The frequency of pharmacological pain relief in university neonatal intensive care units

Objective: To evaluate the use of drugs to relieve the pain of invasive procedures newborn infants cared for at a university hospital NICU. Methods: A prospective cohort study of all newborn infants hospitalized in four NICU during October 2001. The following data were collected: demographic data of the hospitalized newborn infants; clinical morbidity; number of potentially painful procedures and frequency of analgesic administration. Factors associated with the use of analgesia in this cohort of patients were studied by multiple linear regression using SPSS 8.0. Results: Ninety-one newborn infants were admitted to the NICU during the study period (1,025 patient-days). Only 25% of the 1,025 patient-days received systemic analgesia. No specific drugs were administered to relieve acute pain during any of the following painful events: arterial punctures, venous, capillary and lumbar punctures or intubations. For chest tube insertion, 100% of newborn infants received specific analgesia. For the insertion of central catheters 8% of the newborn infants received painkillers. Only nine of the 17 newborn infants that underwent surgical procedures received any analgesic dosage during the postoperative period. For 93% of patients under analgesia the drug of choice was fentanyl. The presence of mechanical ventilation increased the chance of newborn infants receiving painkillers by 6.9 times and the presence of chest tube increased this chance by five times. Conclusion: It is necessary to train health professionals in order to bridge the gap between scientific knowledge regarding newborn infant pain and clinical practice. Copyright © 2005 by Sociedade Brasileira de Pediatria.

Dynamic analysis of a new piezoelectric flextensional actuator using the J1-J4 optical interferometric method

Piezoelectric actuators are widely used in positioning systems which demand high resolution such as scanning microscopy, fast mirror scanners, vibration cancellation, cell manipulation, etc. In this work a piezoelectric flextensional actuator (PFA), designed with the topology optimization method, is experimentally characterized by the measurement of its nanometric displacements using a Michelson interferometer. Because this detection process is non-linear, adequate techniques must be applied to obtain a linear relationship between an output electrical signal and the induced optical phase shift. Ideally, the bias phase shift in the interferometer should remain constant, but in practice it suffers from fading. The J1-J4 spectral analysis method provides a linear and direct measurement of dynamic phase shift in a no-feedback and no-phase bias optical homodyne interferometer. PFA application such as micromanipulation in biotechnology demands fast and precise movements. So, in order to operate with arbitrary control signals the PFA must have frequency bandwidth of several kHz. However as the natural frequencies of the PFA are low, unwanted dynamics of the structure are often a problem, especially for scanning motion, but also if trajectories have to be followed with high velocities, because of the tracking error phenomenon. So the PFA must be designed in such a manner that the first mechanical resonance occurs far beyond this band. Thus it is important to know all the PFA resonance frequencies. In this work the linearity and frequency response of the PFA are evaluated up to 50 kHz using optical interferometry and the J1-J4 method.

Cytologic analysis of alterations induced by smoking and by alcohol consumption

Objective: To analyze cytologically the buccal mucosa of smoking and nonsmoking volunteers to determine what cellular changes are induced by cigarettes and alcohol consumption. Study Design: In order to evaluate cellular changes induced by smoking and alcohol consumption, exfoliative cytology was used for the analysis of mucosal smears obtained from the buccal mucosa of 25 smokers and 25 nonsmokers. The number of cigarettes consumed, duration of smoking, presence or absence of alcohol ingestion, ingested alcohol dose and frequency of consumption, and most frequently used type of alcoholic beverage were determined using a questionnaire. Three smears from each individual stained by the Papanicolaou method were analyzed quantitatively and qualitatively under a light microscope by 2 experienced examiners in terms of inflammatory and dysplastic alterations and of the degree of epithelial maturation. Results: Although numerous alterations were observed in smokers they corresponded up to only Papanicolaou class II and were not significantly different from nonsmokers (Mann-Whitney and χ 2 tests, p < 0.05). A higher proportion of inflammatory cells (polymorphonuclear and mononuclear cells) were obtained from smokers as compared to nonsmokers, while the proportion of bacteria was similar in the 2 groups. Conclusion: The findings indicate that even after a short period of cigarette use and alcohol consumption, inflammatory alterations were detectable on exfoliative cytology of the buccal mucosa in a young group, demonstrating the usefulness of cytology for early detection in smokers. © The International Academy of Cytology.

Transmission analysis of candidate genes for nonsyndromic oral clefts in Brazilian parent-child triads with recurrence

Cleft lip and/or palate (CL/P) is a major congenital defect with complex etiology, including multiple genetic and environmental factors. Approximately two thirds of the cases are not accompanied by other anomalies and are called nonsyndromic (NS). In the present study, we performed transmission distortion analysis of the MSX1-CA, TGFB3-CA and MTHFR-C677T polymorphisms in 60 parent-child triads, in which the NS-CL/ P affected child had at least one affected parent. No association with genes MSX1 or TGFB3 was found, but the results were suggestive of an association of the MTHFR-C677T polymorphism with NS-CL/P. © 2006 Sociedade Brasileira de Genética.

An alternative procedure to decrease the dimension of the frequency dependent modal transformation matrices: Application in three-phase transmission lines with a vertical symmetry plane

The objective of this paper is to show an alternative representation in time domain of a non-transposed three-phase transmission line decomposed in its exact modes by using two transformation matrices. The first matrix is Clarke's matrix that is real, frequency independent, easily represented in computational transient programs (EMTP) and separates the line into Quasi-modes α, β and zero. After that, Quasi-modes α and zero are decomposed into their exact modes by using a modal transformation matrix whose elements can be synthesized in time domain through standard curve-fitting techniques. The main advantage of this alternative representation is to reduce the processing time because a frequency dependent modal transformation matrix of a three-phase line has nine elements to be represented in time domain while a modal transformation matrix of a two-phase line has only four elements. This paper shows modal decomposition process and eigenvectors of a non-transposed three-phase line with a vertical symmetry plane whose nominal voltage is 440 kV and line length is 500 km. © 2006 IEEE.

Frequency of rhabdiasid nematodes in wild Crotalus durissus terrificus (Serpentes, Viperidae) from Botucatu region, São Paulo State, Brazil

The aim of the present study was to evaluate the frequency of rhabdiasid nematodes in recently captured Crotalus durissus terrificus snakes from São Paulo State, Brazil. Fifty snakes (34 males and 16 females) were studied and each one was evaluated for the presence of that nematode at the moment of receipt at the Institution and after 90 days of quarantine inside individual cages. Tracheopulmonary washes were examined. Snakes that died during quarantine underwent necropsy and lung examination. Analysis of the results obtained at the two evaluation times (0 and 90 days), in addition to the data obtained during necropsies, showed that 44% (18 males and 4 females) of the C. d. terrificus snakes were naturally infected by rhabdiasid nematodes. These data demonstrate the parasitism level in natural conditions and are important for the sanitary handling of these reptiles in captivity.

Morphological and histochemical analysis of the human vestibular fold

A morphological and histochemical study of the human vestibular fold was carried out using routine histological techniques. Seven μm-thick histological sections stained with hematoxylin-eosin (HE) and Calleja showed the presence of elastic collagen fibers and seromucous glands in the vestibular fold. Muscle fibers forming the ventricular muscle were also identified. Ultrastructural analyses of the epithelial layer by scanning electron microscopy (SEM) revealed ciliated cells and gland ducts opening on the epithelial surface. Histochemical analyses were performed on ventricular muscles submitted to nicotinamide-adenine-dinucleotide tetrazolium reductase (NADH-TR), succinate dehydrogenase (SDH), and myofibrillar adenosine triphosphatase (mATPase) reactions. Based on these reactions, it was observed that the muscle is formed by three types of muscle fibers: slow-twitch oxidative (SO), fast-twitch oxydative glycolytic (FOG) and fast-twitch glycolytic (FG) fibers distributed in a mosaic pattern. The fiber frequency was 22.7%, 69.9% and 7.4%, respectively. The higher frequency of SO and FOG fibers characterized the muscle as having aerobic metabolism and resistance to fatigue. The ventricular muscle was considered fast. The study of the neuromuscular junctions performed after nonspecific esterase reaction showed that they are of the en-plaque type and have multiple occurrences in the ventricular muscle.

Comparative analysis of synchronization algorithms based on PLL, RDFT and Kalman Filter

This paper discusses the main characteristics and presents a comparative analysis of three synchronization algorithms based respectively, on a Phase-Locked Loop, a Kalman Filter and a Discrete Fourier Transform. It will be described the single and three-phase models of the first two methods and the single-phase model of the third one. Details on how to modify the filtering properties or dynamic response of each algorithm will be discussed in terms of their design parameters. In order to compare the different algorithms, these parameters will be set for maximum filter capability. Then, the dynamic response, during input amplitude and frequency deviations will be observed, as well as during the initialization procedure. So, advantages and disadvantages of all considered algorithms will be discussed. ©2007 IEEE.

Frequency of the HFE C282Y and H63D polymorphisms in Brazilian malaria patients and blood donors from the Amazon region

Malaria is an endemic parasitosis and its causitive agent, Plasmodium, has a metabolism linked to iron supply. HFE is a gene with the polymorphisms C282Y and H63D, which are associated with a progressive iron accumulation in the organism leading to a disease called hereditary hemochromatosis. The aim of the present study was to determine the allelic and genotypic frequencies of the HFE gene polymorphisms in malaria patients and blood donors from the Brazilian Amazon region. We screened 400 blood donors and 400 malaria patients for the HFE C282Y and H63D polymorphisms from four states of the Brazilian Amazon region by polymerase chain reaction and restriction fragment length polymorphism analysis. We did not find any C282Y homozygous individuals, and the only five heterozygous individuals detected were from Pará State. The most frequent genotype in the North region of Brazil was the H63D heterozygote, in both study groups. Our results contribute to the concept that the Brazilian Amazon region should not be regarded as a single entity in South America. These polymorphisms did not influence the symptoms of malaria in the population studied, as neither severe signs nor high parasitemia were observed. Therefore, different hereditary hemochromatosis diagnostic and control measures must be developed and applied within its diverse locations. Investigations are currently being carried out in our laboratory in order to determine the importance of the coexistence of hereditary hemochromatosis in patients affected by parasitic diseases, such as malaria. ©FUNPEC-RP.

Corona effect in frequency dependent transmission line models

The inclusion of the corona effect in a frequency dependent transmission line model is proposed in this paper. The transmission line is represented through a cascade of π circuits and the frequency dependence of the longitudinal parameters is synthesized with series and parallel resistors and inductors. The corona effect will be represented using the Gary and Skilling-Umoto models. The currents and voltages along the line are calculated by using state-space technique. To demonstrate the accuracy and validity of the proposed frequency dependent line model, time domain simulations of a 10 km length single-phase line response under energization procedure will be presented. ©2008 IEEE.