Prevalence of Risk for Obstructive Sleep Apnea Syndrome and Association With Risk Factors in Primary Care

Abstract Background: Obstructive sleep apnea syndrome (OSAS) is a chronic, progressive disease with high morbidity and mortality. It is underdiagnosed, especially among women. Objective: To study the prevalence of high risk for OSAS globally and for the Berlin Questionnaire (BQ) categories, and to evaluate the reliability of the BQ use in the population studied. Methods: Observational, cross-sectional study with individuals from the Niterói Family Doctor Program, randomly selected, aged between 45 and 99 years. The visits occurred between August/2011 and December/2012. Variables associated with each BQ category and with high risk for OSAS (global) were included in logistic regression models (p < 0.05). Results: Of the total (616), 403 individuals (65.4%) reported snoring. The prevalence of high risk for OSA was 42.4%, being 49.7% for category I, 10.2% for category II and 77.6% for category III. Conclusion: BQ showed an acceptable reliability after excluding the questions Has anyone noticed that you stop breathing during your sleep? and Have you ever dozed off or fallen asleep while driving?. This should be tested in further studies with samples mostly comprised of women and low educational level individuals. Given the burden of OSAS-related diseases and risks, studies should be conducted to validate new tools and to adapt BQ to better screen OSAS.

Estudos químico-agrícolas sôbre o enxofre

1. Analyses of soluble sulphates in 2 N ammonium chloride extracts of 24 samples of soils of the state of São Paulo, Brazil, S. A., showed a sulphur content varying from 0,0013 g per 100 g (found in the b layer of a genuine "terra roxa") to 0,007 g per 100 g of soil (b layer of a soil of depression without definite characteristics). (The results are expressed as elemental sulphur). Determinations of total sulphur in 56 samples of soils of the same state using the method of fusion with sodium carbonate and sodium nitrate revealed 0.007 g of elemental S per 100 g of soil as the lowest value (found in several soil types) and 0.096 g as the highest one (found in the b layer of an ar-quean soil). Apparently soluble sulphates accumulate in the upper layers and total sulphur does the opposite. It was found a strong correlation between total S and carbon content. 2. Under laboratory conditions, in a compost of fresh soil, powdered sulphur and apatite, it was verified after a three months period of incubation that the pH value lowered from 6.30 to 3.23; the citric acid solubility of apatite increased to 271.1 per cent of the original one. Lupinus sp. grown in soil manured with sulphur and apatite has showed fresh and dry weights higher than the plants in control pots; the results are significant at 5% level of probability; phosphorus content is also higher in the manured plants. It was observed a net influence of the apatite plus sulphur treatment on the weight of root nodosities that was four times greater than in the control plants. 3. Nearly five hundred determinations of S, N and P were carried out in 35 species of plants cultivated in the state of São Paulo. A great variation in the amounts of these elements was observed. As a general rule, the leaves contain more sulphur than the stems and roots show the lowest percentages. The conjunct roots and stem of guar (Cyamopsis psoraloides) revealed only 0.019 per cent sulphur; the leaves of kale showed the highest sulphur content, i. e., 2.114%. Apparently there is no correlation between the amounts of S, N and P. The ratio S/N increases from 0.006 (guar) to 0.485 (kale). The ratio S/P, always higher than the corresponding S/N, increases from 0.082 (guar) to 6.381 (older leaves of tomato plants). It is interesting to mention that several among the most important crops in the state of São Paulo namely, cotton, rice, coffee and sugar cane contain more sulphur than phosphorus. 4. Tomato plants cultivated in nutrient solution lacking sulphur showed the following visual symptons of deficiency : chlorosis first in the younger leaves and afterwards in all the leaves; anthocyanin pigments in the petioles and stems; absence of fruits; primary roots stunted and secondary ones longer than in the control plants; stems slender, hard, woody. The histological study of petioles suffering from sulphur deficiency revealed anthocyanin in the parenchyme layer instead of clo-rophyll pigments observed in normal petioles; in the chlorotic leaves the large chloroplasts present only the stroma but the small ones have a little amount of green pigments. Chemical analysis revealed in the abnormal plants : less sulphur and an increased proportion of phosphorus; older leaves contain more sulphur and less phosphorus than the younger ones probably due to physiological difficulties in translocation of sulphur bearing material; increased amount of total N attributed to accumulation of nitrates; marked decrease in ash, sugars and starch; increased proportion of crude fiber and dry material. In the plants suffering from sulphur deficiency photosyntetic rate decreased 34 per cent. 5. Tomato plants were succesfully cultivated in nutrient solution in absence of mineral sulphur but in presence of cysteine. The plants absorbed sulphur, under that form and were able to grow up quite well; the fruiting was normal. In this way rested cleary demonstrated the possibility of absorption of organic sulphur without previous mineralization and its utilization in the building up of protein molecules.

O problema técnico-econômico da adubação

The authors discuss from the economic point of view the use of a few functions intended to represent the yield y corresponding to a level xof the nutrient. They point out that under conditions of scarce capital what is actually most important is not to obtain the highest profit per hectare but the highest return per cruzeiro spent, so that we should maximize the function z = _R - C_ = _R_ - 1 , C C where R is the gross income and C the cost of production (fixed plus variable, both per hectare). Being C = M + rx, with r the unit price of the nutrient and Af the fixed cost of the crop, wo are led to the equation (M + rx)R' - rR = 0. With R = k + sx + tx², this gives a solution Xo = - Mt - √ M²t² - r t(Ms - Kr)- _____________________ rt on the other hand, with R = PyA [1 - 10-c(x + b)], x0 will be the root of equation (M + rx)cL 10 + r 10c(x + b) = 0 (12). Another solution, pointed out by PESEK and HEADY, is to maximize the function z = sx + tx² _________ m + rx where the numerator is the additional income due to the nutrient, and m is the fixed cost of fertilization. This leads to a solution x+ = - mt - √m²t² - mrst (13) _________________ rt However, we must have x+< _r_-_s_ I if we want to satisfy t _dy_ > r. dx This condition is satisfied only if we have m < _(s__-__r)² (14), - 4 t a restriction apparently not perceived by PESEK and HEADY. A similar reasoning using Mitscherlich's law leads to equation (mcL 10 + r) + cr(L 10)x - r 10cx = 0 (15), with a similar restriction. As an example, data of VIEGAS referring to fertilization of corn (maize) gave the equation y - 1534 + 22.99 x - 0. 1069 x², with x in kg/ha of the cereal. With the prices of Cr$ 5.00 per kilo of maize, Cr$ 26.00 per kilo of P2O3,. and M = Cr$ 5,000.00, we obtain x0 = 61 kg/ha of P(2)0(5). A similar reasoning using Mitscherlich's law leads to x0 = 53 kg/ha. Now, if we take in account only the fixed cost of fertilization m = Cr$ 600.00 per hectare, we obtain from (13) x+ = 51 kg/ha of P2O5, while (14) gives x+ - 41 kg/ha. Note that if m = Cr$ 5,000.00, we obtain by formula (13) x+ = 88 kg/ha of P2O5, a solution which is not valid, since condition (14) is not satisfied.

The induction of root and shoot morphogenesis in Phaseolus vulgaris tissue cultures

Exogenous concentrations of bean seed extract prepared from seeds pretreated in aerated water, homogenized in Veliky and Martin's 67-V salt solution, filtered, and added to the culture medium at proper concentrations promote callus proliferation, root morphogenesis, and shoot morphogenesis in leaf explains of Phaseolus vulgaris var. Bico de Ouro. The activity of the bean seed factor is dependent upon the period of pretreatment in aerated water.

Host plants of root-knot nematodes

Root-knot nematodes were found attacking Coffea spp. and also roots of a few weed species usually found in the coffee orchards in São Paulo. C. arabica cv. Catuaí, C. arabica cv. Mundo Novo, Timor Hybrid and a few plants of C. racemosa showed to be susceptible to Meloidogyne exigua. Roots of Ageratum conyzoides, Amaranthus viridis, Bidens pilosa, Coffea arabica cv. Mundo Novo, Coffea racemosa, Commelina virginica, Digitaria sanguinalis, Galinsoga parviflora, Gnaphalium spathulatum, Porophyllum ruderale, Portulaca oleracea, Pterocaulon virgatum and Solanum americanum were disfigured by M. incognita M. arenaria was found attacking roots of Eleusine indica and Gnaphalium spathulatum, and the presence of an unidentified Meloidogyne species was verified in roots of the following species: Vernonia ferruginea, C. arabica x C. canephora, Eupatorium pauciflorum, Coffea canephora cv. Kouillou, Coffea eugenioides, Coffea racemosa, Coffea stenophylla, Euphorbia pilullifera, Solanum americanum, Ageratum conyzoides, Phyllanthus corcovadensis, and Emilia sagittata.

Non root feeding with two sources of zinc on Coffea arábica L. 'mundo novo'(B.Rodr.) Choussy

A trial was carried out on an eight old coffee plantation with visible zinc problems. The plantation was situated nearly the city of Jaú (22º30'S, 48º30'W). State of São Paulo, Brazil. The soil is classified as medium texture Oxisol of low base saturation (Latossol Vermelho Amarelo - fase arenosa). The pulverization program started in november 1977, followed in march and July 1978 (heavy harvest) and ended in march and July 1979 (light harvest). Is should be mentioned that a well reconized characteristic of arábica coffe is its habit of biennial bearing, a very heavy harvest is most often followed by a light load the next year. The following treatments and amounts of chemicals per cova hole (4 trees) were tested in accordance with a random block design: 1. 1 g of zinc (zinc sulphate, 0.5%) 2. 3 g of nitrogen (urea, 1.3%) 3. 1 g of zinc + 3 g of nitrogen (zinc sulphate 0.5% + urea 1.3%) 4. 0.25 g, 0.50 g, 1.00 g, 2.00 g of zinc plus 0.75 g, 1.50 g, 3.00 g and 6.00 of nitrogen (correspondent to NZN* 15-0-0-5 as 0.75%, 1-5%, 3.0% and 6.0% by v/v). Foliar absorption data were obtained by collecting the 3rd and 4th pairs of the coffee leaves and analysed them for N, P, K, Ca, Mg, S, B, Cu, Fe, Mn, and Zn. The main results may be summarized as follows: 1. The maximum calculated yields of clean coffee were obtained by the applications of 5.84 1 of NZN (1.13%) per hectare. 2. The applications of zinc sulphate (0.5%) and urea (1.3%) together or separate did not affected the coffee bean production. 3. The applications of 15.0 1 of NZN per hectare reduced the coffee yields. 4. Leaf damages and burning symptoms were observed by the applications of urea (1.3%) plus zinc sulphate (0.5%) and larger doses than 7.5 1 of NZN per hectare. 5. Leaf tissue analysis show that the concentrations of the elements were affecred by the age of the leaves and by the yields of the coffee trees. 6. The applications of increasing doses of NZN causes an increase in the concentration of zinc, manganese and boron in the leaves and decreased the concentration in calcium and potassium the leaves. 7. The concentration of zinc in the leaves associated with the heavy harvest, in July, was 70.0 ppm.

Contribuição para o estudo dos vetores de malaria no Brasil: Anopheles (Nyssorhynchus) Darlingi Root, em Campos, no Estado do Rio

Os autores relatam nesse trabalho observações colhidas no estudo da fauna anofélica da cidade de Campos, Estado do Rio. Assinalaram a presença das espécies A. arbitarsis, A. darlingi, A. triannulatus, A. oswaldoi, A. noroestensis, A. pessoai e A. intermedius. Em capturas domiciliares foram assinalados o darlingi, albitarsis e triannulatus, sendo êste último encontrado em pequeno número e nas casas em que animais domésticos cohabitavam com o homem, dormindo sob o mesmo teto. Como vetores locais encontraram o A. darlingi com 6.8% de oócistos e 4% de esporozoítos, o albitarsis com 2% de oócistos e as glândulas negativas para esporozoítos. Fizeram os A. A. um estudo sumário dos criadouros, assinalaram que as larvas do darlingi tanto podem ser encontradas nas grandes coleções hídricas, lagoas e canais, como em depressão do terreno e valas de drenagem a céu aberto. Fizeram ainda uma revisão bibliográfica em relação a capacidade vetora do darlingi e sôbre a ecologia das suas larvas.

Schistosomiasis control in a primary health care system

The successful implementation of a Primary Health Care System (PHC) in any country depends primarily on the ability to adapt its concepts and principles to the country's culture and development stage. Thus, the PHC system should reflect a balanced interaction between available resources, such as health manpower capabilities, and the nature and magnitude of the health problems. In addition, PHC should be viewed as the inlet to a multi-level pyramidal health system which caters to both community and individual needs in a balanced way. The adage that Ministries of Health should "work with and for the people" in health development, is especially true in the area of PHC, and hence, the health policy should aim to integrate health services in community development and involve people in its planning, implementation and evaluation.

Initiation of primary cell cultures from embryos of the mosquitoes Anopheles albimanus and Aedes taeniorhynchus (Diptera: Culicidae)

Primary cell cultures were obtained from eggs of Anopheles albimanus and Aedes taeniorhynchus mosquitoes, vectors of human malaria and of Venezuelan equine encephalitis virus, respectively. The cellular growth of the An. albimanus cells began four weeks after explanting the embryonic tissues in MK/VP12 medium, supplemented with 15% fetal bovine serum. The culture showed heterogeneous cellular morphology. With regard to the Ae. taeniorhynchus culture, growth occurred three weeks after initiating the culture in MM/VP12 medium. The majority of cells were small and round. Karyotypes were examined in the latter species.

Primary isolation of spotted fever group rickettsiae from Amblyomma cooperi collected from Hydrochaeris hydrochaeris in Brazil

This paper reports the first isolation of a spotted fever group rickettsia from an Amblyomma cooperi ixodid collected from a capybara (Hydrochaeris hydrochaeris) in an endemic area of spotted fever in the County of Pedreira, State of São Paulo, Brazil. Isolation was performed in Vero cell culture and submitted to immunofluorescence, using antibody from Rickettsia rickettsii-positive human serum.

Biological variation in Anopheles darlingi root

Behavioural variation in the South American malaria vector Anopheles darlingi is described. At the centre of its distribution, in forest areas close to the city of Manaus, Brazil, it is primarily exophagic and exophilic. Mosquitoes from this area are chromosomally diverse. Towards the northern edge of its distribution (in Guyana and Venezuela) it is more endophagic and less diverse chromosomally. Similarly in the south (in the state of Minas Gerais) it is less polymorphic. In this area, however, it is primarily zoophilic and exophagic. Evidence is presented that female wing size may vary between populations. The possibility that this widely distributed species may be a complex could have important implications for future malaria control schemes.

Rabies virus infection of cultured adult mouse dorsal root ganglion neurons

An in vitro model of adult dorsal root ganglion neurons infection by rabies virus is described. Viral marked neurotropism is observed, and the percentage and the degree of infection of the neurons is higher than in non neuronal cells, even if neurons are the minority of the cells in the culture. The neuritic tree is also heavily infected by the virus.