Blood alcohol concentration in fatal traffic accidents in the Federal District, Brazil

O objetivo do estudo foi analisar a presença de alcoolemia em vítimas fatais de acidentes de trânsito, no Distrito Federal, em 2005. De 442 óbitos, 163 foram resultantes de atropelamentos, 84 de capotagem e 195 de colisão. A alcoolemia foi dosada em 238 casos (53,7%). A maioria das vítimas era jovem, entre 18 e 35 anos e do sexo masculino. Entre as vítimas de colisão, 44,2% tinham níveis de alcoolemia acima de 0,6 g/l; nas vítimas de capotagens, esse percentual foi de 57,7% e, entre os pedestres, 32,5%. A diferença entre as proporções de vítimas com alcoolemia positiva foi estatisticamente significativa para os que sofreram acidentes de capotagem em relação aos demais.The objective of the study was to assess the association between high blood alcohol levels and fatal victims of traffi c accidents in the Brazilian Federal District, in 2005. A total of 442 casualties (163 pedestrians, 84 victims of overturns, and 195 of collisions) were studied. Blood alcohol concentration was analyzed in 238 cases (53.7%). Most victims were young males, aged between 18 and 35 years. Blood alcohol levels higher than 0.6 g/L were detected in 44.2% of collision victims; 57.7% of victims of overturns and 32.5% of pedestrians. The difference in proportions between overturn victims with blood alcohol concentration higher than 0.6 g/L and those victims of other traffic accidents was statistically signifi cant

Correction to: Cultural dimensions in online purchase behavior: evidence from a cross-cultural study

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Cultural dimensions in online purchase behavior: Evidence from a cross-cultural study

The objective of this research is to investigate how cultural differences affect con- sumers’ online purchase behavior. We reviewed the recent literature on cross-cul- tural studies on online behavior and building on Hofstede’s theory of cultural dimen- sions and the theory of planned behavior (TPB), we developed a conceptual model exploring how the dimensions of national culture influence perceptions of website usability, trust, and perceived risk, which in turn impact on intention to use and online purchase behavior. A web-based questionnaire was distributed to a sample of 350 European and Asian consumers actively using Alibaba e-commerce platforms. The conceptual model was validated through a confirmatory factor analysis (CFA), while structural equation modelling (SEM) was used to empirically test the hypothe- sized relationships among variables. Results showed how culture significantly influ- enced website usability and perceived risk in European consumers and, in turn, their intention and behavior. Differently, culture significantly influenced trust of Asian consumers, as well as their intention and online behavior. With this study, we con- tribute to the literature on consumer online purchase behavior from a cross-cultural perspective. As culture emerged among the significant antecedents of mechanisms explaining online purchase behavior, e-tailers should tailor digital marketing strate- gies according to consumer cultural differences

Terceiro ventriculostomia endoscópica não apresenta custos mais elevados do que a derivação ventrículo peritoneal

Objetivo: Avaliar os custos da terceiro ventriculostomia endoscópica (TVE) comparada à derivação ventrículo peritoneal (DVP) no tratamento da hidrocefalia em crianças. Método: Foram estudadas 103 crianças com hidrocefalia, 52 das quais tratadas com TVE e 51 com DVP numa coorte prospectiva. Foram comparados os custos do tratamento no primeiro ano após a cirurgia, incluindo cirurgias ou internações subsequentes. Resultados: Vinte (38,4%) das 52 crianças tratadas com DVP necessitaram de outro procedimento por disfunção da válvula, em comparação a 11 (21,5%) das 51 crianças do grupo tratado com TVE. Os custos médios por paciente no grupo tratado com TVE foram de USD$2,177.66±517.73 comparados a USD$ 2.890,68±2.835,02 para o grupo DVP. Conclusões: Nesta série não houve diferença significativa de custos entre o grupo TVE e DVP.Objective: To evaluate the cost of endoscopic third ventriculostomy (ETV) compared to ventriculoperitoneal shunt (VPS) in the treatment of hydrocephalus in children. Method: We studied 103 children with hydrocephalus, 52 of which were treated with ETV and 51 with VPS in a prospective cohort. Treatment costs were compared within the first year after surgery, including subsequent surgery or hospitalization. Results: Twenty (38.4%) of the 52 children treated with VPS needed another procedure due to shunt failure, compared to 11 (21.5%) of 51 children in the ETV group. The average costs per patient in the group treated with ETV was USD$2,177,66±517.73 compared to USD$ 2,890.68±2,835.02 for the VPS group. Conclusions: In this series there was no significant difference in costs between the ETV and VPS groups

Neonatal screening program for hemoglobinopathies in Dourados, MS: an analysis

Embora estejam bem definidos os benefícios da implantação do programa de triagem neonatal para hemoglobinopatias, não são raros os estudos que apontam falhas nesses programas. Este estudo teve como objetivo avaliar o programa de triagem neonatal para hemoglobinopatias no município de Dourados, estado do Mato Grosso do Sul (MS). Foram entrevistadas, através da aplicação de formulários, 32 famílias cujos filhos foram identificados como portadores de hemoglobinopatias, durante a triagem neonatal, no período de janeiro de 2000 a dezembro de 2005. Adicionalmente, foram verificadas a cobertura do Programa Nacional de Triagem Neonatal (PNTN) e a incidência de hemoglobinopatias no MS, de 2000 a 2005. Dos 242 casos de hemoglobinopatias diagnosticados neste período, a heterozigose para hemoglobina S demonstrou incidência de 1,37%, a heterozigose para hemoglobina C, 0,37% e a heterozigose para hemoglobina D, 0,007%. Não foram diagnosticados casos de anemia falciforme. A cobertura encontrada foi de 81,4%. Foram detectadas falhas, como a não reconvocação para o exame confirmatório, ausência de encaminhamento médico para orientação, falta de investigação familiar e a falha na compreensão do aconselhamento genético.Although the benefits of implanting a neonatal screening program for hemoglobinopathies are well defined, there are many studies that point to failures in these programs. The objective of this study was to evaluate the efficiency of the neonatal screening program for hemoglobinopathies in the municipality of Dourados, in the state of Mato Grosso do Sul, Brazil. Between January 2000 and December 2005, thirty-two families with children diagnosed during neonatal screening as having hemoglobinopathies were evaluated using questionnaires. Additionally, the coverage of the Brazilian National Neonatal Screening Program and the incidence rates of hemoglobinopathies in the state of Mato Grosso do Sul between 2000 and 2005 were analyzed. Of the 242 cases of hemoglobinopathies that were diagnosed in this period, 1.37% individuals were identified as heterozygotes for hemoglobin S, 0.37% for hemoglobin C, and 0.07% for hemoglobin D. There were no cases of sickle cell anemia diagnosed during this period. The program was found to be positive and provided a broad coverage of 81.4%. Some failures were detected such as not requiring patients to return for confirmation examinations, the lack of medical counseling and follow through, lack of investigations of family histories, and lack of understanding on the part of the family of the genetic counseling they received

The 75-Gram Glucose Load in Pregnancy

OBJECTIVE—To investigate, in pregnant women without gestational diabetes mellitus (GDM), the relation among obstetric/demographic characteristics; fasting, 1-h, and 2-h plasma glucose values resulting from a 75-g glucose load; and the risk of abnormal neonatal anthropometric features and then to verify the presence of a threshold glucose value for a 75-g glucose load above which there is an increased risk for abnormal neonatal anthropometric characteristics. RESEARCH DESIGN AND METHODS—The study group consisted of 829 Caucasian pregnant women with singleton pregnancy who had no history of pregestational diabetes or GDM, who were tested for GDM with a 75-g, 2-h glucose load, used as a glucose challenge test, in two periods of pregnancy (early, 16–20 weeks; late, 26–30 weeks), and who did not meet the criteria for a GDM diagnosis. In the newborns, the following abnormal anthropometric characteristics were considered as outcome measures: cranial/thoracic circumference (CC/TC) ratio ≤10th percentile for gestational age (GA), ponderal index (birth weight/length3 × 100) ≥90th percentile for GA, and macrosomia (birth weight ≥90th percentile for GA), on the basis of growth standard development for our population. For the first part of the objective, logistic regression models were used to identify 75-g glucose load values as well as obstetric and demographic variables as markers for abnormal neonatal anthropometric characteristics. For the second part, the receiver operating characteristic (ROC) curve was performed for the 75-g glucose load values to determine the plasma glucose threshold value that yielded the highest combined sensitivity and specificity for the prediction of abnormal neonatal anthropometric characteristics. RESULTS—In both early and late periods, maternal age >35 years was a predictor of neonatal CC/TC ratio ≤10th percentile and macrosomia, with fasting 75-g glucose load values being independent predictors of neonatal CC/TC ratio ≤10th percentile. In both periods, 1-h values gave a strong association with all abnormal neonatal anthropometric characteristics chosen as outcome measures, with maternal age >35 years being an independent predictor for macrosomia. The 2-h, 75-g glucose load values were significantly associated in both periods with neonatal CC/TC ratio ≤10th percentile and ponderal index ≥90th percentile, whereas maternal age >35 years was an independent predictor of both neonatal CC/TC ratio ≤10th percentile and macrosomia. In the ROC curves for the prediction of neonatal CC/TC ratio ≤10th percentile for GA in both early and late periods of pregnancy, inflection points were identified for a 1-h, 75-g glucose load threshold value of 150 mg/dl in the early period and 160 mg/dl in the late period. CONCLUSIONS—This study documented a significant association, seen even in the early period of pregnancy, between 1-h, 75-g glucose load values and abnormal neonatal anthropometric features, and provided evidence of a threshold relation between 75-g glucose load results and clinical outcome. Our results would therefore suggest the possibility of using a 75-g, 1-h oral glucose load as a single test for the diagnosis of GDM, adopting a threshold value of 150 mg/dl at 16–20 weeks and 160 mg/dl at 26–30 weeks

Prevalence of celiac disease among first degree relatives of Brazilian celiac patients

Background - Several studies have shown that celiac disease, an autoimmune disorder that occurs in genetically susceptible individuals, is highly prevalent among relatives of celiac patients. Aim - To determine the prevalence of celiac disease in a group of first degree relatives of Brazilian celiac patients. Methods - First degree relatives of celiac patients attending the Brasilia University Hospital Pediatric Gastroenterology Outpatient Clinic or the Celiac Disease Investigation Center, Brasília, DF, Brazil, between March 2001 and November 2004 were invited to undergo serological screening for celiac disease applying the IgA anti-endomysium antibody test (IgA-EMA). All positive IgA-EMA sera underwent a second screening using the IgA anti-tissue transglutaminase antibodies test. Duodenal or small intestinal biopsies were performed in all subjects positive to serological testing. Biopsy samples were classified as type (O) normal, (I) infiltrative, (II) infiltrative hyperplastic, (III) flat destructive, and (IV) atrophic hypoplastic. The final diagnosis was ascertained in subjects showing positive serological tests and a grade I to III small intestinal lesion. Results - Nine new cases of celiac disease were found among the 188 first degree relatives tested (4.8%). Conclusion - The present study confirms the high prevalence of celiac disease among first degree celiac patients’ relatives and reinforces the need of extensive diagnostic screening in this specific group