Pelvic floor muscle strength evaluation in different body positions in nulliparous healthy women and its correlation with sexual activity

Objective: The aim of this study was to assess pelvic floor muscle (PFM) strength in different body positions in nulliparous healthy women and its correlation with sexual activity.Materials and Methods: Fifty healthy nulliparous women with mean age of 23 years were prospectively studied. Subjective evaluation of PFM was assessed by transvaginal digital palpation (TDP) of anterior and posterior areas regarding the vaginal introitus. A perineometer with inflatable vaginal probe was used to assess the PFM strength in four different positions: supine with extended lower limbs (P1); bent-knee supine (P2); sitting (P3); standing (P4).Results: Physical activity, 3 times per week, was reported by 58% of volunteers. Sexual activity was observed in 80% of women and 82% of them presented orgasm. The average body mass index (BMI) was 21.76 kg/m(2), considered as normal according World Health Organization (WHO). We observed that 68% of volunteers were conscious about the PFM contraction. TDP showed concordance of 76% when anterior and posterior areas were compared (p = 0.00014). There was not correlation between PFM strength and orgasm in subjective evaluation. The PFM strength was significantly higher in standing position when compared with the other positions (p < 0.000). No statistical difference was observed between orgasm and PFM strength when objective evaluations were performed.Conclusions: There was concordance between anterior and posterior areas in 76% of cases when subjective PFM strength was assessed. In objective evaluation, higher PFM strength was observed when volunteers were standing. No statistical correlation was observed between PFM strength and orgasm in nulliparous healthy women.

Atos discursivos interativos nas variedades do português falado

This paper aims to analyze and to characterize the structure of some linguistic expressions that, in the view of Functional Discourse Grammar (HENGEVELD; MACKENZIE, 2008), are called Interactive Acts because they show the Speaker, the Addressee and the Illocution positions filled in. To do so, we analyse data composed of representative texts of Portuguese spoken in Portugal, in Brazil, in African countries (those that have Portuguese as official language) and in East Timor

E.F. Perus Pirapora: personagens, posicionamentos e conflitos no processo de tombamento estadual (São Paulo/SP)

The process of recognition by the State of E. F. Perus Pirapora records the progress along many different interests and opinions, differences and conflicts unresolved even after the definition of recognition. Different opinions identified and their possible relationships with the subsequent abandonment of the property justify research efforts. Result of discussions over the development of a scientific research about industrial heritage, this article identifies people interested in this subject and conflicts presented in recognition 21.273/80. We understand this identification as possible subsidy for reflections about values, uses and management of the property recognized. Among the methods highlight the documentary research and interviews with the people involved in the recognition of the property. The process 21.273/80 was the focus of our investigation and it has been taken as official record of interests and positions of the people involved. The research concludes that conflicts between requestor and owner limited the effectiveness of the tool of recognition, resulting in abandonment and degradation of the heritage recognized. We also identify the positive presence of the government in this case represented by the Department of Culture of the State of São Paulo and CONDEPHAAT, on the management of the conflicts and the actions to safeguard the E.F. Perus Pirapora.

Fixation of mandibular fractures with 2.0-mm miniplates: review of 191 cases

Our goal was to study the use of 2.0-mm miniplates for the fixation of mandibular fractures. Records of 191 patients who experienced a total of 280 mandibular fractures that were treated with 2.0-mm miniplates were reviewed. One hundred twelve of those patients, presenting 160 fractures, who attended a late follow-up were also clinically evaluated. Miniplates were used in the same positions described by AO/ASIF. No intermaxillary fixation was used. All patients included had a minimum follow-up of 6 months. Demographic data, procedures, postoperative results, and complications were analyzed. Mandibular fractures occurred mainly in males (mean age, 30.3 years). Mean follow-up was 21.92 months. The main etiology was motor vehicle accident. The most common fracture was the angle fracture (28.21%). Twenty-two fractures developed infection, for an overall incidence of 7.85%. When only angle fractures are considered, that incidence is increased to 18.98%. Although only 1 patient (0.89%) described inferior alveolar nerve paresthesia, objective testing revealed sensitivity alterations in 31.52% of the patients who had fractures in regions related to the inferior alveolar nerve. Temporary mild deficit of the marginal mandibular branch was observed in 2.56% of the extraoral approaches performed and 2.48% presented with hypertrophic scars. Incidence of occlusal alterations was 4.0%. Facial asymmetry was observed in 2.67% of the patients, whereas malunion incidence was 1.78%. Fibrous union, mostly partial, occurred in 2.38% of the fractures, but only 1 of those presented with mobility (0.59%). Condylar resorption developed in 6.25% of the fixated condylar fractures. Mean mouth opening was 42.08 mm. The overall incidence of complications, including infections, was similar to those described for more rigid methods of fixation.

Evaluation of the cervical vertebrae maturation index in lateral cephalograms taken in different head positions

The aim of this study was to evaluate if upward or downward head inclination might interfere with determination of the growth stage, using cervical vertebrae maturation index (CVMI), in order to verify the accuracy of such diagnosis when radiographs are taken with errors. Forty-nine patients, 26 females and 23 males, aged 9 to 15 years, were submitted to 3 lateral cephalograms: normal (NHP), with 15° upward head inclination (NHP-Up), and with 15° downward head inclination (NHP-Down). Three examiners evaluated the CVMI on the 147 cephalograms. The agreement among examiners was higher in the evaluation of cephalograms taken in NHP. The weighted Kappa test revealed moderate to substantial agreement between NHP and NHP-Up and between NHP and NHP-Down. There was greater agreement between NHP-Up and NHP-Down. It may be concluded that the evaluation of the CVMI on cephalograms in NHP is different as compared with radiographs taken with inclinations. Both NHP-Up and NHP-Down exhibited greater disagreement in the interpretation among examiners, since the evaluation method was not designed for cephalograms with positioning errors.

Segurança do paciente: análise das notificações de eventos em um hospital privado

Pós-graduação em Enfermagem (mestrado profissional) - FMB