A Surgery Table with a Mouth Prop for Rodents

Laboratory animal research represents a remarkable source of information. Rodents are often used as an  experimental model for studies in the medical field, showing several advantages. The access to the oral  cavity allows one to examine it and to perform surgical restorative procedures. The application of topical  substances on hard tissues and mucosa is also possible. Literature includes reports on mouth-opening systems  for animals, but they are not available on the market. Therefore, researchers must improvise methods  that allow access to the oral cavity, but which may compromise the experiment. The purpose of this technical  report is to introduce an inexpensive and easy-to-use surgery table containing a device for rodent  mouth opening, which facilitates access to the oral cavity, maintaining mouth-opening and spreading the  cheeks apart.

Usefulness and applicability of the revised dengue case classification by disease: multi-centre study in 18 countries

Background In view of the long term discussion on the appropriateness of the dengue classification into dengue fever (DF), dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS), the World Health Organization (WHO) has outlined in its new global dengue guidelines a revised classification into levels of severity: dengue fever with an intermediary group of "dengue fever with warning sings", and severe dengue. The objective of this paper was to compare the two classification systems regarding applicability in clinical practice and surveillance, as well as user-friendliness and acceptance by health staff. Methods A mix of quantitative (prospective and retrospective review of medical charts by expert reviewers, formal staff interviews), semi-quantitative (open questions in staff interviews) and qualitative methods (focus group discussions) were used in 18 countries. Quality control of data collected was undertaken by external monitors. Results The applicability of the DF/DHF/DSS classification was limited, even when strict DHF criteria were not applied (13.7% of dengue cases could not be classified using the DF/DHF/DSS classification by experienced reviewers, compared to only 1.6% with the revised classification). The fact that some severe dengue cases could not be classified in the DF/DHF/DSS system was of particular concern. Both acceptance and perceived user-friendliness of the revised system were high, particularly in relation to triage and case management. The applicability of the revised classification to retrospective data sets (of importance for dengue surveillance) was also favourable. However, the need for training, dissemination and further research on the warning signs was highlighted. Conclusions The revised dengue classification has a high potential for facilitating dengue case management and surveillance

Causas e fatores associados à mortalidade de mulheres em idade reprodutiva em Recife, Brasil Causes and factors associated with reproductive age female mortality in Recife, Brazil

A população de mulheres em idade reprodutiva não tem recebido a devida atenção pela área de saúde fora do período da gestação, especialmente em países em desenvolvimento. Com a finalidade de contribuir para o conhecimento sobre as causas de óbito mais freqüentes que incidem nesse grupo populacional, realizou-se o presente estudo. Seu objetivo principal foi avaliar a ocorrência e os registros das mortes em mulheres com idade entre 10 e 49 anos residentes no Município de Recife, PE, ocorridas durante os anos de 1992 e 1993, identificando e agrupando as causas corrigidas desses óbitos. O estudo foi descritivo, de base populacional. Identificadas todas as Declarações de óbito (DO) elegíveis ao estudo na Secretaria de Saúde do Estado de Pernambuco, procedeu-se à codificação da causa básica do óbito e, quando necessário para sua elucidação, realizou-se investigação complementar hospitalar e/ou no serviço de necrópsia e/ou entrevista com o médico assistente e/ou visita domiciliar. Para a codificação da causa básica corrigida do óbito, utilizou-se a 9ª Revisão do CID. Foram identificados 1.013 óbitos de mulheres em idade reprodutiva, sendo os grupos de causas mais freqüentes as neoplasias, as doenças do aparelho circulatório e as causas externas. As complicações da gravidez, parto e puerpério representaram a nona causa de óbito nesse grupo.<br>Reproductive-age women, especially in developing countries, have failed to receive proper attention from the health care sector except during pregnancy. This study's objective was to contribute to the knowledge of the most frequent causes of death in this population group. The main purpose was to evaluate the occurrence and recording of deaths among women 10 to 49 years of age in Recife, Pernambuco, Brazil, during 1992 and 1993, and to identify and group the corrected causes of these deaths. It was a population-based descriptive study. After all death certificates eligible for the study were identified at the Health Secretariat of the State of Pernambuco, coding of the basic cause of death was performed. When necessary for its elucidation, a complementary investigation was also carried out at the hospital, autopsy service, and/or through an interview with the attending physician and a household visit. The 9th Revision of the ICD was used for coding the corrected basic cause of death. One thousand thirteen deaths of reproductive-age women were identified. The most frequent groups of causes of deaths were neoplasms, circulatory diseases, and external causes. Complications associated with pregnancy, delivery, and puerperium were the ninth most common cause of death in this group

Mortalidade materna em Recife. 1. Avaliação da subenumeração de estatísticas oficiais Maternal mortality in Recife.1. An evaluation of the completeness of vital statistics

Este estudo analisou os óbitos de mulheres com idade entre 10 a 49 anos, ocorridos em Recife, Pernambuco, nos anos de 1992 e 1993, com a finalidade de identificar os óbitos maternos neste período e confrontá-los com as estatísticas oficiais. As informações foram obtidas a partir de 1.013 declarações de óbito, sendo complementadas com consultas aos prontuários médicos, fichas de anestesia, relatórios de enfermagem, perícias tanatoscópicas do Instituto de Medicina Legal, relatórios das necrópsias do Serviço de Verificação de óbitos e por meio de entrevistas com os médicos que assistiram estes óbitos ou com familiares das mulheres que faleceram. Calcularam-se as razões de mortalidade materna (RMM) para o Município de Recife para cada ano e para o período total do estudo. As 20 mortes maternas declaradas representaram 2% dos óbitos entre mulheres nessa faixa etária. Após a investigação encontraram-se mais 22 casos para todo o período. A RMM pelas estatísticas oficiais era de 37,0 por 100.000 nascidos vivos, passando a 77,7 após a correção. Esta diferença representou uma subenumeração de 52,4%. Conclui-se que, no caso de Recife, não se poderia aplicar o fator de correção de 3,0 recomendado para a Região Nordeste pelo Ministério da Saúde, porque a mortalidade materna estaria sendo então superestimada.<br>This study analysed maternal deaths occurring in 1992 and 1993 in the city of Recife, Pernambuco State, Brazil, among all deaths of females aged 10 to 49 years, and to compare the results with vital statistics records. Information was obtained from 1013 death certificates and was supplemented through an analysis of medical records, anesthesia forms, nursing reports, results of autopsies performed by the Forensic Medicine Institute, necropsy reports from the Death Investigation Service, and interviews with both attending physicians and the women's relatives. Maternal mortality rates were calculated for the city of Recife for each year and for the total period studied. Twenty deaths were identified by Death Certificates as reported maternal deaths, and they represented 2% of cases among women in this age group. After the investigation proccess, 22 additional maternal deaths were identified for the entire period. According to vital statistics records, the maternal mortality rate was 37.0 per 100,000 live births; however, after adjustment, this figure increased to 77.7. This difference represents an under-recording rate of 52.4%. The study concluded that in the case of Recife, the 3.0 correction factor recommended by the Ministry of Health for the Northeast Region of the country was not applicable, since it would lead to an overestimation of the maternal mortality rate