Dyspareunia And Lubrication In Premature Ovarian Failure Using Hormonal Therapy And Vaginal Health.

To evaluate vaginal microbiological and functional aspects in women with and without premature ovarian failure (POF) and the relationship with sexual function. A cross-sectional study of 36 women with POF under hormonal therapy who were age-matched with 36 women with normal gonadal function. The vaginal tropism was assessed through hormonal vaginal cytology, vaginal pH and vaginal health index (VHI). Vaginal flora were assessed by the amine test, bacterioscopy and culture for fungi. Sexual function was evaluated through the questionnaire Female Sexual Function Index (FSFI). Women in both groups were of similar age and showed similar marital status. The two groups presented vaginal tropic scores according to the VHI but the tropism was worse among women in the POF group. No difference was observed with respect to hormonal cytology and pH. Vaginal flora was similar in both groups. Women with POF showed worse sexual performance with more pain and poorer lubrication than women in the control group. The VHI, the only parameter evaluated showing statistical difference between the groups, did not correlate with the domains of pain and lubrication in the FSFI questionnaire. These findings suggest that the use of systemic estrogen among women with POF is not enough to improve complaints of lubrication and pain despite conferring similar tropism and vaginal flora. Other therapeutic options need to be evaluated.

Evolution Of The Deaths Registry System In Brazil: Associations With Changes In The Mortality Profile, Under-registration Of Death Counts, And Ill-defined Causes Of Death.

This paper examines the spatial pattern of ill-defined causes of death across Brazilian regions, and its relationship with the evolution of completeness of the deaths registry and changes in the mortality age profile. We make use of the Brazilian Health Informatics Department mortality database and population censuses from 1980 to 2010. We applied demographic methods to evaluate the quality of mortality data for 137 small areas and correct for under-registration of death counts when necessary. The second part of the analysis uses linear regression models to investigate the relationship between, on the one hand, changes in death counts coverage and age profile of mortality, and on the other, changes in the reporting of ill-defined causes of death. The completeness of death counts coverage increases from about 80% in 1980-1991 to over 95% in 2000-2010 at the same time the percentage of ill-defined causes of deaths reduced about 53% in the country. The analysis suggests that the government's efforts to improve data quality are proving successful, and they will allow for a better understanding of the dynamics of health and the mortality transition.

Improvement Of The Physical Performance Is Associated With Activation Of No/pgc-1α/mttfa Signaling Pathway And Increased Protein Expressions Of Electron Transport Chain In Gastrocnemius Muscle From Rats Supplemented With L-arginine.

To examine the influence of l-arginine supplementation in combination with physical training on mitochondrial biomarkers from gastrocnemius muscle and its relationship with physical performance. Male Wistar rats were divided into four groups: control sedentary (SD), sedentary supplemented with l-arginine (SDLA), trained (TR) and trained supplemented with l-arginine (TRLA). Supplementation of l-arginine was administered by gavage (62.5mg/ml/day/rat). Physical training consisted of 60min/day, 5days/week, 0% grade, speed of 1.2km/h. The study lasted 8weeks. Skeletal muscle mitochondrial enriched fraction as well as cytoplasmic fractions were obtained for Western blotting and biochemical analyses. Protein expressions of transcriptor coactivator (PGC-1α), transcriptor factors (mtTFA), ATP synthase subunit c, cytochrome oxidase (COXIV), constitutive nitric oxide synthases (eNOS and nNOS), Cu/Zn-superoxide dismutase (SOD) and manganese-SOD (Mn-SOD) were evaluated. We also assessed in plasma: lipid profile, glycemia and malondialdehyde (MDA) levels. The nitrite/nitrate (NOx(-)) levels were measured in both plasma and cytosol fraction of the gastrocnemius muscle. 8-week l-arginine supplementation associated with physical training was effective in promoting greater tolerance to exercise that was accompanied by up-regulation of the protein expressions of mtTFA, PGC-1α, ATP synthase subunit c, COXIV, Cu/Zn-SOD and Mn-SOD. The upstream pathway was associated with improvement of NO bioavailability, but not in NO production since no changes in nNOS or eNOS protein expressions were observed. This combination would be an alternative approach for preventing cardiometabolic diseases given that in overt diseases a profound impairment in the physical performance of the patients is observed.

Encephalization And Diversification Of The Cranial Base In Platyrrhine Primates.

The cranial base, composed of the midline and lateral basicranium, is a structurally important region of the skull associated with several key traits, which has been extensively studied in anthropology and primatology. In particular, most studies have focused on the association between midline cranial base flexion and relative brain size, or encephalization. However, variation in lateral basicranial morphology has been studied less thoroughly. Platyrrhines are a group of primates that experienced a major evolutionary radiation accompanied by extensive morphological diversification in Central and South America over a large temporal scale. Previous studies have also suggested that they underwent several evolutionarily independent processes of encephalization. Given these characteristics, platyrrhines present an excellent opportunity to study, on a large phylogenetic scale, the morphological correlates of primate diversification in brain size. In this study we explore the pattern of variation in basicranial morphology and its relationship with phylogenetic branching and with encephalization in platyrrhines. We quantify variation in the 3D shape of the midline and lateral basicranium and endocranial volumes in a large sample of platyrrhine species, employing high-resolution CT-scans and geometric morphometric techniques. We investigate the relationship between basicranial shape and encephalization using phylogenetic regression methods and calculate a measure of phylogenetic signal in the datasets. The results showed that phylogenetic structure is the most important dimension for understanding platyrrhine cranial base diversification; only Aotus species do not show concordance with our molecular phylogeny. Encephalization was only correlated with midline basicranial flexion, and species that exhibit convergence in their relative brain size do not display convergence in lateral basicranial shape. The evolution of basicranial variation in primates is probably more complex than previously believed, and understanding it will require further studies exploring the complex interactions between encephalization, brain shape, cranial base morphology, and ecological dimensions acting along the species divergence process.

Jogos dos povos indigenas : trajetórias e interlocuções = Indigenous peoples games : trajectory and interlocutions

Universidade Estadual de Campinas . Faculdade de Educação Física

Maturação somática e desempenho físico em jovens futebolistas = : Somatic maturation and physical performance in young soccer players

Universidade Estadual de Campinas . Faculdade de Educação Física

Self-perception and malocclusion and their relation to oral appearance and function

The aim of this study was to evaluate the relationship between malocclusion and self-perception of oral appearance/function, in 12/15-year-old Brazilian adolescents. The cluster sample consisted of 717 teenagers attending 24 urban public (n=611) and 5 rural public (n=107) schools in Maringá/PR. Malocclusion was measured using the Dental Aesthetic Index (DAI), in accordance with WHO recommendations. A parental questionnaire was applied to collect information on esthetic perception level and oral variables related to oral health. Univariate and multiple logistic regression analyses were performed. Multiple logistic regression confirmed that for 12-year-old, missing teeth (OR=2.865) and presence of openbite (open occlusal relationship) (OR=2.865) were risk indicators for speech capability. With regard to 15-year-old, presence of mandibular overjet (horizontal overlap) (OR=4.016) was a risk indicator for speech capability and molar relationship (OR=1.661) was a risk indicator for chewing capability. The impact of malocclusion on adolescents' life was confirmed in this study. Speech and chewing capability were associated with orthodontic deviations, which should be taken into consideration in oral health planning, to identify risk groups and improve community health services.

Digital subtraction radiographic analysis of the combination of bioabsorbable membrane and bovine morphogenetic protein pool in human periodontal infrabony defects

OBJECTIVES: This study assessed the bone density gain and its relationship with the periodontal clinical parameters in a case series of a regenerative therapy procedure. MATERIAL AND METHODS: Using a split-mouth study design, 10 pairs of infrabony defects from 15 patients were treated with a pool of bovine bone morphogenetic proteins associated with collagen membrane (test sites) or collagen membrane only (control sites). The periodontal healing was clinically and radiographically monitored for six months. Standardized pre-surgical and 6-month postoperative radiographs were digitized for digital subtraction analysis, which showed relative bone density gain in both groups of 0.034 ± 0.423 and 0.105 ± 0.423 in the test and control group, respectively (p>0.05). RESULTS: As regards the area size of bone density change, the influence of the therapy was detected in 2.5 mm² in the test group and 2 mm² in the control group (p>0.05). Additionally, no correlation was observed between the favorable clinical results and the bone density gain measured by digital subtraction radiography (p>0.05). CONCLUSIONS: The findings of this study suggest that the clinical benefit of the regenerative therapy observed did not come with significant bone density gains. Long-term evaluation may lead to a different conclusions.

Bite force in temporomandibular dysfunction (TMD) and healthy complete denture wearers

The signs and symptoms of temporomandibular dysfunction (TMD) may contribute to reduce bite force and muscular activity. The aims of this study were to compare bite force in complete denture wearers with TMD (TMD group) and without TMD (healthy group).The TMD group consisted of 9 individuals, who had worn a maxillary and a mandibular complete removable denture for more than 10 years. The healthy group consisted of 9 participants who wore dentures and had satisfactory interocclusal and maxillomandibular relationship. Helkimo Index was used to analyze the dysfunction level. Maximum bite force was measured using a digital dynamometer with capacity of 100 kgf and adapted to oral conditions.The TMD group presented smaller mean bite force values than the healthy group, though without statistical significance (p>0.05). This outcome suggests that the TMD signs and symptoms and the structural conditions of the dentures did not affect the maximal bite force of complete denture wearers.

Reliability and discriminatory power of methods for dental plaque quantification

OBJECTIVE: This in situ study evaluated the discriminatory power and reliability of methods of dental plaque quantification and the relationship between visual indices (VI) and fluorescence camera (FC) to detect plaque. MATERIAL AND METHODS: Six volunteers used palatal appliances with six bovine enamel blocks presenting different stages of plaque accumulation. The presence of plaque with and without disclosing was assessed using VI. Images were obtained with FC and digital camera in both conditions. The area covered by plaque was assessed. Examinations were done by two independent examiners. Data were analyzed by Kruskal-Wallis and Kappa tests to compare different conditions of samples and to assess the inter-examiner reproducibility. RESULTS: Some methods presented adequate reproducibility. The Turesky index and the assessment of area covered by disclosed plaque in the FC images presented the highest discriminatory powers. CONCLUSION: The Turesky index and images with FC with disclosing present good reliability and discriminatory power in quantifying dental plaque.

Work start time and chronotype of indoor and outdoor daytime workers

Introdução e objetivo: A exposição à luz natural tem efeitos relevantes no sistema de temporização biológica. Pode-se supor que essa exposição poderia promover um ajuste melhor entre os ritmos biológicos e os horários de início de trabalho entre trabalhadores diurnos de ambientes externos. O objetivo deste estudo foi comparar a matutinidade/vespertinidade e a relação entre o horário de trabalho real e o ideal em trabalhadores diurnos expostos a condições de iluminação distintas. Métodos: O estudo foi conduzido com dois grupos de trabalhadores (n=49) que residiam em uma área rural e tinham condições sociais similares. Um grupo trabalhava em ambiente interno (n=20, idade média 30,8 anos (21-50); desvio padrão=9,8) e o outro grupo trabalhava em ambiente externo (n=29, idade média 30,8 anos (17- 50); desvio padrão=10,0). Os trabalhadores preencheram um questionário de matutinidade/vespertinidade (MEQ). Foi realizada uma ANOVA de um fator com o intuito de comparar os escores do MEQ entre os dois grupos de trabalhadores. Resultados: Como esperado, o Grupo do Ambiente Externo (GAE) apresentou média de escores mais elevada que o Grupo do Ambiente Interno (GAI), o que significa uma tendência à matutinidade (GAE: 58,4±7,9; GAI; 47,4±6,4), com significância estatística (F=26,22; p<0,001). De acordo com os dados relatados em relação aos horários de trabalho, o GAE gostaria de atrasar seu horário de trabalho em 31 minutos, em média, enquanto que o GAI gostaria de atrasar em 96 minutos seu horário de trabalho (F=7,71; p<0,01). Conclusões: Os resultados desse estudo sugerem que a exposição à luz natural pode promover um ajuste melhor aos horários de início de trabalho matutinos

Revised criteria for the assessment and interpretation of occlusal deviations in the deciduous dentition: a public health perspective

Dados secundários de uma amostra aleatória de pré-escolares brasileiros foram analisados com o objetivo de avaliar a prevalência de desvios oclusais na dentição decídua, que podem adversamente afetar a dentição permanente, com base em critérios revisados. Overjet e overbite apresentaram pontos de corte descritos na literatura para a remoção dos casos de má oclusão leve. Overjet > 3mm e overbite > 3mm afetaram 16% e 7% das crianças, respectivamente. No plano sagital foram consideradas apenas as taxas de desvios bilaterais: relação molar em degrau distal (9,7%) e mesial (6,0%); relação dos caninos Classe 2 (11,0%) e Classe 3 (2,9%). Para os demais desvios não foram relatados na literatura critérios de severidade. Valores brutos de mordida aberta anterior (27,9%); mordida cruzada posterior (11,3%); apinhamento dentário maxilar (7,0%) e mandibular (11,3%) foram registrados. A avaliação da má oclusão na dentição decídua deve considerar a severidade dos desvios para a identificação de casos e não-casos de relevância em saúde pública. Enfatiza-se a necessidade de maior consenso e melhora na interpretação de dados epidemiológicos sobre a má oclusão nesse estágio de desenvolvimento

Adherence to cervical and breast cancer programs is crucial to improving screening performance

Introduction: Cervical and breast cancer are the most common malignancies among women worldwide. Effective screening can facilitate early detection and dramatically reduce mortality rates. The interface between those screening patients and patients most needing screening is complex, and women in remote areas of rural counties face additional barriers that limit the effectiveness of cancer prevention programs. This study compared various methods to improve compliance with mass screening for breast and cervical cancer among women in a remote, rural region of Brazil. Methods: In 2003, a mobile unit was used to perform 10 156 mammograms and Papanicolaou smear tests for women living in the Barretos County region of Sao Paulo state, Brazil (consisting of 19 neighbouring cities). To reach the women, the following community outreach strategies were used: distribution of flyers and pamphlets; media broadcasts (via radio and car loudspeakers); and community healthcare agents (CHCAs) making home visits. Results: The most useful intervention appeared to be the home visits by healthcare agents or CHCAs. These agents of the Family Health Programme of the Brazilian Ministry of Health reached an average of 45.6% of those screened, with radio advertisements reaching a further 11.9%. The great majority of the screened women were illiterate or had elementary level schooling (80.9%) and were of 'poor' or 'very poor' socioeconomic class (67.2%). Conclusions: Use of a mobile screening unit is a useful strategy in developing countries where local health systems have inadequate facilities for cancer screening in underserved populations. A multimodal approach to community outreach strategies, especially using CHCAs and radio advertisements, can improve the uptake of mass screening in low-income, low-educational background female populations.

Chemical similarities between Galactic bulge and local thick disk red giant stars

Context. The evolution of the Milky Way bulge and its relationship with the other Galactic populations is still poorly understood. The bulge has been suggested to be either a merger-driven classical bulge or the product of a dynamical instability of the inner disk. Aims. To probe the star formation history, the initial mass function and stellar nucleosynthesis of the bulge, we performed an elemental abundance analysis of bulge red giant stars. We also completed an identical study of local thin disk, thick disk and halo giants to establish the chemical differences and similarities between the various populations. Methods. High-resolution infrared spectra of 19 bulge giants and 49 comparison giants in the solar neighborhood were acquired with Gemini/Phoenix. All stars have similar stellar parameters but cover a broad range in metallicity. A standard 1D local thermodynamic equilibrium analysis yielded the abundances of C, N, O and Fe. A homogeneous and differential analysis of the bulge, halo, thin disk and thick disk stars ensured that systematic errors were minimized. Results. We confirm the well-established differences for [O/Fe] (at a given metallicity) between the local thin and thick disks. For the elements investigated, we find no chemical distinction between the bulge and the local thick disk, which is in contrast to previous studies relying on literature values for disk dwarf stars in the solar neighborhood. Conclusions. Our findings suggest that the bulge and local thick disk experienced similar, but not necessarily shared, chemical evolution histories. We argue that their formation timescales, star formation rates and initial mass functions were similar.

Chemical similarities between Galactic bulge and local thick disk red giants: O, Na, Mg, Al, Si, Ca, and Ti

Context. The formation and evolution of the Galactic bulge and its relationship with the other Galactic populations is still poorly understood. Aims. To establish the chemical differences and similarities between the bulge and other stellar populations, we performed an elemental abundance analysis of alpha- (O, Mg, Si, Ca, and Ti) and Z-odd (Na and Al) elements of red giant stars in the bulge as well as of local thin disk, thick disk and halo giants. Methods. We use high-resolution optical spectra of 25 bulge giants in Baade's window and 55 comparison giants (4 halo, 29 thin disk and 22 thick disk giants) in the solar neighborhood. All stars have similar stellar parameters but cover a broad range in metallicity (-1.5 < [Fe/H] < +0.5). A standard 1D local thermodynamic equilibrium analysis using both Kurucz and MARCS models yielded the abundances of O, Na, Mg, Al, Si, Ca, Ti and Fe. Our homogeneous and differential analysis of the Galactic stellar populations ensured that systematic errors were minimized. Results. We confirm the well-established differences for [alpha/Fe] at a given metallicity between the local thin and thick disks. For all the elements investigated, we find no chemical distinction between the bulge and the local thick disk, in agreement with our previous study of C, N and O but in contrast to other groups relying on literature values for nearby disk dwarf stars. For -1.5 < [Fe/H] < -0.3 exactly the same trend is followed by both the bulge and thick disk stars, with a star-to-star scatter of only 0.03 dex. Furthermore, both populations share the location of the knee in the [alpha/Fe] vs. [Fe/H] diagram. It still remains to be confirmed that the local thick disk extends to super-solar metallicities as is the case for the bulge. These are the most stringent constraints to date on the chemical similarity of these stellar populations. Conclusions. Our findings suggest that the bulge and local thick disk stars experienced similar formation timescales, star formation rates and initial mass functions, confirming thus the main outcomes of our previous homogeneous analysis of [O/Fe] from infrared spectra for nearly the same sample. The identical a-enhancements of thick disk and bulge stars may reflect a rapid chemical evolution taking place before the bulge and thick disk structures we see today were formed, or it may reflect Galactic orbital migration of inner disk/bulge stars resulting in stars in the solar neighborhood with thick-disk kinematics.