Devices and Techniques for Blood Pressure Measurement and Criteria for Hypertension Adopted by Brazilian Physicians: Exploratory Study

OBJECTIVE: To determine technical procedures and criteria used by Brazilian physicians for measuring blood pressure and diagnosing hypertension. METHODS: A questionnaire with 5 questions about practices and behaviors regarding blood pressure measurement and the diagnosis of hypertension was sent to 25,606 physicians in all Brazilian regions through a mailing list. The responses were compared with the recommendations of a specific consensus and descriptive analysis. RESULTS: Of the 3,621 (14.1%) responses obtained, 57% were from the southeastern region of Brazil. The following items were reported: use of an aneroid device by 67.8%; use of a mercury column device by 14.6%; 11.9% of the participants never calibrated the devices; 35.7% calibrated the devices at intervals < 1 year; 85.8% measured blood pressure in 100% of the medical visits; 86.9% measured blood pressure more than once and on more than one occasion. For hypertension diagnosis, 55.7% considered the patient's age, and only 1/3 relied on consensus statements. CONCLUSION: Despite the adequate frequency of both practices, it was far from that expected, and some contradictions between the diagnostic criterion for hypertension and the number of blood pressure measurements were found. The results suggest that, to include the great majority of the medical professionals, disclosure of consensus statements and techniques for blood pressure measurement should go beyond the boundaries of medical events and specialized journals.

Assessment of the DIXTAL DX-2710 Automated Oscillometric Device for Blood Pressure Measurement with the Validation Protocols of the British Hypertension Society (BHS) and the Association for the Advancement of Medical Instrumentation (AAMI)

OBJECTIVE: To assess the Dixtal DX2710 automated oscillometric device used for blood pressure measurement according to the protocols of the BHS and the AAMI. METHODS: Three blood pressure measurements were taken in 94 patients (53 females 15 to 80 years). The measurements were taken randomly by 2 observers trained to measure blood pressure with a mercury column device connected with an automated device. The device was classified according to the protocols of the BHS and AAMI. RESULT: The mean of blood pressure levels obtained by the observers was 148±38/93±25 mmHg and that obtained with the device was 148±37/89±26 mmHg. Considering the differences between the measurements obtained by the observer and those obtained with the automated device according to the criteria of the BHS, the following classification was adopted: "A" for systolic pressure (69% of the differences < 5; 90% < 10; and 97% < 15 mmHg); and "B" for diastolic pressure (63% of the differences < 5; 83% < 10; and 93% < 15 mmHg). The mean and standard deviation of the differences were 0±6.27 mmHg for systolic pressure and 3.82±6.21 mmHg for diastolic pressure. CONCLUSION: The Dixtal DX2710 device was approved according to the international recommendations.

Assessment of the techniques of blood pressure measurement by health professionals

OBJECTIVE: To assess blood pressure measurement by health professionals of a public hospital in São Paulo State. METHODS: Semi-structured interviews and direct observation were performed with a verification list according to the criteria reported by Perloff et al. One hundred and five health professionals took part in the study. After measuring blood pressure, the level of concordance between the way the procedure was performed and the recommended one was assessed. RESULTS: Nurses and nurse's aides abided by 40% of the recommended procedures for adequate blood pressure measurement. The other categories of health professionals (nursing and medicine teachers, physicians, residents, and nursing students) abided by approximately 70%. CONCLUSION: Permanent educational activities aiming at standardizing blood pressure measurement should be implemented among the different categories of health professionals.

Radiação solar em superfieies horizontal e vertical com exposição norte

In the field of agrometeorological studies we are in need of the estimation of the solar radiation frequently. At the present study the authors have worked out some dat:t regarding the hours of sunshine during the months of August, September, October, November, December and January of 1957, 1958 and 1959. Based on such hours of sunshine in the Agrometeorological Station, located at the Escola Superior de Agricultura "Luiz de Queiroz" - U.S. P., in Piracicaba, the authors calculated the solar radiation received on a plane and horizontal surface, from the method proposed by Glover and Mc Culloch. With those results the authors estimated the percentual part of radiation that would be received on vertical wall facing north.

Estratificação vertical de formigas em cerrado strictu sensu no Parque Estadual da Serra de Caldas Novas, Goiás, Brasil

Formicidae é um grupo abundante no solo e também largamente distribuído em todos os estratos da vegetação, constituindo-se em um bom modelo biológico para estudos de estratificação vertical. O objetivo geral do trabalho foi determinar os padrões de estratificação da assembléia de formigas em três estratos verticais (solo, estrato arbustivo e estrato arbóreo). Os dados foram coletados no Parque Estadual da Serra de Caldas Novas, em uma área de cerrado strictu sensu. A coleta de formigas foi realizada utilizando-se armadilhas do tipo pitfall. Foram instaladas 11 armadilhas no solo, 17 em plantas do estrato arbustivo e 23 em plantas do estrato arbóreo (uma armadilha por planta). Foi coletado um total de 49 espécies de formigas, pertencentes a 15 gêneros e cinco subfamílias. Através de curvas de acumulação de espécies, pôde-se verificar que existem 37,5% a mais de espécies no solo do que nas árvores e 35% a mais de espécies nas árvores do que nos arbustos. Uma análise de agrupamento indicou uma similaridade mediana entre as espécies de formigas do solo e vegetação (estrato arbustivo e arbóreo). Uma análise de aninhamento demonstrou que as espécies presentes no solo são um subconjunto das espécies presentes nos dois estratos de vegetação. Mesmo sem uma estratificação vertical muito clara, a alta diversidade de formigas encontrada no cerrado pode ser explicada em parte pelo fato de algumas espécies serem especializadas em forragear e/ou nidificar no solo e outras na vegetação.

Diel vertical migration of predators (planktivorous fish larvae) and prey (zooplankton) in a tropical lagoon

ABSTRACT Based on the hypothesis that diel vertical migration (DVM) is a mechanism of predator avoidance, the objective of the present study was to test for the occurrence of DVM in planktivorous fish larvae of Hypophthalmus edentatus (Spix, 1829) (Siluriformes, Pimelodidae) and Plagioscion squamosissimus (Heckel, 1840) (Perciformes, Sciaenidae), and zooplankton (rotifers, cladocerans and copepods) in an isolated tropical lagoon in the floodplain of the Upper Paraná River, Brazil (region of Parque Nacional de Ilha Grande). We investigated spatial overlap between predators (planktivorous fish larvae) and prey (zooplankton), and tested which physical and chemical variables of the water are related to the DVM of the studied communities. We performed nocturnal (8:00 pm and 4:00 am) and diurnal sampling (8:00 am and 4:00 pm) in the limnetic region of the lagoon for six consecutive months, from October 2010 to March 2011, which comprises the reproductive period of the fish species analyzed. During the day the larvae tried to remain aggregated in the bottom of the lagoon, whereas at night they tried to disperse in the water column. Especially for cladocerans, the diel vertical migration is an important behavior to avoid predation larvae of H. edentatus and P. squamosissimus once decreased spatial overlap between secured and its potential predators, which corroborates the hypothesis that DVM is a mechanism of predator avoidance. Although significant correlations were observed between the abiotic factors and WMD of microcrustaceans at certain times of day, the effect of predation of fish larvae on zooplankton showed more important in this environment, because the small depth and isolation not allow great variation of abiotic factors seasonally and between strata the lagoon.

Sôbre a distribuição vertical dos criadouros de Anopheles do subgênero Kerteszia, no Sul do Brasil

Analisando dados sôbre a distribuição vertical das Bromeliáceas onde se criam Anopheles do subgênero Kerteszia, o autor obteve as seguintes conclusões: 1 - A influência da luminosidade, na distribuição das Bromeliáceas, e a umidade, com respeito áquelas que são criadouros de Kerteszia, se bem que conspícuas, não se apresentam da maneira esquemática como foram observadas em Trinidad F.I.O); 2 - As alturas preferenciais das três espécies de kerteszia variam de acôrdo com as condições de umidade reinantes na mata, porém, na maior parte da área de distribuição dêsses mosquitos, o A. bellator é uma espécies dos níveis mais elevados, o A. homunculus prefere as bromeliáceas mais baixas e o A. cruzii prolifera em qualquer nível, sendo, entretanto, mais encontradiço nas alturas preferenciais das duas outras espécies; 3 - Como foi mostrado, anteriormente por PITTENDRIGH (1950a) em Trinidad, a densidade de cada espécie está na dependência da amplitude da faixa de alturas que ela pode explorar e, portanto, do número de criadouros de que dispõe; assim, apesar da predominância quase total do A. cruzii, o A. bellator é abundante na orla litorânea, onde pode se criar até ao nível do solo, e o A. homunculus chega a ser a espécie mais numerosa em algumas várzeas da área de relêvo movimentado, onde os seus criadouros são encontrados até nos esgalhamentos das árvores; 4 - As distribuições de freqüência das Bromeliáceas em geral e daquelas que são criadouros de Kerteszia, apresentaram diferenças estatísticamente significativas; 5 - O fato do A. cruzii apresentar duas alturas preferenciais e o de sua distribuição vertical ser significativamente diferente daquela observada para as bromeliáceas das mesmas matas, sugere a hipótese de tratar-se de duas entidades biológicas difíceis de serem distinguidas pelos caracteres morfológicos, atualmente, utilizados na classificação dêsses mosquitos.

New field observations on the competitive displacement between two species of planorbid snails inhabiting Northeastern Brasil

Observations reported in the present paper have shown that Biomphalaria glabrata is being gradually displaced by B. straminea in coastal areas of two counties on the state of Pernambuco, Brazil, confirming former observations made in the same region.

The vertical dispersión of Anopheles (Kerteszia) cruzi in a forest in southern Brazil suggests that human cases of malaria of simian origin might be expected

By staining females of Anopheles cruzi with fluorescent coloured powders in a forest in the State of Santa Catarina, we showed that they move from canopy to ground and vice-versa to feed. This suggests that in areas where this mosquito is a vector of human and simian malarias sporadic infections of man with monkey plasmodia might be expected.

Mosquitos no Parque Nacional da Serra dos Orgãos, Estado do Rio de Janeiro, Brasil: II. Distribuição vertical

Em prosseguimento aos estudos sobre a ecologia de culicídeos que vimos realizando no Parque Nacional da Serra dos Orgãos (PNSO), apresentamos nesta oportunidade a sua distribuição vertical. Por meio de capturas feitas em isca humana concomitantemente ao nível do solo e nas imediações da copa das árvores, estabelecemos as tendências das espécies que ali ocorreram de março de 1981 a fevereiro de 1982, por se alimentarem de sangue na copa da floresta ou junto ao solo. A distribuição é analisada comparativamente em ambos os níveis levando-se em consideração as variações de temperatura, umidade, precipitações pluviométricas e estações do ano. Dentre as espécies com nítida preferência à acrodendrofilia encontramos alguns importantes transmissores de doenças: Anopheles cruzii - malária humana e simiana; Culex nigripalpus - encefalite de São Luis (SLE); Haemagogus leucocelaenus e Haemagogus capricornii - febre amarela silvestre, todas também sendo obtidas, embora em menor número, a nível do solo. Os sabetíneos - Wyeomyia Knabi, Phoniomyia theobaldi, Sabethes tarsopus, Sabethes quasicyaneus, Sabethes chloropterus - completam a relação das principais espécies que preferem a copa. Por outro lado, Aedes fluviatilis, Trichoprosopon digitatum, Tr. similis, Tr. frontosus, Tr. theobaldi, Wy, arthrostigma, Wy. aporonoma, Wy. personata, Wy undulata, Wy. mystes, Limatus durhami, Li. pseudomethisticus, Sa. identicus e Sa. undosus foram capturados em grande maioria próximo ao solo.

Aspectos da ecologia dos flebótomos do Parque Nacional da Serra dos Orgãos, Rio de Janeiro: II. Distribuição vertical (Diptera, Psychodidae, Phlebotominae)

Durante um ano completo efetuamos capturas de flebótomos em isca humana, simultaneamente no solo e na copa da floresta em plataforma a dez metros de altura. Lutzomyia fischeri foi a espécie mais numerosa na copa. L.sp. 1 (espécie ainda não descrita) também foi mais freqüente neste nivel; L.shannoni, apesar de ser mais ativa ao nivel do solo, compareceu várias vezes na copa; L.pessoai, L.ayrozai, L.davisi. L.sp.2 (espécie também não identificada), L.microps e L.monticola só picaram iscas situadas no solo; L.hirsuta esteve pouco representada na copa, porém sua maior densidade foi no solo, onde figura como espécie dominante nos meses mais frios e secos do ano. Dois aspectos devem ser enfatizados com relação à distribuição vertical: a acrodendrofilia de L. fischeri e, ao contrário, o fato de L.ayrozai alimentar-se exclusivamente ao nível do solo. Este comportamento de L.ayrozai e sua preferência em sugar nas partes mais baixas do corpo fazem supor que seus abrigos naturais sejam as folhas caídas no solo florestal. Dentre os fatores mesológicos que influenciam na estratificação dos flebótomos consideramos que a luminosidade seja preponderante, pois em noites mais claras (lua crescente ou cheia) a atividade foi nula, todos os flebotomíneos capturados na copa das árvores foram obtidos em noites mais escuras (lua nova ou minguante).

Competitive displacement of Biomphalaria glabrata by B. straminea

Data on the interaction between populations of closely related species of Biomphalaria, B. glabrata and B. straminea, are presented in the current paper. Laboratory and field observations and experiments have shown that B. straminea has competitive advantages over B. glabrata.

Rheotaxis of Biomphalaria glabrata on vertical substrates and its role in the recolonization of habitats treated with molluscicides

The authors observed specimens of Biomphalaria glabrata climbing up the vertical wall of a ditch against the current. The snails that showed this behavior during application of a molluscicide in the breeding site survived and probably played a role in repopulation, which was observed three months later. These observations motivated field and laboratory investigations which led the authors to conclude that: a) this species is able to climb vertical surfaces both in field and laboratory situations; b) the current of water, as a physical stimulus, is sufficient to trigger this behavior (rheotaxis); c) rheotaxis on vertical surfaces depends on the presence of a necessarily moderate current; d) there are indications that B. glabrata may undergo habituation with respect to rheotaxis on vertical walls, e) the relationship between rheotaxis and habituation should be considered as a factor causing snail grouping in water bodies which may contribute to their localization in the field; f) rheotaxis on vertical surfaces may facilitate population dispersal, and its occurrence should be considered when campaigns for the control of schistosomiasis transmission are planned. The authors present some proposals to avoid the manifestation of this behavior in some filed situations.

Displacement of Biomfhalaria glabrata by thiara granifera under natural conditions in the Dominican Republic

After a study of the population dynamics of Biomphalaria glabrata snails in several breeding places in the Dominican Republic, the snail Thiara granifera was introduced in some B. glabrata habitats. T. granifera became established in one point in one habitat in the townof Quisqueya, in the east of the country. Around this point of establishment 6 points were selected in order to observe the population dynamics of both species of snails and the chemical and biological characteristics at each point. Four of these points already harbored B. glabrata. One control point was selected also harboring B. glabrata. After 14 months of observations, the results showed that T. granifera was competing with and displacing B. glabrata. This competition does not seem to be competition for food or vital space. Rather, B. glabrata avoids the presence of T. granifera and moves away to new areas, and this is possibly due to a chemical substance(s) secreted by T. granifera or by physical contact with the large number of individuals of T. granifera.

Simian malaria at two sites in the Brazilian Amazon - II: Vertical distribution and frequency of anopheline species inside and outside the forest

An anopheline survey was carried out in two simian malaria areas in the Brazilian Amazon, Balbina and Samuel, to determine the potential vectors of Plasmodium brasilianum. The most abundant and/or acrodendrophilic anophelines in the forest and the most likely vector were Anopheles mediopunctatus, An. nuneztovari, An. oswaldoi, An. triannulatus and An. shannoni. An. darlingi and An. marajoara were captured essentially in anthropic habitats outside the forest and are unlikely to be involved in the transmission of P. brasilianum among monkeys within the forests and from monkeys to man in their surroundings in the Amazon.