Brazilian network for the surveillance of maternal potentially life threatening morbidity and maternal near-miss and a multidimensional evaluation of their long term consequences

Background. It has been suggested that the study of women who survive life-threatening complications related to pregnancy (maternal near-miss cases) may represent a practical alternative to surveillance of maternal morbidity/mortality since the number of cases is higher and the woman herself is able to provide information on the difficulties she faced and the long-term repercussions of the event. These repercussions, which may include sexual dysfunction, postpartum depression and posttraumatic stress disorder, may persist for prolonged periods of time, affecting women's quality of life and resulting in adverse effects to them and their babies. Objective. The aims of the present study are to create a nationwide network of scientific cooperation to carry out surveillance and estimate the frequency of maternal near-miss cases, to perform a multicenter investigation into the quality of care for women with severe complications of pregnancy, and to carry out a multidimensional evaluation of these women up to six months. Methods/Design. This project has two components: a multicenter, cross-sectional study to be implemented in 27 referral obstetric units in different geographical regions of Brazil, and a concurrent cohort study of multidimensional analysis. Over 12 months, investigators will perform prospective surveillance to identify all maternal complications. The population of the cross-sectional component will consist of all women surviving potentially life-threatening conditions (severe maternal complications) or life-threatening conditions (the maternal near miss criteria) and maternal deaths according to the new WHO definition and criteria. Data analysis will be performed in case subgroups according to the moment of occurrence and determining cause. Frequencies of near-miss and other severe maternal morbidity and the association between organ dysfunction and maternal death will be estimated. A proportion of cases identified in the cross-sectional study will comprise the cohort of women for the multidimensional analysis. Various aspects of the lives of women surviving severe maternal complications will be evaluated 3 and 6 months after the event and compared to a group of women who suffered no severe complications in pregnancy. Previously validated questionnaires will be used in the interviews to assess reproductive function, posttraumatic stress, functional capacity, quality of life, sexual function, postpartum depression and infant development. © 2009 Cecatti et al.

Análise de séries temporais de coordenadas estimadas com gps: Uma proposta metodológica para detecção, remoção e recuperação de efeitos sazonais

GPS active networks are more and more used in geodetic surveying and scientific experiments, as water vapor monitoring in the atmosphere and lithosphere plate movement. Among the methods of GPS positioning, Precise Point Positioning (PPP) has provided very good results. A characteristic of PPP is related to the modeling and / or estimation of the errors involved in this method. The accuracy obtained for the coordinates can reach few millimeters. Seasonal effects can affect such accuracy if they are not consistent treated during the data processing. Coordinates time series analyses have been realized using Fourier or Harmonics spectral analyses, wavelets, least squares estimation among others. An approach is presented in this paper aiming to investigate the seasonal effects included in the stations coordinates time series. Experiments were carried out using data from stations Manaus (NAUS) and Fortaleza (BRFT) which belong to the Brazilian Continuous GPS Network (RBMC). The coordinates of these stations were estimated daily using PPP and were analyzed through wavelets for identification of the periods of the seasonal effects (annual and semi-annual) in each time series. These effects were removed by means of a filtering process applied in the series via the least squares adjustment (LSQ) of a periodic function. The results showed that the combination of these two mathematical tools, wavelets and LSQ, is an interesting and efficient technique for removal of seasonal effects in time series.

Conhecimento Odontológico e Comportamento de Retorno de Escolares em Função do Tipo de Instituição (Pública ou Privada)

Objective: To evaluate the dental knowledge and attendance of elementary schoolchildren according to the type of institution (public or private). Method: The sample was composed of 800 children from the 5th to 8th grades of the elementary education. The research instrument was a questionnaire composed of open questions referring to the last recall visit, type and importance of the recall visit, and knowledge of dental caries and periodontal disease. Descriptive statistical analysis was done and the chisquared test was used with a significance level of 5%. Results: There was statistically significant difference between the students from the different institutions regarding the time (p=0.001) and main reason (p=0.001) of the last visit to the dentist, knowledge of the need of periodic visits to the dentist (p=0.001), importance (p=0.001) and frequency (p=0.001) of periodic recalls, and knowledge of dental caries (p=0.001) and periodontal disease (p=0.001). Conclusion: The adolescents presented different dental knowledge and attendance, according to the type of teaching institution.

Avaliação de Diferentes Compósitos na Resistência à Fratura de Núcleos de Preenchimento

Objective: To evaluate and compare the fracture strength of different composite resins used for core buildup. Method: Thirty-six bovine teeth were decoronated at the cervical third to standardize the length of specimens at 20 mm. Under constant irrigation, the canals were prepared with #5 Largo drills corresponding to the size and diameter of #3 Reforpost fiberglass post. The posts were cemented with Enforce resin sealer, being 16 mm inside the root canal and 4 mm outside the root canal, and the material was light-activated for 30 seconds at each side. The specimens were divided into 3 groups (n=12), in which cores (4 mm diameter and 5 mm high) were prepared from a prefabricated standard with three types of composite resins: Group 1: Z100 (3M), Group 2: Z250 (3M) and Group 3: P60 (3M). The specimens were fixed in a cylindrical device with an adaptor at 45o inclination. This device was adapted to a universal testing machine (EMIC) to simulate the force until fracture of the specimen. Data were subjected to ANOVA (p<0.05). Results: The Z250 resin cores presented the highest mean fracture strength (45.453 kgf), while the mean fracture strengths in Group 1 and Group 3 were 38.014 and 39.506 kgf, respectively. P60 caused the largest number of root fractures. Conclusion: Considering the characteristics and properties of the tested resins, Z250 appears as the most indicated for core buildup.

Avaliação das dimensões transversas na maxila e mandíbula em pacientes na fase da dentição mista tratados com aparelho ortodôntico removível superior

Objeti vo: Avaliar os efeitos da expansão lenta na maxila e na mandíbula com o aparelho ortodônti co removível superior com torno de expansão simétrico e mediano, nas regiões oclusal, gengival e alveolar de pacientes jovens com atresia maxilar. Método: A amostra compreendeu 18 indivíduos leucodermas (11 meninas e 7 meninos; idade média: 8 anos e 10 meses no início do tratamento) que apresentavam atresia da maxila, acompanhadas ou não de mordida cruzada posterior uni ou bilateral na fase de denti ção mista. Todos os pacientes foram tratados com aparelho ortodônti co removível superior com torno de expansão simétrico e mediano, sendo o tempo médio de tratamento de 15,4 meses (± 7,6). Para avaliar a infl uência do tratamento nas mensurações dos pontos demarcados nas regiões oclusal, gengival e alveolar, foram uti lizados os modelos de gesso dos arcos superior e inferior (36 pares) obti dos em dois tempos: T1: início do tratamento e T2: ao fi nal do tratamento. Para cada paciente em ambos os tempos, foram mensuradas as distâncias transversas na região oclusal entre caninos decíduos, 1o molares decíduos ou 1o pré-molares permanentes e entre 1o molares permanentes, superiores e inferiores. Para verifi car se a movimentação ocorreu por inclinação ou por movimento de corpo, foram uti lizadas também medidas nas regiões gengival e alveolar. Os dados foram avaliados estati sti camente pelo teste “t student para amostras pareadas (5%). Resultados: Observou-se que em T2, todas as distâncias mensuradas para as regiões oclusal, gengival e alveolar apresentaram valores estati sti camente superiores às mesmas medidas em T1 (p<0,05). Conclusão: O aparelho ortodônti co removível superior é efeti vo nos casos de expansão lenta da maxila, agindo também indiretamente nas dimensões transversas do arco inferior.

Response of human dental pulp to calcium hydroxide paste preceded by a corticosteroid/antibiotic dressing agent

Aim: To evaluate the treatment with corticosteroid/antibiotic dressing in pulpotomy with calcium hydroxide. Methods: Forty-six premolars were pulpotomized and randomly assigned into 3 groups. In Group I pulpal wound was directly capped with calcium hydroxide, and Group II and Group III received corticosteroid/antibiotic dressing for 10 min or 48 h, respectively, before pulp capping. Teeth were processed for histological analysis after 7, 30 or 60 days to determine inflammatory cell response, tissue disorganization, dentin bridge formation and presence of bacteria. Attributed scores were analyzed by Kruskal-Wallis and Mann-Whitney tests (α=0.05). Results: On the 7th day, all groups exhibited dilated and congested blood vessels in the tissue adjacent to pulpal wound. The inflammatory cell response was significantly greater in Group III (p<0.05). On the 30th day, in all groups, a thin dentin matrix layer was deposited adjacent to the pulpal wound and a continuous odontoblast-like cell layer underlying the dentin matrix was observed. On the 60th day, all groups presented a thick hard barrier characterized by an outer zone of dystrophic calcification and an inner zone of tubular dentin matrix underlined by a defined odontoblast-like cell layer. Conclusions: Within the limitations of present study, considering that the treatment was performed in healthy teeth, it may be concluded that the use of a corticosteroid/antibiotic dressing before remaining tissue protection with calcium hydroxide had no influence on pulp tissue healing.

Dental caries experience in children attending an infant oral health program

Aim: To investigate: a) caries experience in 5 year-old children and its relationship to the caries risk evaluation made before 1 year of age; b) compliance of parents to an infant oral health program as well as the abandonment reasons. Methods: Group A (GA) - 242 children (60-71 months old) who stayed in the program and had been enrolled since their first year of life underwent a clinical examination according to the WHO's criteria; their parents/caregivers were interviewed to ascertain their compliance to the program. Group B (GB) - parents of 60 children, who had dropped out of the program, were interviewed to check the reasons of withdrawing. The caries risk classification was based on the file at the first appointment. Chi-square test was used (α=0.05) for statistical analyses. Results: Most of the children were free of caries (71.1%). Caries risk evaluation showed low sensibility (34.3%, 95% CI = 22.4-46.1) and high specificity (74.4%, 95% CI = 67.6-81.2) to caries experience. Sixty-two mothers (25.6%) reported difficulty to follow the guidelines. The main reason for dropping out was changing to similar health services (40.0%). Conclusions: Caries risk in the first year of life was not efficient to predict dental caries experience at 5 years of age. Educational practice should be improved to increase the compliance of the parents to the program.

Effect of photochemical activation of hydrogen peroxide bleaching gel with and without TiO2 and different wavelengths

Aim: To evaluate the effect of photochemical activation of hydrogen peroxide (H2O2) bleaching gel with different wavelengths. Methods: In the study, 80 bovine incisors were used, which were stained in 25% soluble coffee and divided in 4 groups. The initial color was measured with the Easy Shade spectrophotometer by CIE Lab. An experimental 35% H2O2 bleaching gel was used, either with or without the presence of titanium dioxide (TiO2) pigment, associated with two light sources: G1 - Transparent Gel (TG) and no activation; G2 - Gel with TiO2 and activation with blue LED (l=470nm)\laser (Easy Bleach) appliance; G3 - Gel with TiO2 and activation with ultraviolet (l=345nm - UV); G4 - TG and activation with UV. Three applications of the gels were made for 10 min, and in each, 3 activations of 3 min, with interval of 30 s between them. The coloration was evaluated again and the variation in color perception (DE) was calculated. The data were submitted to one-way ANOVA and Tukey's test at 5% significance level. Results: There were significant differences between G1 and G4. The greatest E value was observed in G4 (13.37). There was no statistically significant difference (p>0.05) between the groups 2, 3 and 4. Conclusions: The presence of TiO2 particules in the bleaching gel did not interfere at the bleaching results.

Bone mineral density on conventional and digitized images under different parameters of digitization and storage

Aim: To assess the bone mineral density on conventional and digitized images, comparing whether different parameters of digitization and storage change these values. Methods: Twenty radiographs were taken from five partially dentulous dry mandibles with an aluminum 7-mm stepwedge placed on the superior edge of the film. After processing, the films were digitized with a resolution of 600 and 2,400 d.p.i. and saved as TIFF and JPEG files. On every conventional and digitized image, circular regions of interest were selected for densitometry and radiographic contrast analysis. Results: Pearson's correlation coefficient showed a significant and strong mean gray values association between digitized and conventional images, differing from radiographic contrast that did not show a significant association. ANOVA did not reveal a statistically significant difference in bone density and radiographic contrast among the four digitized image groups, but the conventional image contrast was significantly lower. Conclusions: Bone mineral density did not differ in both conventional and digitized images. The parameters of image compression and resolution, tested in this study, did not change the results of densitometry and digitization process increased the radiographic contrast.

Progress report on the programme on the removal of language barriers

Examina los progresos del CDCC en su programa para eliminar las barreras de lenguaje en el Caribe, con el fin de facilitar una colaboracion mas estrecha en areas del desarrollo economico y social entre los paises miembros del CDCC, especialmente en lo que se refiere al establecimiento de un Instituto Caribeno del Lenguaje que coordine las tareas en ese sentido de las organizaciones a nivel nacional y subregional existentes en la region.

Uruguay: un modelo macroeconómico de compatibilización de políticas y proyecciones a mediano plazo

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Modelo macroeconómico de Venezuela

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Shvo's catalyst in chemoenzymatic dynamic kinetic resolution of amines-inner or outer sphere mechanism?

Evidence is provided for the inner-sphere mechanism with actual metal coordination of the racemic amine in the crucial hydrogen transfer step promoted by Shvo's catalyst of the chemoenzymatic dynamic kinetic resolution (DKR) of amines. Key intermediates involved in this H-transfer step were intercepted and continuously monitored by electrospray ionization mass spectrometry (ESI-MS) and characterized by their dissociation chemistries via ESI-MS/MS. © 2013 The Royal Society of Chemistry.