O cuidado em saúde no ciclo gravídico-puerperal sob a perspectiva de usuárias de serviços públicos

O objetivo do trabalho foi apreender as representações sociais de puérperas sobre o cuidado em saúde no período pré-natal, no parto e no puerpério, em um contexto regional de serviços públicos de saúde do interior paulista. Seguindo a abordagem de pesquisa qualitativa, os dados foram colhidos por meio de entrevistas semi-estruturadas, realizadas em 2004, e organizados segundo o método do Discurso do Sujeito Coletivo, tendo o Programa de Humanização do Pré-natal e Nascimento (PHPN) como referencial teórico para discussão dos resultados. A perspectiva das puérperas sobre o cuidado em saúde no ciclo gravídico-puerperal evidenciou a importância das relações interpessoais, a essencialidade da qualidade técnica do atendimento e a propriedade da percepção de que o sujeito da atenção é a mulher e, como tal, dela deve participar efetivamente. Conclui-se que as diretrizes do PHPN devem ser incorporadas de forma mais ampla nas práticas de saúde voltadas à mulher, recomendando-se a adoção de indicadores específicos para avaliação das dimensões do cuidado evidenciadas por este estudo.

Associations between healthy eating patterns and indicators of metabolic risk in postmenopausal women

Background: Since human diets contain many components that may work synergistically to prevent or promote disease, assessing diet quality may be informative. The purpose of this study was to investigate the association between quality diet, by using Healthy Eating Index (HEI), and metabolic risk indicators in postmenopausal women.Methods: This cross-sectional study included a total of 173 Brazilian women, aged 45-75 years, seeking healthcare at a public outpatient center. Food consumption assessed by 24 h-recall food inquiry was used to calculate HEI scores: >80 implied diet good, 80-51 diet needed improvement, and <51 diet poor. Anthropometric data included: body mass index (BMI = weight/height(2)), waist-circumference (WC), body fat (%BF) and lean mass (%LM). Data on total cholesterol (TC), high density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC), and triglycerides (TG) were also collected. Fisher's Exact test, and logistic regression method (to determine odds ratio, OR) were used in the statistical analysis.Results: Overweight and obesity were observed in 75.7% of the participants. Excessive %BF (> 35%) was observed in 56.1%, while %LM was reduced (<70%) in 78.1%. WC was elevated (= 88 cm) in 72.3%. Based on HEI values, diet quality was good in 3% (5/173), needed improvement in 48.5% (84/173), and was poor in 48.5% (84/173) of the cases. In this group, 75% of women had high intakes of lipids (> 35%), predominantly saturated and monounsaturated fat. on average, plasma TC, LDLC, and TG levels were higher than recommended in 57.2%, 79.2% and 45.1% of the women, respectively, while HDLC was low in 50.8%. There was association between HEI scores and the %BF that it was higher among women with HEI score < 80 (p = 0.021). There were not observed significant risk associations between HEI and lipid profile.Conclusion: Among the Brazilian postmenopausal women attending a public outpatient clinic, diet was considered to need improvement or to be of poor quality, attributed to high saturated fat ingestion, which probably caused a negative impact on metabolic risk indicators, namely body composition.

Association between anthropometric indicators of body fat and metabolic risk markers in post-menopausal women

Objective. to evaluate anthropometric indicators of body fat and their association with metabolic risk markers in postmenopausal women.Methods. A cross-sectional study with 80 Brazilian women (40-70 years) was carried out. Body mass index (BMI = weight/height(2)), waist circumference (WC) and waist-to-hip ratio (WHR) were obtained for anthropometric evaluation. Trunk fat mass (TFM) was measured by dual-energy X-ray absorptiometry. The following metabolic variables were evaluated: total cholesterol (TC), HDL, LDL, triglycerides (TG), as well as glycemia and insulin to determine insulin resistance (HOMA-IR).Results. Overweight and obesity were observed in 81% of the women. Values of WC >88 cm were observed in 68.5% of the women. on average, TC, LDL and TG levels were above normal levels in 60, 50 and 42.5% of the women, respectively; and HDL was normal in 82.5%. IR was observed in 37.5% of the women. Positive correlations were found between anthropometric indicators and TFM (P < 0.05). WC was most correlated with TFM (r = 0.92), followed by BMI (r = 0.88) and by WHR (r = 0.48; P < 0.05). All anthropometric indicators and TFM showed significant negative correlations with HDL and significant positive correlations with HOMA-IR (P < 0.05). Only WHR was significantly associated with dysglycemia (R(2) = 12%), hypertriglyceridemia (R(2) = 17%) and decreased HDL (R(2) = 27%). WC was significantly associated with HOMA-IR (R(2) = 34%).Conclusion. WC and WHR are anthropometric measures that showed strong correlation with TFM and with metabolic risk markers in postmenopausal women.

Ten-week lifestyle changing program reduces several indicators for metabolic syndrome in overweight adults

We aim to investigate the effectiveness of a 10-week lifestyle intervention focusing on physical activity and high fiber intake for reducing indicators for metabolic syndrome in overweight-obese individuals. A prospective study of 50 overweight (OW) adults (22 in the general educational group - G1; 28 in the high fiber nutrition group - G2) was performed. Both groups were offered dietary counseling and supervised exercise. Clinical, anthropometric, dietary and plasma biochemical tests were performed at baseline - time 0 (T0) and after 10 weeks - time 1 (T1). Both groups improved their dietary quality, but only G2 presented higher intake of fruit and vegetables (servings/day), higher plasma beta-carotene levels and a 24% reduction of MetS incidence. Additionally G2 showed greater reductions in body fat (4%), and waist circumference (7%), obesity class III (2%) and obesity class II (14%) rate. Lifestyle intervention, including a high dietary fiber intake, improved healthy eating index and decreased body fat composition and plasma lipid concentrations leading to MetS incidence reduction.

Microbiological Evaluation of Chicken Carcasses in an Immersion Chilling System with Water Renewal at 8 and 16 Hours

Since 2004, Brazil has been the leading exporter of chicken. Because of the importance of this sector in the Brazilian economy, food safety must be ensured by control and monitoring of the production stages susceptible to contamination, such as the chilling process. The goal of this study was to evaluate changes in microbial levels on chicken carcasses and in chilling water after immersion in a chilling system for 8 and 16 h during commercial processing. An objective of the study was to encourage discussion regarding the Brazilian Ministry of Agriculture Livestock and Food Supply regulation that requires chicken processors to completely empty, clean, and disinfect each tank of the chilling system after every 8-h shift. Before and after immersion carcasses were collected and analyzed for mesophilic bacteria, Enterobacteriaceae, conforms, and Escherichia coli. Samples of water from the chilling system were also analyzed for residual free chlorine. The results do not support required emptying of the chiller tank after 8 h; these tanks could be emptied after 16 h. The results for all carcasses tested at the 8- and 16-h time points indicated no significant differences in the microbiological indicators evaluated. These data provide both technical and scientific support for discussing changes in federal law regarding the management of immersion chilling water systems used as part of the poultry processing line.

Bone Spreading and Standardized Dilation of Horizontally Resorbed Bone: Technical Considerations

The uses of a new bone spreading technique with simultaneous implant placement are discussed. The spreading system is an alternative technique to Summers' osteotome. Specific screw designs (spreader) served to laterally compress the bone to increase the cancellous density adjacent to the site. The spreader achieved a controlled and standardized dilation of horizontal bone. The advantages, material selection, and the application of this new procedure are detailed. (Implant Dent 2009; 18:119-125)

Evaluation of chronic periapical lesions by digital subtraction radiography by using adobe photoshop CS: A technical report

The purpose of this study was to describe a new technique by using Adobe Photoshop CS (San Jose, CA) image-analysis software to evaluate the radiographic changes of chronic periapical lesions after root canal treatment by digital subtraction radiography. Thirteen upper anterior human teeth with pulp necrosis and radiographic image of chronic periapical lesion were endodontically treated and radiographed 0, 2, 4, and 6 months after root canal treatment by using a film holder. The radiographic films were automatically developed and digitized. The radiographic images taken 0, 2, 4, and 6 months after root canal therapy were submitted to digital subtraction in pairs (0 and 2 months, 2 and 4 months, and 4 and 6 months) choosing image, calculation, subtract, and new document tools from Adobe Photoshop CS image-analysis software toolbar. The resulting images showed areas of periapical healing in all cases. According to this methodology, the healing or expansion of periapical lesions can be evaluated by means of digital subtraction radiography by using Adobe Photoshop CS software.

Atypical dento-alveolar fracture fixed with screws: a technical note

Dento-alveolar process fracture is an important and common event in the dental office practice usually managed under the well-established protocols, but sometimes this kind of lesion is evaluated in the hospital emergency rooms without attention to the dental injuries. In this type of trauma, the time between the injury and the definitive resolution is essential for the treatment success, usually 1 h in cases of dento-alveolar fractures (tooth and alveolar bone). This paper describes the management of a patient with unusual dento-alveolar fracture caused by gunshot and treated using screw fixation.

Stable carbon (delta(13)C) and nitrogen (delta(15)N) isotopes as natural indicators of live and dry food in Piaractus mesopotamicus (Holmberg, 1887) larval tissue

This study proposed the use of the stable isotope technique to track the type of food utilized by pacu Piaractus mesopotamicus larvae during their development, and to identify the moment when the larvae start using nutrients from the dry diet by retaining its carbon and nitrogen atoms in their body tissues. Five-day-old pacu larvae at the onset of exogenous feeding were fed Artemia nauplii or formulated diet exclusively; nauplii+formulated diet during the entire period; or were weaned from nauplii to a dry diet after 3, 6 or 12 days after the first feeding. delta(13)C and delta(15)N values for Artemia nauplii were -15.1 parts per thousand and 4.7 parts per thousand, respectively, and -25.0 parts per thousand and 7.4 parts per thousand for the dry diet. The initial isotopic composition of the larval tissue was -20.2 parts per thousand and 9.5 parts per thousand for delta(13)C and delta(15)N respectively. Later, at the end of a 42-day feeding period, larvae fed Artemia nauplii alone reached values of -12.7 parts per thousand and 7.0 parts per thousand for delta(13)C and delta(15)N respectively. Larvae that received the formulated diet alone showed values of -22.7 parts per thousand for delta(13)C and 9.6 parts per thousand for delta(15)N. The stable isotope technique was precise, and the time at which the larvae utilized Artemia nauplii, and later dry diet as a food source could be clearly defined.

Zooplankton composition, dominance and abundance as indicators of environmental compartmentalization in Jurumirim Reservoir (Paranapanema River), São Paulo, Brazil

Spatial and temporal patterns in the distribution of the zooplankton in a large tropical reservoir were investigated for a year. The zooplankton was sampled at 10 limnetic stations. Rotifera were richest in number of species and individuals, especially in transitional river-lake zones. They were dominant during the summer in nine sampling stations, and decreased in spring. The main species were Polyarthra vulgaris, Keratella americana, K. cochlearis and Conochilus unicornis. Polyarthra vulgaris was widely distributed. Keratella was more abundant at upstream stations, and a dense population of C. unicornis was observed in a lateral, sheltered compartment. Among copepods, Calanoida were more abundant in spring and Cyclopoida in autumn. Longitudinal gradients in the Calanoida/Cyclopoida relation were observed, with the predominance of Cyclopoida at upstream sampling stations and Calanoida in more lacustrine zones towards the dam. Notodiaptomus iheringi, Thermocyclops minutus and T. decipiens were the main species. Diaphanosoma birgei, the most abundant cladoceran, mainly occurred in lacustrine zones, while Moina minuta was more abundant at riverine sampling stations, generally in association with Bosminopsis deitersi. Peaks of tintinnid protozoans were observed in upstream zones during summer and spring.

Phytoplankton composition, dominance and abundance as indicators of environmental compartmentalization in Jurumirim Reservoir (Paranapanema River), São Paulo, Brazil

Patterns in the spatial and temporal composition, dominance and abundance of the phytoplankton community of the Jurumirim Reservoir (Brazil) were studied during one year at ten different sampling stations. The main phytoplankton associations were characterized by diatoms and blue-green algae, in distinctive patterns of dominance. The main species were Microcystis aeruginosa Kuetz, Anabaena circinalis Rabenhorst, A. spiroides Kleb., A. solitaria Kleb., Aulacoseira cf. italica Grunow and A. granulata (Ehr.) Simon. A high growth of Aulacoseira was observed in the upstream zones of the reservoir in spring, at the beginning of the seasonal rainy period. This growth was a response to increased flow rates and input of fresh nutrients by the main feeder rivers. A high concentration of blue-green algae, especially Anabaena circinalis and A. spiroides, was observed in winter (dry season) in the lacustrine part of the reservoir, towards the dam. These algae benefitted from the longer water retention times and greater internal circulation of nutrients in the absence of a thermocline at this time of the year. Among the Cyanophyceae, there was an alternation between M. aeruginosa, more abundant in summer, and Anabaena, dominant in autumn and winter. A conspicuous growth of Anabaena occurred in a diverticle of the reservoir, sheltered from the main advective processes that predominate in the central channel. Higher phytoplankton diversity was associated with the contact zone between riverine and lacustrine systems.

Fish as Indicators of Disturbance in Streams Used for Snorkeling Activities in a Tourist Region

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Screw Spreading: Technical Considerations and Case Report

The spreading system is an alternative technique to the Summers osteotome. The crest expansion technique is a less invasive procedure in which the facial wall expands after the medullary bone is compressed against the cortical wall. It improves the density of the maxillary bone, which allows for greater initial stability of implants. A specific screw instrument, the "spreader," achieved a controlled and standardized dilation of the bone horizontally. The use of spreaders to enhance the dental implant site is a highly predictable procedure. (Int J Periodontics Restorative Dent 2011;31:141-147.)

CMS physics technical design report, volume II: Physics performance

CMS is a general purpose experiment, designed to study the physics of pp collisions at 14 TeV at the Large Hadron Collider ( LHC). It currently involves more than 2000 physicists from more than 150 institutes and 37 countries. The LHC will provide extraordinary opportunities for particle physics based on its unprecedented collision energy and luminosity when it begins operation in 2007. The principal aim of this report is to present the strategy of CMS to explore the rich physics programme offered by the LHC. This volume demonstrates the physics capability of the CMS experiment. The prime goals of CMS are to explore physics at the TeV scale and to study the mechanism of electroweak symmetry breaking - through the discovery of the Higgs particle or otherwise. To carry out this task, CMS must be prepared to search for new particles, such as the Higgs boson or supersymmetric partners of the Standard Model particles, from the start- up of the LHC since new physics at the TeV scale may manifest itself with modest data samples of the order of a few fb(-1) or less. The analysis tools that have been developed are applied to study in great detail and with all the methodology of performing an analysis on CMS data specific benchmark processes upon which to gauge the performance of CMS. These processes cover several Higgs boson decay channels, the production and decay of new particles such as Z' and supersymmetric particles, B-s production and processes in heavy ion collisions. The simulation of these benchmark processes includes subtle effects such as possible detector miscalibration and misalignment. Besides these benchmark processes, the physics reach of CMS is studied for a large number of signatures arising in the Standard Model and also in theories beyond the Standard Model for integrated luminosities ranging from 1 fb(-1) to 30 fb(-1). The Standard Model processes include QCD, B-physics, diffraction, detailed studies of the top quark properties, and electroweak physics topics such as the W and Z(0) boson properties. The production and decay of the Higgs particle is studied for many observable decays, and the precision with which the Higgs boson properties can be derived is determined. About ten different supersymmetry benchmark points are analysed using full simulation. The CMS discovery reach is evaluated in the SUSY parameter space covering a large variety of decay signatures. Furthermore, the discovery reach for a plethora of alternative models for new physics is explored, notably extra dimensions, new vector boson high mass states, little Higgs models, technicolour and others. Methods to discriminate between models have been investigated. This report is organized as follows. Chapter 1, the Introduction, describes the context of this document. Chapters 2-6 describe examples of full analyses, with photons, electrons, muons, jets, missing E-T, B-mesons and tau's, and for quarkonia in heavy ion collisions. Chapters 7-15 describe the physics reach for Standard Model processes, Higgs discovery and searches for new physics beyond the Standard Model.