Psychiatric disorders and psychiatric consultation in a general hospital: A case- control study

Introduction: Psychiatric consultation (PC) has been considered an efficient tool to develop research, to track and to give assistance benefiting patients, health professionals and the institution. However, it has not been much used in Brazil. Although 30 to 50% of general hospital (GH) inpatients may present a psychiatric disorder, only 1 to 12% of them are referred to assessment. The aims of this study were: to assess mental disorders in a GH; to identify which of these patients are sent to psychiatric care; to verify alleged reasons for referral to psychiatric consultation, and to examine the relationship between PC and psychiatric learning (during medical school and residence). Methods: A case-control patient study was conducted (47 cases and 94 controls) to analyze in detail the following variables: socio-demographic; clinical; degree of information (about the disease and diagnostic/therapeutic procedures), and relationship between patient and health team. Psychiatric diagnoses were made according to the ICD- 10 criteria. The Self Report Questionnaire (SRQ), the CAGE and Brief Psychiatric Rating Scale (BPRS) were used as well as a specifically designed questionnaire to collect clinical and demographic data. Results: Behavioral alterations, either of elation or of depression, were the main for requesting a PC; 95.8% of the cases and 27.7% of the controls had a mental disorder. Organic mental disorders and alcohol-related disorders were the most frequent diagnoses in group I (cases), while anxiety, depressive and alcohol-related disorders were predominant in group II (controls). Control group patients were better informed and more able to establish an appropriate relationship with the health team than case patients. The logistic regression showed CAGE-positive patients having 12.85 times greater risk of being referred to PC, followed by unemployed patients (2.44 times more PC referrals). Discussion: The SRQ and CAGE were quite useful in the screening of possible patients and might be important for medical students to learn and use as generalists. Further research is needed to verify if and how the newly-established service will improve the diagnostic and treatment skills of our students.

Immunocytochemical study of Ki-67 as a prognostic marker in canine mammary neoplasia

Background: Canine mammary tumors are challenging for clinicians and pathologists because of complex histologic classification, low specificity of cytologic diagnosis, and unpredictable biological behavior. In histologic specimens, expression of tumor proliferation marker Ki-67, a nuclear nonhistone protein, has been shown to have prognostic value for canine mammary tumors and to correlate with malignancy and low survival rates. Objective: The objective of this study was to measure the proliferation index of canine mammary tumors by immunochemical detection of Ki-67 in cytologic specimens and to determine its relationship to clinical and pathologic variables and patient outcome. Methods: Spontaneous mammary tumors from 31 female dogs were surgically excised. Imprint specimens for cytologic evaluation were wet-fixed in ethanol; histologic specimens were prepared routinely. Immunostaining was performed with the PH 177 monoclonal antibody against Ki-67; proliferation index was graded from negative to +++. Dogs were followed for 18 months. Multivariate logistic regression analysis was used to determine correlations between immunocytochemical results, tumor and clinical variables, and patient outcome. Results: Ki-67 proliferation indices in cytologic specimens were significantly lower for nonmalignant tumors than for malignant tumors. High index values of Ki-67 were positively correlated with metastasis, death from neoplasia, low disease-free survival rates, and low overall survival rate. With the exception of 4 specimens for which cellularity was insufficient, positive expression of Ki-67 in cytologic specimens correlated with that of histologic specimens. Conclusions: The prognostic value of the Ki-67 index in canine mammary tumors by using wet-fixed cytology imprint specimens was similar to that observed previously for histologic specimens. Immunocytochemical detection of Ki-67 could improve the accuracy and value of cytology by providing safe and rapid information about malignancy and patient outcome. © 2004 American Society for Veterinary Clinical Pathology.

Surface roughness of packable composite resins polished with various systems

Purpose: The aim of this study was to evaluate the surface roughness of four packable composite resins, SureFil™ (Dentsply, Petrópolis, Rio de Janeiro, Brazil), Prodigy Condensable™ (Kerr Co., Orange, CA, USA), Filtek P60™ (3M do Brasil, São Paulo, Brazil), and ALERT® (Jeneric/Pentron, Inc., Wallingford, CT, USA) and one microhybrid composite resin (Filtek Z250™, 3M do Brasil) after polishing with four finishing systems. Materials and Methods: Twenty specimens were made of each material (5 mm in diameter and 4 mm high) and were analyzed with a profilometer (Perthometer® S8P, Perthen, Mahr, Germany) to measure the mean surface roughness (Ra). The specimens were then divided into four groups according to the polishing system: group 1 - Sof-Lex™ (3M do Brasil), group 2 - Enhance™ (Dentsply), group 3 - Composite Finishing Kit (KG Sorensen, Barueri, São Paulo, Brazil), and group 4 - Jiffy Polisher Cups® (Ultradent Products, Inc., South Jordan, UT, USA). The specimens were polished and then evaluated for Ra, and the data were subjected to analysis of variance, analysis of covariance, and Tukey's test (p = .05). Results: The mean Ra of SureFil polished with Sof-Lex was significantly lower than that of KG points. Prodigy Condensable polished with Enhance showed a significantly less rough surface than when polished with Sof-Lex. Filtek P60 did not exhibit a significant difference with the various polishing systems. For ALERT the lowest mean Ra was obtained with Sof-Lex and the highest mean Ra with KG points. Regarding Filtek Z250, polishing with KG and Jiffy points resulted in a significantly lower mean Ra than when polished with Enhance. Conclusions: Packable composite resins display variable roughness depending on the polishing system used; the Sof-Lex disks and Jiffy points resulted in the best Ra values for the majority of the materials tested.

Progression of liver fibrosis in blood donors infected with hepatitis C virus

Background/Aims. Chronic hepatitis by HCV is progressive towards cirrhosis, with variable rate. We evaluated the rate of fibrosis progression (RFP), risk factors associated with advanced fibrosis (F3 and F4), and estimated the evolution time to cirrhosis. Methods. We transversely selected 142 blood donors infected only with HCV, with a known route of infection, submitted to liver biopsy at admission. RFP= ratio between stage of fibrosis (METAVIR)/estimated duration of infection in years. Non-parametric tests and logistic regression analysis, with significance level of 5% were used. Results. Median RFP was 0.086 U/year (0.05 - 0.142). Ten patients had F4 and 25 had F3. Median RFP values were significantly different (p=0.001) from one age group at contamination to the others and ALT and AST levels. There were no differences in the expected evolution to cirrhosis between intermediate fibrosers (F2) and the rapid fibrosers (F3 and F4). The independent variables associated with advanced fibrosis were ALT (OR 7.2) and GGT (OR 6.4) and age at inclusion (OR 1.12). Conclusion. This study suggests that RFP is extremely variable, it is exponential with age, and mainly influenced by host characteristics, especially age at contamination and possibly ethnical group. These asymptomatic patients had high percentage of fibrosis F2, F3 and F4.

Studies on the interaction between humic substances and conducting polymers for sensor application

The interaction between humic substances and poly(o-ethoxyaniline) (POEA), a conducting polymer, was investigated for both solution and self-assembled films. The results have shown that the humic substances induce a doping of POEA by protonation, as indicated by UV-Vis and Raman spectroscopies. The atomic force microscopy (AFM) studies on the self-assembled films have shown that the average roughness of the polymer film has increased after exposing it to humic substances (fulvic and humic acids), consistent with the interaction between POEA and humic substances. However, this change in morphology is reversible by washing the films with water in agreement with the electrical data allowing using this system in sensor applications. Here, the sensor formed by an array of different sensing units was able to detect and distinguish humic substances in aqueous solution, as shown by multivariate analysis (principal component analysis). The motivation to detect humic substance comes due to its importance in terms of quality control of water or soil. ©2005 Sociedade Brasileira de Química.

Efficacy of hormone therapy with and without methyltestosterone augmentation of venlafaxine in the treatment of postmenopausal depression: A double-blind controlled pilot study

Objective: This study evaluated the augmentation of venlafaxine with hormone therapy in the treatment of postmenopausal depression. The hormones evaluated were estrogen (0.625 mg) in combination with medroxyprogesterone acetate (2.5 mg) and methyltestosterone (2.5 mg). Design: Seventy-two menopausal women (mean age: 53.6 ± 4.27 years) diagnosed with depression (Montgomery-Åsberg Depression Rating Scale [MADRS] scores ≥ 20) were treated with venlafaxine and one of the following hormone therapy combinations, in a double-blind regimen: estrogen + medroxyprogesterone + methyltestosterone (group 1, n = 20); estrogen + medroxyprogesterone acetate (group 2, n = 20); methyltestosterone only (group 3, n = 16); and no hormone therapy (group 4, n = 16). Study duration was 24 weeks. Primary efficacy outcome was remission according to the MADRS, whereas secondary efficacy measures included the Clinical Global Impression (CGI), Blatt-Kupperman Index, and Women's Health Questionnaire (WHQ). Results: Forty-eight patients completed the study. All groups showed significant improvement from baseline. Group 3 demonstrated significant improvement on the MADRS compared with placebo (group 4) at weeks 20 (P = 0.048) and 24 (P = 0.030); effect size 8.04 (0.83; 15.26) (P = 0.029), but also had the highest dropout rate. Groups 1 and 3 had significant CGI improvement rates compared with placebo: 42.23% (P = 0.012) and 44.45% (P = 0.08), respectively. There were no differences in the WHQ or BKI scores among the groups. Conclusions: Methyltestosterone 2.5 mg had the highest effect size compared with placebo, but the high dropout rate prevented its efficacy from being determined. Estrogen plus medroxyprogesterone, combined with methyltestosterone or otherwise, demonstrated a trend toward increased efficacy of venlafaxine. Further larger-scale clinical trials are needed to elucidate the findings of this pilot study. © 2006 by The North American Menopause Society.

Fatores associados à vacinação contra a influenza em idosos

Objective. To investigate the epidemiologic profile of elderly persons who do or do not participate in influenza vaccination campaigns and to identify the variables that bear an influence on participation. Method. A cross-sectional population-based study was performed using data on individuals aged 60 years or older who were living in the municipalities of São Paulo, Itapecerica da Serra, Embu, Taboão da Serra, Campinas and Botucatu, Brazil, in 2001 and 2002. A stratified random sample of 1 908 elderly individuals was selected by means of two-stage cluster sampling. Exploratory data analysis was performed, including bivariate analysis and multiple logistic regression. Results. Sixty-six percent of the elderly subjects reported having received vaccination against influenza. After adjustment, the following factors were found to be associated with having received vaccination, based on self-report: age (OR = 1.47; 95% CI = 1.09 to 1.99), self-reported hypertension (OR = 1.39; 95% CI = 1.03 to 1.87) and educational level (OR = 0.64; 95% CI = 0.41 to 0.98). The highest number of vaccinated individuals was observed in the group = 70 years of age and in the hypertension group. Individuals with 9 or more years of schooling reported less adherence to influenza vaccination. Conclusions. The results suggest the need for campaigns to make information on the benefits of influenza vaccination more easily accessible to the elderly and health professionals.

Genetic divergence in sesame based on morphological and agronomic traits

The evaluation of diversity in germplasm collections is important for both plant breeders and germplasm curators to optimize the use of the variability available. Diversity can be estimated by different genetic markers. The purpose of this study was to estimate the genetic divergence of 30 morphological and agronomic traits in 108 sesame genotypes by multivariate analysis. The Cole-Rodgers index was used to establish the dissimilarity matrices. The principal component analysis identified the traits that contributed most to the divergence and the genotypes were clustered by Tocher's optimization. Despite the narrow genetic basis, the markers were efficient to characterize the genotypes and identify the most similar groups or duplicate and divergent genotypes. Greatest variation was found for the traits number of capsules per plant and grain yield.

Exercise programs improve mobility and balance in people with Parkinson's disease

Compromised balance and loss of mobility are among the major consequences of Parkinson's disease (PD). The literature documents numerous effective interventions for improving balance and mobility. The purpose of this study was to verify the effectiveness of two exercise programs on balance and mobility in people with idiopathic PD. Thirty-four participants, with idiopathic PD that ranged from Stage I to Stage III on the Hoehn & Yahr (H&Y) scale, were assigned to two groups. Group 1 (n = 21; 67±9 years old) was engaged in an intensive exercise program (aerobic capacity, flexibility, strength, motor coordination and balance) for 6 months: 72 sessions, 3 times a week, 60 minutes per session; while Group 2 (n = 13; 69±8 years old) participated in an adaptive program (flexibility, strength, motor coordination and balance) for 6 months: 24 sessions, once a week, 60 minutes per session. Balance and basic functional mobility were assessed in pre- and post-tests by means of the Berg Balance Scale and the Timed Up and Go Test. Before and after the interventions, groups were similar in clinical conditions (H&Y, UPDRS, and Mini-Mental). A MANOVA 2 (programs) by 2 (moments) revealed that both groups were affected by the exercise intervention. Univariate analyses showed that participants improved their mobility and balance from pre- to post-test. There were no differences between groups in either mobility or balance results. Both the intensive and adaptive exercise programs improved balance and mobility in patients with PD. © 2009 Elsevier Ltd. All rights reserved.

Potential use of the veris apparent EC sensor to predict soil texture under the semi-arid conditions of central Arizona

The operational details of the apparent electrical conductivity (ECa) sensor manufactured by Veris Technologies have been extensively documented in literature reports, but the geographical distribution of these research studies indicate a strong regional concentration in the US Mid-west and Southern states. The agricultural lands of these states diverge significantly to the soil conditions and water regime of irrigated land in the US South-western states such as Arizona where there is no previous research reports of the use of this particular sensor. The objectives of the present study were to analyze the performance of this sensor under the conditions of typical soils in irrigated farms of Central Arizona. We tested under static conditions the performance of the sensor on three soils of contrasting texture. Observations were collected as time series data as soil moisture changed from saturation to permanent wilting point. Observations were repeated at the hours of lowest and highest temperatures. In addition, this study included soil penetration resistance and salinity determinations. Preliminary results indicate that soil temperature of the upper layer caused the most dynamic change in the sensor output. The ECa curves of the three soil textures tested had well defined distinctive characteristics. Final multivariate analysis is pending.

Cohesión social en América Latina y el Caribe : una revisión de conceptos, marcos de referencia e indicadores

Incluye prólogo de la Sra. Alicia Bárcena

Seleção de genótipos resistentes de amendoinzeiro a Anticarsia gemmatalis Hübner (Lepidoptera: Noctuidae) com base em análises multivariadas

The velvetbean caterpillar Anticarsia gemmatalis Hübner attacks peanut leaves, and the use of resistant varieties has directly contributed to ecological and economic aspects of pest control. The aim of this work was to select resistant peanut genotypes to A. gemmatalis using cluster analyses (dendogram obtained by Ward's methods and K-means) and Principal Components analysis for data interpretation. The evaluated genotypes were: IAC 5, IAC 8112, IAC 22 and IAC Tatu ST with upright growth habit, and IAC 147, IAC 125, IAC Caiapó and IAC Runner 886 with runner growth habit, and soybean genotype BR 16 as a susceptible control. The biological parameters: leaf consumption, larval (4o instar) and pupal (24h old) weight, larval and pupal development time and adult longevity were evaluated at laboratory conditions. The genotypes IAC 147 and IAC Runner 886 were resistant to A. gemmatalis in both cluster tests, grouping apart from most of the other genotypes. Both dendrogram and K-means methods provided satisfactory biological explanation, and they can be complementary used together with Principal Component and vice-versa. These results suggest that cluster analyses may be an important statistical tool in the selection of host plant resistance.

La viabilidad de la construcción de un índice sintético de cohesión social para América Latina

Incluye Bibliografía

Análise multivariada de microbacias em relação ao tipo de solo

The objective of this work was to study the dimensional parameters of the drainage net using 12 third-order ramification hydrological watersheds: 4 watersheds per soil unit (LVA, RL and RQ). The soil distinction was realized using ''t'' test to verify the orthogonal contrast among three soil averages and the grouping analysis and mean components. The results showed that the multivariance analysis was not able to discriminate three soils using the dimensional analysis. The t test of this isolated variable allowed discriminating RQ soil from LVA and RL soil units; but it was not sensitive to discriminate the LVA soil and RL unit.

Social cohesion in Latin America: concepts, frames of reference and Indicators

Includes bibliography