Risk factors for dengue virus infection in rural Amazonia: Population-based cross-sectional surveys

A comparison of dengue virus (DENV) antibody levels in paired serum samples collected from predominantly DENV-naive residents in an agricultural settlement in Brazilian Amazonia (baseline seroprevalence, 18.3%) showed a seroconversion rate of 3.67 episodes/100 person-years at risk during 12 months of follow-up. Multivariate analysis identified male sex, poverty, and migration from extra-Amazonian states as significant predictors of baseline DENY seropositivity, whereas male sex, a history of clinical diagnosis of dengue fever, and travel to an urban area predicted subsequent seroconversion. The laboratory surveillance of acute febrile illnesses implemented at the study site and in a nearby town between 2004 and 2006 confirmed 11. DENV infections among 102 episodes studied with DENV IgM detection, reverse transcriptase-polymerise chain reaction, and virus isolation; DENV-3 was isolated. Because DENV exposure is associated with migration or travel, personal protection measures when visiting high-risk urban areas may reduce the incidence of DENV infection in this rural population.

Uma investigação sobre o impacto dos accruals na variabilidade dos resultados nos diferentes contrastes cross-sectional nas firmas brasileiras de capital aberto

Esta dissertação tem como objetivo principal investigar o impacto dos accruals na variabilidade dos resultados corporativos (EVAR) que influenciam a aplicação prática do income smoothing nas firmas brasileiras de capital aberto. Inicialmente, é demonstrada a importância das demonstrações contábeis que devem ser evidenciadas em cumprimento aos princípios contábeis geralmente aceitos. Sua evidenciação deve representar a realidade econômico-financeira da firma para o processo de tomada de decisão dos acionistas e credores. Porém, em determinados momentos, os gestores se sentem motivados a praticar o gerenciamento dos resultados contábeis na tentativa de reduzir a variabilidade dos lucros por meio da utilização dos accruals. Os accruals correspondem à diferença entre o lucro líquido e o fluxo de caixa operacional. Nesse processo de redução da volatilidade dos resultados, os gestores se utilizam da prática do income smoothing procurando reduzir eventuais distorções no preço das ações da firma. A amostra neste estudo é composta por um grupo de 163 firmas de capital aberto listadas na Bovespa e que apresentaram informações financeiras no intervalo de 2000 a 2007, categorizadas por setores através de dados obtidos na Economática. O modelo estatístico utilizado na pesquisa foi a análise de regressão para explicar os diferentes modelos de cross-sectional. Os resultados desta pesquisa indicam que os accruals são significativos para explicar a variabilidade dos resultados corporativos (EVAR) de empresas brasileiras. Além disso, nossos resultados sugerem que o modelo estrutural de identificação do EVAR nas empresas brasileiras deve ser explicado por variáveis não contábeis diferentes das que são apresentadas pelas firmas norte-americanas.

The safe motherhood referral system to reduce cesarean sections and perinatal mortality - a cross-sectional study [1995-2006]

Background: In 2000, the eight Millennium Development Goals (MDGs) set targets for reducing child mortality and improving maternal health by 2015.Objective: To evaluate the results of a new education and referral system for antenatal/intrapartum care as a strategy to reduce the rates of Cesarean sections (C-sections) and maternal/perinatal mortality.Methods: Design: Cross-sectional study. Setting: Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University/UNESP, Brazil. Population: 27,387 delivering women and 27,827 offspring. Data collection: maternal and perinatal data between 1995 and 2006 at the major level III and level II hospitals in Botucatu, Brazil following initiation of a safe motherhood education and referral system. Main outcome measures: Yearly rates of C-sections, maternal (/100,000 LB) and perinatal (/1000 births) mortality rates at both hospitals. Data analysis: Simple linear regression models were adjusted to estimate the referral system's annual effects on the total number of deliveries, C-section and perinatal mortality ratios in the two hospitals. The linear regression were assessed by residual analysis (Shapiro-Wilk test) and the influence of possible conflicting observations was evaluated by a diagnostic test (Leverage), with p < 0.05.Results: Over the time period evaluated, the overall C-section rate was 37.3%, there were 30 maternal deaths (maternal mortality ratio = 109.5/100,000 LB) and 660 perinatal deaths (perinatal mortality rate = 23.7/1000 births). The C-section rate decreased from 46.5% to 23.4% at the level II hospital while remaining unchanged at the level III hospital. The perinatal mortality rate decreased from 9.71 to 1.66/1000 births and from 60.8 to 39.6/1000 births at the level II and level III hospital, respectively. Maternal mortality ratios were 16.3/100,000 LB and 185.1/100,000 LB at the level II and level III hospitals. There was a shift from direct to indirect causes of maternal mortality.Conclusions: This safe motherhood referral system was a good strategy in reducing perinatal mortality and direct causes of maternal mortality and decreasing the overall rate of C-sections.

Evaluation of postural balance in postmenopausal women and its relationship with bone mineral density- a cross sectional study

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

Metabolic syndrome and dietary components are associated with coronary artery disease risk score in free-living adults: a cross-sectional study

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Independent and Combined Effects of Physical Activity and Sedentary Behavior on Blood Pressure in Adolescents: Gender Differences in Two Cross-Sectional Studies

Objectives: To examine the independent and combined association of physical activity (PA) and sedentary behavior (SB) on both systolic (SBP) and diastolic blood pressure (DBP) in adolescents from two observational studies. Methods: Participants from two cross-sectional studies, one conducted in Europe (n = 3,308; HELENA study) and the other in Brazil (n = 991; BRACAH study), were selected by complex sampling. Systolic and diastolic blood pressure (outcomes), PA and SB, both independently and combined, and potential confounders were analyzed. Associations were examined by multilevel linear regression. Results: Performing the recommended amount of PA (≥60 min/d) attenuated the effect of SB on DBP in BRACAH study girls and in boys from both studies. In contrast, PA did not attenuate the effects of SB on the SBP of girls in the HELENA study. The combination of less than recommended levels of PA with 2-4 h/d of sedentary behavior was found to be associated with increased SBP in boys from both studies. Conclusions: Meeting current PA recommendations could mediate the association between SB and DBP in both sexes. In boys, the joint effect of low levels of PA and excessive sedentary activity increases SBP levels. Longitudinal studies are required to confirm these findings. © 2013 de Moraes et al.

Facial pain associated with fibromyalgia can be marked by abnormal neuromuscular control: A cross-sectional study

Background. Temporomandibular disorder (TMD) development in fibromyalgia syndrome (FMS) is not yet fully understood, but altered neuromuscular control in FMS may play a role in triggering TMD. Objective. The purpose of this study was to verify the association between neuromuscular control and chronic facial pain in groups of patients with FMS and TMD. Design. A cross-sectional study was conducted. Methods. This study involved an analysis of facial pain and electromyographic activity of the masticatory muscles in patients with FMS (n=27) and TMD (n=28). All participants were evaluated according to Research Diagnostic Criteria for Temporomandibular Disorders and surface electromyography (SEMG). Myoelectric signal calculations were performed using the root mean square and median frequency of signals. Results. The data revealed premature interruption of masticatory muscle contraction in both patient groups, but a significant correlation also was found between higher median frequency values and increased facial pain. This correlation probably was related to FMS because it was not found in patients with TMD only. Facial pain and increased SEMG activity during mandibular rest also were positively correlated. Limitations. Temporal conclusions cannot be drawn from the study. Also, the study lacked a comparison group of patients with FMS without TMD as well as a control group of individuals who were healthy. Conclusions. Altered neuromuscular control in masticatory muscles may be correlated with perceived facial pain in patients with FMS. © 2013 American Physical Therapy Association.

Keratosis pilaris and prevalence of acne vulgaris: a cross-sectional study

BACKGROUND: Acne vulgaris has an important genetic predisposition, as well as keratosis pilaris. Clinical observations suggest that patients with keratosis pilaris have less frequent or less severe acne breakouts; however, we found no studies on this regard OBJECTIVE: To determine if the presence of keratosis pilaris is associated with lower prevalence and severity of acne. METHODS: A cross-sectional study was conducted with dermatology outpatients aged between 14 and 35 years. We evaluated history and clinical grade of acne, demographic variables, history of atopy, smoking, and use of hormonal contraceptives. Two groups were defined by the presence or absence of moderate to severe keratosis pilaris on the arms and were compared by bivariate analysis and by conditional multiple logistic regression. RESULTS: We included 158 patients (66% women), with a median age of 23 +/- 11 years. Twenty-six percent of them had keratosis pilaris, which was associated with a history of atopy (odds ratio [OR]=2.80 [1.36 to 5.75]; p<0.01). Acne was present in 66% of subjects, and was related to family history of acne (OR=5.75 [2.47 to 13.37]; p<0.01). In bivariate and multivariate analysis, the group with keratosis pilaris had a less frequent history of acne (OR=0.32 [0.14 to 0.70]; p<0.01). CONCLUSION: The presence of moderate to severe keratosis pilaris on the arms was associated with lower prevalence of acne vulgaris and lower severity of facial lesions in adolescents and young adults.

Clinical and Microbiologic Evaluation of Chronic Leg Ulcers: A Cross-sectional Study

OBJECTIVE: This study aimed at evaluating the flora and bacterial load of chronic leg ulcers (CLUs) according to the clinical judgment of colonization or infection.DESIGN: This was an analytical and cross-sectional study.SETTING: This study was conducted in an outpatient wound care unit in the Dermatology Department of the Botucatu School of Medicine-UNESP, Brazil.PARTICIPANTS: The participants were patients with CLUs who did not use systemic antibiotics.METHODS: The ulcers were clinically divided into 3 groups: ulcers with good granulation tissue (GGT), critical colonization (CC), and infection. Secretion was collected from a 1-cm(2) area using a swab and seeded by the semiquantitative method.OUTCOME MEASURES: The main outcome measures were genus and species of the bacteria found in the cultures and result of the semiquantitative culture correlating with the clinical diagnosis of GGT, CC, and infection.MAIN RESULTS: Seventy-seven ulcers were evaluated: 27 with GGT, 29 with CC, and 21 with infection. Gram-negative bacteria were most often found in all groups (81%): Pseudomonas aeruginosa, in granulation and colonized ulcers, and Proteus mirabilis, in infected ulcers. Ulcers from the infected group showed higher bacterial load.CONCLUSIONS: The flora of CLUs was predominantly constituted by gram-negative bacteria, and P aeruginosa was the most prevalent. The bacterial load of infected ulcers was higher as compared with the others, although some ulcers with GGT also presented a high load. The interpretation of microbiologic tests based on the swab techniques and even on semiquantitative analysis requires close clinical correlation.

A cross-sectional electromyography assessment in linear scleroderma patients

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

Porphyromonas endodontalis in chronic periodontitis: a clinical and microbiological cross-sectional study

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

Quality of life and satisfaction of patients wearing implant-supported fixed partial denture: a cross-sectional survey of patients from Aracatuba city, Brazil

ObjectivesThe aim of this study was to evaluate the quality of life and satisfaction of patients wearing implant-supported fixed partial dentures.Materials &methodsA total of 106 patients were selected and submitted to clinical examination and collection of the demographic data for evaluation of the implant-supported fixed dentures conditions. All participants agreed to answer to the Oral Health Impact Profile (OHIP-EDENT) questionnaire and another questionnaire about satisfaction with the implant-supported prostheses. The patients were classified into the following three groups for statistical analysis: patients wearing splinted implant-supported prosthesis (E), patients wearing single implant-supported prosthesis (U), and patients wearing single implant-supported prosthesis associated with splinted prosthesis (E+U). Kruskal-Wallis test was used to compare the answers between the groups, and a logistic regression model was measured to verify the relation between variables of the patients and the questionaries'items.ResultsThere were significant differences among groups (P=0.006) for discomfort during surgery itself of the satisfaction questionnaire. The marital status, groups, and hygiene condition were significant mainly for physical pain item.ConclusionsIt was concluded that the patients presented high level of satisfaction and quality of life for the most of the items evaluated as well as the groups showed similar results.

Prevalence and Predictors of Potential Drug-Drug Interactions in the Elderly: A Cross-Sectional Study in the Brazilian Primary Public Health System

Purpose. The primary objective of this study was to investigate the prevalence of clinically important potential drug-drug interactions (DDIs) in elderly patients attending the public primary health care system in Brazil. The secondary objective was to investigate possible predictors of potential DDIs. Methods. A cross-sectional study was carried out in 5 Brazilian cities located in the Ourinhos Micro-region, Sao Paulo State, between November 2010 and April 2011. The selected sample was divided according to the presence (exposed) or absence (unexposed) of one or more potential DDIs (defined as the presence of a minimum 5-day overlap in supply of an interacting drug pair). Data were collected from medical prescriptions and patients' medical records. Potential DDIs (rated major or moderate) were identified using 4 DDI-checker programs. Logistic regression analysis was used to study potential DDI predictors. Results. The prevalence of clinically important potential DDIs found during the study period was 47.4%. Female sex (OR = 2.49 [95% CI 2.29-2.75]), diagnosis of = 3 diseases (OR = 6.43 [95% CI 3.25-12.44]), and diagnosis of hypertension (OR = 1.68 [95% CI 1.23-2.41]) were associated with potential DDIs. The adjusted OR increased from 0.90 [95% CI 0.82-1.03] in patients aged 60 - 64 years to 4.03 [95% CI 3.79 - 4.28] in those aged 75 years or older. Drug therapy regimens involving = 2 prescribers (OR = 1.39 [95% CI 1.17-1.67]), = 3 drugs (OR = 3.21 [95% CI 2.78-3.59]), = 2 ATC codes (OR = 1.19 [95% CI 1.12-1.29]), = 2 drugs acting on cytochrome P450 (OR = 2.24 [95% CI 2.07-2.46]), and ATC codes B (OR = 1.89 [95% CI 1.05-2.08]) and C (OR = 4.01 [95% CI 3.55-4.57]) were associated with potential DDIs. Conclusion. Special care should be taken with the prescription and therapeutic follow-up of patients who present characteristics identified as predictors. Knowledge of potential DDI predictors could aid in developing preventive practices and policies that allow public health services to better manage this situation.

Dental caries related to quality of life in two Brazilian adolescent groups: a cross-sectional randomised study

Objectives: To analyse dental caries-related quality of life (QoL) in adolescent (1519-year-old) subjects in a suburban area (SA) and a downtown area (DA) of Bauru, Sao Paulo, Brazil, in 2009. Methods: This was a cross-sectional, randomised study. The sample consisted of 185 and 147 adolescents from the SA and DA, respectively. The caries index used was that for decayed, missing and filled teeth (DMFT) (World Health Organization criteria). The 14-item Oral Health Impact Profile (OHIP-14) was used to assess QoL. The non-parametric MannWhitney test, Spearmans correlation coefficient and chi-squared test were used in the statistical analysis. Results: The DMFT index, Significant Caries (SiC) Index and percentage of caries-free students were similar (P > 0.05) between these populations, but findings on the Care Index differed (P < 0.05). There was a correlation between the DMFT index and OHIP-14 score in SA subjects (mean DMFT index = 3.01) in the dimensions of physical pain (r = 0.25; P < 0.01) and psychological disability (r = 0.17; P = 0.02). The DMFT index in DA subjects (mean DMFT index = 2.95) showed a correlation with functional limitation (r = 0.19; P = 0.02). The correlation in SA subjects between the caries component (mean = 1.22) of the DMFT index and OHIP-14 was significant only for the physical pain dimension (r = 0.16; P = 0.03). In DA subjects, correlations between the caries component (mean = 0.37) and all dimensions of OHIP-14 were statistically significant (P < 0.05). Conclusions: Despite the similarities in means in the DMFT index, the SiC Index and the caries-free percentage of subjects in both localities, access to dental treatment proved to be less effective for SA adolescents. Physical pain and psychological disability were the most frequent negative manifestations of impact on QoL. The SA adolescents were more negatively affected by dental caries in terms of QoL.

Modified technique to increase nostril cross-sectional area after using rib and septal cartilage graft over alar nasal cartilages

PURPOSE: Describe a modified technique to increase nostril cross-sectional area using rib and septal cartilage graft over alar nasal cartilages. METHODS: A modified surgical technique was used to obtain, carve and insert cartilage grafts over alar nasal cartilages. This study used standardized pictures and measured 90 cadaveric nostril cross-sectional area using Autocad (c); 30 were taken before any procedure and 60 were taken after grafts over lateral crura (30 using costal cartilage and 30 using septal cartilage). Statistical analysis were assessed using a model for repeated measures and ANOVA (Analysis of Variance) for the variable "area". RESULTS: There's statistical evidence that rib cartilage graft is more effective than septal cartilage graft. The mean area after the insertion of septal cartilage graft is smaller than the mean area under rib graft treatment (no confidence interval for mean difference contains the zero value and all P-values are below the significance level of 5%). CONCLUSIONS: The technique presented is applicable to increase nostril cross section area in cadavers. This modified technique revealed to enhance more nostril cross section area with costal cartilage graft over lateral crura rather than by septal graft.