Food frequency consumption and lipoproteins serum levels in the population of an urban area, Brazil

OBJECTIVE: To identify the association between food group consumption frequency and serum lipoprotein levels among adults. METHODS: The observations were made during a cross-sectional survey of a representative sample of men and women over 20 years old living in Cotia county, S. Paulo, Brazil. Data on food frequency consumption, serum lipids, and other covariates were available for 1,045 adults. Multivariate analyses adjusted by age, gender, body mass index, waist-to-hip ratio, educational level, family income, physical activity, smoking, and alcohol consumption were performed. RESULTS: Consumption of processed meat, chicken, red meat, eggs and dairy foods were each positively and significantly correlated with LDL-C, whereas the intake of vegetables and fruits showed an inverse correlation. Daily consumption of processed meat, chicken, red meat, eggs, and dairy foods were associated with 16.6 mg/dl, 14.5 mg/dl, 11.1 mg/dl, 5.8 mg/dl, and 4.6 mg/dl increase in blood LDL-C, respectively. Increases of daily consumption of fruit and vegetables were associated with 5.2 mg/dl and 5.5 mg/dl decreases in LDL-C, respectively. Alcohol beverage consumption showed a significant positive correlation with HDL-C. CONCLUSIONS: Dietary habits in the study population seem to contribute substantially to the variation in blood LDL and HDL concentrations. Substantially CHD risk reduction could be achieved with dietary changes.

Estudo da função sistólica do ventrículo direito por ecocardiografia transtorácica: relatório de projecto

Mestrado em Tecnologia de Diagnóstico e Intervenção Cardiovascular. Área de especialização - Ultrassonografia Cardiovascular

Avaliação da posição ortostática em plataforma de forças de dois indivíduos com acidente vascular encefálico antes e após uma intervenção baseado no conceito Bobath

Introdução: O acidente vascular encefálico (AVE) é uma importante e frequente condição de saúde que se repercute na funcionalidade do indivíduo. No sentido de reabilitar a função perdida, é comum o recurso a intervenções de fisioterapia baseado o conceito de Bobath. Como tal, importa verificar, as modificações no âmbito do controlo postural, através da migração do centro de pressão na base de suporte, face à aplicação de uma intervenção segundo abordagem baseada no conceito de Bobath em dois indivíduos com AVE. Métodos e participantes: Foram recrutados dois indivíduos com diagnóstico de AVE num hospital da zona do grande Porto. Dados referentes ao equilíbrio estático na condição de medição “olhos abertos ou fechados” e “calçado ou descalço” foram obtidos através de plataforma de forças, antes e após uma intervenção baseado no conceito de Bobath durante 13 semanas (M0 e M1). Nestes dois momentos foram ainda avaliados a mobilidade, função cognitiva, participação, equilíbrio através do teste Timed Up & Go (TUG) e Timed Up & Go Modificado (TUGM), e das escalas Mini Mental State Examination (MMSE), Postural Assessment for Stroke Scale (PASS), Escala de Berg (EB) e Índice de Barthel Modificado (IBM). Resultados: Os participantes obtiveram em ambos os momentos pontuação máxima no MMSE. Ambos os indivíduos atingiram o valor máximo no IBM em M1 (Mo: A: 78; B: 65). Ambos os indivíduos aumentaram o score entre M0 e M1, relativamente ao PASS (A: M0:21; M1:33; B: M0: 26; M1:34) e EB (A: M0:48; M1:54; B: M0: 30; M1:50). O tempo de realização do TUG e do TUGM diminuíram entre momentos em ambos os indivíduos (respectivamente: A: 15''13'' a 13''27''; B: 24''13'' a 13''88'' e A: 19''08''' a 13''27''; B: 29''60''' a 17''64'''). A área de deslocação do centro de pressão (CP) variou entre momentos em todas as condições de avaliação, sendo menor na condição “olhos abertos e descalço” em ambos os participantes (“olhos abertos e calçado”: A: M0= 1,364, M1=2,796; B: M0=1,892, M1=2,979; “olhos abertos e descalço”: A: M0= 0,758, M1=0,727; B: M0=3,064, M1=1,952; “olhos fechados e calçado”: A: M0= 2,360, M1=2,998; B: M0=2,232, M1= 4,392; “olhos fechados e descalço”: A: M0= 1,347, M1=2,388; B: M0=1,652, M1= 1,016). O desvio padrão das deslocações anteroposteriores variou entre momentos, sendo tendencialmente maior em M1 e na condição “descalço e olhos abertos”(“olhos abertos e calçado”: A: M0= 0,201, M1=0,500; B: M0=0,252, M1=0,310; “olhos abertos e descalço”: A: M0= 0,118, M1=0,165; B: M0=0,282, M1=0,276; “olhos fechados e calçado”: A: M0= 0,308, M1=0,398; B: M0=0,274, M1= 0,471; “olhos fechados e descalço”: A: M0= 0,158 , M1=0,373; B: M0=0,230, M1= 0,172), o desvio padrão das deslocações médio-lateral seguem a mesma tendência (“olhos abertos e calçado”: A: M0= 0,370 , M1=0,473; B: M0=0,454, M1=0,517; “olhos abertos e descalço”: A: M0= 0,354, M1=0,236 ; B: M0=0,584, M1=0,381; “olhos fechados e calçado”: A: M0= 0,425, M1=0,463; B: M0=0,462, M1= 0,583; “olhos fechados e descalço”: A: M0= 0,475, M1=0,416; B: M0=0,389, M1= 0,342). A velocidade de oscilação na direcção antero – posterior variou entre momentos, sendo tendencialmente menor em M1, em ambos os participantes e em todas as condições de avaliação: “olhos abertos e calçado”: A: M0= 0,886 , M1=0,532; B: M0=2,507, M1=01,072; “olhos abertos e descalço”: A: M0= 2,562, M1=3,815 ; B: M0=4,367, M1=0,262; “olhos fechados e calçado”: A: M0= 2,689, M1=1,757; B: M0=2,821, M1= 0,769; “olhos fechados e descalço”: A: M0= 2,984, M1=2,525; B: M0=4,100, M1= 0,265), a velocidade de oscilação na direcção médio – lateral seguem a mesma tendência para as condições de “olhos abertos e calçado”: A: M0= 6,524 , M1=6,218; B: M0=0,467, M1=0,404; “olhos fechados e calçado”: A: M0= 6,387, M1=1,927; B: M0=0,351, M1= 0,505; mas a velocidade de oscilação aumenta para as condições de “olhos abertos e descalço”: A: M0= 3,108, M1=7,806 ; B: M0=1,150, M1=8,054; “olhos fechados e descalço”: A: M0= 3,444, M1=3,839; B: M0=1,434, M1= 7,891). Conclusão: Entre os dois momentos os indivíduos melhoraram a sua mobilidade, equilíbrio, participação e actividades, potencialmente devido à intervenção baseado no conceito de Bobath.

Reproductive outcomes in an area adjacent to a petrochemical plant in southern Brazil

OBJECTIVE: To evaluate possible adverse reproductive outcomes in an area adjacent to a petrochemical plant in southern Brazil. METHODS: A review of 17,113 birth records of the main hospital of the municipality of Montenegro, southern Brazil, from 1983 to 1998 was carried out. Three groups of cases were selected: (1) newborns with major congenital malformations; (2) newborns with low birth weight (<2,500 g); and (3) stillborns (>500 g). A control was assigned to each case. Controls were the first newborns weighing > or = 2,500 g without malformations and of case-matching sex. Mother's residence during pregnancy was used as an exposure parameter. Statistical analyses were performed using Chi-square test or Fisher test, odds ratio, 0.05 significance level, and 95% confidence interval. RESULTS: For unadjusted analysis, it was found a correlation between low birth weight and geographical proximity of mother's residence to the petrochemical plant (OR = 1.66; 95% CI = 1.01--2.72) or residence on the way of preferential wind direction (OR = 1.62; 95% CI = 1.03--2.56). When other covariates were added in the conditional logistic regression (maternal smoking habits, chronic disease and age), there was no association. CONCLUSIONS: Despite final results were negative, low birth weight could be a good parameter of environmental contamination and should be closely monitored in the studied area.

Comparison of deposited surface area of airborne ultrafine particles generated from two welding processes

This article describes work performed on the assessment of the levels of airborne ultrafine particles emitted in two welding processes metal-active gas (MAG) of carbon steel and friction-stir welding (FSW) of aluminium in terms of deposited area in alveolar tract of the lung using a nanoparticle surface area monitor analyser. The obtained results showed the dependence from process parameters on emitted ultrafine particles and clearly demonstrated the presence of ultrafine particles, when compared with background levels. The obtained results showed that the process that results on the lower levels of alveolar-deposited surface area is FSW, unlike MAG. Nevertheless, all the tested processes resulted in important doses of ultrafine particles that are to be deposited in the human lung of exposed workers.

Survival of adult AIDS patients in a reference hospital of a metropolitan area in Brazil

OBJECTIVE: To evaluate the influence of sociodemographic, clinical, and epidemiological factors in AIDS patients survival in a reference hospital. METHODS: A sample of 502 adult AIDS patients out of 1,494 AIDS cases registered in a hospital in Fortaleza, Brazil, was investigated between 1986 and 1998. Sixteen cases were excluded due to death at the moment of the AIDS diagnosis and 486 were analyzed in the study. Socioeconomic and clinical epidemiological were the variables studied. Statistical analysis was conducted using the Kaplan-Meier survival analysis and the Cox proportional hazards model. RESULTS: Three hundred and sixty two out of the 486 patients studied took at least one antiretroviral drug and their survival was ten times longer than those who did not take any drug (746 and 79 days, respectively, p <0.001). Patients who took two nucleoside reverse transcriptase inhibitors (NRTI) plus protease inhibitor were found to have higher survival rates (p <0.001). The risk of dying in the first year was significantly lower for patients who took NRTI and a protease inhibitor compared to those who took only NRTI. In addition, this risk was much lower from the second year on (0.10; 95%CI: 0.42-0.23). The risk of dying in the first year was significantly higher for less educated patients (15.58; 95%CI: 6.64-36.58) and those who had two or more systemic diseases (3.03; 95%CI: 1.74-5.25). After the first year post-diagnosis, there was no risk difference for these factors. CONCLUSIONS: Higher education revealed to exert a significant influence in the first-year survival. Antiretroviral drugs had a greater impact in the survival from the second year on. A more aggressive antiretroviral therapy started earlier could benefit those patients.

Aedes albopictus in an area of Misiones, Argentina

Until early 1998 the presence of Aedes albopictus had never been detected in Argentina. During April of the same year, few individuals of this species were recorded in 33 breeding sites found in 25 out of 161 inspected houses in the city of Eldorado, Province of Misiones. The homogeneous spatial distribution of the proliferation foci suggests the existence of a generalized infestation in this locality during the study period.

Análise da sequência do movimento de levantar/sentar, em indivíduos pós AVE: Estudo da relação da activação dos músculos vasto medial oblíquo e vasto lateral

O objectivo deste estudo foi comparar o rácio dos músculos Vasto Medial Oblíquo (VMO) e Vasto Lateral (VL), na sequência de movimento de levantar e sentar, em indivíduos sem patologia e em indivíduos com Acidente Vascular Encefálico (AVE). Pretendeu-se também verificar a sequência de activação de alguns músculos do membro inferior na sequência de movimento de levantar. Verificou-se existir diferenças significativas para afirmar que, no movimento de levantar, indivíduos com sequelas de AVE apresentam menor rácio VMO/VL no membro predominantemente atingido em relação aos indivíduos sem patologia. Diferentes sequências de activação muscular durante o movimento de levantar foram observadas.

Optimal scheduling of a renewable micro-grid in an isolated load area using mixed-integer linear programming

In the energy management of the isolated operation of small power system, the economic scheduling of the generation units is a crucial problem. Applying right timing can maximize the performance of the supply. The optimal operation of a wind turbine, a solar unit, a fuel cell and a storage battery is searched by a mixed-integer linear programming implemented in General Algebraic Modeling Systems (GAMS). A Virtual Power Producer (VPP) can optimal operate the generation units, assured the good functioning of equipment, including the maintenance, operation cost and the generation measurement and control. A central control at system allows a VPP to manage the optimal generation and their load control. The application of methodology to a real case study in Budapest Tech, demonstrates the effectiveness of this method to solve the optimal isolated dispatch of the DC micro-grid renewable energy park. The problem has been converged in 0.09 s and 30 iterations.

A probabilistic methodology for distributed generation location in isolated electrical service area

Distributed generation unlike centralized electrical generation aims to generate electrical energy on small scale as near as possible to load centers, interchanging electric power with the network. This work presents a probabilistic methodology conceived to assist the electric system planning engineers in the selection of the distributed generation location, taking into account the hourly load changes or the daily load cycle. The hourly load centers, for each of the different hourly load scenarios, are calculated deterministically. These location points, properly weighted according to their load magnitude, are used to calculate the best fit probability distribution. This distribution is used to determine the maximum likelihood perimeter of the area where each source distributed generation point should preferably be located by the planning engineers. This takes into account, for example, the availability and the cost of the land lots, which are factors of special relevance in urban areas, as well as several obstacles important for the final selection of the candidates of the distributed generation points. The proposed methodology has been applied to a real case, assuming three different bivariate probability distributions: the Gaussian distribution, a bivariate version of Freund’s exponential distribution and the Weibull probability distribution. The methodology algorithm has been programmed in MATLAB. Results are presented and discussed for the application of the methodology to a realistic case and demonstrate the ability of the proposed methodology for efficiently handling the determination of the best location of the distributed generation and their corresponding distribution networks.

Phlebotomine fauna in a rural area of the Brazilian Pantanal

The aim of the study was to identify among the phlebotomine fauna potential leishmaniasis vectors. The study was carried out in Corumbá county, State of Mato Grosso do Sul, Mid-West Brazil (18º59'S, 56º39'W). Sand fly captures were undertaken fortnightly with automatic light traps at 11 sites in forested environments and anthropic areas from April 2001 to July 2003. A total of only 41 specimens were captured. Thirty-one percent of the specimens were captured in forests and 68.3% in anthropic areas. The predominance of non-anthropophilic groups and the low density of N. whitmani, a known cutaneous leishmaniasis vector, does not seem to indicate any actual risk of the transmission of this disease in the study area.

Seismic imaging of the western Iberian crust using ambient noise: Boundaries and internal structure of the Iberian Massif

We present new Rayleigh-wave dispersion maps of the western Iberian Peninsula for periods between 8 and 30 s, obtained from correlations of seismic ambient noise, following the recent increase in seismic broadband network density in Portugal and Spain. Group velocities have been computed for each station pair using the empirical Green's functions generated by cross-correlating one-day-length seismic ambient-noise records. The resulting high-path density allows us to obtain lateral variations of the group velocities as a function of period in cells of 0.5 degrees x 0.5 degrees with an unprecedented resolution. As a result we were able to address some of the unknowns regarding the lithospheric structure beneath SW Iberia. The dispersion maps allow the imaging of the major structural units, namely the Iberian Massif, and the Lusitanian and Algarve Meso-Cenozoic basins. The Cadiz Gulf/Gibraltar Strait area corresponds to a strong low-velocity anomaly, which can be followed to the largest period inverted, although slightly shifted to the east at longer periods. Within the Iberian Massif, second-order perturbations in the group velocities are consistent with the transitions between tectonic units composing the massif. (C) 2013 Elsevier B.V. All rights reserved.

O uso do smartphone na avaliação do risco de queda associado ao envelhecimento

Introdução: O declínio do equilíbrio, da força dos membros inferiores e o medo de cair são fatores de risco de queda associados ao envelhecimento e a sua avaliação pode ser realizada pelo teste One Leg Standing (OLS), Sit to Stand (STS) e pela Falls Eficacy Scale (FES), respetivamente. As aplicações para smartphone constituem uma alternativa para a avaliação dos fatores de risco de queda no envelhecimento. Objetivo: Analisar a capacidade de uma aplicação para smartphone na avaliação dos testes STS, OLS e FES. Metodologia: Realizou-se um estudo analítico numa amostra de 27 voluntários com idade ≥ 60 anos. Realizaram-se os testes STS, OLS e a FES (versão iconográfica, apresentada no smartphone). Os dados foram recolhidos simultaneamente por um smartphone e pelo Qualisys Motion Capture Systems associado a uma plataforma de forças. Foi utilizado o r de Pearson ou Spearman para analisar as possíveis correlações. Resultados: No STS obteve-se uma correlação muito forte (rp=0.97) no número de repetições de ciclos Sit Stand Sit (SLS) e forte na duração média do SLS (rp=0.85) e das subfases Sit to Stand (rp=0.69) e Stand to Sit (rp=0.778), com p<0.001. As medidas de inclinação do tronco apresentaram correlações fortes, com exceção do ângulo inicial (p≥0.05). No OLS, verificou-se uma correlação moderada entre o deslocamento do centro de pressão peak to peak médio-lateral (rs=0.45; p=0.017) e antero-posterior (rs=0.39; p=0.046), root mean square médio-lateral (rs=0.39; p=0.046) e antero-posterior (rs=0.46; p=0.017) e área do estatocinesiograma (rs=0.45; p=0.018). Na FES obteve-se uma correlação moderada em três categorias: ‘tomar banho/duche’ (rs=0.49; p=0.010), ‘deitar/levantar da cama (rs=0.43; p=0.024) e ‘chegar aos armários’ (rs=0.38; p=0.050). Conclusão: A aplicação para smartphone parece avaliar corretamente os ciclos e a variação da inclinação do tronco no STS, porém parece necessitar de ser reajustada na FES e na velocidade do deslocamento do centro de pressão, no OLS.

A efectividade da intervenção da fisioterapia nas disfunções crânio- cervico-mandibulares

Introdução: As teorias etiológicas recíprocas que relacionam as disfunções da articulação temporo mandibular (ATM) com as disfunções da coluna cervical, os seus critérios de diagnóstico e formas de tratamento, não reúnem consenso, constituindo, actualmente, uma temática de debate e investigação. Objectivo: Descrever a avaliação e intervenção em fisioterapia, e os seus resultados numa utente com disfunção do complexo crânio-cervico-mandibular. Métodos: Foi realizado um estudo observacional descritivo, do tipo estudo de caso, reportando-se a uma enfermeira, de 28 anos, com quadro sintomatológico compatível com disfunção crânio-cervico-mandibular, com antecedentes de condilectomia e artroplastia da ATM, aos 14 anos. Inicialmente a utente apresentava dor irradiada na região cervical (7/10) e limitação dos movimentos articulares da coluna cervical. Referia, também, dor na região do ptérion direito (6/10), limitação dos movimentos da mandíbula, desvio lateral na abertura da boca e dificuldades funcionais na mastigação. A avaliação inicial e final (após tratamento), foi efectuada recorrendo-se à utilização do Goniometro CROM e da Therabite Range of Motion Scale, para medição das amplitudes articulares da cervical e ATM, respectivamente; Estetoscópio, para avaliação dos sons articulares da ATM; Escala Visual Analógica para graduação da dor. A intervenção decorreu ao longo de 10 sessões, bissemanais. No tratamento, foram aplicadas técnicas sobre os trigers points da musculatura cervical e músculos da mastigação; Mobilização passiva da cervical e ATM; Manipulação dos segmentos vertebrais cervicais e torácicos; Streching e técnicas de energia muscular; Técnicas funcionais para a ATM; Técnicas miofasciais para a coluna cervical e ATM; Exercícios de controlo motor da coluna cervical. Resultados: No final do tratamento, as amplitudes dos movimentos cervicais estavam completas e sem dor (0/10), mantendo, sensibilidade dolorosa à palpação das espinhosas de C5-C6 (1/10). Relativamente à ATM, verifica-se a abolição da dor (0/10) e a ausência do desvio lateral da mandíbula na abertura da boca, bem como, o aumento das amplitudes de movimento na abertura da boca (33 para 36 mm), e no desvio lateral esquerdo (2 para 2,8 mm). Conclusão: os resultados sugerem que a intervenção, com recurso a técnicas de terapia manual, no caso em estudo, parecem surtir efeitos positivos no quadro sintomatológico e funcional da utente.

Dosimetric effect by shallow air cavities in high energy electron beams

This study evaluates the dosimetric impact caused by an air cavity located at 2 mm depth from the top surface in a PMMA phantom irradiated by electron beams produced by a Siemens Primus linear accelerator. A systematic evaluation of the effect related to the cavity area and thickness as well as to the electron beam energy was performed by using Monte Carlo simulations (EGSnrc code), Pencil Beam algorithm and Gafchromic EBT2 films. A home-PMMA phantom with the same geometry as the simulated one was specifically constructed for the measurements. Our results indicate that the presence of the cavity causes an increase (up to 70%) of the dose maximum value as well as a shift forward of the position of the depthedose curve, compared to the homogeneous one. Pronounced dose discontinuities in the regions close to the lateral cavity edges are observed. The shape and magnitude of these discontinuities change with the dimension of the cavity. It is also found that the cavity effect is more pronounced (6%) for the 12 MeV electron beam and the presence of cavities with large thickness and small area introduces more significant variations (up to 70%) on the depthedose curves. Overall, the Gafchromic EBT2 film measurements were found in agreement within 3% with Monte Carlo calculations and predict well the fine details of the dosimetric change near the cavity interface. The Pencil Beam calculations underestimate the dose up to 40% compared to Monte Carlo simulations; in particular for the largest cavity thickness (2.8 cm).