Envenomation by caterpillars (erucism): proposal for simple pain relief treatment

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Volt-VAR multiobjective optimization to peak-load relief and energy efficiency in distribution networks

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Spatial distribution of runoff depth from a watershed located in a cuesta relief area of São Paulo State, Brazil

This study was undertaken in a 1566 ha drainage basin situated in an area with cuesta relief in the state of São Paulo, Brazil. The objectives were: 1) to map the maximum potential soil water retention capacity, and 2) to simulate the depth of surface runoff in each geographical position of the area based on a typical rainfall event. The database required for the development of this research was generated in the environment of the geographical information system ArcInfo v.10.1. Undeformed soil samples were collected at 69 points. The ordinary kriging method was used in the interpolation of the values of soil density and maximum potential soil water retention capacity. The spherical model allowed for better adjustment of the semivariograms corresponding to the two soil attributes for the depth of 0 to 20 cm, while the Gaussian model enabled a better fit of the spatial behavior of the two variables for the depth of 20 to 40 cm. The simulation of the spatial distribution revealed a gradual increase in the depth of surface runoff for the rainfall event taken as example (25 mm) from the reverse to the peripheral depression of the cuesta (from west to east). There is a positive aspect observed in the gradient, since the sites of highest declivity, especially those at the front of the cuesta, are closer to the western boundary of the watershed where the lowest depths of runoff occur. This behavior, in conjunction with certain values of erodibility and depending on the land use and cover, can help mitigate the soil erosion processes in these areas.

Soil profile, relief features and their relation to structure and distribution of Brazilian Atlantic rain forest trees

In tropical forests, the environmental heterogeneity can provide niche partitioning at local scales and determine the diversity and plant species distribution. Thus, this study aimed to investigate the variations of tree species structure and distribution in response to relief and soil profile features in a portion of the largest remnant of Brazilian Atlantic rain forest. All trees >= 5 cm diameter at breast height were recorded in two 0.99 ha plots. Topographic survey and a soil characterization were accomplished in both plots. Topsoil samples (0-20 cm) were taken from 88 quadrats and analyzed for chemical and particle size properties. Differences for both diversity and tree density were identified among three kinds of soils. A canonical correspondence analysis (CCA) indicated that the specific abundance varied among the three kinds of soils mapped: a shallow Udept - Orthent / Aquent gradient, probably due to differences in soil drainage. Nutrient content was less likely to affect tree species composition and distribution than relief, pH, Al3+, and soil texture. Some species were randomly distributed and did not show restriction to relief and soil properties. However, preferences in niche occupation detected in this study, derived from the catenary environments found, rise up as an important explanation for the high tree species diversity in tropical forests.

Breast Milk and Glucose for Pain Relief in Preterm Infants: A Noninferiority Randomized Controlled Trial

OBJECTIVE: The study goal was to compare the efficacy of expressed breast milk (EBM) versus 25% glucose on pain responses of late preterm infants during heel lancing. METHODS: In a noninferiority randomized controlled trial, a total of 113 newborns were randomized to receive EBM (experimental group [EG]) or 25% glucose (control group [CG]) before undergoing heel lancing. The primary outcome was pain intensity (Premature Infant Pain Profile [PIPP]) and a 10% noninferiority margin was established. Secondary outcomes were incidence of cry and percentage of time spent crying and adverse events. Intention-to-treat (ITT) analysis was used. RESULTS: Groups were similar regarding demographics and clinical characteristics, except for birth weight and weight at data collection day. There were lower pain scores in the CG over 3 minutes after lancing (P<.001). A higher number of infants in the CG had PIPP scores indicative of minimal pain or absence of pain (P = .002 and P = .003 on ITT analysis) at 30 seconds after lancing, and the mean difference in PIPP scores was 3 (95% confidence interval: 1.507-4.483). Lower incidence of cry (P = .001) and shorter duration of crying (P = .014) were observed for CG. Adverse events were benign and self-limited, and there was no significant difference between groups (P = .736 and P = .637 on ITT analysis). CONCLUSIONS: Results based on PIPP scores and crying time indicate poorer effects of EBM compared with 25% glucose during heel lancing. Additional studies exploring the vol and administration of EBM and its combination with other strategies such as skin-to-skin contact and sucking are necessary. Pediatrics 2012;129:664-670

High-frequency TENS in post-episiotomy pain relief in primiparous puerpere: A randomized, controlled trial

Aim: We evaluated the effectiveness of high-frequency transcutaneous electrical nerve stimulation (TENS) as a pain relief resource for primiparous puerpere who had experienced natural childbirth with an episiotomy. Methods: A controlled, randomized clinical study was conducted in a Brazilian maternity ward. Forty puerpere were randomly divided into two groups: TENS high frequency and a no treatment control group. Post-episiotomy pain was assessed in the resting and sitting positions and during ambulation. An 11-point numeric rating scale was performed in three separate evaluations (at the beginning of the study, after 60 min and after 120 min). The McGill pain questionnaire was employed at the beginning and 60 min later. TENS with 100 Hz frequency and 75 mu s pulse for 60 min was employed without causing any pain. Four electrodes ware placed in parallel near the episiotomy site, in the area of the pudendal and genitofemoral nerves. Results: An 11-point numeric rating scale and McGill pain questionnaire showed a significant statistical difference in pain reduction in the TENS group, while the control group showed no alteration in the level of discomfort. Hence, high-frequency TENS treatment significantly reduced pain intensity immediately after its use and 60 min later. Conclusion: TENS is a safe and viable non-pharmacological analgesic resource to be employed for pain relief post-episiotomy. The routine use of TENS post-episiotomy is recommended.

Low-level laser therapy for pain relief after episiotomy: a double-blind randomised clinical trial

Aims and objectives. To evaluate the effectiveness of a low-level laser therapy for pain relief in the perineum following episiotomy during childbirth. Background. Laser irradiation is a painless and non-invasive therapy for perineal pain treatment and its effects have been investigated in several studies, with no clear conclusion on its effectiveness. Design. A double-blind randomised controlled clinical trial. Method. One hundred and fourteen women who underwent right mediolateral episiotomies during vaginal birth in an in-hospital birthing centre in Sao Paulo, Brazil and reported pain =3 on a numeric scale (010) were randomised into three groups of 38 women each: two experimental groups (treated with red and infrared laser) and a control group. The experimental groups were treated with laser applied at three points directly on the episiotomy after suturing in a single session between 656 hours postpartum. We used a diode laser with wavelengths of 660 nm (red laser) and 780 nm (infrared laser). The control group participants underwent all laser procedures, excluding the emission of irradiation. The participants and the pain scores evaluator were blinded to the type of intervention. The perineal pain scores were assessed at three time points: before, immediately after and 30 minutes after low-level laser therapy. Results. The comparison of perineal pain between the three groups showed no significant differences in the three evaluations (p = 0.445), indicating that the results obtained in the groups treated with low-level laser therapy were equivalent to the control group. Conclusions. Low-level laser therapy did not decrease the intensity of perineal pain reported by women who underwent right mediolateral episiotomy. Relevance to clinical practice. The effect of laser in perineal pain relief was not demonstrated in this study. The dosage may not have been sufficient to provide relief from perineal pain after episiotomy during a vaginal birth.