Contraceptive methods with male participation: a perspective of brazilian couples

OBJECTIVE: To assess the perspectives of couples who requested vasectomy in a public health service on the use of male participation contraceptive methods available in Brazil: male condoms, natural family planning/calendar, coitus interruptus and vasectomy. METHODS: A qualitative study with semi-structured interviews was held with 20 couples who had requested vasectomy at the Human Reproduction Unit of the Universidade Estadual de Campinas, Brazil. Data analysis was carried out through thematic content analysis. FINDINGS: The couples did not, in general, know any effective contraceptive options for use by men and/or participating in their use, except for vasectomy. The few methods with male participation that they knew of were perceived to interfere in spontaneity and in pleasure of intercourse. Men accepted that condom use in extra-conjugal relations offered them protection from sexually transmitted diseases; that their wives might also participate in extra-marital relationships was not considered. DISCUSSION: The few contraceptive options with male participation lead to difficulty in sharing responsibilities between men and women. On the basis of perceived gender roles, women took the responsibility for contraception until the moment when the situation became untenable, and they faced the unavoidable necessity of sterilization. CONCLUSIONS: Specific actions are necessary for men to achieve integral participation in relation to reproductive sexual health. These include education and discussions on gender roles, leading to greater awareness in men of the realities of sexual and reproductive health

Echocardiographic study of paediatric patients with mucopolysaccharidosis

Principle Mucopolysaccharidosis is an inborn error of metabolism causing glucosaminoglycans tissue storage. Cardiovascular involvement is variable but contributes significantly towards the morbidity and mortality of the patients. Objective To characterise the echocardiographic abnormalities in children and adolescents with different types of mucopolysaccharidosis. Method Echocardiograms and medical records of 28 patients aged 2–14 years, seen from 2003 to 2005, were revised. At that time, the enzymatic replacement therapy was still not available in our institution.Results Echocardiographic alterations were detected in 26 patients (93 per cent), whereas 16 (57 per cent) had abnormal auscultation, and only 6 (21 per cent) presented with cardiovascular complaint. Mitral valve thickening with dysfunction (regurgitation, stenosis, or double lesion) was diagnosed in 60.8 per cent, left ventricular hypertrophy in 43 per cent and aortic valve thickening with regurgitation in 35.8 per cent of the patients. There was no systolic dysfunction and mild left diastolic dysfunction was shown in 21.5 per cent of the patients. Pulmonary hypertension was present in 36 per cent of the patients, causing the only two deaths recorded. There was a strong association between the accumulation of dermatan sulphate and the presence of mitral valve dysfunction (p = 0.0003), aortic valve dysfunction (p = 0.006), and pulmonary hypertension (p = 0.006). Among individuals with two or more examinations, 82 per cent had a worsening evolution. Conclusions Echocardiographic alterations in children with Mucopolysaccharidosis are frequent and have a progressive character Left valve lesions, ventricular hypertrophy, and pulmonary hypertension were the most common findings and there was an association between the accumulation of dermatan sulphate and cardiovascular involvement. Unlike in adults, pulmonary hypertension was the main cause of death, not left ventricle systolic dysfunction

Detection of Ureaplasma diversum in bovine semen straws for artificial insemination

Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)[06/56855-0]

Abdominal compartment syndrome in trauma resuscitation

Purpose of review Swelling is inexorably linked to shock and resuscitation in trauma. In many forms, swelling complicates and interacts with traumatic injury to raise pressures in the abdomen, resulting in intraabdominal hypertension, which may overtly manifest as abdominal compartment syndrome (ACS) driving multiple organ failure. Despite renewed clinical interest in posttraumatic intraabdominal pressure, there remains a chiasm between knowledge of the risks and clinical interventions to mitigate them. This review provides a concise overview of definitions, risk factors, diagnosis and management using an illustrative trauma case. Recent findings Intraabdominal pressure commonly increases following trauma, wherein ACS may manifest earlier than generally appreciated and complicate other insults such as shock and hemorrhage. Contemporary resuscitation strategies may exacerbate intraabdominal hypertension, particularly massive crystalloid resuscitation. Although unproven, the recent transition to crystalloid restriction and high plasma resuscitation strategies may influence the prevalence of ACS. Nonetheless, aggressive intraabdominal pressure monitoring should be mandatory in the critically ill. Despite potential nonoperative options, decompressive laparotomy remains the only definitive but often morbid treatment. Summary ACS results from many dysfunctions acting in concert with each other in self-propagating vicious cycles. Starting with greater awareness, it is imperative that the growing knowledge should be translated into clinical practice.

Multiple recurrent genetic events converge on control of histone lysine methylation in medulloblastoma

We used high-resolution SNP genotyping to identify regions of genomic gain and loss in the genomes of 212 medulloblastomas, malignant pediatric brain tumors. We found focal amplifications of 15 known oncogenes and focal deletions of 20 known tumor suppressor genes (TSG), most not previously implicated in medulloblastoma. Notably, we identified previously unknown amplifications and homozygous deletions, including recurrent, mutually exclusive, highly focal genetic events in genes targeting histone lysine methylation, particularly that of histone 3, lysine 9 (H3K9). Post-translational modification of histone proteins is critical for regulation of gene expression, can participate in determination of stem cell fates and has been implicated in carcinogenesis. Consistent with our genetic data, restoration of expression of genes controlling H3K9 methylation greatly diminishes proliferation of medulloblastoma in vitro. Copy number aberrations of genes with critical roles in writing, reading, removing and blocking the state of histone lysine methylation, particularly at H3K9, suggest that defective control of the histone code contributes to the pathogenesis of medulloblastoma.

In vitro wear, surface roughness and hardness of propanal-containing and diacetyl-containing novel composites and copolymers based on bis-GMA analogs

Objective. To evaluate the effect of two additives, aldehyde or diketone, on the wear, roughness and hardness of bis-GMA-based composites/copolymers containing TEGDMA, propoxylated bis-GMA (CH(3)bis-GMA) or propoxylated fluorinated bis-GMA (CF(3)bis-GMA). Methods. Fifteen experimental composites and 15 corresponding copolymers were prepared combining bis-GMA and TEGDMA, CH3bis-GMA or CF3bis-GMA, with aldehyde (24mol% and 32 mol%) or diketone (24 mol% and 32 mol%) totaling 30 groups. For composites, hybrid treated filler (barium aluminosilicate glass/pyrogenic silica; 60 wt%) was added to monomer mixtures. Photopolymerization was affected by 0.2 wt% each of camphorquinone and N,N-dimethyl-p-toluidine. Wear (W) test was conducted in a toothbrushing abrasion machine (n = 6) and quantified using a profilometer. Surface roughness (R) changes, before and after abrasion test, were determined using a rugosimeter. Microhardness (H) measurements were performed for dry and wet samples using a Knoop microindenter (n = 6). Data were analyzed by one-way ANOVA and Tukey`s test (alpha = 0.05). Results. Incorporation of additives led to improved W and H values for bis-GMA/TEGDMA and bis-GMA/CH(3)bis-GMA systems. Additives had no significant effect on the W and H changes of bis-GMA/CF(3)bis-GMA. With regard to R changes, additives produced decreased values for bis-GMA/CH3bis-GMA and bis-GMA/CF3bis-GMA composites. Bis-GMA/TEGDMA and bis-GMA/CH(3)bis-GMA copolymers with additives became smoother after abrasion test. Significance. The findings correlate with additives ability to improve degree of conversion of some composites/copolymers thereby enhancing mechanical properties. Published by Elsevier Ltd on behalf of Academy of Dental Materials

The effect of musculoskeletal pain on motor activity and control

Aberrant movement patterns and postures are obvious to clinicians managing patients with musculoskeletal pain. However, some changes in motor function that occur in the presence of pain are less apparent. Clinical and basic science investigations have provided evidence of the effects of nociception on aspects of motor function. Both increases and decreases in muscle activity have been shown, along with alterations in neuronal control mechanisms, proprioception, and local muscle morphology. Various models have been proposed in an attempt to provide an explanation for some of these changes. These include the vicious cycle and pain adaptation models. Recent research has seen the emergence of a new model in which patterns of muscle activation and recruitment are altered in the presence of pain (neuromuscular activation model). These changes seem to particularly affect the ability of muscles to perform synergistic functions related to maintaining joint stability and control. These changes are believed to persist into the period of chronicity. This review shows current knowledge of the effect of musculoskeletal pain on the motor system and presents the various proposed models, in addition to other shown effects not covered by these models. The relevance of these models to both acute and chronic pain is considered. It is apparent that people experiencing musculoskeletal pain exhibit complex motor responses that may show some variation with the time course of the disorder. (C) 2001 by the American Pain Society.

Distribution of C-14 Cylindrospermopsin in vivo in the mouse

Radiolabelled C-14 cylindrospermopsin (CYN) has been prepared and used to investigate the distribution and excretion of CYN in vivo in male Quackenbush mice. At a dose of 0.2 mg/kg (i.e., approx. median lethal dose) the following mean (SID) urinary and faecal recoveries (cumulative) were obtained, respectively: (0-6 hours, n = 4) 48.2 (29.3)%, 11.9 (21.4)%; (0-12 hours, n = 12) 66.0 (27.1)%, 5.7 (5.6)%; (0-24 hours, n = 12) 68.4 (26.7)%, 8.5 (8.1)%. Mean (SD) recoveries from livers at 6 hours were 20.6 (6.4)% (n = 4), at 48 hours 13.1 (7.7)% (n = 8), and 5-7 days were 2.1 (2.1)% (n = 8). A substantial amount (up to 23%) can be retained in the liver for up to 48 hours with a lesser amount retained in the kidneys. The excretion patterns show substantial interindividual variability between predominantly faecal or urinary excretion, but these patterns are not related in any simple manner to the outcome in terms of toxicity. There is at least one methanol-extractable metabolite as well as a nonmethanol-extractable metabolite in the liver. The methanol-extractable metabolite was not found in the kidney and is more hydrophilic than CYN itself on reverse phase. (C) 2001 by John Wiley & Sons, Inc.

Desenvolvimento sustent??vel: o desafio da admininstra????o p??blica brasileira nas dimens??es da relev??ncia social, da prud??ncia ecol??gica e da viabilidade econ??mica

Partindo do conceito de bem-estar social, definido em lei como de responsabilidade da administra????o p??blica, especialmente no que diz respeito ?? preserva????o dos recursos naturais para a manuten????o da decente qualidade de vida dos cidad??os, o artigo foi estruturado a partir do relat??rio de pesquisa de inicia????o cient??fica financiada pela Funda????o de Amparo ?? Pesquisa do Estado de S??o Paulo (Fapesp) e desenvolvido na Universidade Estadual de S??o Paulo (Unesp). Tal relat??rio objetivou investigar os par??metros de regularidade da administra????o p??blica, analisando-se a jurisprud??ncia dos tribunais. Foram evidenciadas irregularidades na atua????o da administra????o p??blica, constatando a desarticula????o da gest??o p??blica ao gerir as tr??s dimens??es que definem o desenvolvimento sustent??vel: a relev??ncia social, a viabilidade econ??mica e a prud??ncia ecol??gica. Foi poss??vel constatar com esta pesquisa que a administra????o p??blica brasileira d?? mais import??ncia para a quest??o econ??mica que ??s quest??es sociais e ambientais. Pudemos perceber que enquanto o meio ambiente ?? degradado e a sociedade prejudicada com a piora da qualidade de vida, o econ??mico vem sendo privilegiado constantemente. Sendo assim, evidenciaremos esse descaso propondo algumas mudan??as para a melhora da gest??o das tr??s dimens??es do desenvolvimento sustent??vel; por??m, em contrapartida, mostraremos a seriedade na atua????o dos ??rg??os colegiados ambientais e institui????es do poder p??blico, tais como o Minist??rio P??blico, que hoje atuam em parceria com a popula????o, crescentemente envolvida no processo mediante a pr??tica de den??ncias e reclama????es.

Caminhos da sustentabilidade para o cinema brasileiro

O artigo pretende mostrar as dificuldades de sustentabilidade da atividade cinematogr??fica brasileira. Com base na an??lise da cadeia produtiva, na estrutura tribut??ria e nas falhas da legisla????o de incentivo fiscal, prop??e-se a exist??ncia de um ciclo vicioso de depend??ncia aos incentivos fiscais. Tendo em vista as dificuldades de acesso a salas de cinema, devido, entre outros fatores, ao baixo poder aquisitivo da popula????o e ?? concentra????o geogr??fica de cinemas nas grandes cidades, prop??e-se uma parceria efetiva entre cinema e televis??o, facilitada pela tecnologia digital. Isso implicar?? altera????es na legisla????o atual, bem como a cria????o de regras regulat??rias, como forma de ampliar o acesso de filmes nacionais ?? grade de programa????o televisiva e tamb??m de viabilizar, em termos industriais, essa atividade econ??mica.

Comparação entre os bioenxertos de hidroxiapatita de cálcio e submucosa de intestino delgado porcino no preenchimento de defeitos ósseos criados em mandíbula de ratos

OBJETIVO: O objetivo do presente estudo consiste em avaliar a regeneração óssea em defeito criado na mandíbula de ratos utilizando dois bioenxertos: hidroxiapatita de cálcio sintética e submucosa de intestino delgado porcina. FORMA DE ESTUDO: Experimental randomizado. MATERIAL E MÉTODO: Foram utilizados 24 ratos da linhagem Wisthar-Furth. Um defeito ósseo de 0,75cm x 1,5cm no corpo de cada hemimandíbula foi realizado em todos os animais com broca esférica de baixa rotação. Padronizou-se à esquerda o preenchimento do defeito ósseo, no grupo I com 15 microgramas de hidroxiapatita e no grupo II com preenchimento de submucosa de intestino delgado porcina (SID), e à direita o não-preenchimento serviu como controle. A eutanásia foi realizada no 40° dia de pós-operatório, após a qual se procederam as análises macroscópicas e histológicas das peças. RESULTADOS: O comprimento médio em milímetros das hemimandíbulas do grupo hidroxiapatita foi de 3,75, e o do grupo SID 3,03 e o do grupo controle foi de 2,63 (p: 0,0022). No grupo hidroxiapatita a neoformação óssea perfez uma área correspondente à 76,64% do total já no grupo SID 63,64% do total. CONCLUSÃO: Os resultados macroscópios e microscópicos foram superiores com a utilização do enxerto de hidroxiapatita quando comparado ao grupo submucosa de intestino delgado porcino. Entretanto os dois bioenxertos mostraram-se osteoindutores quando comparados ao controle.

How logrolling can explain the failure of the government coalition in Brazil

This article presents an analysis of the behavior of federal representatives in the Brazilian House of Representatives between 1995 and 1998, when a series of constitutional amendments were presented by the president to be voted on by Congress. The objective is to show that the lack of a stable government coalition resulted in costs to society that were not anticipated by the government. The study argues that a logroll - a trade of votes - was the strategy used by the government in order to guarantee the number of votes necessary to approve the amendments. This strategy created a vicious system in which representatives would only vote with the government if they had benefits in return.

Avaliação de ensino em tecnologias da saúde: sugestões para a construção e implementação de um plano sustentado

A avaliação do ensino é a construção de um juízo, tão amplo quanto possível, acerca da qualidade do ensino e da aprendizagem e de como adequar edicientemente todos os aspectos que influenciam esta qualidade. Qualquer docente do ensino superior com vontade de evoluir e de se adaptar às condicionantes do processo ensino/aprendizagem deverá estar particularmente atento a estas premissas, sob pena de não atingir o objectivo maior da sua profissão: facultar ou facilitar a aprendizagem de forma duradoura de novos conhecimentos, actos ou comportamentos - "professionals should be rigorous in maintaining and developing their standards of practice" (Reece & Walker, 1994).

O crédito concedido às empresas: antes e no decorrer da crise mundial. Análise e gestão do risco de crédito

O tema do trabalho de investigação é a análise do risco de crédito às empresas antes e durante a actual crise financeira, bem como a sua gestão. A gestão de risco de crédito das instituições financeiras tem-se transformado cada vez mais numa peça chave para toda a actividade bancária, tendo ainda mais significado no mundo actual, em constante mudança e globalização. A concessão de crédito às empresas tornou-se numa tarefa cada vez mais árdua, para as instituições financeiras devido ao risco de crédito. A presente dissertação foi desenvolvida visando os objectivos de efectuar uma avaliação na concessão de crédito a empresas durante a crise, com ênfase na gestão do risco de crédito, bem como na utilização do Acordo de Basileia II. Para atingir os objectivos traçados a metodologia utilizada foi o inquérito por questionário a colaboradores da Caixa Geral de Depósitos (CGD). O questionário foi efectuado, de forma a captar quer os desenvolvimentos passados, como recentes, bem como a evolução esperada. Relativamente à evolução passada, as perguntas respeitam aos anos anteriores à crise, enquanto as perguntas prospectivas se referem aos anos seguintes. O trabalho desenvolvido permitiu-nos concluir que as instituições financeiras mundiais, desde o início da recessão, têm restringido ao máximo a concessão de crédito às empresas. Muitas instituições têm-no feito através da exigência de mais garantias, aumento do spread, bem como a diminuição de maturidades. Todas estas situações geram um ciclo vicioso, na medida em que as empresas que se vêem confrontadas na restrição do acesso ao crédito, não têm condições para sobreviver, gerando assim várias falências.

Increasing source to image distance for AP pelvis imaging: impact on radiation dose and image quality

Aim - A quantative primary study to determine whether increasing source to image distance (SID), with and without the use of automatic exposure control (AEC) for antero-posterior (AP) pelvis imaging, reduces dose whilst still producing an image of diagnostic quality. Methods - Using a computed radiography (CR) system, an anthropomorphic pelvic phantom was positioned for an AP examination using the table bucky. SID was initially set at 110 cm, with tube potential set at a constant 75 kVp, with two outer chambers selected and a fine focal spot of 0.6 mm. SID was then varied from 90 cm to 140 cm with two exposures made at each 5 cm interval, one using the AEC and another with a constant 16 mAs derived from the initial exposure. Effective dose (E) and entrance surface dose (ESD) were calculated for each acquisition. Seven experienced observers blindly graded image quality using a 5-point Likert scale and 2 Alternative Forced Choice software. Signal-to-Noise Ratio (SNR) was calculated for comparison. For each acquisition, femoral head diameter was also measured for magnification indication. Results - Results demonstrated that when increasing SID from 110 cm to 140 cm, both E and ESD reduced by 3.7% and 17.3% respectively when using AEC and 50.13% and 41.79% respectively, when the constant mAs was used. No significant statistical (T-test) difference (p = 0.967) between image quality was detected when increasing SID, with an intra-observer correlation of 0.77 (95% confidence level). SNR reduced slightly for both AEC (38%) and no AEC (36%) with increasing SID. Conclusion - For CR, increasing SID significantly reduces both E and ESD for AP pelvis imaging without adversely affecting image quality.