Prevalência da incontinência anal na população urbana de Pouso Alegre - Minas Gerais

Os objetivos deste estudo foram conhecer a prevalência da incontinência anal (IA) em adultos da cidade de Pouso Alegre (Minas Gerais) e verificar os fatores demográficos e clínicos preditores de sua presença. Estudo epidemiológico desenvolvido por meio de amostragem estratificada por conglomerado, tendo amostra final composta de 519 indivíduos, com idade >18 anos, em condições físicas e mentais adequadas, residentes em 341 domicílios da área urbana e sorteados aleatoriamente. As prevalências foram padronizadas por sexo e idade, resultando em 7,0% para IA, tanto geral como para homens e mulheres. No modelo final de regressão logística, número de filhos (OR=5,1; p<0,001), doença hemorroidária (OR=4,4; p<0,001) e cistocele (OR=3,0; p<0,001) estavam associados à presença de IA. O estudo permitiu conhecer a epidemiologia da IA e pode contribuir para o desenvolvimento de políticas públicas visando à prevenção primária e secundária, e ao tratamento, ainda que inicialmente em nível municipal.

Fatores associados ao uso de psicotrópicos por idosos residentes no Município de São Paulo

Os objetivos do estudo foram identificar a prevalência e os fatores associados ao uso de psicotrópicos entre os idosos do Município de São Paulo. Trata-se de um estudo transversal, de base populacional, cujos dados foram obtidos do Estudo Saúde, Bem-estar e Envelhecimento. A amostra foi constituída de 1.115 idosos de 65 anos ou mais, os quais foram entrevistados por meio de instrumento padronizado. Na análise dos dados utilizou-se regressão logística univariada e múltipla stepwise forward e nível de significância de 5%. A prevalência de uso de psicotrópicos foi 12,2% e os fatores associados foram sexo feminino (OR=3,04 IC95%=1,76-5,23) e polifarmácia (OR=4,91 IC95%=2,74-8,79). O uso de psicotrópicos por idosos deve ter sua avaliação risco-benefício muito bem estabelecida. Mulheres idosas, especialmente as submetidas à polifarmácia merecem atenção diferenciada, no ajuste posológico e tempo de tratamento, visando à minimização dos desfechos adversos a que estão sujeitas.

Neonatal mortality in infants with low birth weigh

Objective To evaluate the factors associated with neonatal mortality in infant born with low birth weight. Method Cross-sectional study that analyzed data from 771 live births with low birth weight (<2500 g) in the city of Cuiabá, MT, in 2010, of whom 54 died in the neonatal period. We obtained data from the Information System on Live Births and Mortality, by integrated linkage. Results In multiple logistic regression, neonatal mortality was associated with: number of prenatal visits less than 7 (OR=3.80;CI:1,66-8,70); gestational age less than 37 weeks (OR=4.77;CI:1.48-15.38), Apgar score less than 7 at the 1st minute (OR=4.25;CI:1.84-9.81) and the 5th minute (OR=5.72,CI:2.24-14.60) and presence of congenital anomaly (OR=14.39;IC:2.72-76.09). Conclusion Neonatal mortality in infants with low birth weight is associated with avoidable factors through adequate attention to prenatal care, childbirth and infants.R33;

Hipertensos com e sem doença renal: avaliação de fatores de risco

RESUMO Objetivo Comparar pacientes hipertensos com e sem doença renal e identificar fatores associados à condição clínica e tratamento anti-hipertensivo. Método Estudo transversal realizado com pacientes admitidos em clínica médica de um hospital universitário da cidade de São Paulo. Os dados foram coletados por meio de análise do prontuário. Valores de p<0,05 foram considerados significantes. Resultados Dos 386 pacientes avaliados, 59,3% eram hipertensos e destes 37,5% tinham doença renal crônica. Houve associação independente da presença de doença renal crônica para antecedentes de diabetes (OR 1,86; IC 1,02-3,41) e de insuficiência cardíaca congestiva (OR 3,42; IC 1,36-9,03); além do fato de viver com companheiro (OR 1,99; IC 1,09-3,69). Quanto ao tratamento anti-hipertensivo, houve diferença (p<0,05) entre os hipertensos com e sem doença renal em relação a fazer acompanhamento de saúde (93,2%vs 77,7%); uso contínuo de medicamentos anti-hipertensivos, (79,1% vs 66,4%); maior número de medicamentos anti-hipertensivos; uso de bloqueadores beta-adrenérgicos (34,9% vs 19,6%), bloqueadores dos canais de cálcio (29,1%vs 11,2%), diuréticos de alça (30,2%vs 10,5%) e vasodilatadores (9,3% vs2,1%). Conclusão Os hipertensos com doença renal crônica apresentaram perfil clínico mais comprometido, porém em relação ao tratamento anti-hipertensivo as atitudes foram mais positivas do que os sem doença renal.

Lysine and arginine requirements of Salminus brasiliensis

The objective of this work was to determine the dietary lysine (DL) and dietary arginine (DA) requirements of dourado (Salminus brasiliensis), through dose-response trials using the amino acid profiles of whole carcasses as a reference. Two experiments were carried out in a completely randomized design (n=4). In the first experiment, groups of 12 feed-conditioned dourado juveniles (11.4±0.2 g) were stocked in 60 L cages placed in 300 L plastic indoor tanks in a closed circulation system. Fish were fed for 60 days on diets containing 1.0, 1.5, 2.0, 2.5, 3.0, or 3.5 % dietary lysine. In the second experiment, dourado juveniles (27.0±0.8 g) were fed for 60 days on semipurified diets containing arginine at 1.0, 1.5, 2.0, 2.5 or 3.0%, in similar conditions to those of the first experiment. Optimal DL requirements, as determined by broken-line analysis method for final weight, weight gain and specific growth rate, were 2.15% DL or 5% lysine in dietary protein, and 1.48% DA or 3.43% arginine in dietary protein. The best feed conversion ratio is attained with 2.5% DL or 5.8% lysine in dietary protein and 1.4% DA or 3.25% arginine in dietary protein.

Optimization of a protocol for the micropropagation of pineapple

The present work aimed at maximizing the number of plantlets obtained by the micropropagation of pineapple (Ananas comosus (L.) Merrill) cv. Pérola. Changes in benzylaminopurine (BAP) concentration, type of medium (liquid or solidified) and the type of explant in the proliferation phase were evaluated. Slips were used as the explant source, which consisted of axillary buds obtained after careful excision of the leaves. A Sterilization was done in the hood with ethanol (70%), for three minutes, followed by calcium hypochlorite (2%), for fifteen minutes, and three washes in sterile water. The explants were introduced in MS medium supplemented with 2mg L-1 BAP and maintained in a growth room at a 16h photoperiod (40 mmol.m-2.s-1), 27 ± 2ºC. After eight weeks, cultures were subcultured for multiplication in MS medium. The following treatments were tested: liquid x solidified medium with different BAP concentrations (0.0, 1.5 or 3.0 mg L-1), and the longitudinal cut, or not, of the shoot bud used as explant. The results showed that liquid medium supplemented with BAP at 1.5 mg L-1, associated with the longitudinal sectioning of the shoot bud used as explant presented the best results, maximizing shoot proliferation. On average, the best treatment would allow for an estimated production of 161,080 plantlets by the micropropagation of the axillary buds of one plant with eight slips and ten buds/slips, within a period of eight months.

Growth of lulo (Solanum quitoense Lam.) plants affected by salinity and substrate

The effects of 0, 30 and 60 mM NaCl and substrates (red peat, sand or 3:1:1 [w/w] mixture of peat, sand, or soil) on vegetative growth of lulo, an Andean fruit species, during 12 weeks were studied. The experiment was carried out by using 2000 cm³ of polypropylene plastic pots under greenhouse conditions. Plant height, number of leaves and nodes, leaf area, total plant dry matter (DM), and shoot/root ratio were evaluated. With the increase of salt concentration, the plant height, the number of leaves and nodes, the leaf areas and plant dry mass DM decreased, whereas shoot/root ratio increased. Sand grown lulo plants were most affected by salinity and presented total mortality at 60 mM NaCl. On the other hand, plants held either in peat or in substrate mixture developed larger height, greater leaf and node numbers, higher leaf area and dry matter content. Shoot/root ratio in control (soil) and sand-grown plants (30 mM NaCl) was lower.

Prevalence and sonographic changes compatible with fatty liver disease in patients referred for abdominal ultrasound examination in Aracaju, SE

Abstract Objective: To estimate the prevalence and evaluate sonographic findings compatible with changes consistent with hepatic steatosis in patients referred for abdominal ultrasonography at four reference centers in Aracaju, SE, Brazil. Materials and Methods: Prospective, descriptive survey, with analytical and quantitative approach, comprising abdominal ultrasonography scans performed with a convex, dynamic 3.75 MHz transducer. Liver dimensions and parenchymal echotexture were evaluated, classifying hepatic steatosis into grades (1, 2 or 3). The SPSS® 22.0 software was used for statistical analysis, adopting p < 0.05 as significance level. Results: A total of 800 individuals (561 women and 239 men) were evaluated. The prevalence of steatosis was 29.1%, and the male patients were most affected, presenting with more advanced grades of disease (p = 0.021), as follows: 119 grade 1 (51.0%); 94 grade 2 (40.4%); and 20 grade 3 (8.6%). The median age patients' was 46 years. Conclusion: In the present study sample, the prevalence of hepatic steatosis was high, particularly in the male patients. Ultrasonography is suggested as a first choice for the diagnosis of this condition, considering its wide availability, low cost and absence of side effects or risks to the patient.

Novos derivados do sistema heterocíclico 1H-pirazolo[3,4-b]piridina: síntese e assinalamentos de hidrogênios e carbonos por RMN 1D e 2D

The synthesis and NMR analysis of seven new 4-(aryl)amino-5-carboethoxy-1,3-dimethyl-1H-pyrazolo[3,4- b]pyridines (7-13) are described. The synthetic approach used involved the preparation of intermediates 5-aminopyrazol (4), the enamine derivative (5) and the 4-chloro-1H-pyrazolo[3,4-b]pyridine (6). Compounds (7-13) were obtained by treatment of 6 with the desired aniline. The structures of new heterocyclic compounds and their precursors intermediates were assigned on the basis of spectral analysis including 1D and 2D NMR experiments [¹H; 13C{¹H} and DEPT; ¹H x ¹H - COSY; ¹H x13C - COSY, nJ CH, n = 1, 2 or 3 (HETECOR and COLOC)].

Síntese, caracterização e comportamento térmico de amidossulfonatos de terras raras

Hydrated compounds prepared in aqueous solution by reaction between amidosulfonic acid [H3NSO3] and suspensions of rare earth hydroxycarbonates [Ln2(OH)x(CO3)y.zH2O] were characterized by elemental analysis (% Ln, % N and % H), infrared spectroscopy (FTIR) and thermogravimetry (TG). The compounds presented the stoichiometry Ln(NH2SO3)3.xH2O (where x = 1, 5, 2.0 or 3.0). The IR spectra showed absorptions characteristic of H2O molecules and NH2SO3 groups. Degree of hydration, thermal decomposition steps and formation of stable intermediates of the type [Ln2(SO4)3] and (Ln2O2SO4), besides formation of their oxides, was determined by thermogravimetry.

Regeneration of five commercially-valuable tree species after experimental logging in an Amazonian forest

This study investigated the regeneration variation of five commercially valuable tree species in relation to different intensities of felling in fourteen 4-ha plots in an area under experimental forest management. This experiment was carried out in a typical Amazonian tropical forest sample on "terra-firme," in Manaus (AM). Plots were logged 7 and 8 years (1987 and 1988), or 3 years (1993) before the study. All trees with height greater than 2 m, and diameter at breast height (DBH) smaller than 10 cm were measured. Only Aniba hostmanniana, Ocotea aciphylla, Licaria pachycarpa, Eschweilera coriacea and Goupia glabra were sufficiently common for individual analyses. These species have high timber values in the local market. Eight years after logging, the species responded differently to logging intensities. The numbers of individuals of Goupia glabra and Aniba hostmanniana were positively related to the intensity of logging, while Ocotea aciphylla, Licaria pachycarpa, and Eschweilera coriacea showed no statistically significant response. In the most recently (1993) logged areas, Goupia glabra and Aniba hostmanniana had higher numbers of individuals than the control plots.

Incidência de empiema pleural nos ferimentos tóraco-abdominais

OBJETIVO: Os ferimentos penetrantes com comprometimento simultâneo das cavidades torácica e abdominal (FTA), além da dificuldade diagnóstica, merecem especial atenção em relação à conduta adotada para o tratamento do espaço pleural. O objetivo do presente estudo foi identificar os principais fatores relacionados à incidência de empiema pleural em pacientes com ferimentos penetrantes localizados na transição toracoabdominal. MÉTODO: Utilizando-se o modelo estatístico de regressão logística múltipla, os autores analisaram 110 pacientes com ferida toracoabdominal penetrante, submetidos à drenagem pleural fechada e laparotomia. A complicação empiema pleural foi estudada quanto à incidência e fatores envolvidos. Considerou-se o nível alfa igual a 0,05. RESULTADOS: Do total, 91 (82,7%) pacientes eram do sexo masculino e 19 (17,3%) do feminino. A faixa etária situou-se entre 13 e 63 anos. Os FTA foram causados por projétil de arma de fogo em 60 casos (54,5%) e por arma branca em 50 casos (45,5%). O empiema pleural incidiu em quatro (3,6%) dos pacientes estudados. Na análise estatística a incidência de empiema pleural esteve relacionada com: lesão de víscera oca (OR=3,1386, p=0.4005); lesão do lado esquerdo do diafragma (OR= 12,98, p=0,1178) e choque hemorrágico à admissão (OR=23,9639, p=0,0250). CONCLUSÕES: A chance da ocorrência de empiema pleural foi cerca de três vezes maior em pacientes com lesão de víscera oca e, de 13 vezes se a esta lesão estava associada à lesão do lado esquerdo do diafragma; aumentando para 24 vezes se estes pacientes apresentavam, concomitantemente, estado de choque hemorrágico à admissão.

Night admission is an independent risk factor for mortality in trauma patients - a systemic error approach

ABSTRACTObjective:to assess the impact of the shift inlet trauma patients, who underwent surgery, in-hospital mortality.Methods:a retrospective observational cohort study from November 2011 to March 2012, with data collected through electronic medical records. The following variables were statistically analyzed: age, gender, city of origin, marital status, admission to the risk classification (based on the Manchester Protocol), degree of contamination, time / admission round, admission day and hospital outcome.Results:during the study period, 563 patients injured victims underwent surgery, with a mean age of 35.5 years (± 20.7), 422 (75%) were male, with 276 (49.9%) received in the night shift and 205 (36.4%) on weekends. Patients admitted at night and on weekends had higher mortality [19 (6.9%) vs. 6 (2.2%), p=0.014, and 11 (5.4%) vs. 14 (3.9%), p=0.014, respectively]. In the multivariate analysis, independent predictors of mortality were the night admission (OR 3.15), the red risk classification (OR 4.87), and age (OR 1.17).Conclusion:the admission of night shift and weekend patients was associated with more severe and presented higher mortality rate. Admission to the night shift was an independent factor of surgical mortality in trauma patients, along with the red risk classification and age.

Predictors of "occult" intra-abdominal injuries in blunt trauma patients

Objective: to assess predictors of intra-abdominal injuries in blunt trauma patients admitted without abdominal pain or abnormalities on the abdomen physical examination. Methods: We conducted a retrospective analysis of trauma registry data, including adult blunt trauma patients admitted from 2008 to 2010 who sustained no abdominal pain or abnormalities on physical examination of the abdomen at admission and were submitted to computed tomography of the abdomen and/or exploratory laparotomy. Patients were assigned into: Group 1 (with intra-abdominal injuries) or Group 2 (without intra-abdominal injuries). Variables were compared between groups to identify those significantly associated with the presence of intra-abdominal injuries, adopting p<0.05 as significant. Subsequently, the variables with p<0.20 on bivariate analysis were selected to create a logistic regression model using the forward stepwise method. Results: A total of 268 cases met the inclusion criteria. Patients in Group I were characterized as having significantly (p<0.05) lower mean AIS score for the head segment (1.0±1.4 vs. 1.8±1.9), as well as higher mean AIS thorax score (1.6±1.7 vs. 0.9±1.5) and ISS (25.7±14.5 vs. 17,1±13,1). The rate of abdominal injuries was significantly higher in run-over pedestrians (37.3%) and in motorcyclists (36.0%) (p<0.001). The resultant logistic regression model provided 73.5% accuracy for identifying abdominal injuries. The variables included were: motorcyclist accident as trauma mechanism (p<0.001 - OR 5.51; 95%CI 2.40-12.64), presence of rib fractures (p<0.003 - OR 3.00; 95%CI 1.47-6.14), run-over pedestrian as trauma mechanism (p=0.008 - OR 2.85; 95%CI 1.13-6.22) and abnormal neurological physical exam at admission (p=0.015 - OR 0.44; 95%CI 0.22-0.85). Conclusion Intra-abdominal injuries were predominantly associated with trauma mechanism and presence of chest injuries.

Fatores prognósticos para o parto transvaginal em pacientes com cesárea anterior

O objetivo deste estudo foi determinar os fatores prognósticos para a ultimação do parto por via transpélvica em gestantes com cesárea anterior admitidas em trabalho de parto no CAM-IMIP. Foi realizado um estudo tipo caso-controle, analisando os partos de pacientes com cesárea prévia assistidos no CAM-IMIP no período de janeiro/1991 a dezembro/1994. Foram considerados casos as pacientes com cesárea anterior (n=156) e controles as que tiveram parto transvaginal (n=338). Os critérios de inclusão foram: idade gestacional > 36 semanas, cesárea anterior há pelo menos 1 ano, concepto vivo, trabalho de parto espontâneo e apresentação cefálica fletida. Foram excluídas as gestações de alto risco, os casos de sofrimento fetal anteparto e pacientes com história de parto transpélvico anterior depois da cesárea. A análise estatística foi realizada em Epi-Info 6.0 e Epi-Soft, utilizando-se os testes chi² de associação, teste exato de Fisher e "t" de Student, bem como a odds ratio e seu intervalo de confiança a 95%. Análise de regressão logística múltipla foi efetuada para controle das variáveis confundidoras. O percentual de cesáreas no grupo estudado foi de 31,6%. Os fatores maternos que apresentaram associação significativa com o parto transvaginal foram a idade materna < 20 anos (OR = 2,07, IC a 95% = 1,18-3,66) ou > 35 anos (OR = 0,54, IC a 95% = 0,36-0,82), a história de parto vaginal anterior (OR = 1,6, IC a 95% = 1,01-2,55) e a indicação da cesárea anterior por doenças da gestação (OR = 3,67, IC a 95% = 1,19-12,02). Fatores como intervalo entre a cesárea anterior e o parto atual, outras indicações de cesárea e o tipo de histerorrafia não apresentaram associação significativa com o parto transpélvico. No modelo de regressão logística múltipla, persistiram como variáveis associadas significativamente ao parto vaginal a idade materna e a história de parto vaginal anterior. Os autores concluíram que sendo a idade materna < 20 anos, a indicação de cesárea por doença da gestação e parto vaginal anterior associaram-se favoravelmente ao parto transpélvico em pacientes com cesárea anterior. O risco de cesariana está aumentado em gestantes a partir de 35 anos. Esses fatores devem ser considerados na avaliação obstétrica da via de parto nessas gestantes.