Anesthesia-related mortality in pediatric patients: a systematic review

This systematic review of the Brazilian and worldwide literature aimed to evaluate the incidence and causes of perioperative and anesthesia-related mortality in pediatric patients. Studies were identified by searching EMBASE (1951-2011), PubMed (1966-2011), LILACS (1986-2011), and SciElo (1995-2011). Each paper was revised to identify the author(s), the data source, the time period, the number of patients, the time of death, and the perioperative and anesthesia-related mortality rates. Twenty trials were assessed. Studies from Brazil and developed countries worldwide documented similar total anesthesia-related mortality rates (<1 death per 10,000 anesthetics) and declines in anesthesia-related mortality rates in the past decade. Higher anesthesia-related mortality rates (2.4-3.3 per 10,000 anesthetics) were found in studies from developing countries over the same time period. Interestingly, pediatric perioperative mortality rates have increased over the past decade, and the rates are higher in Brazil (9.8 per 10,000 anesthetics) and other developing countries (10.7-15.9 per 10,000 anesthetics) compared with developed countries (0.41-6.8 per 10,000 anesthetics), with the exception of Australia (13.4 per 10,000 anesthetics). The major risk factors are being newborn or less than 1 year old, ASA III or worse physical status, and undergoing emergency surgery, general anesthesia, or cardiac surgery. The main causes of mortality were problems with airway management and cardiocirculatory events. Our systematic review of the literature shows that the pediatric anesthesia-related mortality rates in Brazil and in developed countries are similar, whereas the pediatric perioperative mortality rates are higher in Brazil compared with developed countries. Most cases of anesthesiarelated mortality are associated with airway and cardiocirculatory events. The data regarding anesthesia-related and perioperative mortality rates may be useful in developing prevention strategies.

Estudo integrado geológico/tecnológico de rochas ornamentais: os granitos flores e jacarandá, RN

The main purpose of the present study is to integrate a geological and technological investigation of ornamental rocks of the Flores and Jacarandá granites, which are located near the Afonso Bezerra city, in the north central part of the Rio Grande do Norte State. The study area encompasses four litho-stratigrafic units: a Gneiss-Migmatitic Complex(cristalline basement), which is mainly composed of banded gneisses, usually deformed as mylonitic rocks and with several migmatic features, an Augen Gneiss, which occurs as an elongated body that constitutes the Jacarandá granite, a small granite stock, which presents a semi-circular form, named Flores granite, composed of pink, fine to medium coarse rocks, and fine to coarse alluvial sediments, which form extensive areas of large fluvial deposits. The technological characterization of the Flores and Jacarandá granites, carried out through several tests, has as the main purpose the determination of petrographic, physical, and mechanic parameters that allowed the characterization of these rocks. The test followed procedures recommended by Brazilian (ABNT Associação Brasileira de Normas Técnicas) and foreigner institutions (ASTM American Society for Testing and Materials). The petrografhic analysis indicated that the rocks investigated are granite sensu estrictu, summing an average 85-90% modal. The Flores granite is the more felsic rock, which presents mafic content ∼ 10% and monzonitic composition. The Jacarandá granite is an Augen Gneiss rock that presents sienogranitic composition and mafic modal content ∼ 15%. Several technological tests carried out (alterability, physical indices, velocity of ultrasonic wave propagation, uniaxial compression, flection resistence, Amsler desgaste, and resistence to freezing and heating) indicated that parameters and values were identical for both granites investigated. These parameters and values are consistent with the Brazilian and international standards for siliciclastic rocks of ornamental use, as well as other Brazilian ornamental granites. The analysis of all results indicates that both the Flores and Jacarandá granites present good quality, and that they are indicated for ornamental use of revetment interior and exterior of buildings

Alterações cognitivas em escolares de classe socio-econômica desfavorecida: resultados de intervenção psicopedagógica

O objetivo deste estudo é analisar o resultado de intervenções psicopedagógicas no desempenho intelectual e em algumas funções cognitivas específicas em crianças provenientes de famílias de baixa renda, expostas a fatores pessoais e sociais adversos, como desnutrição, stress familiar, ambientes doméstico e de estimulação empobrecidos. Foram examinadas 63 crianças, alunas de escola, gratuita e em regime de semi-internato, que recebe crianças consideradas sob risco pessoal e social. Quarenta e três crianças receberam atividades que objetivam ativação cognitiva, durante período mínimo de 1 ano. Vinte crianças eram recém-admitidas. As técnicas da ativação escolhidas foram: método de aprendizagem ativa, com base em Piaget e método de ativação cognitiva para, através de exercícios psicomotores, desenvolver os pré-requisitos para aprendizagem e prevenção de dificuldades escolares, segundo Lambert. A avaliação das funções cognitivas mostrou: nível intelectual insatisfatório em 30% e médio ou superior em 70% e deficiências cognitivas específicas (noção do esquema corporal, percepção viso-motora, percepção de forma e perseveração) em 74%. Maior prevalência de crianças com inteligência superior (p < 0,05) associou-se a dois fatores: 1º: maior tempo de freqüência à escola (de 1 a 3 anos) e 2º: programas de ativação cognitiva. Não foram observadas diferenças entre os 2 grupos em relação à prevalência de alterações das funções cognitivas específicas examinadas. Os resultados demonstram que a recuperação de crianças com as dificuldades descritas é difícil. Exige investigação sistemática sobre os métodos psicopedagógicas selecionados e possivelmente, grande tempo de permanência da criança na escola, além de admissão mais precoce.

Adaptação transcultural Portugal-Brasil do Inventário de Burnout de Maslach para estudantes

OBJETIVO: Realizar a adaptação transcultural da versão em português do Inventário de Burnout de Maslach para estudantes e investigar sua confiabilidade, validade e invariância transcultural. MÉTODOS: A validação de face envolveu participação de equipe multidisciplinar. Foi realizada validação de conteúdo. A versão em português foi preenchida em 2009, pela internet, por 958 estudantes universitários brasileiros e 556 portugueses da zona urbana. Realizou-se análise fatorial confirmatória utilizando-se como índices de ajustamento o χ²/df, o comparative fit index (CFI), goodness of fit index (GFI) e o root mean square error of approximation (RMSEA). Para verificação da estabilidade da solução fatorial conforme a versão original em inglês, realizou-se validação cruzada em 2/3 da amostra total e replicada no 1/3 restante. A validade convergente foi estimada pela variância extraída média e confiabilidade composta. Avaliou-se a validade discriminante e a consistência interna foi estimada pelo coeficiente alfa de Cronbach. A validade concorrente foi estimada por análise correlacional da versão em português e dos escores médios do Inventário de Burnout de Copenhague; a divergente foi comparada à Escala de Depressão de Beck. Foi avaliada a invariância do modelo entre a amostra brasileira e a portuguesa. RESULTADOS: O modelo trifatorial de Exaustão, Descrença e Eficácia apresentou ajustamento adequado (χ²/df = 8,498; CFI = 0,916; GFI = 0,902; RMSEA = 0,086). A estrutura fatorial foi estável (λ: χ²dif = 11,383, p = 0,50; Cov: χ²dif = 6,479, p = 0,372; Resíduos: χ²dif = 21,514, p = 0,121). Observou-se adequada validade convergente (VEM = 0,45;0,64, CC = 0,82;0,88), discriminante (ρ² = 0,06;0,33) e consistência interna (α = 0,83;0,88). A validade concorrente da versão em português com o Inventário de Copenhague foi adequada (r = 0,21;0,74). A avaliação da validade divergente do instrumento foi prejudicada pela aproximação do conceito teórico das dimensões Exaustão e Descrença da versão em português com a Escala de Beck. Não se observou invariância do instrumento entre as amostras brasileiras e portuguesas (λ:χ²dif = 84,768, p < 0,001; Cov: χ²dif = 129,206, p < 0,001; Resíduos: χ²dif = 518,760, p < 0,001). CONCLUSÕES: A versão em português do Inventário de Burnout de Maslach para estudantes apresentou adequada confiabilidade e validade, mas sua estrutura fatorial não foi invariante entre os países, apontando ausência de estabilidade transcultural.

Testing option pricing with the Edgeworth expansion

There is a well-developed framework, the Black-Scholes theory, for the pricing of contracts based on the future prices of certain assets, called options. This theory assumes that the probability distribution of the returns of the underlying asset is a Gaussian distribution. However, it is observed in the market that this hypothesis is flawed, leading to the introduction of a fudge factor, the so-called volatility smile. Therefore, it would be interesting to explore extensions of the Black-Scholes theory to non-Gaussian distributions. In this paper, we provide an explicit formula for the price of an option when the distributions of the returns of the underlying asset is parametrized by an Edgeworth expansion, which allows for the introduction of higher independent moments of the probability distribution, namely skewness and kurtosis. We test our formula with options in the Brazilian and American markets, showing that the volatility smile can be reduced. We also check whether our approach leads to more efficient hedging strategies of these instruments. (C) 2004 Elsevier B.V. All rights reserved.

Sexagem cirúrgica em aves silvestres

Relata-se a utilização da laparoscopia na sexagem de 349 aves silvestres nacionais e exóticas, pertencentes a 61 espécies, de 11 famílias e seis ordens. Foram sexadas aves com idades entre quatro meses e 42 anos e peso corpóreo entre 55g e 3,4kg. Com essa técnica foi possível visualizar as gônadas, avaliar seu estágio de desenvolvimento e observar os órgãos adjacentes. A técnica cirúrgica utilizando endoscópio rígido para sexagem de aves silvestres foi considerada rápida e segura. Nenhum óbito foi verificado durante ou em conseqüência do procedimento cirúrgico.

Uma brasileira: a outra história de Julia Mann

O texto parte da recente valorização da origem brasileira de Julia Mann, a matriarca da célebre família de escritores alemães, para discutir o tema da nacionalidade associado às categorias de gênero e raça. Discutimos a historicidade de categorias sociais e como estas determinam a auto-compreensão dos indivíduos. A sociedade alemã do século XIX caracterizou Julia como brasileira e, apesar do estigma que isto representava, ela utilizou-se desta origem exótica como forma de autocompreensão e resistência.

Práticas de saúde em Enfermagem e Comunicação: um estudo de revisão da literatura

As mudanças na prática de saúde do enfermeiro em programas emergentes como o Programa Saúde da Família nos levaram a estudar os processos comunicacionais que se colocam a esta prática. Mediante estudo de revisão bibliográfica de janeiro de 1994 até dezembro de 2004, investigamos 26 artigos de periódicos nacionais e internacionais, quatro dissertações, três teses e quatro livros nas bases de dados da BIREME (LILACS e SCIELO-Br) a partir dos unitermos comunicação, Programa Saúde da Família e enfermagem. Foram identificadas 373 citações com comunicação e enfermagem, 12 citações usando programa saúde da família e comunicação (LILACS) e 18 citações com comunicação e enfermagem e zero citações com programa saúde da família e comunicação (SCIELO-Br). Para analisar as publicações, buscamos agrupá-las em quatro tendências acerca da relação comunicação e práticas na enfermagem: comunicação nas equipes do PSF, comunicação na prática profissional do enfermeiro, comunicação como instrumento de liderança do enfermeiro, comunicação no contexto do ensino da enfermagem. O estudo permitiu observar que, apesar do modelo hegemônico nas práticas de saúde ser o unilinear, já é nítido um movimento no sentido de uma prática comunicacional mais dialógica que aparece como um desafio na prática do enfermeiro no PSF.

THE FAMILY COMPSOPOGONACEAE (RHODOPHYTA) IN BRAZIL

A taxonomic revision of the family Compsopogonaceae in Brazil was carried out, resulting in the recognition of a single genus (Compsopogon) with two species (C. coeruleus and C. leptoclados). For both species the following information was provided: a) nomenclatural type; b) type locality; c) description (with illustrations); d) diagnostic features; e) world distribution; f) distribution in Brazil (with map); g) habitat, associated species and seasonality; h) remarks, including discussion of taxonomic and/or nomenclatural problems and comparison with previous reports based on Brazilian and foreign material. Currently accepted diagnostic criteria for genera and species within Compsopogonaceae are critically analysed. The circumscription of Compsopogon and Compsopogonopsis are evaluated and the single genus Compsopogon is recognized in the family.

A novel technique to produce polygenic resistance to anthracnose in Stylosanthes capitata

An improved cultivar, based on 17 genotypes of S. capitata and six of S.macrocephala, was developed at the wEmbrapa Beef Cattle Research Center, Campo Grande, Brazil. The aim was to create durable, race non-specific resistance to anthracnose controlled by polygenic factors. A mass hybridisation technique was employed to produce a high degree of genetic diversity and sizeable quantities of seed of hybrid-derived progenies of Brazilian and Venezuelan genotypes of S. capitata. Outcrossing resulted in a significant improvement in the forage production of progeny of Venezuelan accessions. The multicross was evaluated in multilocational trials, each representing a large tract of country in the Cerrados ecosystem along a north-south transect from lat.6degrees S to 20degrees S. The genetic shift that occurred in S. capitata was a key element in the formation of the new cultivar. It is a complex mixture of two species, and a recombination of much desired forage traits of Brazilian x Venezuelan genotypes, high forage and seed yields coupled with anthracnose resistance. The new cultivar with its diverse genetic make-up has a wide application in the acid-soil savannas of tropical America. It was released by Embrapa for the Cerrados in 2000.

Use of homeopathic preparations in experimental studies with healthy plants

Background. The last comprehensive review of experimental research on effects of homeopathic treatments on plants was published in 1984, and lacked formal predefined criteria to assess study quality. Since then several new studies with more advanced methods have been published.Objectives: To compile a review of the literature on basic research in homeopathy with healthy plants with particular reference to studies investigating specific effects of homeopathic remedies.Methods: The literature search included English, French, German, Italian, Portuguese and Spanish publications from 1920 to April 2009, using predefined selection criteria. We included experiments with healthy whole plants, seeds, plant parts and cells. The outcomes had to be measured by established procedures and statistically evaluated. We developed a Manuscript Information Score (MIS) and included only publications which provided enough information for proper interpretation (MIS >= 5). A formallised Study Methods Evaluation Procedure (SMEP) was used to evaluate these studies, and the subgroup of studies with adequate controls to identify specific effects.Results: A total of 86 studies in 79 publications was identified, 43 studies included statistics, 29 had MIS >= 5, and 15 studies investigated the specificity of homeopathic preparations. Specific effects of decimal, centesimal and fifty millesimal potencies were found including dilution levels far beyond the Avogadro number. In consecutive series of potencies only some of the tested potencies showed effects. There were many individual studies with diverse methods and very few reproduction trials.Conclusions: Healthy plant models seem an useful approach to investigate basic research questions about the specificity of homeopathic preparations. More investigations with more advanced methods are recommended, especially in the sectors of potentisation techniques, effective potency levels and conditions for reproducibility. Systematic negative control experiments should become a routine procedure to control the stability of the experimental systems. Homeopathy (2009) 98, 228-243.

Genetic profile characterization of 10 X-STRs in four populations of the southeastern region of Brazil

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

Allozyme differentiation among allopatric populations of Anopheles nuneztovari (Diptera: Culicidae)

Four enzymes in six geographic populations, four Brazilian and two Colombian, of Anopheles nuneztovari were studied. There were differences among the most frequent alleles in the EST5, ACON and MDH loci in the populations from Brazil and Colombia. The α-GPD(*)C allele was encountered very frequently in the Palo/Sit population in Colombia and the α-GPD(*)B allele was found to be fixed in most of the Brazilian populations. An additional α-GPD band was found only in Palo/Sit. The considerable genetic differentiation between populations in western Colombia vs. Brazil suggests that a certain degree of reproductive isolation exists between them.

A new cunaxid genus with descriptions of two new species from Brazil (Acari: Prostigmata: Bdelloidea: Cunaxidae)

The genus Pseudobonzia Smiley 1975 is revised and divided into two genera. The genus Pseudobonzia Smiley, 1975, with its type species and five other related species, is retained. The remainder of the group is now known as Coleobonzia gen. nov. of which the main characteristics are provided. Coleobonzia argillae (Den Heyer, 1977) is designated as type species for the new genus. Two species from Brazil, viz. Coleobonzia clava sp. nov. and C. moraesi sp. nov. are described and figured. A key to the two genera as well as a key to the Brazilian and South African species of the new genus are provided. Copyright © 2008 Magnolia Press.

Metacryphaeus rotundatus, um novo elemento da fauna de trilobites calmoniidae (phacopida), da formação Ponta Grossa (Devoniano), bacia do Paraná, Brasil

Calmoniids (Delo, 1935) are the most common and abundant group of trilobites of the fossil record of the Devonian Ponta Grossa Formation in the Apucarana sub-basin. Although known since the past century, the study of calmoniids has been taxonomically and stratigraphically biased. This is because some authors centered their studies on some particular genera from a few stratigraphic horizons within the basal portion of the Ponta Grossa Formation. The analyses of 398 specimens of calmoniid trilobites of the rocks of Jaguariaiva Member of the Ponta Grossa Formation, mainly from Tibagi county in the state of Paraná, Brazil, indicate the presence of specimens that are referable to Metacryphaeus rotundatus (Kozlowski, 1923). This is the first record of M. rotundatus in Brazilian Devonian rocks. Metacryphaeus rotundatus is a conspicuous species of the Emsian rocks of the Icla Formation, Bolivia. Although the affinities of the trilobite fauna of the Devonian Paraná Basin, in the context of the Malvinokaffric realm, are with the Brazilian and South Africa provinces, this finding is in accordance with new evidence (e.g., conulariids, homalonotids trilobites), indicating the presence of cosmopolitan species with Andean affinities. Metacryphaeus rotundatus lived in a broad paleoclimatic range, from a temperate, cold temperate to a subpolar climate. Finally, in the Devonian of the Paraná Basin, M. rotundatus lived and were preserved in muddy, organic rich bottoms, deposited in offshore waters, below the storm wave base, associated to marine flooding surfaces.