Case-control study on infant mortality in Southern Brazil

OBJECTIVE: To identify risk factors associated with infant mortality and, more specifically, with neonatal mortality. METHODS: A case-control study was carried out in the municipality of Caxias do Sul, Southern Brazil. Characteristics of prenatal care and causes of mortality were assessed for all live births in the 2001-2002 period with a completed live-birth certificate and whose mothers lived in the municipality. Cases were defined as all deaths within the first year of life. As controls, there were selected the two children born immediately after each case in the same hospital, who were of the same sex, and did not die within their first year of life. Multivariate analysis was performed using conditional logistic regression. RESULTS: There was a reduction in infant mortality, the greatest reduction was observed in the post-neonatal period. The variables gestational age (<36 weeks), birth weight (<2,500 g), and 5-minute Apgar (<6) remained in the final model of the multivariate analysis, after adjustment. CONCLUSIONS: Perinatal conditions comprise almost the totality of neonatal deaths, and the majority of deaths occur at delivery. The challenge for reducing infant mortality rate in the city is to reduce the mortality by perinatal conditions in the neonatal period.

Evolution of coauthorship networks: worldwide scientific production on leishmaniasis

Introduction Collaboration is one of the defining features of contemporary scientific research, and it is particularly important with regard to neglected diseases that primarily affect developing countries. Methods The present study has identified publications on leishmaniasis in the Medline database from 1945 to 2010, analyzing them according to bibliometric indicators and statistics from social network analysis. Examining aspects such as scientific production, diachronic evolution, and collaboration and configuration of the research groups in the field, we have considered the different types of Leishmania studied and the institutional affiliation and nationality of the authors. Results Seven-hundred and thirty-five authors participate in 154 prominent research clusters or groups. Although the most predominant and consolidated collaborations are characterized by members from the same country studying the same type of Leishmania, there are also notable links between authors from different countries or who study different clinical strains of the disease. Brazil took the lead in this research, with numerous Brazilian researchers heading different clusters in the center of the collaboration network. Investigators from the USA, India, and European countries, such as France, Spain, the United Kingdom, and Italy, also stand out within the network. Conclusions Research should be fostered in countries such as Bangladesh, Nepal, Sudan, and Ethiopia, where there is a high prevalence of different forms of the disease but limited research development with reference authors integrated into the collaboration networks.

Color Doppler sonography with contrast in the differentiation of ovarian tumors

The objective of this study was to differentiate benign ovarian tumors from malignant ones before surgery using color and pulsed Doppler sonography, and to compare results obtained before and after use of contrast medium, thereby verifying whether contrast results in an improvement in the diagnostic sensitivity. METHODS: Sixty two women (mean age 49.9 years) with ovarian tumors were studied, 45 with benign and 17 with malignant tumors. All women underwent a transvaginal color Doppler ultrasonographic exam. A study of the arterial vascular flow was made in all tumor areas, as well as an impedance evaluation of arterial vascular flow using the resistance index. RESULT: Localization of the vessels in the tumor revealed a greater proportion of malignant tumors with detectable internal vascular flows (64%) than benign tumors with such flows (22%). There was a considerable overlap of these findings. The use of contrast identified a greater number of vessels with confirmation in the totality of tumors, but did not improve the Doppler capacity in tumoral differentiation. Malignant tumors presented lower values of resistance index than the benign ones, whether or not contrast was used. The cutoff value for resistance index that better maximized the Doppler sensitivity and specificity was 0.55. Through this value, an increase of the sensitivity after contrast use was obtained, varying from 47% to 82%, while specificity remained statistically unchanged. CONCLUSION: Although the injection of a microbubble agent improved the sensitivity of the method detecting vascularization of tumors, a positive finding for vascularization by this method was not clinically useful in the differentiation of benign and malignant ovarian tumors.

Soil carbon and nitrogen in pasture soil reforested with eucalyptus and guachapele

In spite of the normally low content of organic matter found in sandy soils, it is responsible for almost the totality of cation exchange capacity (CEC), water storage and availability of plant nutrients. It is therefore important to evaluate the impact of alternative forest exploitation on the improvement of soil C and N accumulation on these soils. This study compared pure and mixed plantations of Eucalyptus grandis and Pseudosamanea guachapele, a N2-fixing leguminous tree, in relation to their effects on soil C and N stocks. The studied Planosol area had formerly been covered by Panicum maximum pasture for at least ten years without any fertilizer addition. To estimate C and N contents, the soil was sampled (at depths of 0-2.5; 2.5-5.0; 5.0-7.5; 7.5-10.0; 10.0-20.0 and 20.0-40.0 cm), in pure and mixed five-year-old tree plantations, as well as on adjacent pasture. The natural abundance 13C technique was used to estimate the contribution of the soil organic C originated from the trees in the 0-10 cm soil layer. Soil C and N stocks under mixed plantation were 23.83 and 1.74 Mg ha-1, respectively. Under guachapele, eucalyptus and pasture areas C stocks were 14.20, 17.19 and 24.24 Mg ha-1, respectively. For these same treatments, total N contents were 0.83; 0.99 and 1.71 Mg ha-1, respectively. Up to 40 % of the soil organic C in the mixed plantation was estimated to be derived from trees, while in pure eucalyptus and guachapele plantations these same estimates were only 19 and 27 %, respectively. Our results revealed the benefits of intercropped leguminous trees in eucalyptus plantations on soil C and N stocks.