Simplified periodontal record for pregnant women

The assessment using the PSR (Periodontal Screening and Recording) of the prevalence and severity of and the basic treatment needs for periodontal disease in a group of pregnant women who attended the Preventive Dentistry Clinic at the School of Dentistry of Araraquara--UNESP. Forty-one pregnant women of 16 to 37 years of age, were examined. The PSR index was evaluated with a suitable periodontal probe (Trinity-model 621-WHO) with index codes scores of from 0 to 4, capable of indicating the presence of the following conditions: periodontal health, bleeding on probing, calculus, shallow and deep pockets. These codes were attributed to each sextant and could be marked with an asterisk (*) to indicate the presence of gingival recession, furcation lesions, mobility or any other mucogingival alterations. It is shown that 100% of the pregnant women had some kind of gingival alteration, represented mainly by PSR code 2 (56.1%) and * (19.5%). The women in the youngest age groups, 15-19 and 20-24 years, had code 2 as their highest score with no sextant excluded. In the 25-29 age group, the PSR code 2 still prevailed (54.5%) although codes 3 and 4 were already appearing. The code * and the occurrence of excluded sextants tended to increase in the oldest age group (30-37). In general, the affected sextants showed codes 1 and 2 more frequently, corresponding to 41.6% and 39.8% respectively, which represented a mean of 2.49 and 2.39 sextants affected in each pregnant woman. Regarding the treatment needs, 90.2% of the women needed some treatment beyond the preventive measures begun, including scaling and root planning and/or corrections of defective restorative margins (61%), and more complex treatment (29.2%). The meeting of the treatment needs during pregnancy must include special efforts to increase motivation and promote oral health, minimizing the possibility of vertical transmission of pathogenic microrganisms to the child, and thus contributing to the primary prevention of the main oral diseases.

The glasgow prognostic score. An useful tool to predict survival in patients with advanced esophageal squamous cell carcinoma

To evaluate the usefulness of the Glasgow Prognostic Score (GPS) in patients with esophageal carcinoma (EC). A total of 50 patients with EC were analyzed for GPS, nutritional and clinicopathologic parameters. Patients with CRP ≤ 1.0mg/L and albumin ≥ 3.5mg/L were considered as GPS=0. Patients with only CRP increased or albumin decreased were classified as GPS=1 and patients with CRP > 1.0mg/L and albumin < 3.5mg/L were considered as GPS=2. GPS of 0, 1 and 2 were observed in seven, 23 and 20 patients, respectively. A significant inverse relationship was observed between GPS scores and the survival rate. The survival rate was greatest in patients with GPS= 0 and significantly higher than those from patients with GPS=1 and GPS=2. Minimum 12-month survival was observed in 71% patients with GPS=0 and in 30% patients with GPS=1. None of the patients with GPS=2 survived for 12 months. A significant relationship between CRP or albumin individually and the survival rate was observed. No significant relationship among nutritional, clinic pathological parameters and survival was found. Glasgow Prognostic Score is an useful tool to predict survival in patients with esophageal carcinoma.

Body condition score of Nellore beef cows: a heritable measure to improve the selection of reproductive and maternal traits

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Automated peritoneal dialysis is associated with better survival rates compared to continuous ambulatory peritoneal dialysis: a propensity score matching analysis

The impact of peritoneal dialysis modality on patient survival and peritonitis rates is not fully understood, and no large-scale randomized clinical trial (RCT) is available. In the absence of a RCT, the use of an advanced matching procedure to reduce selection bias in large cohort studies may be the best approach. The aim of this study is to compare automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) according to peritonitis risk, technique failure and patient survival in a large nation-wide PD cohort. This is a prospective cohort study that included all incident PD patients with at least 90 days of PD recruited in the BRAZPD study. All patients who were treated exclusively with either APD or CAPD were matched for 15 different covariates using a propensity score calculated with the nearest neighbor method. Clinical outcomes analyzed were overall mortality, technique failure and time to first peritonitis. For all analysis we also adjusted the curves for the presence of competing risks with the Fine and Gray analysis. After the matching procedure, 2,890 patients were included in the analysis (1,445 in each group). Baseline characteristics were similar for all covariates including: age, diabetes, BMI, Center-experience, coronary artery disease, cancer, literacy, hypertension, race, previous HD, gender, pre-dialysis care, family income, peripheral artery disease and year of starting PD. Mortality rate was higher in CAPD patients (SHR1.44 CI95%1.21-1.71) compared to APD, but no difference was observed for technique failure (SHR0.83 CI95%0.69-1.02) nor for time till the first peritonitis episode (SHR0.96 CI95%0.93-1.11). In the first large PD cohort study with groups balanced for several covariates using propensity score matching, PD modality was not associated with differences in neither time to first peritonitis nor in technique failure. Nevertheless, patient survival was significantly better in APD patients.

Factors associated with red blood cell transfusions in very-low-birth-weight preterm infants in Brazilian neonatal units

Preterm infants in neonatal intensive care units frequently receive red blood cells (RBC) transfusions due to the anemia of prematurity. A number of variables related to gestational age, severity of illness and transfusion practices adopted in the neonatal unit where the neonate was born may contribute to the prescription of RBC transfusions. This study aimed to analyse the frequency and factors associated with RBC transfusions in very-low-birth-weight preterm infants. A prospective cohort of 4283 preterm infants (gestational age: 29.9 ± 2.9 weeks; birth weight: 1084 ± 275 g) carried out at 16 university hospitals in Brazil between January 2009 and December 2011 was analysed. Factors associated with RBC transfusions were evaluated using univariate and multiple logistic regression analysis. A total of 2208 (51.6%) infants received RBC transfusions (variation per neonatal unit: 34.1% to 66.4%). RBC transfusions were significantly associated with gestational age (OR: -1.098; 95%CI: -1.12 to -1.04), SNAPPE II score (1.01; 1.00-1.02), apnea (1.69; 1.34-2.14), pulmonary hemorrhage (2.65; 1.74-4.031), need for oxygen at 28 days of life (1.56; 1.17-2.08), clinical sepsis (3.22; 2.55-4.05), necrotising enterocolitis (3.80; 2.26-6.41), grades III/IV intraventricular hemorrhage (1.64; 1.05-2.58), mechanical ventilation (2.27; 1.74-2.97), use of umbilical catheter (1.86; 1.35-2.57), parenteral nutrition (2.06; 1.27-3.33), >60 days of hospitalization (5.29; 4.02-6.95) and the neonatal unit where the neonate was born. The frequency of RBC transfusions varied among neonatal intensive care units. Even after adjusting for adverse health conditions and therapeutic interventions, the neonatal unit continued to influence transfusion practices in very-low birth-weight infants.

Obsessive-compulsive symptoms among alcoholics in outpatient treatment: prevalence, severity and correlates

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Análise da pevalência da osteoporose e dos principais fatores associados á perda óssea em portadores de cirrose

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Carga e trabalho de enfermagem em unidade de terapia intensiva especializada em queimados

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Exercise and cognitive functions in Parkinson's disease: Gender differences and disease severity

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Necrólise epidérmica tóxica/síndrome de Stevens Johnson: emergência em dermatologia pediátrica

Contexto: É descrito caso clínico de farmacodermia grave e de alta letalidade, cujo reconhecimento imediato é fundamental. Relato decaso: Paciente do sexo masculino de três anos de idade, cuja mãe refere histórico de crises convulsivas, consultou-se com neurologistaparticular, que prescreveu ácido valproico. Uma semana depois, voltou a ter crise convulsiva, sendo então introduzida lamotrigina.Poucos dias depois, a criança começou apresentar tosse e coriza hialina. Procurou pronto-socorro de sua cidade e foi orientada a usarfluimucil. Iniciou, então, febre e exantema máculo-papular inicialmente na face, que depois se generalizou. Foi levantada a hipótesediagnóstica de farmacodermia secundária à associação de anticonvulsivante. Discussão: Síndrome de Stevens-Johnson e necróliseepidérmica tóxica são variantes do mesmo processo mucocutâneo agudo, raro e grave, causado principalmente por reação adversaa fármacos e caracterizado por erupção cutânea macular de padrão eritematoso, formação de bolhas de conteúdo sero-hemático edestacamento epidérmico. As afecções são diferenciadas pela porcentagem de superfície corpórea acometida, sendo menor que10% na síndrome de Stevens-Johnson, e maior que 30% na necrólise epidérmica tóxica. O prognóstico pode ser estimado através doescore Severity Illness Score for Toxic Epidermal Necrolysis (SCORTEN), que prevê mortalidade de até 90% para os casos mais graves.O tratamento consiste na interrupção imediata da droga, transferência do paciente para unidade de queimados ou unidade de terapiaintensiva, e medidas de suporte. Terapias adjuvantes, como imunoglobulinas intravenosas e corticosteroides, ainda não têm papelconsolidado na literatura. Conclusões: Relata-se afecção rara e extremamente grave cuja suspeição clínica é importante na conduçãodo tratamento.

Sitios Assistenciais em Unidade de Terapia Intensiva e Relação do Nursing Activities Score com a Infecção Hospitalar

The Patient Classification System has become essential concerning to the practice in management and care from a nurse. This study analyzed the implementation of Assistance Sites in an intensive care unit for adults as a way of organization and classification of patients, as well as the impact of this process on the quality of care according to the Nursing Activities Score and the relation with the Hospital Infection. This is a quantitative, prospective, descriptive and transversal study. The data collection was realized from July until October 2010. The sample was consisted of 214 patients, mostly male, neurosurgical and with a mid age of 57 years. The NAS was on the average of 71.72%. Regarding the Hospital Infection before and after implantation, there was a reduction in the rates of pneumonia. However, the nursing workload remained the same. Moreover, It was evident the importance of using the Nursing Activities Score and the implementation of new ways for classification of patients to improve the organization of the care.

Indicadores de qualidade assistencial e Nursing Activities Score análise correlacional em um Hospital Especializado

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Dixie Music Score - Accession 1398 - M690 (746)

This collection consists of an autographed copy of Herman F. Arnold’s “Dixie”. The music scale is inscribed with “At the request of Miss Minnie Parker the copy of Dixie is presented to Winthrop College [in 1923] by Prof. Herman F. Arnold + the score in 159 of + who wrote Dixie and was made the war tune of the south at the inauguration of Jefferson Davis Feb. 18th 1861 at Montgomery, Ala.” There is also a note stating that this score is “One of the Four Autograph Copies of the Score of Dixie.” Minnie Barker was curator of the Winthrop museum and the music score was displayed there until Tillman Science Building was razed in 1962 which housed the museum.

Dixie Music Score Collection - Accession 268 - M114 (146)

The “Dixie” Music Score Collection consists of two photographs of one of the four original autographed copies of the musical score Dixie which was presented to Winthrop College in 1923 by Professor Herman F. Arnold and a photograph of Professor Herman F. Arnold. The Dixie Score is inscribed "At the request of Miss Minnie Barker the copy of Dixie is presented to Winthrop College by Prof. Herman F. Arnold who wrote Dixie and was made the war tune of the south at the inauguration of Jefferson Davis Feb 18th 1861 at Montgomery, Ala." Minnie Barker was curator of the Winthrop museum and the music score was displayed there until Tillman Science Building was razed in 1962 which housed the museum. The collection also contains newspaper clippings and correspondence relating to the controversy surrounding Dixie and whether it is racially insensitive.

The Quality of Spousal Social Support as a Moderator of the Associations Between Child Maltreatment Severity and Adult Trauma Symptoms

Child maltreatment has been linked to a myriad of long-term difficulties, including trauma symptomatology. However, not all victims experience long-term distress. Thus, a burgeoning area of research focuses on factors that may impede or facilitate resiliency to the psychological correlates of child maltreatment. Specifically, the severity of the abusive acts may be associated with greater long-term difficulties. To date, however, with the exception of child sexual abuse, few studies have examined the severity of maltreatment as a risk factor in the development of trauma symptoms. In contrast, social support has been theorized to contribute to resiliency following abuse. However, to date, the majority of studies examining positive social support as a protective factor have relied on self-report measures of perceived social support, rather than observational measures of received social support. Moreover, no study to date has examined the role that negative social support (i.e, blaming, criticizing) may play in potentiating trauma symptoms among victims of child maltreatment. Because child maltreatment involves serious boundary violations by a trusted person, a marital relationship is an important domain in which to examine these constructs. That is, it may serve as an arena for the manifestation of psychological disturbances related to maltreatment. Thus, the present study examined whether observationally measured positive and negative spousal social support moderated the relationship between child maltreatment severity (i.e., sexual, physical, psychological abuse; neglect) and trauma symptomatology in women and men. Results indicated that the severity of each type of child maltreatment significantly predicted increased adult trauma symptomatology. Contrary to hypothesized outcomes, positive spousal social support did not predict decreased trauma symptomatology. However, negative spousal social support generally did predict increased trauma symptomatology. There were no consistent patterns of interactions between child maltreatment severity and either type of social support. Future directions for research will be discussed and clinical implications with regard to the intrapersonal and interpersonal functioning of child maltreatment victims will be highlighted.