Adequacy of antenatal care and its relationship with low birth weight in Botucatu, Sao Paulo, Brazil: a case-control study

Background: Birth weight reflects gestational conditions and development during the fetal period. Low birth weight (LBW) may be associated with antenatal care (ANC) adequacy and quality. The purpose of this study was to analyze ANC adequacy and its relationship with LBW in the Unified Health System in Brazil.Methods: A case-control study was conducted in Botucatu, Sao Paulo, Brazil, 2004 to 2008. Data were collected from secondary sources (the Live Birth Certificate), and primary sources (the official medical records of pregnant women). The study population consisted of two groups, each with 860 newborns. The case group comprised newborns weighing less than 2,500 grams, while the control group comprised live newborns weighing greater than or equal to 2,500 grams. Adequacy of ANC was evaluated according to three measurements: 1. Adequacy of the number of ANC visits adjusted to gestational age; 2. Modified Kessner Index; and 3. Adequacy of ANC laboratory studies and exams summary measure according to parameters defined by the Ministry of Health in the Program for Prenatal and Birth Care Humanization.Results: Analyses revealed that LBW was associated with the number of ANC visits adjusted to gestational age (OR = 1.78, 95% CI 1.32-2.34) and the ANC laboratory studies and exams summary measure (OR = 4.13, 95% CI 1.36-12.51). According to the modified Kessner Index, 64.4% of antenatal visits in the LBW group were adequate, with no differences between groups.Conclusions: Our data corroborate the association between inadequate number of ANC visits, laboratory studies and exams, and increased risk of LBW newborns. No association was found between the modified Kessner Index as a measure of adequacy of ANC and LBW. This finding reveals the low indices of coverage for basic actions already well regulated in the Health System in Brazil. Despite the association found in the study, we cannot conclude that LBW would be prevented only by an adequate ANC, as LBW is associated with factors of complex and multifactorial etiology. The results could be used to plan monitoring measures and evaluate programs of health care assistance during pregnancy, at delivery and to newborns, focusing on reduced LBW rates.

Absorção e níveis críticos de fósforo na parte aérea da mamoneira cultivada em diferentes classes de solos

Soil that has a high degree of weathering, with more inorganic P bound to Fe and Al oxides, has less P availability to plants. Thus, the critical element of a plant refers to the level below which the growth rate and plant production decreases, demonstrating the need for supplementary fertilization. Accordingly, an experiment was conducted in a greenhouse at Embrapa Algodao with the objective of evaluating the response of castor plants to five doses of P in four types of soil with different adsorption characteristics and critical levels of foliar P. The experimental design was completely randomized in a 4 x 5 factorial design, four types of soil and 5 levels of P with four replications. For TCo, there was an increase in height growth, with dose of 229.6 mg dm(-3) responsible for maximum plant height (74.3 cm). The largest diameter stem (17.58 mm) was observed in CXve with an application of 229.6 mg dm(-3) of P; a decrease was seen when using higher doses. The increase in leaf area was smaller in RY (4724.8 cm(2)), where it was obtained with a dose of 280.2 mg dm(-3). In general, critical levels of P in the plant shoots did not vary much between the soils. The critical level of P in castor bean shoot dry mass was higher (4.61 g kg(-1)) in TCo, this result being directly related to the low clay content of the soil.

Lê Cycles and Milnor Classes of Compact Hypersurfaces

We determine the relation amongst the global Lê cycles and the Milnor classes of analytic hypersurfaces defined by a section of a very ample line bundle over a compact complex manifold. The key point is finding appropriate expressions for the global Lê cycles and for the Milnor classes in terms of polar varieties. Our starting points are an interpretation of the Lê cycles given by T. Gaffney and R. Gassler, a formula by A. Parusinski and P. Pragacz for the Milnor classes via McPherson’s functor, and a conjecture of J.-P. Brasselet, that we prove, stating that Milnor classes can be expressed in terms of polar varieties. We then use the work by R. Piegne for Mather classes, by J. Schürmann and M. Tibăr for MacPherson’s classes for constructible functions, and by D. Massey for an extension of the local Lê cycles for constructible sheaves.

A importância das classes socias na relação médico-paciente: adesão ao pré-natal

This article is focused in the understanding of how can social classes influence in prenatal, throughout the patient medical relationship as well as the many aspects surrounding. In the first chapter, reflected about the adherence to prenatal and considerations in gestational period when dealing with public health treatment offer by SUS. Next chapter, patient medical relationship is addressed as a relationship classes, over questioning how this relationship use to be in front of disadvantaged extracts, focused in prenatal. In the third chapter, the patient medical relationship is analyzed throughout the patient vision, pointing the many factors that can induce the success of a therapeutic. In the last chapter, there are reflections about whereby health professionals upgrading, as well as the improve of basic health care networks are necessary to a larger prenatal adherence.

Uma amostra do tratamento concedido às classes de palavras na tradição gramatical do português

Within a broader study of the apparatus governing the establishment of word classes in grammatical tradition, this study is centered on examining the treatment of the (sub)class of pronouns in two grammar guide groups from different periods. The collation was especially oriented by the existing general notion of a very strong link of the first grammarians with logic and, as a counterpart, of an insertion of the most recent works in the universe of a linguistic science and, at the same time, in the universe of a parameterization limiting actions and decisions.

Aprendizagem após via exclusão e formação de classes de equivalência em crianças com deficiência auditiva e implante coclear (aceito condicionalmente)

Studies on learning by exclusion have shown that participants tend to select a new object or a new figure when a new word is dictated, rejecting the objects and figures they already know or that were associated with other words. This study aimed at training conditional relations between dictated word-picture and between picture-printed word, by exclusion, and verify whether this training would be a condition for the emergence of relations between dictated word-printed word, printed word-figure, picture naming and reading. We also investigated whether responding to the words dictated with a female voice generalized to other frequencies such as male and child voices. Participants were five children between five and nine years old, with acute neurosensorial bilateral hearing impairment, users of cochlear implant Nucleus 24k®. They were exposed, individually, to tasks that consisted in selecting a comparison stimulus (either picture or printed word) related to the sample (either dictated word or picture). Words with lowest scores on a pre-test were used. The relations between dictated word-figure (AB) and figure-printed word (BC) were taught by exclusion. We assessed the emergence of the relations between dictated and printed words (AC), printed word and picture (CB), male and child voices generalization (A’C and A’’C), naming (BD) and reading (CD). All the children responded by exclusion and learned relations AB and BC, showing receptive vocabulary; AC and CB relations also were learned, consistent with class formation. Responding generalized to male and child voices, but data on naming were not systematic. Learning by exclusion was similar to that of children with typical hearing and these results describe some conditions that can improve receptive verbal repertoire.

Discriminação de classes de cobertura vegetal utilizando técnicas de classificação digital de imagens de sensoriamento remoto

The aim of this work is to discriminate vegetation classes throught remote sensing images from the satellite CBERS-2, related to winter and summer seasons in the Campos Gerais region Paraná State, Brazil. The vegetation cover of the region presents different kinds of vegetations: summer and winter cultures, reforestation areas, natural areas and pasture. Supervised classification techniques like Maximum Likelihood Classifier (MLC) and Decision Tree were evaluated, considering a set of attributes from images, composed by bands of the CCD sensor (1, 2, 3, 4), vegetation indices (CTVI, DVI, GEMI, NDVI, SR, SAVI, TVI), mixture models (soil, shadow, vegetation) and the two first main components. The evaluation of the classifications accuracy was made using the classification error matrix and the kappa coefficient. It was defined a high discriminatory level during the classes definition, in order to allow separation of different kinds of winter and summer crops. The classification accuracy by decision tree was 94.5% and the kappa coefficient was 0.9389 for the scene 157/128. For the scene 158/127, the values were 88% and 0.8667, respectively. The classification accuracy by MLC was 84.86% and the kappa coefficient was 0.8099 for the scene 157/128. For the scene 158/127, the values were 77.90% and 0.7476, respectively. The results showed a better performance of the Decision Tree classifier than MLC, especially to the classes related to cultivated crops, indicating the use of the Decision Tree classifier to the vegetation cover mapping including different kinds of crops.

A dinâmica das classes sociais no pensamento de Florestan Fernandes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Discriminating Different Classes of Biological Networks by Analyzing the Graphs Spectra Distribution

The brain's structural and functional systems, protein-protein interaction, and gene networks are examples of biological systems that share some features of complex networks, such as highly connected nodes, modularity, and small-world topology. Recent studies indicate that some pathologies present topological network alterations relative to norms seen in the general population. Therefore, methods to discriminate the processes that generate the different classes of networks (e. g., normal and disease) might be crucial for the diagnosis, prognosis, and treatment of the disease. It is known that several topological properties of a network (graph) can be described by the distribution of the spectrum of its adjacency matrix. Moreover, large networks generated by the same random process have the same spectrum distribution, allowing us to use it as a "fingerprint". Based on this relationship, we introduce and propose the entropy of a graph spectrum to measure the "uncertainty" of a random graph and the Kullback-Leibler and Jensen-Shannon divergences between graph spectra to compare networks. We also introduce general methods for model selection and network model parameter estimation, as well as a statistical procedure to test the nullity of divergence between two classes of complex networks. Finally, we demonstrate the usefulness of the proposed methods by applying them to (1) protein-protein interaction networks of different species and (2) on networks derived from children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and typically developing children. We conclude that scale-free networks best describe all the protein-protein interactions. Also, we show that our proposed measures succeeded in the identification of topological changes in the network while other commonly used measures (number of edges, clustering coefficient, average path length) failed.

Expression of the P2X(2) receptor in different classes of ileum myenteric neurons in the female obese ob/ob mouse

AIM: To examine whether the ob/ob mouse model of obesity is accompanied by enteric nervous system abnormalities such as altered motility. METHODS: The study examined the distribution of the P2X(2) receptor (P2X(2)R) in myenteric neurons of female ob/ob mice. Specifically, we used immunohistochemistry to analyze the co-expression of the P2X(2)R with neuronal nitric oxide synthase (nNOS), choline acetyltransferase (ChAT), and calretinin (CalR) in neurons of the small intestine myenteric plexus in ob/ob and control female mice. In these sections, we used scanning confocal microscopy to analyze the co-localization of these markers as well as the neuronal density (cm(2)) and area profile (mu m(2)) of P2X(2)R-positive neurons. In addition, enteric neurons were labeled using the nicotinamide adenine dinucleotide (NADH) diaphorase method and analyzed with light microscopy as an alternate means by which to analyze neuronal density and area. RESULTS: In the present study, we observed a 29.6% increase in the body weight of the ob/ob animals (OG) compared to the control group (CG). In addition, the average small intestine area was increased by approximately 29.6% in the OG compared to the CG. Immunoreactivity (IR) for the P2X(2)R, nNOS, ChAT and CaIR was detectable in the myenteric plexus, as well as in the smooth muscle, in both groups. This IR appeared to be mainly cytoplasmic and was also associated with the cell membrane of the myenteric plexus neurons, where it outlined the neuronal cell bodies and their processes. P2X(2)R-IR was observed to co-localize 100% with that for nNOS, ChAT and CaIR in neurons of both groups. In the ob/ob group, however, we observed that the neuronal density (neuron/cm(2)) of P2X(2)R-IR cells was increased by 62% compared to CG, while that of NOS-IR and ChAT-IR neurons was reduced by 49% and 57%, respectively, compared to control mice. The neuronal density of CaIR-IR neurons was not different between the groups. Morphometric studies further demonstrated that the cell body profile area (mu m(2)) of nNOS-IR, ChAT-IR and CaIR-IR neurons was increased by 34%, 20% and 55%, respectively, in the OG compared to controls. Staining for NADH diaphorase activity is widely used to detect alterations in the enteric nervous system; however, our qualitative examination of NADH-diaphorase positive neurons in the nnyenteric ganglia revealed an overall similarity between the two groups. CONCLUSION: We demonstrate increases in P2X(2)R expression and alterations in nNOS, ChAT and CaIR IR in ileal myenteric neurons of female ob/ob mice compared to wild-type controls. (c) 2012 Baishideng. All rights reserved.

Local inflammatory events induced by Bothrops atrox snake venom and the release of distinct classes of inflammatory mediators

Bothrops atrox is responsible for most accidents involving snakes in the Brazilian Amazon and its venom induces serious systemic and local effects. The local effects are not neutralized effectively by commercial antivenoms, resulting in serious sequelae in individuals bitten by this species. This study investigates the local inflammatory events induced in mice by B. atrox venom (Bay), such as vascular permeability, leukocyte influx and the release of important inflammatory mediators such as cytokines, eicosanoids and the chemokine CCL-2, at the injection site. The effect of Bay on cyclooxygenase (COX-1 and COX-2) expression was also investigated. The results showed that intraperitoneal (i.p.) injection of BaV promoted a rapid and significant increase in vascular permeability, which reached a peak 1 h after venom administration. Furthermore, BaV caused leukocyte infiltration into the peritoneal cavity between 1 and 8 h after i.p. injection, with mononuclear leukocytes (MNs) predominating in the first 4 h, and polymorphonuclear leukocytes (PMNs) in the last 4 h. Increased protein expression of COX-2, but not of COX-1, was detected in leukocytes recruited in the first and fourth hours after injection of BaV. The venom caused the release of eicosanoids PGD(2), PGE(2), TXA(2) and LTB4, cytokines TNF-alpha, IL-6, IL-10 and IL-12p70, but not IFN-gamma, and chemokine CCL-2 at different times. The results show that Bay is able to induce an early increase in vascular permeability and a leukocyte influx to the injection site consisting mainly of MNs initially and PMNs during the later stages. These phenomena are associated with the production of cytokines, the chemokine CCL-2 and eicosanoids derived from COX-1 and COX-2. (c) 2012 Elsevier Ltd. All rights reserved.

Antenatal depression strongly predicts postnatal depression in primary health care

Objective: To estimate the association between antenatal and postnatal depression and to examine the role of socioeconomic conditions in the risk of postnatal depression. Methods: A prospective cohort study, conducted between May 2005 and January 2006, with 831 pregnant women recruited from primary care clinics in the public sector in the city of Sao Paulo, Brazil. The presence of antenatal and postnatal depression was measured with the Self Report Questionnaire (SRQ-20). Sociodemographic and socioeconomic characteristics and obstetric information were obtained through a questionnaire. Crude and adjusted risk ratios (RR), with 95% CI, were calculated using a Poisson regression. Results: The prevalence of postnatal depressive symptoms was 31.2% (95% CI: 27.8-34.8%). Among the 219 mothers who had depressive symptoms, nearly 50% had already shown depressive symptoms during pregnancy. Women who had antenatal depression were 2.4 times more likely to present with postnatal depression than were women who did not have such symptoms during pregnancy. In the multivariate analysis, higher scores for assets (RR: 0.76, 95% CI 0.61-0.96), higher education (RR: 0.75 95% CI 0.59-0.96), daily contact with neighbors (RR: 0.68, 95% CI 0.51-0.90) and antenatal depression (RR: 2.44, 95% CI 1.93-3.08) remained independently associated with postnatal depression. Conclusions: Antenatal and postnatal depression are highly prevalent in the primary care setting.

Molecular Characterization and Physical Mapping of Two Classes of 5S rDNA in the Genomes of Gymnotus sylvius and G. inaequilabiatus (Gymnotiformes, Gymnotidae)

The nucleotide sequences of the 5S rRNA multigene family and their distribution across the karyotypes in 2 species of Gymnotiformes, genus Gymnotus (G. sylvius and G. inaequilabiatus) were investigated by means of fluorescence in situ hybridization (FISH). The results showed the existence of 2 distinct classes of 5S rDNA sequences in both species: class I and class II. A high conservative pattern of the codifying region of the 5S rRNA gene was identified, contrasting with significant alterations detected in the nontranscribed spacer (NTS). The presence of TATA-like sequences along the NTS of both species was an expected occurrence, since such sequences have been associated with the regulation of the gene expression. FISH using 5S rDNA class I and class II probes revealed that both gene classes were collocated in the same chromosome pair in the genome of G. sylvius, while in that of G. inaequilabiatus, class II appeared more disperse than class I. Copyright (C) 2012 S. Karger AG, Basel