Injury death in são josé do rio preto-1996-1998

Introdução: Um estudo epidemiológico sobre causas externas, utilizando taxas de mortalidade, foi realizado no Município de São José do Rio Preto, Estado de São Paulo, Brasil. O período considerado foi o triênio 1996-1998. Objetivos: Descrever as taxas de mortalidade por causas externas no Município de São José do Rio Preto, no período de 1996-1998. Metodologia: O estudo foi baseado em dados oficiais do Sistema de Informação de Mortalidade do Ministério da Saúde, e de investigação baseada nas informações dos médicos legistas (IML).A análise dos dados foi feita através dos softwares Epinfo 6.0 e Tabwin. Resultados: Os resultados foram comparados com os valores, obtidos na literatura, de algumas cidades e estados do Brasil. No caso de São José do Rio Preto, observou-se, no peírodo, diminuição no número dos óbitos por causas externas, particularmente nas mortes devidas a acidentes de trânsito, que são mais altas em relação aos valores observados no Brasil e no Estado de São Paulo. O estudo também detectou aumento no número absoluto de homicídios, principalmente nas faixas etárias de 15 a 39 anos de idade. Conclusão: Os resultados demonstram a necessidade de iniciar programas de prevenção à mortalidade pelas citadas causas externas e monitorizar, em nível local, suas ocorrências .Introduction: An epidemiological study of the mortality rates by injuries in São José do Rio Preto, State of São Paulo, Brazil, has been carried out. The period considered is 1996-1998. Objectives: To show injuries mortality rates in São José do Rio Preto-SP in 1996-98. Methods: The study was based on official data from the Mortality Information Service of the Brazilian Ministry of Health, and in a survey based on data from medical forensic examiners (IML).Software Epinfo6.0 and Tabwin was utilized for data analises. Results:The results were compared to values obtained in the literature for the other cities of São Paulo and Brazil. In the case of São José do Rio Preto, was observed a decrease in the number of deaths associated with external causes in the period, but particularly in deaths due to traffic accidents with motor vehicles an increase in cases of pedestrians killed by hit-and-run drivers, that is much larger than the corresponding values for Brazil and for the State of São Paulo. The study showed increase in rates of homicides, mainly in the 15 to 39 years age group . Conclusion: This result suggests that is important to start programs to reduce the number of deaths by injuries, as well as the necessity of monitoring locally all these data

Meningoradiculitis Due To Cryptococcus Neofermans In An Immunocompetent Patient.

Meningoradiculitis refers to combined involvement of meninges and nerve roots. The most frequent location is the lumbosacral region. Etiology is diverse, including inflammatory, infectious and neoplastic disorders. Meningoradiculitis is a rare form of involvement in cryptococcal infection. We describe a case of subacute lower limbs flaccid paresis diagnosed as lumbosacral meningoradiculitis in view of cerebrospinal fluid (CSF) inflammatory changes and typical enhancement on MRI of lumbar spine. Cryptococcus neoformans was isolated from CSF. Extensive screening yielded no immunodeficiencies.62147-

Translation, cross-cultural adaptation, and reproducibility of the Brazilian portuguese-language version of the Wisconsin Smoking Withdrawal Scale

OBJECTIVE: To cross-culturally adapt the Wisconsin Smoking Withdrawal Scale (WSWS) for use in Brazil and evaluate the reproducibility of the new (Brazilian Portuguese-language) version. METHODS: The original English version of the WSWS was translated into Brazilian Portuguese. For cross-cultural adaptation, the Brazilian Portuguese-language version of the WSWS was administered to eight volunteers, all of whom were smokers. After adjustments had been made, the WSWS version was back-translated into English. The Brazilian Portuguese-language version was thereby found to be accurate. The final Brazilian Portuguese-language version of the WSWS was applied to 75 smokers at three distinct times. For the assessment of interobserver reproducibility, it was applied twice within a 30-min interval by two different interviewers. For the assessment of intraobserver reproducibility, it was applied again 15 days later by one of the interviewers. Intraclass correlation coefficients (ICCs) were used in order to test the concordance of the answers. The significance level was set at p < 0.05. RESULTS: Of the 75 volunteers, 43 (57.3%) were female. The overall mean age was 46.3 years. Interobserver and intraobserver reproducibility was determined for each of the WSWS seven domains, the ICCs for which ranged from 0.87 to 0.94 and from 0.76 to 0.92, respectively. The mean time to completion of the WSWS was 6 min and 44 s, and the response time per question ranged from 4.2 to 12.6 s. CONCLUSIONS: The Brazilian Portuguese-language version of the WSWS is reproducible, fast, and simple. It can therefore be used as a tool for assessing the severity of the symptoms of nicotine withdrawal syndrome.OBJETIVO: Adaptar culturalmente e avaliar a reprodutibilidade da Wisconsin Smoking Withdrawal Scale (WSWS) para o português do Brasil. MÉTODOS: Foi realizada a tradução da versão original em língua inglesa para o português. A versão traduzida foi aplicada em 8 voluntários fumantes para a adaptação cultural. Após ajustes, a versão da WSWS foi submetida à tradução retrógrada do português para o inglês. A versão em português do Brasil foi considerada adequada. Para a avaliação da reprodutibilidade, a escala foi aplicada em 75 fumantes em dois momentos, com intervalo de 30 minutos (reprodutibilidade interobservador) e, num terceiro momento, após 15 dias (reprodutibilidade intraobservador). Utilizou-se o coeficiente de correlação intraclasse (CCI) para testar a concordância entre as respostas. O nível de significância adotado foi p < 0,05. RESULTADOS: Dos 75 voluntários, 43 (57,3%) eram do gênero feminino. A média geral de idade foi 46,3 anos. A reprodutibilidade interobservador e intraobservador foi determinada para cada um dos sete domínios da WSWS, com CCI variando de, respectivamente, 0,87 a 0,94 e de 0,76 a 0,92. O tempo médio de resposta da WSWS foi 6 min e 44 s, e o tempo de resposta para cada questão variou de 4,2 a 12,6 s. CONCLUSÕES: A versão da WSWS para o português do Brasil é reprodutível, de aplicação rápida e simples, podendo ser utilizada como um instrumento de avaliação da gravidade dos sintomas da síndrome da abstinência à nicotina.Universidade Estadual de Ciências da Saúde de AlagoasUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUniversity of Wisconsin Center for Tobacco Research and InterventionUNIFESP, EPMSciEL

Survival Analysis of COPD Patients in a 13-Year Nationwide Cohort Study of the Brazilian National Health System

Background: Chronic obstructive pulmonary disease (COPD) has an appreciable socioeconomical impact in low- and middle-income countries, but most epidemiological data originate from high-income countries. For this reason, it is especially important to understand survival and factors associated with survival in COPD patients in these countries. Objective: To assess survival of COPD patients in Brazil, to identify risk factors associated with overall survival, including treatment options funded by the Brazilian National Health System (SUS). Methodology: We built a retrospective cohort study of patients dispensed COPD treatment in SUS, from 2003 to 2015 using a National Database created from the record linkage of administrative databases. We further matched patients 1:1 based on sex, age and year of entry to assess the effect of the medicines on patient survival. We used the Kaplan-Meier method to estimate overall survival of patients, and Cox's model of proportional risks to assess risk factors. Result: Thirty seven thousand and nine hundred and thirty eight patients were included. Patient's survival rates at 1 and 10 years were 97.6% (CI 95% 97.4–97.8) and 83.1% (CI 95% 81.9–84.3), respectively. The multivariate analysis showed that male patients, over 65 years old and underweight had an increased risk of death. Therapeutic regimens containing a bronchodilator in a free dose along with a fixed-dose combination of corticosteroid and bronchodilator seem to be a protective factor when compared to other regimens. Conclusion: Our findings contribute to the knowledge of COPD patients' profile, survival rate and related risk factors, providing new evidence that supports the debate about pharmacological therapy and healthcare of these patients

Giant Amazonian fish pirarucu (Arapaima gigas): Its viscera as a source of thermostable trypsin

A trypsin was purified from pyloric caeca of pirarucu (Arapaima gigas). the effect of metal ions and protease inhibitors on its activity and its physicochemical and kinetic properties, as well its N-terminal sequence, were determined. A single band (28.0 kDa) was observed by SDS-PAGE. Optimum pH and temperature were 9.0 and 65 degrees C, respectively. the enzyme was stable after incubation for 30 min in a wide pH range (6.0-11.5) and at 55 degrees C. the kinetic parameters K-m, k(cat) and k(cat)/K-m were 0.47 +/- 0.042 mM, 1.33 s(-1) and 2.82 s(-1) mM(-1), respectively, using BApNA as substrate. This activity was shown to be very sensitive to some metal ions, such as Fe2+, Hg2+, Zn2+, Al3+, Pb2+, and was highly inhibited by trypsin inhibitors. the trypsin N-terminal sequence IVGGYECPRNSVPYQ was found. the features of this alkaline peptidase suggest that it may have potential for industrial applications (e.g. food and detergent industries). (C) 2012 Elsevier B.V. All rights reserved.Financiadora de Estudos e Projetos (FINEP/RECAR-CINE)Ministerio da Aquicultura e Pesca (MAP)Empresa brasileira de pesquisa agropecuaria (Embrapa)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundacao de Apoio a Ciencia e Tecnologia do Estado de Pernambuco (FACEPE)Petroleo do Brasil S/A (PETROBRAS)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Univ Fed Pernambuco, Lab Enzimol LABENZ, Dept Bioquim, BR-50670420 Recife, PE, BrazilUniv Fed Pernambuco, LIKA, BR-50670420 Recife, PE, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Biofis, BR-04044020 São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Biofis, BR-04044020 São Paulo, BrazilWeb of Scienc

Metal-sensitive and thermostable trypsin from the crevalle jack (Caranx hippos) pyloric caeca: purification and characterization

Background: Over the past decades, the economic development and world population growth has led to increased for food demand. Increasing the fish production is considered one of the alternatives to meet the increased food demand, but the processing of fish leads to by-products such as skin, bones and viscera, a source of environmental contamination. Fish viscera have been reported as an important source of digestive proteases with interesting characteristics for biotechnological processes. Thus, the aim of this study was to purify and to characterize a trypsin from the processing by-products of crevalle jack (Caranx hippos) fish.Results: A 27.5 kDa trypsin with N-terminal amino acid sequence IVGGFECTPHVFAYQ was easily purified from the pyloric caeca of the crevalle jack. Its physicochemical and kinetic properties were evaluated using N-alpha-benzoyl-(DL)-arginine-p-nitroanilide (BApNA) as substrate. in addition, the effects of various metal ions and specific protease inhibitors on trypsin activity were determined. Optimum pH and temperature were 8.0 and 50 degrees C, respectively. After incubation at 50 degrees C for 30 min the enzyme lost only 20% of its activity. K-m, k(cat), and k(cat)/K-m values using BApNA as substrate were 0.689 mM, 6.9 s(-1), and 10 s(-1) mM(-1), respectively. High inhibition of trypsin activity was observed after incubation with Cd2+, Al3+, Zn2+, Cu2+, Pb2+, and Hg2+ at 1 mM, revealing high sensitivity of the enzyme to metal ions.Conclusions: Extraction of a thermostable trypsin from by-products of the fishery industry confirms the potential of these materials as an alternative source of these biomolecules. Furthermore, the results suggest that this trypsin-like enzyme presents interesting biotechnological properties for industrial applications.Financiadora de Estudos e Projetos (FINEP/RECARCINE)Petroleo do Brasil S/A (PETROBRAS)Secretaria Especial de Aquicultura e Pesca (SEAP/PR)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Fundacao de Apoio a Ciencia e Tecnologia do Estado de Pernambuco (FACEPE)Univ Fed Pernambuco, Lab Enzimol LABENZ, Dept Bioquim CCB, BR-50670910 Recife, PE, BrazilUniv Fed Pernambuco, LIKA, BR-50670910 Recife, PE, BrazilUniversidade Federal de São Paulo, Dept Biofis, Escola Paulista Med, BR-04044020 São Paulo, BrazilUniv Fed Pernambuco, Lab Glicoprot, Dept Bioquim CCB, BR-50670910 Recife, PE, BrazilUniversidade Federal de São Paulo, Dept Biofis, Escola Paulista Med, BR-04044020 São Paulo, BrazilWeb of Scienc

Oral Angiotensin-(1–7) prevented obesity and hepatic inflammation by inhibition of resistin/TLR4/MAPK/NF-κB in rats fed with high-fat diet

AbstractObesity is characterized by a pro-inflammatory state commonly associated with type 2 diabetes and fat-liver disease. In the last few years, different studies pointed out the role of Angiotensin (Ang)-(1–7) in the metabolic regulation. The aim of the present study was to evaluate the effect of oral-administration of Ang-(1–7) in metabolism and inflammatory state of high-fat feed rats. Twenty-four male Sprague Dawley rats were randomized into three groups: High Fat Diet (HFD); Standard Diet (ST); High Fat Diet+Angiotensin-(1–7) [HFD+Ang-(1–7)]. Glycemic profile was evaluated by glucose tolerance and insulin sensitivity tests, plasmatic glucose and insulin. Cholesterol, HDL and triglycerides analyses presented lipidic profile. RT-PCR evaluated mRNA expression to ACE, ACE2, resistin, TLR4, IL-6, TNF-α and NF-κB genes. The main results showed that oral Ang-(1–7) decreased body weight and abdominal fat-mass. In addition, HFD+Ang-(1–7) treated rats presented enhanced glucose tolerance, insulin-sensitivity and decreased plasma-insulin levels, as well as a significant decrease in circulating lipid levels. These alterations were accompanied by a marked decreased expression of resistin, TLR4, ACE and increased ACE2 expression in liver. Furthermore, Ang-(1–7) decreases phosphorylation of MAPK and increases NF-κB expression. These alterations diminished expression of interleukin-6 and TNF-α, ameliorate inflammatory state in liver. In summary, the present study showed that oral-treatment with Ang-(1–7) in high-fat feed rats improved metabolism down-regulating resistin/TLR4/NF-κB-pathway

Elastic scattering, inelastic excitation, and neutron transfer for Li 7 + Sn 120 at energies around the Coulomb barrier

Experimental angular distributions for the 7 Li + 120 Sn elastic and inelastic (projectile and target excitations) scattering, and for the neutron stripping reaction, have been obtained at E LAB = 20, 22, 24, and 26 MeV, covering an energy range around the Coulomb barrier ( V (LAB) B ≈ 21 . 4 MeV). Coupled channel and coupled reaction channel calculations were performed and both describe satisfactorily the experimental data sets. The 1 2 − state 7 Li inelastic excitation (using a rotational model), as well as the projectile coupling to the continuum ( α plus a tritium particle) play a fundamental role on the proper description of elastic, inelastic, and transfer channels. Couplings to the one-neutron stripping channel do not significantly affect the theoretical elastic scattering angular distributions. The spectroscopic amplitudes of the transfer channel were obtained through a shell model calculation. The theoretical angular distributions for the one-neutron stripping reaction agreed with the experimental data

Qualidade da assistência ao trabalho de parto pelo Sistema Único de Saúde, Rio de Janeiro (RJ), 1999-2001

OBJECTIVE: Quality of labor care has been recognized as a major factor for prevention of obstetric complications which can lead to maternal, perinatal and neonatal morbidity and mortality. The objective of the study was to assess quality of labor care by gestational risk and type of health provider. METHODS: Observational, cross-sectional study of labor care provided to 574 pregnant women. Stratified sampling in 20 Unified Health System maternity hospitals in Rio de Janeiro, Brazil, was carried out between 1999 and 2001. Quality of labor care was assessed by gestational risk and type of health provider. Statistical analyses consisted of variance analysis and the analysis of difference between proportions. RESULTS: Of all women studied, 29.6% were classified at obstetric risk. Although hypertension is the main cause of maternal death in Brazil, 71.6% did not have their prelabor blood pressure measured. Five measures were taken on average per parturient and the lowest rate was found in privately insured hospitals (average of 2.9). As to humanized health care, only 21.4% of the parturients had an accompanying person on their side during labor, 75.7% were submitted to intravenous hydration and 24.3% to amniotomy. The single care-related factor that varied by obstetric risk was frequency of blood pressure measures: high-risk parturients had their blood pressure measured twice as much as those low-risk women (mean 0.36 vs. 0.18 measures/h, p=0.006). CONCLUSIONS: In general, low-risk parturients were submitted to unnecessary interventions while high-risk women did not receive adequate care. As a result, there are poor perinatal outcomes, high cesarean rates and high maternal mortality rates, which do not reflect health care investments and technology available.OBJETIVO: La calidad de asistencia en el trabajo de parto ha sido reconocida en la prevención de complicaciones obstétricas que pueden llevar a la morbi-mortalidad maternal, perinatal y neonatal. El objetivo del estudio fue analizar la calidad de la asistencia en el trabajo de parto de acuerdo con el riesgo gestacional y tipo de asistencia médica. MÉTODOS: Se realizó estudio transversal de observación de la asistencia en el trabajo de parto de 574 mujeres, seleccionadas por muestra estratificada en 20 maternidades del Sistema Único de Salud de Rio de Janerio (Sureste de Brasil), entre 1999 y 2001. La calidad de asistencia fue analizada de acuerdo con el riesgo gestacional y tipo de asistencia médica. Se utilizaron procedimientos estadísticos de análisis de varianza y de diferencia de proporciones. RESULTADOS: Del total de la muestra, 29,6% de las gestantes fueron clasificadas como de riesgo. A pesar de la hipertensión ser una de las causas más importantes de la muerte materna en Brasil, la presión arterial no fue evaluada en 71,6% de las gestantes durante la observación en pre-parto. En promedio se realizaron cinco estimaciones por parturienta, siendo el menor número en los hospitales con convenios privados (promedio 2,9). Con relación a la humanización de la asistencia, se observó que apenas 21,4% de las parturientas tuvieron la presencia de acompañante en el pre-parto, 75,7% fueron sometidas a hidratación venosa y 24,3% a amniotomía. El único tipo de cuidado que varió según el riesgo obstétrico fue la frecuencia de estimación de la presión arterial, en el que las gestantes de riesgo fueron monitoreadas doblemente con relación a las demás (promedio de 0,36 x 0,18 estimaciones/h respectivamente, p=0,006). CONCLUSIONES: De modo general, las gestantes de bajo riesgo son sometidas a intervenciones innecesarias y las de alto riesgo no reciben el cuidado adecuado. En consecuencia, los resultados perinatales son desfavorables y las tasas de cesáreas y de mortalidad materna son incompatibles con las inversiones y la tecnología disponible.OBJETIVO: A qualidade da assistência ao trabalho de parto tem sido reconhecida na prevenção de complicações obstétricas que podem levar à morbi-mortalidade materna, perinatal e neonatal. O objetivo do estudo foi analisar a qualidade da assistência ao trabalho de parto segundo o risco gestacional e tipo de prestador. MÉTODOS: Estudo transversal de observação da assistência ao trabalho de parto de 574 mulheres, selecionadas por amostra estratificada em 20 maternidades do Sistema Único de Saúde do Rio de Janeiro (RJ), entre 1999 e 2001. A qualidade da assistência foi analisada segundo o risco gestacional e o tipo de prestador. Utilizaram-se procedimentos estatísticos de análise de variância e de diferença de proporções. RESULTADOS: Do total da amostra, 29,6% das gestantes foram classificadas como de risco. Apesar da hipertensão ser a causa mais importante de morte materna no Brasil, a pressão arterial não foi aferida em 71,6% das gestantes durante a observação no pré-parto. Em média foram feitas cinco aferições por parturiente, sendo o menor número nos hospitais conveniados privados (média de 2,9). Quanto à humanização da assistência, observou-se que apenas 21,4% das parturientes tiveram a presença de acompanhante no pré-parto, 75,7% foram submetidas à hidratação venosa e 24,3% à amniotomia. O único tipo de cuidado que variou segundo o risco obstétrico foi a freqüência da aferição da pressão arterial, em que as gestantes de risco foram monitoradas o dobro de vezes em relação às demais (média de 0,36 x 0,18 aferições/h respectivamente, p=0,006). CONCLUSÕES: De modo geral, as gestantes de baixo risco são submetidas a intervenções desnecessárias e as de alto risco não recebem cuidado adequado. Como conseqüência, os resultados perinatais são desfavoráveis e as taxas de cesariana e de mortalidade materna são incompatíveis com os investimentos e a tecnologia disponível

Algorithm for the treatment of type 2 diabetes: a position statement of Brazilian Diabetes Society

The Brazilian Diabetes Society is starting an innovative project of quantitative assessment of medical arguments of and implementing a new way of elaborating SBD Position Statements. The final aim of this particular project is to propose a new Brazilian algorithm for the treatment of type 2 diabetes, based on the opinions of endocrinologists surveyed from a poll conducted on the Brazilian Diabetes Society website regarding the latest algorithm proposed by American Diabetes Association /European Association for the Study of Diabetes, published in January 2009