Estudo retrospectivo dos aspectos cirúrgicos do protocolo cooperativo brasileiro para o tratamento dos tumores de células germinativas na infância: repercussão no prognóstico em função da adesão do cirúrgião ao protocolo cirúrgico

Pós-graduação em Bases Gerais da Cirurgia - FMB

Indicadores de avaliação de programas de pós-graduação no Brasil: uma análise multivariada na área de Matemática

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Indicadores de Avaliação de Programas de Pós-Graduação: um estudo comparativo na área da Matemática

The aim of this research is to analyze, in a comparative way, by category of grade, some indicators used by Coordination for the Improvement of Higher Education Personnel (CAPES) in evaluating the performance of Graduate Programs in Mathematics in Brazil, for the triennium 2007-2009, in order to contribute to understanding of the complex methodology involved in triennial evaluations of graduate programs. Based on the indicators present in the Comparative Worksheet of Triennial Assessment, Area Mathematics / Probability and Statistics, from 2007 to 2009, present at CAPES Portal, contingency tables were built for the 26 graduate programs in Mathematics, presenting each indicator and the program concepts. Overall, there was a trend of association of all indicators analyzed and the concept obtained, with older and larger programs with better grades in the assessment. Also, with the exception of journal articles Qualis B5, the article average per professor grows as grows the program grade.

Influence of professional experience on detection and treatment decision of occlusal caries lesions in primary teeth

To evaluate the influence of examiner's clinical experience on detection and treatment decision of caries lesions in primary molars. Design Three experienced dentists (Group A) and three undergraduate students (Group B) used the International Caries Detection and Assessment System (ICDAS) criteria and bitewing radiographs (BW) to perform examinations twice in 77 primary molars that presented a sound or carious occlusal surface. For the treatment decision (TD), the examiners attributed scores, analyzing the teeth in conjunction with the radiographs. The presence and the depth of lesion were validated histologically, and reproducibility was evaluated. The sensitivity, specificity, accuracy, and area under the ROC curve values were calculated for ICDAS and BW. The associations between ICDAS, BW, and TD were analyzed by means of contingency tables. Results Interexaminer agreement for ICDAS, BW, and TD were excellent for Group B and moderate for Group A. The two groups presented similar and satisfactory performance for caries lesion detection using ICDAS and BW. In the treatment decision, Group A was shown to have a less invasive approach than Group B. Conclusion The examiner's experience was not determinant for the clinical and radiographic detection of occlusal lesions in primary teeth but influenced the treatment decision of initial lesions.

SOBRECARGA E DESCONFORTO EMOCIONAL EM CUIDADORES DE IDOSOS

A finalidade deste estudo foi descrever a sobrecarga e o desconforto emocional dos cuidadores de idosos. Estudo epidemiológico e transversal conduzido em 2009 com 124 cuidadores residentes na comunidade de Ribeirão Preto-SP, por meio dos instrumentos: Escala de Sobrecarga de Zarit e Self-Reporting Questionaire (SRQ-20) para o cuidador. A análise dos dados foi realizada no aplicativo SPSS, 15.0, de forma descritiva, univariada (tabelas de frequência) e bivariada (tabelas de contingência para variáveis qualitativas). Os cuidadores, 85,6% do sexo feminino, média de 56,5 anos, utilizaram, em média, 12,4 horas diárias para o cuidar e 57,6% dos cuidadores apresentaram de leve a moderada sobrecarga. Dependência funcional do idoso, sexo do cuidador e tempo em horas para o cuidado, foram preditores da sobrecarga (p<0,05). Encontrou-se, também, que a sobrecarga é fator de risco para desconforto emocional (p<0,05). Cabe aos enfermeiros utilizarem protocolos de avaliação, com base nos fatores de risco, para prevenir a sobrecarga.

Immunohistochemical evaluation of MMP-2, MMP-9 and CD31/microvascular density in squamous cell carcinomas of the floor of the mouth

The aim of this study was to evaluate the immunoexpression of MMP-2, MMP-9 and CD31/microvascular density in squamous cell carcinomas of the floor of the mouth and to correlate the results with demographic, survival, clinical (TNM staging) and histopathological variables (tumor grade, perineural invasion, embolization and bone invasion). Data from medical records and diagnoses of 41 patients were reviewed. Histological sections were subjected to immunostaining using primary antibodies for human MMP-2, MMP-9 and CD31 and streptavidin-biotin-immunoperoxidase system. Histomorphometric analyses quantified positivity for MMPs (20 fields per slide, 100?points grade, ×200) and for CD31 (microvessels <50?µm in the area of the highest vascularization, 5 fields per slide, 100?points grade, ×400). Statistical design was composed by non-parametric Mann-Whitney U test (investigating the association between numerical variables and immunostainings), chi-square frequency test (in contingency tables), Fisher's exact test (when at least one expected frequency was less than 5 in 2×2 tables), Kaplan-Meier method (estimated probabilities of overall survival) and Iogrank test (comparison of survival curves), all with a significance level of 5%. There was a statistically significant correlation between immunostaining for MMP-2 and lymph node metastasis. Factors associated negatively with survival were N stage, histopathological grade, perineural invasion and immunostaining for MMP-9. There was no significant association between immunoexpression of CD31 and the other variables. The intensity of immunostaining for MMP-2 can be indicative of metastasis in lymph nodes and for MMP-9 of a lower probability of survival

Occurrence of bipolar spectrum disorder and comorbidities in women with eating disorders

Abstract Background Eating disorder (ED) patients often have comorbidities with other psychiatric disorders, especially with mood disorders. Although recent studies suggest an intimate relationship between ED and bipolar disorder (BD), the study on a broader bipolar spectrum definition has not been done in this population. We aimed to study the occurrence of bipolar spectrum (BS) and comorbidities in eating disorder patients of a tertiary service provider. Methods Sixty-nine female patients diagnosed with anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified were evaluated. The assessment comprised the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), clinical criteria for diagnosis of the Zurich bipolar spectrum. Mann–Whitney tests compared means of continuous variables. The association between categorical variables and the groups was described using contingency tables and analyzed using the chi-square or Fisher's exact test. The level of significance alpha was set at 5%. Results The results showed that 68.1% of patients had comorbidity with bipolar spectrum, and this was associated with higher family income, proportion of married people, and comorbidity with substance use. The ED with BS group showed higher rates of substance use comorbidity (40.4%) than the ED without BS group (13.6%). Discussion These results showed that the bipolar spectrum is a common comorbidity in patients with eating disorders and is associated with correlates of clinical importance, notably the comorbidity with substance use. Due to the pattern of similarity between the groups with and without comorbid bipolar spectrum in relation to various outcomes evaluated, the identification of comorbidity can be difficult. However, the precise diagnosis and careful identification of clinical correlates may contribute to future advances in treating these conditions. Further studies are necessary to evaluate the association of other clinical correlates and its possible causal association.

COVARIATE-ADJUSTED NONPARAMETRIC ANALYSIS OF MAGNETIC RESONANCE IMAGES USING MARKOV CHAIN MONTE CARLO

Permutation tests are useful for drawing inferences from imaging data because of their flexibility and ability to capture features of the brain that are difficult to capture parametrically. However, most implementations of permutation tests ignore important confounding covariates. To employ covariate control in a nonparametric setting we have developed a Markov chain Monte Carlo (MCMC) algorithm for conditional permutation testing using propensity scores. We present the first use of this methodology for imaging data. Our MCMC algorithm is an extension of algorithms developed to approximate exact conditional probabilities in contingency tables, logit, and log-linear models. An application of our non-parametric method to remove potential bias due to the observed covariates is presented.

Antiretroviral therapy adherence and the use of condoms among African American HIV-positive crack cocaine users

Safer sex practices, such as consistent condom use, are essential to reduce HIV transmission. Determining causes and/or co-variants related to the likelihood of participating in high-risk sexual behaviors may allow the content of interventions and treatments to minimize HIV transmission to be tailored more effectively. The goal of this study was to examine whether a relationship exists between consistent condom use among African American HIV-positive crack cocaine users and both (1) the use of antiretroviral therapy, and (2) adherence to antiretroviral therapy regimens. The study population consisted of 390 participants. They were at least 18 years old, African American, HIV-positive, and had used crack cocaine within a month prior to an interview conducted sometime between April, 2004, and September, 2007. Bivariate associations were examined using contingency tables and χ2-statistics. The Mantel-Haenszel method was used to control for confounding. This study found neither a significant relationship between use of antiretroviral therapy and consistent condom use (Odds ratio (OR) = 1.38; 95% Confidence interval (95%CI) = 0.86–2.22), nor an association between antiretroviral therapy adherence and consistent condom use (OR = 1.02, 95%CI = 0.60–1.75). The exception was more consistent condom use when sex was traded for money or drugs in those on antiretroviral therapy, compared to those not on such therapy (OR = 2.28, 95%CI = 1.08–4.85). Further studies examining condom use and HIV treatment adherence are recommended. ^

Soft tissue oral wound healing in diabetic patients

This prospective observational cohort study investigated whether diabetic dental patients with poor glycemic control experience a higher risk of post-operative complications and diminished wound healing abilities after an oral surgical procedure such as implant placement. This study compared soft tissue oral wound healing complications between poorly controlled diabetic patients, well controlled diabetic patients and non-diabetic patients following surgical implant placement in the mandible with a total of 131 patients. A one week post-surgical follow-up visit involved an oral wound examination that consisted of evaluating for edema, erythema, exudate, oral pain, problems with flap closure, infection, and hematoma. Analyses were performed to determine significance differences in frequency of oral wound complications between the 3 diabetic groups. Two-by-two contingency tables using chi-square analysis were used to evaluate for significant differences in the proportion of each post-operative oral wound healing complication. This was done separately between non-diabetics and diabetics and between well-controlled and poorly controlled diabetics to calculate odds ratios. Confidence intervals were also calculated. This preliminary study showed that many of the complications were found not to be associated with diabetic status. Other complications such as edema and problems with flap closure were found to be less likely to occur in diabetics compared to non-diabetics and even in poorly controlled diabetics when compared to well-controlled diabetics. The results did not support the hypothesis that diabetic dental patients experience a higher risk than non-diabetic patients of post-operative soft tissue oral wound complications.^

Effect of insurance status on stage of breast cancer diagnosis

Objective: The purpose of this study is to compare the stages of breast cancer presented between the insured and uninsured patients diagnosed at The Rose, an active non-profit breast healthcare organization to determine if uninsured patients present with more advanced stage breast cancer as compared to their insured counterparts. ^ Study Design: Retrospective cross-sectional study. ^ Methods: The study included 1,265 patients who received breast healthcare services and were diagnosed with breast cancer at The Rose between FY 2007 and FY 2012. 738 of the patients in the study were presumably uninsured since their breast healthcare services were sponsored through various funding sources and they were navigated into treatment through The Rose patient navigation program. We compared breast cancer stages for women who had insurance with those who did not have insurance. The effects of age and race/ethnicity along with the insurance status on the stage of reast cancer diagnosis were also analyzed. We calculated the odds ratio using the contingency tables; and estimated odds ratios (ORs) and 95% confidence intervals (CIs) using ordinal logistic regression by applying multiple imputation method for missing tumor stage data. ^ Results: The ordered logistic regression analysis with ordered tumor stage as dependent variable and uninsured as independent variable gave us an odds ratio of 1.73 (OR=1.73; p-value<0.05; 95% CI: 1.36 - 2.12). ^ Conclusions: Insurance status is a strong predictor of stage of breast cancer diagnosed among women seen at The Rose. Uninsured women seen at The Rose are almost twice as likely to present at a advanced stage of breast cancer as opposed to their insured counterparts.^

Análisis económico de la brecha tecnológica en la producción de uva de mesa sanjuanina

Este estudio se realizó en una zona productora de uva de mesa de la provincia de San Juan, que incluyó los departamentos Zonda, Ullum, Albardón, Pocito, Caucete, 25 de Mayo, San Martín y 9 de Julio. De 335 explotaciones existentes, según la base obtenida a partir del CNA 2002, se tomó una muestra de 83 casos, para 2 sigmas de intervalo de confianza y 10 % de error. Los objetivos planteados fueron: determinar el nivel tecnológico para este rubro productivo, medir el grado de severidad de un grupo de restricciones asociadas a la incorporación de tecnología y estimar el beneficio económico alcanzado por el cierre de la brecha tecnológica. De este modo, se plantearon tres dimensiones de estudio, evaluando oportunamente las variables asociadas, de acuerdo a los estudios preeliminares. Los datos fueron procesados con el programa SPSS 11. Se realizó, para el estudio de la primera dimensión, análisis de componentes principales, escalamiento multidimensional y análisis de conglomerados no jerárquicos y en dos fases. En el caso de la segunda dimensión, se utilizaron tablas de contingencia con los estadísticos chi-cuadrado y t de student. Para estimar el beneficio económico alcanzado por el cierre de la brecha tecnológica, se utilizó un programa de simulación SIGMA 2.0. Se encontró la existencia de dos niveles tecnológicos dentro del rubro productivo uva de mesa de exportación, en donde existen inconvenientes referidos a la carencia de infraestructura, falta de rentabilidad asociada a los ingresos de la alternativa tecnológica, incompatibilidad entre los intereses al crédito que se puede acceder y las ganancias de la alternativa tecnológica y, por último, falta de planificación empresarial. Del cierre de la brecha tecnológica, en un escenario positivo, de cinco años, se concluye que el beneficio social medido como excedente bruto de la producción, puede ascender a casi $ 27 millones.

Las formas sociales de producción familiar : Un análisis de su construcción a partir de los modelos de clasificación para el caso pampeano. Rojas 2002

En este artículo proponemos un abordaje de las formas sociales de producción familiar, articulando la reflexión teórica sobre las dimensiones de interés que comprenden su definición y la propuesta de identificación de distintos subtipos agrarios, dentro de la categoría de explotación familiar. Asimismo revisamos una serie de factores que suelen considerarse al momento de explicar y/o definir el carácter familiar de las unidades productivas familiares, para luego avanzar a través de un ejercicio de estimación de la importancia de los distintos subtipos familiares.A partir de este ejercicio, buscaremos acercarnos al debate sobre los obstáculos al desarrollo del capitalismo en el agro a la luz de los datos obtenidos. El artículo se basa en el reprocesamiento de los datos censales originales del Censo Agropecuario Nacional del año 2002, tomando como caso de aplicación el partido bonaerense de Rojas.

Las formas sociales de producción familiar : Un análisis de su construcción a partir de los modelos de clasificación para el caso pampeano. Rojas 2002

En este artículo proponemos un abordaje de las formas sociales de producción familiar, articulando la reflexión teórica sobre las dimensiones de interés que comprenden su definición y la propuesta de identificación de distintos subtipos agrarios, dentro de la categoría de explotación familiar. Asimismo revisamos una serie de factores que suelen considerarse al momento de explicar y/o definir el carácter familiar de las unidades productivas familiares, para luego avanzar a través de un ejercicio de estimación de la importancia de los distintos subtipos familiares.A partir de este ejercicio, buscaremos acercarnos al debate sobre los obstáculos al desarrollo del capitalismo en el agro a la luz de los datos obtenidos. El artículo se basa en el reprocesamiento de los datos censales originales del Censo Agropecuario Nacional del año 2002, tomando como caso de aplicación el partido bonaerense de Rojas.

Las formas sociales de producción familiar : Un análisis de su construcción a partir de los modelos de clasificación para el caso pampeano. Rojas 2002

En este artículo proponemos un abordaje de las formas sociales de producción familiar, articulando la reflexión teórica sobre las dimensiones de interés que comprenden su definición y la propuesta de identificación de distintos subtipos agrarios, dentro de la categoría de explotación familiar. Asimismo revisamos una serie de factores que suelen considerarse al momento de explicar y/o definir el carácter familiar de las unidades productivas familiares, para luego avanzar a través de un ejercicio de estimación de la importancia de los distintos subtipos familiares.A partir de este ejercicio, buscaremos acercarnos al debate sobre los obstáculos al desarrollo del capitalismo en el agro a la luz de los datos obtenidos. El artículo se basa en el reprocesamiento de los datos censales originales del Censo Agropecuario Nacional del año 2002, tomando como caso de aplicación el partido bonaerense de Rojas.