Avaliação do volume da placenta no primeiro trimestre de gestação por meio da ultrassonografia tridimensional utilizando o método XI VOCAL

OBJETIVO: Determinar valores de referência para o volume da placenta entre 7 e 10 semanas e 6 dias de gestação por meio da ultrassonografia tridimensional utilizando o método XI VOCAL (eXtended Imaging Virtual Organ Computer-aided Analysis). MATERIAIS E MÉTODOS: Realizou-se estudo de corte transversal com 70 gestantes normais entre 7 e 10 semanas e 6 dias. Para o cálculo de volume, utilizou-se o método XI VOCAL com delimitação de dez planos adjacentes. Foram determinadas médias, medianas, desvios-padrão, valores máximo e mínimo para o volume da placenta. Para avaliar a correlação do volume da placenta com a idade gestacional, foi criado gráfico de dispersão, sendo o ajuste realizado pelo coeficiente de determinação (R²). RESULTADOS: A média do volume da placenta variou de 4,6 cm³ (2,6-8,6 cm³) a 28,9 cm³ (11,4-66,9 cm³). O volume da placenta (VP) se mostrou altamente correlacionado com a idade gestacional (IG), sendo o melhor ajuste com a regressão exponencial [VP = exp(0,582 × IG + 0,063); R² = 0,82]. CONCLUSÃO: Valores de referência para o volume da placenta no primeiro trimestre de gestação utilizando o método XI VOCAL foram determinados.

Identification of Propionibacterium avidum from a breast abscess: an overlooked etiology of clinically significant infections.

We report the case of a 37-year-old previously healthy woman diagnosed with a breast abscess due to Propionibacterium avidum after breast reduction surgery. This case emphasizes the potential pathogenicity and morbidity associated with this commensal skin organism.

A systematic review of ultrasound-guided methods for brachial plexus blockade.

We systematically reviewed 25 randomised controlled trials of ultrasound-guided brachial plexus blockade that recruited 1948 participants: either one approach vs another (axillary, infraclavicular or supraclavicular); or one injection vs multiple injections. There were no differences in the rates of successful blockade with approach, relative risk (95% CI): axillary vs infraclavicular, 1.0 (1.0-1.1), p = 0.97; axillary vs supraclavicular, 1.0 (1.0-1.1), p = 0.68; and infraclavicular vs supraclavicular, 1.0 (1.0-1.1), p = 0.32. There was no difference in the rate of successful blockade with the number of injections, relative risk (95% CI) 1.0 (1.0-1.0), p = 0.69, for one vs multiple injections. The rate of procedural paraesthesia was less with one injection than multiple injections, relative risk (95% CI) 0.6 (0.4-0.9), p = 0.004.

Automobile Corporate Networks in Europe : Sectoral Specialization of Central and Eastern European Cities

The global automobile industry is made up of very large corporations and their various subsidiaries containing different functions that create complex locational structures. The networks formed by the 19 largest automobile transnational corporations constitute an automobile "oligopoly" representing more than 90% (OICA, 2012) of the world's production. Since the mid-1990s, Central and Eastern European cities have become attractive for transnational corporations and particularly for the production functions in the automobile sector. This leads to a crucial question. Are strategic functions (such as R&D) within these networks also located in Central and Eastern Europe, or is the region still manufacturing-oriented in the automobile industry? This paper focuses on the patterns and the main factors influencing the role of some of these new central and Eastern European cities that have become integrated in the global value chain of the automobile industry. By analysing the various locations of the specialized functions within the corporations, this study aims to extend the research on global value chains (Gereffi and Korzeniewicz; 1994, Sturgeon, 2000; Krätke, 2014). The spatial patterns of the various functions and the ownerships networks of the automobile industry are constructed in order to identify the cities supporting it. In particular, the way that national metropolises bring their national territories into the globalization of the automobile industry is addressed. For example, are there some specific advantages of capital cities compared to cities that have less integration in globalization terms?

Les expositions universelles comme communautés émotionnelles imaginées: du bon usage des émotions dans l'art d'instruire et de divertir

Cette contribution commence par établir que les expositions universelles sont traversées par un ensemble de dynamiques contradictoires qui reflètent celles intervenant dans le processus de la mondialisation qu'elles ont précisément pour vocation de mettre en scène. Parmi ces différents dynamiques, il en est une qui mérite que l'on s'y arrête de nouveau : celle ayant d'abord opposé sciences et loisirs avant de les associer comme organisateurs de la vie sociale. Comment les expositions universelles ont-elles représenté ces deux types d'activités qui leur ont été centrales ? L'article avance que l'évolution de la fonction de normalisation sociale attachée aux sciences et aux divertissements peut être éclairée par une analyse de l'usage qui a été fait des émotions par les organisateurs et commentateurs de ces manifestations. Le phénomène est examiné à la lumière des concepts d'émotionologie, d'émotif et de communauté émotionnelle développés par les historiens des émotions. This article starts from the premise that international exhibitions are driven by the same contradictory dynamics underlying the process of globalization which they seek to stage. Among these various dynamics, there is need to further study the one that has involved science and leisure as organizers of social life in a dyadic relationship evolving historically from opposition to accommodation. Drawing on the concepts of «emotionolgy », « emotives » and « emotional communities », the study attempts to show how changes in the normalizing functions of science and leisure can be highlighted through the shifting use of emotions by the organizers and commentators of world's fairs.

ESTRO-HERO survey: Radiotherapy equipment and departments in the European countries: Final results from the ESTRO-HERO survey

Background: Documenting the distribution of radiotherapy departments and the availability of radiotherapy equipment in the European countries is an important part of HERO the ESTRO Health Economics in Radiation Oncology project. HERO has the overall aim to develop a knowledge base of the provision of radiotherapy in Europe and build a model for health economic evaluation of radiation treatments at the European level. The aim of the current report is to describe the distribution of radiotherapy equipment in European countries. Methods: An 84-item questionnaire was sent out to European countries, principally through their national societies. The current report includes a detailed analysis of radiotherapy departments and equipment (questionnaire items 2629), analyzed in relation to the annual number of treatment courses and the socio-economic status of the countries. The analysis is based on validated responses from 28 of the 40 European countries defined by the European Cancer Observatory (ECO). Results: A large variation between countries was found for most parameters studied. There were 2192 linear accelerators, 96 dedicated stereotactic machines, and 77 cobalt machines reported in the 27 countries where this information was available. A total of 12 countries had at least one cobalt machine in use. There was a median of 0.5 simulator per MV unit (range 0.31.5) and 1.4 (range 0.44.4) simulators per department. Of the 874 simulators, a total of 654 (75%) were capable of 3D imaging (CT-scanner or CBCToption). The number of MV machines (cobalt, linear accelerators, and dedicated stereotactic machines) per million inhabitants ranged from 1.4 to 9.5 (median 5.3) and the average number of MV machines per department from 0.9 to 8.2 (median 2.6). The average number of treatment courses per year per MV machine varied from 262 to 1061 (median 419). While 69% of MV units were capable of IMRT only 49% were equipped for image guidance (IGRT). There was a clear relation between socio-economic status, as measured by GNI per capita, and availability of radiotherapy equipment in the countries. In many low income countries in Southern and Central-Eastern Europe there was very limited access to radiotherapy and especially to equipment for IMRT or IGRT. Conclusions: The European average number of MV machines per million inhabitants and per department is now better in line with QUARTS recommendations from 2005, but the survey also showed a significant heterogeneity in the access to modern radiotherapy equipment in Europe. High income countries especially in Northern-Western Europe are well-served with radiotherapy resources, other countries are facing important shortages of both equipment in general and especially machines capable of delivering high precision conformal treatments (IMRT, IGRT)

Patria

Soitinnus: orkesteri. Dokumentin lopussa kaksi ylimääräistä lehteä (sivut 3,4 ja 9,10). Melartinin käsikirjoitusluettelon tunnus Mel 12:70 (ks. http://lib.siba.fi/fi/kokoelmat/kasikirjoitusarkisto/melartin_erkki/).

Estudio de la contaminación por metales en sedimentos acuáticos de la Bahía de Matanzas

Surface sediments of the Bay of Matanzas (Cuba) were studied to assess its environmental quality by using several criteria (metal content index, pollution load index and sediment quality guidelines). Two partial digestion sediment procedures and a modified BCR sequential extraction were used. The concentrations of metals were measured by atomic spectroscopy methods. The founded contents of Cu (2,4-27,9 mg kg-1), Zn (2,5-55,5 mg kg-1) and Ni (8,8-99,2 mg kg-1) were below those reported by other authors. The results obtained suggested that the most polluted sites were 3, 5, and 6. The sequential extraction procedure showed that most of the studied metals were associated to the more stable fractions.

Novas fontes de resistência do feijoeiro comum à mancha angular

Vinte e oito genótipos, incluindo cultivares de algumas instituições de pesquisa e linhagens do programa de melhoramento da Embrapa Arroz e Feijão, foram avaliados quanto a resistência a oito patótipos do fungo Phaeoisariopsis griseola, agente causal da mancha angular do feijoeiro comum. Estes genótipos foram inoculados aos 14-16 dias após o plantio com uma suspensão contendo 2,0 x 10(4) conídios mL-1. Os sintomas foram avaliados de 14 a 18 dias após a inoculação, utilizando uma escala de nove graus onde foram consideradas resistentes (reação compatível) as plantas que apresentaram os graus de 1 a 3 e suscetíveis (reação incompatível), as que apresentaram os graus de 4 a 9. Os genótipos 'Ouro Negro' e 'LM 202202530' apresentaram reação de resistência a oito e a sete dos oito patótipos utilizados, respectivamente. A cultivar BRS Requinte foi resistente a cinco patótipos e as cultivares BRS Pontal e Cornell 49-242 foram resistentes a apenas quatro patótipos.

Resistência de progênies de café Catimor à ferrugem

Visando avaliar o desempenho de genótipos de café Catimor, foram realizadas avaliações em nível de campo quanto à capacidade produtiva e a incidência da ferrugem e, em casa-de-vegetação os componentes da resistência quantitativa à raça II do patógeno. A reação à infecção foi avaliada por meio de uma escala de notas de 0 a 9, sendo 0 a 3 para plantas consideradas resistentes e 4 a 9 para suscetíveis. Os componentes da resistência quantitativa avaliados foram: freqüência de infecção, esporulação, área foliar lesionada, período de incubação e de latência. As progênies UFV 5550, UFV 6861, UFV 6870, UFV 6831 e UFV 6834 apresentaram produtividade semelhante à da cultivar Catuaí utilizada como testemunha (P < 0,05). Nenhuma planta das progênies UFV 5530, 5451, 5550, 6903 e 5464 apresentou pústulas com esporos. Os descendentes das progênies em estudo variaram quanto à reação à ferrugem, desde resistência completa a alta suscetibilidade, sendo que a maioria situou-se nos níveis intermediários, evidenciando a presença de resistência quantitativa. O número médio de lesões e a área foliar lesionada foram 13 e 21 vezes menores, respectivamente, em UFV 6866. A progênie UFV 6870 apresentou a nota 0,1 de esporulação e a cv. Catuaí, 3,6. O período de incubação nos genótipos estudados variou de 18 a 36 dias e o período latente variou de 20 a 46 dias. Comparado à cultivar Catuaí Vermelho IAC 15, conclui-se que a maioria dos genótipos de Catimor estudados possuem resistência quantitativa.

Síntese e avaliação da atividade antimalárica de novos ozonídeos

A reação de cicloadição [3+4] entre diferentes dienos (ciclopentadieno, 2-metilfurano e furano) e halocetonas levou aos cicloadutos correspondentes, cuja reação de ozonólise forneceu os ozonídeos 3alfa,5alfa-Dimetil-8,9,10-trioxatriciclo[5.2.1.1(2,6)]undecan-4-ona (6), 2,3alfa,5alfa-Trimetil-8,9,10,11-tetraoxatriciclo[5.2.1.1(2,6)]undecan-4-ona (9), 2,3beta,5beta-Trimetil-8,9,10,11-tetraoxatriciclo[5.2.1.1(2,6)]undecan-4-ona (10, isômero exo), 2,3beta,5beta-Trimetil-8,9,10,11-tetraoxatriciclo [5.2.1.1(2,6)]undecan-4-ona (11, isômero endo), 3alfa-Isopropil-8,9,10,11-tetraoxatriciclo[5.2.1.1(2,6)]undecan-4-ona (14). A atividade antimalárica dos ozonídeos foi avaliada em testes "in vitro" contra cepas de Plasmodium falciparum, oriundos da Tailândia.

Conhecimento e interesse em ética médica e bioética na graduação médica

OBJETIVOS: Avaliar o interesse e o conhecimento sobre ética médica e bioética na graduação médica. MÉTODOS: Estudo transversal e descritivo. Foram utilizados dois questionários auto-aplicáveis, um para docentes e outro para discentes, com questões sobre o interesse em ética médica e bioética e conhecimento sobre o Código de Ética Médica (CEM). RESULTADOS: Foram avaliados 101 professores e 331 estudantes. O CEM brasileiro foi lido por 86,2% dos professores e 100% dos alunos. A importância dada à disciplina de ética médica, numa escala de 1 a 5, foi semelhante entre professores e estudantes (4,7 ± 0,7 vs. 4,5 ± 0,8; p = 0,086), enquanto o autoconhecimento sobre o tema foi maior no primeiro grupo (3,4 ± 0,9 vs. 3,2 ± 0,7; p = 0,017). De um total de nove questões avaliadas sobre o conhecimento do CEM, a média de acertos foi de 5,0 ± 1,9 questões para os professores e de 5,9 ± 1,5 para os acadêmicos (p < 0,001), sendo os acertos correlacionados positivamente com a leitura do código. CONCLUSÕES: Este estudo fornece um panorama inédito sobre a percepção de professores e estudantes de Medicina sobre a ética médica e bioética, podendo servir para fundamentar a melhora do ensino dessa disciplina em nossas faculdades.

Fractures in older people - incidence, predictors and consequences

In older populations, fractures are common and the consequences of fractures may be serious both for an individual and for society. However, information is scarce about the incidence, predictors and consequences of fractures in population-based unselected cohorts including both men and women and a long follow-up. The objective of this study was to analyse the incidence and predictors of fractures as well as functional decline and excess mortality due to fractures, among 482 men and 695 women aged 65 or older in the municipality of Lieto, Finland from 1991 until 2002. In analyses, Poisson’s, Cox proportional Hazards and Cumulative Logistic regression models were used for the control of several confounding variables. During the 12-year follow-up with a total of 10 040 person-years (PY), 307 (26%) persons sustained altogether 425 fractures of which 77% were sustained by women. The total incidence of fractures was 53.4 per 1000 PY (95% confidence intervals [95% CI]: 47.9 - 59.5) in women and 24.9 per 1000 PY (95% CI: 20.4 - 30.4) in men. The incidence rates of fractures at any sites and hip fractures were associated with increasing age. No significant changes in the ageadjusted incidence rates of fractures were found in either gender during the 12-year follow-up. The predictors of fractures varied by gender. In multivariate analyses, reduced handgrip strength and body mass index (BMI) lower than 30 in women and a large number of depressive symptoms in men were independent predictors of fractures. A compression fracture in one or more thoracic or upper lumbar vertebras on chest radiography at baseline was associated with subsequent fractures in both genders. Lower body fractures independently predicted both short- (0-2 years) and long-term (up to 8 years) functional decline in mobility and activities of daily living (ADL) performance during the 8-year follow-up. Upper body fractures predicted decline in ADL performance during longterm follow-up. In the 12-year follow-up, hip fractures in men (Hazard Ratio [HR] 8.1, 95% CI: 4.4-14.9) and in women (HR 3.0, 95% CI: 1.9-4.9), and fractures at the proximal humerus in men (HR 5.4, 95% CI: 1.6-17.7) were independently associated with excess mortality. In addition, leisure time inactivity in physical exercise predicted independently both functional decline and excess mortality. Fractures are common among older people posing serious individual consequences. Further studies about the effectiveness of preventing falls and fractures as well as improving care and rehabilitation after fractures are needed.