Confiabilidade interobservador da escala do equilíbrio de Berg entre fisioterapeutas com extensa e escassa prática clínica

This study aimed at assessing the interobserver reliability of the Brazilian-Portuguese version of the Berg Balance Scale (BBS). The assessment was made by physiotherapists with extensive or little clinical experience in non-institutionalized elderly individuals. Participants comprised 12 elderly subjects (10 women and 2 men) with mean ages of 75.8 ± 8.4 years (range = 63-87) and 18 physiotherapists with varying clinical experience. Inter-examiner reliability obtained for each scale item yielded weighted kappa value > 0.75 in 11 of the 14 items (varying from 0.37 to 1.0). The intra-class correlation coefficient (ICC) for the total sum of BBS scores between the two groups of physiotherapists was 0.996 (95% confidence interval, 0.987 0.999) with a Cronbach alpha coefficient of 0.996. We found no difference between the rater groups when we compared the sum score means obtained with the student s T-test (p = 0.86). Although some items had low reliability values, in general our results suggest that the Brazilian Version of the BBS showed good levels of interrater reliability and agreement when used by physiotherapists with different clinical practice levels and without previous training on non-institutionalized elderly patients. We concluded that the BBS can be useful as an important evaluation instrument on a protocol for Rehabilitation clinics. It may be used by various health professionals, as: Physicians, Physical therapists, Physical educators, Occupational therapists, Nurses and Phonoaudiologists, so confirming the interdisciplinary character of this study

Estudo epidemiológico das parasitoses oculares na população de escolares da cidade de Natal-RN, Brasil

The objective of this study is to estimate the prevalence of Ocular Toxocariasis, Diffuse Unilateral Subacute Neuroretinitis (DUSN), Toxoplasma gondii infection and Ocular Toxoplasmosis in a student population in Natal-RN/Brazil and relate it to demographic, epidemiologic and socio-economic risk factors. The incidence of DUSN was observed in patients at the Federal University of Rio Grande do Norte Ophthalmology Service and the Prontoclinica de Olhos Ophthalmology clinic in Natal. In cases where a worm was found in the subretinal space, the result of treatment with photocoagulation using Green Laser (Eye Light ALCON) was evaluated in relation to final visual result. The sample was randomly selected among the schools of the four districts of Natal, according to the type of institution (public or private), its level (elementary or secondary), and study period (morning, afternoon or evening). The school population was studied from March to May, 2001. Initially, the students answered a questionnaire to evaluate demographic, epidemiologic and socio-economic risk factors. Afterwards, the following procedures were carried out: blood samples were taken for Toxoplasmosis (IgG, IgM) serology, hemogram, ophthalmological examination, consisting of clinical history, measurement of visual acuity, refraction under cycloplegia, biomicroscopy of the anterior segment and annexa, funduscopy and examination of extrinsic motility. The prevalence of Toxocariasis was 0.2% or 2 per one thousand students. The sample was insufficient to estimate the prevalence of DUSN. Seventy patients with DUSN diagnosis were examined from January, 2001 to January, 2003. A live worm was found in the subretinal space of all four patients in the acute phase, and these were treated with laser photocoagulation. After follow-up (average = 11.5 months), visual acuity improved in three eyes and remained unaltered in one eye. Worms were found in 22 of the 66 patients in the chronic phase, and these also were treated with laser photocoagulation. After a follow-up period of 13.1 months, on average, visual acuity improved in two of the patients, remained unchanged in 19 and worsened in one. The comparison of visual result before and after treatment was not statistically significant (p = 0.302). The diagnosis of DUSN in the acute phase, followed by prompt localization and destruction of the worm by photocoagulation, can improve the patient s vision. However, destruction of the worm by laser photocoagulation in eyes with DUSN in the chronic phase does not improve visual acuity. Seroprevalence for IgG was 46% (Confidence Interval CI 95%-42.9-49.2%) and for IgM it was 1.4% (CI 95% = 0.8-2.4%). The prevalence of ocular lesion was 1.15% (CI 95% = 0.6 - 2.0%). Socio-economic conditions were determinants in the prevalence of Systemic and Ocular Toxoplasmosis in the bivaried analysis and confirmed in the multivaried analysis (mother s scholarity illiterate/ OR = 2.9 and p < 0.001). The T. gondii infection prevalence, although high, was less than that found in studies performed in the South and Southeast of Brazil and that of Ocular Toxoplasmosis was completely discrepant, varying from 5 to 17 times less. Although important epidemiological variables such as owning a cat, drinking unfiltered water, and coming into contact with rivers or lakes showed an association in the preliminary analysis, they lost their influence when included in the logistic model. Future studies are scheduled to begin in March, 2004, in collaboration with other Brazilian and American universities in an attempt to discover the reason for these findings, as well as identifying the different strains of Toxoplasma gondii, and studying the sources of water utilized by the population of Natal Brazil

Controle de qualidade físico-químico e biodisponibilidade relativa em ratos de suspensões orais de naproxeno sódico obtidas de farmácias de manipulação na cidade do Natal RN

Compounded medicines have been reported by the ANVISA due to decreased of the therapeutic response or toxicity of these formulations. The aim of this work was to investigate the physicochemical quality control among naproxen sodium oral suspensions 25 mg/mL obtained from six compounding pharmacies (A, B, C, D, E and F) and the manufactured suspension (R). In the quality control test, the tests of pH, content, homogeneity, volume and physical and organoleptic characteristics were performed according to the Brazilian Pharmacopoeia. The analytical method for determination of naproxen in suspensions was validate. This method showed excellent precision, accuracy, linearity and specificity. In the content test the suspensions B, C and E showed lower value and the F suspension showed a high value of the content. The products C and E were disapproved in the description of the physical and organoleptic characteristics test. In the pH test, three suspensions were outside specifications (C, E and F). Only the products R, A and D showed satisfactory results in these tests and therefore they were approved for relative bioavailability test. The R, A and D suspensions were orally administered to Wistar rats and the blood samples were taken at time intervals of 10, 20, 40, 60 min, 3, 4, 6, 24 and 48 h. The plasma samples were immediately stored at 80 ºC until analysis of HPLC. The bioanalytical method validation showed specificity, linearity (R2 0.9987), precision, accuracy, good recovery and stability. The chromatographic conditions were: flow rate of 1.2 mL.min-1 with a mobile phase of acetonitrile : sodium phosphate buffer pH 4.0 (50:50, v/v) at 280 nm, using a C18 column. The confidence interval of 90% for the Cmax and AUCt ratio was within the range of 80 - 125% proposed by the FDA. Only one suspension, obtained from the compounding pharmacy D, was considered bioequivalent to the rate of absorption under the conditions proposed by this study. Thus, the results indicate the need for strict supervision from the relevant authorities to ensure the patient safety and the quality of compounded drugs by pharmacies

Amostragem para diagnose do estado nutricional de mangueiras

Dentre todas as etapas que permeiam um laudo foliar, ainda a amostragem continua sendo a mais sujeita a erros. O presente trabalho teve como objetivo determinar o tamanho de amostras foliares e a variação do erro amostral para coleta de folhas de pomares de mangueiras. O experimento contou com delineamento inteiramente casualizado, com seis repetições e quatro tratamentos, que constaram da coleta de uma folha, em cada uma das quatro posições cardeais, em 5; 10; 20 e 40 plantas. Com base nos resultados dos teores de nutrientes, foram calculados as médias, variâncias, erros-padrão das médias, o intervalo de confiança para a média e a porcentagem de erro em relação à média, através da semi-amplitude do intervalo de confiança expresso em porcentagem da média. Concluiu-se que, para as determinações químicas dos macronutrientes, 10 plantas de mangueira seriam suficientes, coletando-se uma folha nos quatro pontos cardeais da planta. Já para os micronutrientes, seriam necessárias, no mínimo, 20 plantas e, se considerarmos o Fe, seria necessário amostrar, pelo menos, 30 plantas.

Prevalence of pigs infected by Salmonella typhimurium at slaughter after an enterocolitis outbreak

A cross-sectional study was performed to estimate the prevalence of slaughter pigs infected by Salmonella typhimurium after an enterocolitis outbreak in a commercial pig farm, which was characterised by diarrhoea during the growing phase. Anatomopathological and histopathological findings were suggestive of salmonellosis, which was further confirmed by isolation of S. typhimurium from organs and faeces samples from diseased animals. Ileocolic lymph nodes were aseptically collected from 43 pigs during slaughter procedures. The estimated prevalence of Salmonella-infected pigs was 53.48% [confidence interval (CI): 42.94:64.02%]. This finding demonstrates that the carriage of S. typhimurium at slaughter might be high if pigs originate from a batch previously affected by Salmonella-enterocolitis outbreak at the pre-harvest pork production chain. (c) 2005 Elsevier B.V. All rights reserved.

Molecular and serological detection of Theileria equi and Babesia caballi in donkeys (Equus asinus) in Brazil

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

O conhecimento e as atitudes das famílias de pacientes em tratamento em tuberculose na atenção primária à saúde

This study thus sought to examine knowledge about TB and attitudes of patients families in disease treatment in Primary Health Care in Natal- RN. To this end, a cross-sectional study was undertaken through a questionnaire with families of patients diagnosed with TB and follow up by APS from Natal. The study subjects were recruited from a non-probabilistic way, by convenience, contemplating a sample of 50 families. Among the criteria considered for inclusion of subjects, older than 18 years were considered, as well as residing with the TB patient and in Natal and availability to participate in the research. Data collection was performed by own researcher and an assistant, through a questionnaire with families of patients diagnosed with TB following the double independent digitalization of data. In the analytical phase, was initially conducted an exploratory phase and univariate data, with description of the position measurements (mean, median, mode) and dispersion (confidence interval and standard deviation). In bivariate analysis, it was conducted an intersection of dependent variables of knowledge e and changes of attitude dichotomous, with each of the independent variables, using contingency tables and calculating the chi-square test and, when appropriate, the Fisher exact test. In 2x2 tables, calculated the odds ratio (OR) with confidence intervals of 95% (95% CI). From the selected sample, 43 (86%) subjects were female, average age and median respectively of 46.64 and 46.50 years, 25 (50%) had elementary school. The knowledge expressed by family members about TB was considered satisfactory. However, the lack of interest of the family (54%) in seeking information about tuberculosis; the wrong way of reply in relation to the organism causing the disease (64%); the water content (62%) and contaminated food (54% ) as a means of spreading TB was a weakness identified in the investigation. Regarding the time of transmission, 90% of respondents indicated not know or answered wrong. From investigated independent variables, only two were associated with lack of knowledge of TB, and they did not have religion (OR: 0.146, 95% CI: 0.027 to 0.800) and income below 1, 7 minimum wages (OR: 0.155, 95% CI: 0.029 to 0.813). Thus they seem to exercise a protective effect on this outcome. As for the changes in attitude, most of the found variables had no association with statistical significance, except no internet access (OR: 0.212, 95% CI: 0,048-0, 935). Most attitudes were positive in relation to TB patient. Results have demonstrated weaknesses in TB care, which has taken on a more individual and welfare character. Data not only express health outcomes produced by health services, but also the political and social situation of the families that are affected by TB

Padrões nutricionais para lavouras arrozeiras irrigadas por inundação pelos métodos da CDN chance matemática

Para o arroz irrigado, poucos trabalhos utilizam métodos de diagnose foliar desenvolvidos para as condições locais de clima, solo ou cultivares. O objetivo deste trabalho foi avaliar os métodos da Diagnose da Composição Nutricional e da Chance Matemática na definição dos padrões nutricionais de lavouras arrozeiras do Estado do Rio Grande do Sul. Resultados de produtividade de grãos e teores foliares de N, P, K, Ca, Mg, S, B, Cu, Fe, Mn, Zn e Mo de 356 lavouras arrozeiras cultivadas sob sistema de irrigação por inundação foram utilizados para a determinação das faixas de suficiência calculadas pelo método da Chance Matemática. As faixas de suficiência foram comparadas com valores críticos propostos pela literatura e com o intervalo de confiança do teor médio dos nutrientes em lavouras consideradas nutricionalmente equilibradas, identificadas pelo método Diagnose da Composição Nutricional. Observou-se pouca concordância entre os valores das faixas de suficiência indicados pelos métodos da Chance Matemática e da Diagnose da Composição Nutricional e os respectivos valores indicados na literatura. A faixa de teores foliares adequados, consistentes com maior produtividade média das lavouras arrozeiras, foi indicada ser de 23 a 28 g kg-1 para N; 11 a 14 g kg-1 para K; 1,4 a 2,0 g kg-1 para S; 6 a 12 mg kg-1 para B; e 70 a 200 mg kg-1 para Fe. Para os teores foliares de P, Ca, Mg, B, Cu, Mn e Zn e Mo nenhuma das faixas adequadas testadas indicou capacidade para distinguir as lavouras arrozeiras quanto à produtividade média.

Systems of aerial spraying for soybean rust control

A ferrugem asiática da soja, causada pelo fungo Phakopsora pachyrhizi, é considerada a principal doença da soja, e, portanto, a escolha e o uso adequado dos equipamentos de pulverização são essenciais para seu controle. O objetivo deste trabalho foi avaliar o desempenho de diferentes equipamentos de pulverização aérea para o controle curativo da ferrugem da soja, utilizando o fungicida Impact 125 SC (flutriafol) a 0,5 L p c ha-1. Os seguintes tratamentos foram avaliados: atomizador Micronair AU 5000 (10 L ha-1 com óleo e 20 L ha-1 sem óleo na calda); atomizador Stol ARD (10 e 20 L ha-1 ambos com óleo) e o sistema eletrostático Spectrum (10 L ha-1 sem óleo a 64 e 71% de umidade relativa). Utilizou-se óleo de algodão (1,0 L ha-1) acrescido de emulsificante BR 455 a 0,025 L ha-1. O ensaio foi realizado na terceira aplicação de fungicidas, quando foram analisadas quatro repetições nas áreas aplicadas e quatro testemunhas não aplicadas para cada tratamento, avaliando-se a severidade da ferrugem, os depósitos de flutriafol nas folhas de soja e o percentual de redução de ferrugem. A análise dos depósitos nas folhas mostrou que não houve diferenças significativas entre os tratamentos. Os melhores controles da ferrugem foram obtidos com os tratamentos Micronair (10 L ha-1 com óleo), Stol (20 L ha-1 com óleo) e o sistema elestrostático (10 L ha-1) com a menor umidade relativa do ar (64 %).

The Accuracy of National Body Fat Cutoff Levels in the Prediction of Elevated Blood Pressure among Brazilian Male Adolescents

Objective: To assess viability of the development of percentage body fat cutoffs based on blood pressure values in Brazilian adolescents.Methods: A cross-sectional study was conducted with a sample of 358 male subjects from 8 to 18 years old. Blood pressure was measured by the oscilometric method, and body composition was measured by dual-energy X-ray absorptiometry (DXA).Results: For the identification of elevated blood pressure, these nationally developed body fat cutoffs presented relative accuracy. The cutoffs were significantly associated with elevated blood pressure [odds ratio = 5.91 (95% confidence interval: 3.54-9.86)].Conclusions: Development of national body fat cutoffs is viable, because presence of high accuracy is an indication of elevated blood pressure.