Recent decrease in the prevalence of congenital heart defects in europe.

OBJECTIVES: To examine trends in the prevalence of congenital heart defects (CHDs) in Europe and to compare these trends with the recent decrease in the prevalence of CHDs in Canada (Quebec) that was attributed to the policy of mandatory folic acid fortification. STUDY DESIGN: We used data for the period 1990-2007 for 47 508 cases of CHD not associated with a chromosomal anomaly from 29 population-based European Surveillance of Congenital Anomalies registries in 16 countries covering 7.3 million births. We estimated trends for all CHDs combined and separately for 3 severity groups using random-effects Poisson regression models with splines. RESULTS: We found that the total prevalence of CHDs increased during the 1990s and the early 2000s until 2004 and decreased thereafter. We found essentially no trend in total prevalence of the most severe group (group I), whereas the prevalence of severity group II increased until about 2000 and decreased thereafter. Trends for severity group III (the most prevalent group) paralleled those for all CHDs combined. CONCLUSIONS: The prevalence of CHDs decreased in recent years in Europe in the absence of a policy for mandatory folic acid fortification. One possible explanation for this decrease may be an as-yet-undocumented increase in folic acid intake of women in Europe following recommendations for folic acid supplementation and/or voluntary fortification. However, alternative hypotheses, including reductions in risk factors of CHDs (eg, maternal smoking) and improved management of maternal chronic health conditions (eg, diabetes), must also be considered for explaining the observed decrease in the prevalence of CHDs in Europe or elsewhere.

Iowa Public Library Statistics Pocket Digest, 2008

The information in this digest comes from the FY08 Iowa Annual Public Library Survey. It reflects the activities of 522 of the 543 public libraries in Iowa. Full details may be found at http://www.statelibraryofiowa.org/ld/statistics. Information for the national rankings on pages 3 to 4 comes from Public Libraries in the United States: Fiscal Year 2006 by the Institute of Museum and Library Services, Washington D.C., December 2008. http://harvester.census.gov/imls/pubs/pls/pub_detail.asp?id=121#

The Visual Dysphagia Questionnaire: Evaluating the first Tool for Assessing Food Consistency-Dependent Dysphagia in Eosinophilic Esophagitis

Background and Aims: The international EEsAI study group iscurrently developing the first a ctivity index specific forEosinophilic Esophagitis (EoE). None of the existing dysphagiaquestionnaires take into account the consistency of theingested food t hat considerably impacts the symptompresentation. Goal: To d evelop and evaluate an E oE-specificquestionnaire assessing dysphagia caused by foods of differentconsistencies.Methods: B ased on patient interviews and chart reviews, a nexpert panel ( EEsAI study g roup) identified internationallystandardizedfood prototypes t ypically a ssociated with EoErelateddysphagia. Food consistencies were c orrelated withEoE-related d ysphagia, t aking into account p otential f oodavoidance and f ood processing. This V isual D ysphagiaQuestionnaire (VDQ) was piloted in 20 patients and is currentlyevaluated in a cohort of 150 adult EoE patients.Results: T he following 8 food c onsistency prototypes w ereidentified: soft foods (pudding, jelly), grits, toast bread, Frenchfries, dry rice, ground meat, raw fibrous f oods (eg. apple,carrot), s olid m eat. Dysphagia was r anked o n a 4-point Likertscale (0=no difficulties; 3= severe difficulties, food will not pass).First analysis demonstrated that severity of dysphagia is relatedto the eosinophil load and presence of esophageal strictures.Conclusions: T he VDQ i s the first EoE-specific tool f orassessing dysphagia caused by i nternationally-standardizedfoods of different consistencies. This instrument also addressesfood avoidance behaviour and food processing habits. This toolperformed well in a p ilot study a nd is currently evaluated in acohort of 150 adult EoE patients.

Interestratificado caulinita-esmectita em um argissolo desenvolvido a partir de rocha sedimentar do Sul do Brasil

Caulinita é um argilomineral comumente encontrado nas frações finas de solos tropicais e subtropicais do Sul do Brasil. Em difratometria de raios X, sua presença é verificada pelo pico correspondente à distância 00l de d = 0,715 nm. Contudo, em alguns solos pode-se observar pico superior a d = 0,720 nm, correspondendo a uma haloisita ou a um interestratificado caulinita-esmectita (C-E). A avaliação dessa hipótese e posterior discussão sobre a gênese do solo constituiu o objetivo deste trabalho. Amostras de rocha e dos horizontes A1, A2, E e Bt de um Argissolo Vermelho-Amarelo sob vegetação pioneira foram coletadas no campus da Universidade Federal de Santa Maria. A fração argila foi extraída por sedimentação, saturada com Ca2+ e submetida à difratometria de raios X nas seguintes condições: normal, à temperatura ambiente (N); depois de saturada com etilenoglicol (EG); depois de aquecida a 300 e 550 °C; e depois da solvatação com formamida. Os difratogramas de raios X (DRX) brutos foram submetidos à modelagem matemática na região entre 11 e 15 ° de 2 teta, com auxílio do programa DecompRX. Os DRX indicaram a presença de dois picos: um estreito e intenso a d = 0,717 nm, atribuído à caulinita; e outro mais largo e menos intenso a d = 0,720 nm. Este último foi sensível à solvatação com etilenoglicol, deslocando-se a d = 0,730 nm, e, depois de aquecido a 300 °C, retornando a d = 0,720 nm. Esse comportamento é típico de entrecamadas expansíveis. Em face disso, atribuiu-se a existência de interestratificado caulinita-esmectita, visto que a presença de haloisita não foi confirmada pelo teste com formamida. Em DRX modelado, confirmou-se a presença de interestratificado caulinita-esmectita, na proporção de 0,8-0,9 de caulinita e 0,1-0,2 de camadas de esmectitas. Ademais, a C-E representa cerca de 90 % e a caulinita em torno de 10 % do pico a d = 0,720 nm. A presença de C-E foi também observada na rocha, indicando que ela é proveniente de herança do material de origem. A mineralogia deste solo indica estádio intermediário entre argilominerais de estrutura do tipo 2:1 e 1:1 no processo de intemperismo.