DF intake was 29.9% below the minimum recommended and at the last visit 49.9% above it. Twenty-four children accepted bran at 60 visits, at which median bran intake was 20 g/day and median proportion of DF due to bran 26.9%. Children had significantly higher DF and higher bran intake at V2 to V5 at which they had REC than at those at which they presented BAD BH. DF intake > age+10 g/day was associated with bran acceptance and REC. At the last visit 21 children presented REC (75%); 20 of them were asymptomatic and 18 were off washout/laxatives.Conclusions: High DF and bran intake are feasible in constipated children and contribute to amelioration of constipation.

EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part I: Overall methodology and clinical characterisation

Objectives To report methodology and overall clinical, laboratory and radiographic characteristics for Henoch-Schonlein purpura (HSP), childhood polyarteritis nodosa (c-PAN), c-Wegener granulomatosis (c-WG) and c-Takayasu arteritis (c-TA) classification criteria.Methods The preliminary Vienna 2005 consensus conference, which proposed preliminary criteria for paediatric vasculitides, was followed by a EULAR/PRINTO/PRES-supported validation project divided into three main steps. Step 1: retrospective/prospective web-data collection for HSP, c-PAN, c-WG and c-TA, with age at diagnosis <= 18 years. Step 2: blinded classification by consensus panel of a subgroup of 280 cases (128 difficult cases, 152 randomly selected) enabling expert diagnostic verification. Step 3: Ankara 2008 Consensus Conference and statistical evaluation (sensitivity, specificity, area under the curve, kappa-agreement) using as 'gold standard' the final consensus classification or original treating physician diagnosis.Results A total of 1183/1398 (85%) samples collected were available for analysis: 827 HSP, 150 c-PAN, 60 c-WG, 87 c-TA and 59 c-other. Prevalence, signs/symptoms, laboratory, biopsy and imaging reports were consistent with the clinical picture of the four c-vasculitides. A representative subgroup of 280 patients was blinded to the treating physician diagnosis and classified by a consensus panel, with kappa-agreement of 0.96 for HSP (95% CI 0.84 to 1), 0.88 for c-WG (95% CI 0.76 to 0.99), 0.84 for c-TA (95% CI 0.73 to 0.96) and 0.73 for c-PAN (95% CI 0.62 to 0.84), with an overall. of 0.79 (95% CI 0.73 to 0.84).Conclusion EULAR/PRINTO/PRES propose validated classification criteria for HSP, c-PAN, c-WG and c-TA, with substantial/almost perfect agreement with the final consensus classification or original treating physician diagnosis.

Preliminary Criteria for Global Flares in Childhood-Onset Systemic Lupus Erythematosus

Objective. To develop widely acceptable preliminary criteria of global flare for childhood-onset systemic lupus erythematosus (cSLE).Methods. Pediatric rheumatologists (n = 138) rated a total of 358 unique patient profiles with information about the cSLE flare descriptors from 2 consecutive visits: patient global assessment of well-being, physician global assessment of disease activity (MD-global), health-related quality of life, anti-double-stranded DNA antibodies, disease activity index scores, protein: creatinine (P:C) ratio, complement levels, and erythrocyte sedimentation rate (ESR). Based on 2,996 rater responses about the course of cSLE (baseline versus followup), the accuracy (sensitivity, specificity, and area under the receiver operating characteristic curve) of candidate flare criteria was assessed. An international consensus conference was held to rank these candidate flare criteria as per the American College of Rheumatology recommendations for the development and validation of criteria sets.Results. The highest-ranked candidate criteria considered absolute changes (Delta) of the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) or British Isles Lupus Assessment Group (BILAG), MD-global, P:C ratio, and ESR; flare scores can be calculated (0.5 x Delta SLEDAI + 0.45 x Delta P:C ratio + 0.5 x Delta MD-global + 0.02 x Delta ESR), where values of >= 1.04 are reflective of a flare. Similarly, BILAG-based flare scores (0.4 x Delta BILAG + Delta 0.65 x Delta P:C ratio + 0.5 + Delta MD-global + 0.02 x Delta ESR) of >= 1.15 were diagnostic of a flare. Flare scores increased with flare severity.Conclusion. Consensus has been reached on preliminary criteria for global flares in cSLE. Further validation studies are needed to confirm the usefulness of the cSLE flare criteria in research and for clinical care.

Teaching the Rational Use of Medicines to medical students: a qualitative research

Background: Prescribing is a complex and challenging task that must be part of a logical deductive process based on accurate and objective information and not an automated action, without critical thinking or a response to commercial pressure. The objectives of this study were 1) develop and implement a discipline based on the WHO's Guide to Good Prescribing; 2) evaluate the course acceptance by students; 3) assess the impact that the Rational Use of Medicines (RUM) knowledge had on the students habits of prescribing medication in the University Hospital.Methods: In 2003, the RUM principal, based in the WHO's Guide to Good Prescribing, was included in the official curriculum of the Botucatu School of Medicine, Brazil, to be taught over a total of 24 hours to students in the 4th year. We analyzed the students' feedback forms about content and teaching methodology filled out immediately after the end of the discipline from 2003 to 2010. In 2010, the use of RUM by past students in their medical practice was assessed through a qualitative approach by a questionnaire with closed-ended rank scaling questions distributed at random and a single semistructured interview for content analysis.Results: The discipline teaches future prescribers to use a logical deductive process, based on accurate and objective information, to adopt strict criteria (efficacy, safety, convenience and cost) on selecting drugs and to write a complete prescription. At the end of it, most students considered the discipline very good due to the opportunity to reflect on different actions involved in the prescribing process and liked the teaching methodology. However, former students report that although they are aware of the RUM concepts they cannot regularly use this knowledge in their daily practice because they are not stimulated or even allowed to do so by neither older residents nor senior medical staff.Conclusions: This discipline is useful to teach RUM to medical students who become aware of the importance of this subject, but the assimilation of the RUM principles in the institution seems to be a long-term process which requires the involvement of a greater number of the academic members.

Effect of grape pre-drying and static pomace contact on physicochemical properties and sensory acceptance of Brazilian (Bordo and Isabel) red wines

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Multi-criteria spatial decision analysis for demarcation of greenway: A case study of the city of Rio Claro, São Paulo, Brazil

Concern regarding hydrological resources has been a theme of growing importance in Brazil, associating the development of new management policies and maintenance of natural areas related to rivers. An efficient way to maintain natural areas around rivers has been the development of greenways, and some cites have already adopted specific legislation in this respect. Following this growing evolution in the treatment of hydrological resources, this study was carried out to demarcate a greenway along the Corumbatai River in the state of São Paulo, Using multi-criteria analysis in a GIS environment. First, thematic maps were elaborated based on Landsat 7 satellite, aerial photographs and digital topographic base, Supported by field activities. With the use of multi-criteria analysis, for which ad hoe consultations were conducted to attribute weights to the thematic maps, a suitability map was elaborated for the allocation of the greenway. Sites that should be included in the greenway were also selected, such as areas appropriate for leisure activities, and ecologically important areas. Based on the suitability map, a pathway analysis was done, connecting the relevant points of interest, thus generating a greenway that runs along the Corumbatai River, with the aim of contributing to the conservation of this important hydrological resource. (c) 2007 Elsevier B.V. All rights reserved.

Identification of Landslide Scars in the Region of the Serra do Mar, São Paulo State, Brazil, Using Digital Image Processing and Spatial Analysis Tools

The objective of the present study, developed in a mountainous region in Brazil where many landslides occur, is to present a method for detecting landslide scars that couples image processing techniques with spatial analysis tools. An IKONOS image was initially segmented, and then classified through a Batthacharrya classifier, with an acceptance limit of 99%, resulting in 216 polygons identified with a spectral response similar to landslide scars. After making use of some spatial analysis tools that took into account a susceptibility map, a map of local drainage channels and highways, and the maximum expected size of scars in the study area, some features misinterpreted as scars were excluded. The 43 resulting features were then compared with visually interpreted landslide scars and field observations. The proposed method can be reproduced and enhanced by adding filtering criteria and was able to find new scars on the image, with a final error rate of 2.3%.

The Pediatric Rheumatology International Trials Organization American-College-of-Rheumatology provisional criteria for the evaluation of response to therapy in juvenile systemic lupus erythematosus: Prospective validation of the definition of improvement

Objective. To use the Pediatric Rheumatology International Trials Organization (PRINTO) core set of outcome measures to develop a validated definition of improvement for the evaluation of response to therapy in juvenile systemic lupus erythematosus (SLE).Methods. Thirty-seven experienced pediatric rheumatologists from 27 countries, each of whom had specific experience in the assessment of juvenile SLE patients, achieved consensus on 128 patient profiles as being clinically improved or not improved. Using the physicians' consensus ratings as the gold standard measure, the chi-square, sensitivity, specificity, false-positive and false-negative rates, area under the receiver operating characteristic curve, and kappa level of agreement for 597 candidate definitions of improvement were calculated. Only definitions with a kappa value greater than 0.7 were retained. The top definitions were selected based on the product of the content validity score multiplied by its kappa statistic.Results. The definition of improvement with the highest final score was at least 50% improvement from baseline in any 2 of the 5 core set measures, with no more than 1 of the remaining worsening by more than 30%.Conclusion. PRINTO proposes a valid and reproducible definition of improvement that reflects well the consensus rating of experienced clinicians and that incorporates clinically meaningful change in core set measures in a composite end point for the evaluation of global response to therapy in patients with juvenile SLE. The definition is now proposed for use in juvenile SLE clinical trials and may help physicians to decide whether a child with SLE responded adequately to therapy.

Criteria for peanut seed pre-conditioning for the tetrazolium test

The staining pattern of peanut (Arachis hypogaea L.) seeds with a tetrazolium solution was evaluated to determine the adequate conditions of seed quality evaluations. Three seed lots with different vigour levels and similar moisture content were pre-conditioned using the combination of five periods of time (4, 8, 12, 16 and 20 hours) and four temperatures (20, 25, 30 and 35 degrees C) and then exposed to a 1.0% tetrazolium solution for three hours. The moisture content levels of seeds conditioned for 8 hours at the temperatures of 25, 30 or 35 degrees C, for 12 hours at 20 or 25 degrees C and for 16 hours at 20 degrees C, were above 30%. In this range of moisture level, the staining in tetrazolium was clear and uniform, reflecting an appropriate conditioning of the seeds. However, under a practical point of view, the period of 16 hours at 20 degrees C showed to be the best option, since it allows to start the pre-conditioning an late afternoon of one day and submit the seeds for staining in the following morning.

Some particularities of dam rehabilitation projects

The number of dams, which need rehabilitation, is growing, not only in countries that have a long tradition in dam building and operation but,also in those regions where the infrastructure is still in full development. Though rehabilitation projects generally deal with problems that are common in dam engineering practice there are some peculiarities which are a characteristic of such projects and which must be duly taken into account to avoid unsuccess and/or unnecessary costs. Regular safety inspection is essential to forestall the development of structural, hydrological and operational unsafety. if need of major repair or overall rehabilitation of a dam becomes apparent design oft he rehabilitation project must be preceded by a comprehensive checkup of the structure and appurtenant works, as well as by an evaluation of its hydrological safety inclusive of all relevant environmental aspects. The availability of complete records on the clam's structural behaviour and on meteorological and hydrological data, as well as the knowledge of the materials properties of the existing structure are important for the successful design of a rehabilitation project. To this end the installation of monitoring devices in the existing structure may be necessary to generate representative data. While the criteria to be used in structural design should correspond to current standards, the definition of hydrological design criteria depends on considerations that vary widely from region to region or even from one country to another. Some basic hydrological safety requirements, however, are recommended for general acceptance. Dam rehabilitation projects demand very careful and detailed construction planning because of their dependence on river flow conditions, operational restrictions and, often, on procedures or limitations imposed to avoid harm to the environment. of utmost importance is the timely availability of the financial funds required to complete the project, in order to avoid delays which could result in structural or operational unsafety. Since every dam sooner or later will have to undergo major repair or updating of safety, rehabilitation may evolve to a speciality of dam engineering.