Depression with postpartum onset: a prospective cohort study in women undergoing elective cesarean section in Brasilia, Brazil

PURPOSE: It was to determine the prevalence of depressive symptoms in a sample of puerperal women from Brasília, Brazil, distinguishing cases with onset after delivery from those already present during pregnancy. METHODS: A prospective cohort study with convenience sampling of patients submitted to elective cesarean section at two private hospitals. As an instrument for assessing depressive symptoms, the Edinburgh Postnatal Depression Scale with cutoff >13 was applied shortly before delivery and four to eight weeks after childbirth. RESULTS: Among the 107 women who completed the study, 11 (10.3%) had significant depressive symptoms during pregnancy and 12 (11.2%) during the postpartum period. Among the 12 patients with postpartum symptoms, 6 had symptoms during pregnancy, so that 5.6% of the sample had postpartum onset of depression. The higher overall frequency of depression was significantly among single women than among married women (p=0.04), a fact mainly due to a higher frequency of single women experiencing persistent depressive symptoms both before and after delivery (p=0.002). The risk of depression was not influenced by age, parity or educational level. CONCLUSION: Women with depression identified during the postpartum period comprise a heterogeneous group, in which symptoms may have started before pregnancy, during pregnancy or after childbirth. In this sample, half of the postpartum depression cases already presented symptoms during late pregnancy. Since depression can arise before and after childbirth, it may have different etiologies and, therefore, a different response to treatment, a possibility that should be considered by clinicians and researchers.

Ultimate capacity of stainless steel rectangular hollow section X- joints at low temperatures

Growing demand for stainless steel construction materials has increased the popularity of substitutive materials for austenitic stainless steels. The lean duplex grades have taken their place in building of structures exposed to corrosive environments. Since the duplex grades are relatively new materials, the current codes and norms do not fully cover the newest duplex grades. The joints tested in this thesis were designed and studied according to Eurocode 3, even though all the materials are not yet accepted to the standards. The main objective in this thesis was to determine the differences of the used materials in behaviour under loading at low temperatures. Tests in which the deformation and strength properties of the joints were determined were done at the temperature of -46°C, which is the requirement of temperature for structures designed according to Norsok standards. Results show that replacing the austenitic grade with the lean duplex grade is acceptable.

Cesarean section - short term maternal complications related to the mode of delivery

Cesarean section (CS) is the most common major surgery performed on women worldwide. CS can save the life of the mother or the fetus, but is associated with the typical complications of any major surgery: hemorrhage, infection, venous thromboembolism and complications of anesthesia, sometimes leading to maternal death. Recently there have been several reports from well resourced countries on increased severe maternal morbidity and even mortality. Increased rates of CS, obesity and older mothers may explain this rise. The aim of this thesis is to study the rates and risk factors of short term maternal complications associated with CS. Also, we compared maternal morbidity by mode of delivery and over time. The complication rates were assessed in a prospective study involving 2496 CS performed in the 12 largest delivery units in Finland in 2005. The rates of severe complications were studied by mode of delivery in a register-based study comparing national cohorts in 1997 and 2002. The impact of several risk factors on severe maternal morbidity by mode of delivery was studied in a register-based study of all singleton deliveries in 2007-2011. In the prospective study, 27% of the women who underwent CS had one or more intraoperative or postoperative complications during their hospital stay, and 10% had a severe complication. In the register-based study the incidence of life-threatening maternal complications was 7.6 in 1000 deliveries. The incidence was lowest for vaginal delivery (VD), followed by instrumental VD and elective CS, and highest in emergency CS. An attempt of VD, including the risks associated with emergency CS, seems to be the safest mode of delivery, even for most high-risk women.

Anatomia do lenho de Croton urucurana Baill. (Euphorbiaceae) de solos com diferentes níveis de umidade

Este estudo analisou a anatomia do lenho de indivíduos de Croton urucurana de áreas com o solo alagado, úmido e seco. A estrutura anatômica foi analisada quantitativamente através de medições de vinte e duas características, envolvendo os elementos de vasos, as fibras, os parênquimas axial e radial; o valor médio das características em cada tipo de solo foi comparado estatisticamente. Foram obtidos dados de umidade de solo, quinzenalmente, no período de um ano, de cada uma das três áreas, juntamente com a curva de retenção de água do solo para a caracterização do nível de umidade. Quatorze características, ao nível de 5% de significância, apresentaram-se diferentes nos espécimes de pelo menos duas localidades diferentes de solo. De tais características, dez apresentaram-se significativamente diferentes entre os espécimes de solo da condição seca e alagada. A freqüência e o diâmetro dos vasos, apresentaram-se com médias maiores nos espécimes do solo alagado, e menores nos de solo seco. Tal dado revela um fato novo: o aumento da freqüência e do diâmetro dos vasos dos espécimes que vivem na condição estressante do solo alagado.

Croton faroensis, uma nova Euphorbiaceae da Amazônia brasileira

Uma nova espécie de Euphorbiaceae da Amazônia brasileira, Croton faroensis R. Secco, é descrita. Essa espécie é superficialmente semelhante a C. paraensis Müll. Arg., mas distingue-se por apresentar folhas sem glândulas ou com glândulas inconspícuas na base, nervuras secundárias formando arcos pouco evidentes na face abaxial, flores estaminadas solitárias, filetes com tricomas vilosos, flores pistiladas pediceladas e frutos levemente trígonos no ápice. A posição sistemática de C. faroensis em relação às seções de Croton é discutida.

Uma nova espécie de Croton sect. Geiseleria (Euphorbiaceae) da Amazônia Oriental brasileira

Uma nova espécie de Euphorbiaceae da Amazônia brasileira, Croton strobiliformis Secco, é descrita. Essa espécie é superficialmente semelhante a C. hirtus L'Heritier, mas pode ser distinguida pelos seguintes caracteres: ramos esparsamente pubescentes, glabrescentes, folhas com denso indumento de tricomas estrelado-porrectos em ambas as faces, levemente áspera na abaxial, com nervuras acentuadamente mais evidentes que na face adaxial, estípulas 2, aciculadas, inflorescência em racemo estrobiliforme, flores pistiladas várias, agrupadas na base da inflorescência, pétalas das flores estaminadas com denso indumento de tricomas vilosos internamente, estames com tricomas vilosos na base e frutos com indumento denso-velutino. A posição sistemática de C. strobiliformis em relação às seções de Croton é discutida.

Radar cross-section measurement using the Doppler effect

In this Master Thesis we discuss issues related to the measurement of the effective scattering surface, based on the Doppler Effect. Modeling of the detected signal was made. Narrowband signal filtering using low-frequency amplifier was observed. Parameters of the proposed horn antennas were studied; radar cross section charts for three different objects were received.

Antinociceptive effects of the essential oil of Croton zehntneri in mice

Croton zehntneri is an aromatic plant native to Northeastern Brazil, where it is often used in folk medicine. In the present study the antinociceptive effects of the essential oil of Croton zehntneri (EOCz) were evaluated in mice. EOCz administered orally at doses of 100 and 300 mg/kg reduced paw licking time in the second phase of the formalin test from the control value of 41.61 ± 8.62 to 12.01 ± 7.97 and 6.57 ± 3.42 s, respectively. During the first phase of the formalin test only 300 mg/kg induced a significant alteration (from 58.2 ± 7.02, control, to 28.7 ± 4.73 s). The number of contortions in response to intraperitoneal injections of acetic acid did not differ significantly between controls (80.6 ± 9.01) and experimental (300 mg/kg body weight) animals (89.1 ± 9.53% of the control numbers; P > or = 0.05, Student t-test). In the hot-plate test, EOCz at doses > or = 100 mg/kg significantly increased the latency time with respect to controls (11.2 ± 0.80). At 100 and 300 mg/kg this increase persisted for 180 and 240 min, respectively. The data show that EOCz is effective as an antinociceptive agent.

Antinociceptive effects of the essential oil of Croton nepetaefolius on mice

Croton nepetaefolius Baill., is an aromatic plant native to the northeast of Brazil where it is extensively used in folk medicine as a sedative, orexigen and antispasmodic agent. In the present study the antinociceptive effects of the essential oil of C. nepetaefolius (EOCn), administered orally, were evaluated in male Swiss mice (20-25 g). In the acetic acid-induced writhing test, EOCn (100 and 300 mg/kg; N = 14 and N = 12, respectively) was effective at the highest dose. In the hot-plate test, EOCn at 30 and 300 mg/kg, but not at 3 mg/kg, significantly increased the latency at all observation times up to the 180th min (N = 12 for each dose). In the formalin test, EOCn significantly reduced paw licking in the second phase of the test at 100 mg/kg (N = 12), but decreased it in both phases at 300 mg/kg (N = 12). At 30 mg/kg, the effect of EOCn did not differ from control values in either phase of the formalin test (N = 6). Pretreatment with naloxone (5 mg/kg, ip) significantly reversed the analgesic effect of morphine (5 mg/kg, sc) on both phases, but not that of EOCn at 300 mg/kg (N = 6) on both phases of the formalin test. The data show that orally administered EOCn promotes a dose-dependent antinociceptive effect whose mechanisms remain to be elucidated.

Distortion and internal warping torsion of a double symmetric hollow section

This thesis is made in cooperation with Laboratory of Steel Structures and the steel company SSAB. Maximization of the benefits of high-strength steel usually requires the usage of thin wall thicknesses. This means the failures related to buckling, distortion and warping stand out. One must be aware of these phenomena to design thin-walled structures stressed with forces such as torsional loading. It is also important to take into account small stress ranges when evaluating the accurate fatigue strength of structures. The objective of this thesis is to clarify the theory of the uniform and non-uniform torsion. This paper focuses on warping due to the non-uniform torsion in double symmetric box girder and structural hollow section. The arisen stress states are explained and researched using the finite element method. Another research target is the distortion in double symmetric box girder due to torsion, and the restraining effect of transverse diaphragms at the load end. Multiple transverse diaphragms are used to study more efficient restraining against warping and distortion than a common one end plate structure.

Why are the rates of cesarean section in Brazil higher in more developed cities than in less developed ones?

The objective of the present study was to investigate factors associated with cesarean sections in two cities located in different regions of Brazil and to determine factors that explain the higher cesarean section rate in the more developed city, Ribeirão Preto, compared to the less developed one, São Luís. Data from two cohort studies comprising 2846 women in Ribeirão Preto in 1994, and 2443 women in São Luís in 1997/1998 were used. Adjusted and non-adjusted risk estimates were calculated using a Poisson regression model. The cesarean section rate was 33.7% in São Luís and 50.8% in Ribeirão Preto. Adjusted analysis in a joint sequential model revealed a 51% higher risk of cesarean section in Ribeirão Preto compared to São Luís (prevalence rate ratio (PRR) = 1.51). Adjustment for category of hospital admission reduced the PRR to 1.09, i.e., this variable explained 82% of the difference in the cesarean section rate between the two cities. Adjustment for the variable "the same physician for prenatal care and delivery" reduced the PRR to 1.07, with the "physician" factor explaining 86% of the difference between rates. When simultaneously adjusted for the two variables, the PRR decreased to 1.05, with these two variables explaining 90% of the difference in the cesarean section rate between the two cities, and the difference was no longer significant. The difference in the cesarean section rate between the two Brazilian cities, one more and one less developed, was mainly explained by the physician factor and, to a lesser extent, by the category of hospital admission.

The effect of epidural and general anesthesia on newborn rectal temperature at elective cesarean section

Both epidural and general anesthesia can impair thermoregulatory mechanisms during surgery. However, there is lack of information about the effects of different methods of anesthesia on newborn temperature. The purpose of this study was to determine whether there are differences in newborn rectal temperature related to type of anesthesia. Sixty-three pregnant women were randomly assigned to receive general or epidural anesthesia. Maternal core temperature was measured three times with a rectal probe just before anesthesia, at the beginning of surgery and at delivery. In addition, umbilical vein blood was sampled for pH. The rectal temperatures of the babies were recorded immediately after delivery, and Apgar scores were determined 1, 5, and 10 min after birth. The duration of anesthesia and the volume of intravenous fluid given during the procedure (833 ± 144 vs 420 ± 215 mL) were significantly higher in the epidural group than in the general anesthesia group (P < 0.0001). Maternal rectal temperatures were not different in both groups at all measurements. In contrast, newborn rectal temperatures were lower in the epidural anesthesia group than in the general anesthesia group (37.4 ± 0.3 vs 37.6 ± 0.3°C; P < 0.05) immediately after birth. Furthermore, the umbilical vein pH value (7.31 ± 0.05 vs 7.33 ± 0.01; P < 0.05) and Apgar scores at the 1st-min measurement (8.0 ± 0.9 vs 8.5 ± 0.7; P < 0.05) were lower in the epidural anesthesia group than in the general anesthesia group. Since epidural anesthesia requires more iv fluid infusion and a longer time for cesarean section, it involves a risk of a mild temperature reduction for the baby which, however, did not reach the limits of hypothermia.

Thick Section Laser Beam Welding of Structural Steels: Methods for Improving Welding Efficiency

Laser beam welding (LBW) is applicable for a wide range of industrial sectors and has a history of fifty years. However, it is considered an unusual method with applications typically limited to welding of thin sheet metal. With a new generation of high power lasers there has been a renewed interest in thick section LBW (also known as keyhole laser welding). There was a growing body of publications during 2001-2011 that indicates an increasing interest in laser welding for many industrial applications, and in last ten years, an increasing number of studies have examined the ways to increase the efficiency of the process. Expanding the thickness range and efficiency of LBW makes the process a possibility for industrial applications dealing with thick metal welding: shipbuilding, offshore structures, pipelines, power plants and other industries. The advantages provided by LBW, such as high process speed, high productivity, and low heat input, may revolutionize these industries and significantly reduce the process costs. The research to date has focused on either increasing the efficiency via optimizing process parameters, or on the process fundamentals, rather than on process and workpiece modifications. The argument of this thesis is that the efficiency of the laser beam process can be increased in a straightforward way in the workshop conditions. Throughout this dissertation, the term “efficiency” is used to refer to welding process efficiency, specifically, an increase in efficiency refers an increase in weld’s penetration depth without increasing laser power level or decreasing welding speed. These methods are: modifications of the workpiece – edge surface roughness and air gap between the joining plates; modification of the ambient conditions – local reduction of the pressure in the welding zone; modification of the welding process – preheating of the welding zone. Approaches to improve the efficiency are analyzed and compared both separately and combined. These experimentally proven methods confirm previous findings and contribute additional evidence which expand the opportunities for laser beam welding applications. The focus of this research was primarily on the effects of edge surface roughness preparation and pre-set air gap between the plates on weld quality and penetration depth. To date, there has been no reliable evidence that such modifications of the workpiece give a positive effect on the welding efficiency. Other methods were tested in combination with the two methods mentioned above. The most promising - combining with reduced pressure method - resulted in at least 100% increase in efficiency. The results of this thesis support the idea that joining those methods in one modified process will provide the modern engineering with a sufficient tool for many novel applications with potential benefits to a range of industries.