Undernutrition, and overweight and obesity: the two faces of malnutrition in Brazil, analysis of the Global Burden of Disease, 1990 to 2019.

OBJECTIVES: The objective of this study was to analyse the global burden of disease attributable to undernutrition and high body mass index (BMI) in Brazil and its 27 states, as well as its association with the socio-demographic index (SDI) from 1990 to 2019. STUDY DESIGN: This is an epidemiological time-series study. METHODS: This study analysed the undernutrition and high BMI estimated by the Global Burden of Disease study conducted from 1990 to 2019 for Brazil and its states, using the following metrics: absolute number of deaths, standardised mortality rate, and disability-adjusted life years (DALYs). This study also analysed the correlation between the percentage variation of mortality rates and SDI. RESULTS: A decrease in the number of deaths (-75 %), mortality rate (-75.1 %), and DALYS (-72 %) attributable to undernutrition was found in Brazil and in all regions. As regarding the high BMI, an increase in the number of deaths was found (139.6 %); however, the mortality rate (-9.7) and DALYs (-6.4 %) declined in all regions, except in the North and Northeast regions, which showed an increase. A strong correlation was identified between undernutrition and high BMI with SDI. CONCLUSION: Our study observed a double burden of malnutrition in Brazil, with a reduction in the burden of diseases due to malnutrition in Brazil and variation in the burden due to high BMI according to the socioeconomic status of the region. Public policies are necessary in order to guarantee the human right to a healthy and sustainable diet, together with food and nutrition security and a diminishing of social inequality.

Dietary tryptophan deficiency and its supplementation compromises inflammatory mechanisms and disease resistance in a teleost fish.

Tryptophan participates on several physiological mechanisms of the neuroendocrine-immune network and plays a critical role in macrophages and lymphocytes function. This study intended to evaluate the modulatory effects of dietary tryptophan on the European seabass (Dicentrarchus labrax) immune status, inflammatory response and disease resistance to Photobacterium damselae piscicida. A tryptophan deficient diet (NTRP); a control diet (CTRL); and two other diets supplemented with tryptophan at 0.13% (TRP13) and 0.17% (TRP17) of feed weight were formulated. Fish were sampled at 2 and 4 weeks of feeding and the remaining were i.p. injected with Phdp (3 × 106 cfu/fish) at 4 weeks and the inflammatory response (at 4, 24, 48 and 72 hours post-infection) as well as survival were evaluated. Results suggest that fish immune status was not altered in a tryptophan deficient scenario whereas in response to an inflammatory insult, plasma cortisol levels increased and the immune cell response was compromised, which translated in a lower disease resistance. When dietary tryptophan was offered 30% above its requirement level, plasma cortisol increased and, in response to bacterial infection, a decrease in lymphocytes, monocytes/macrophages and several immune-related genes was observed, also compromising at some degree fish disease resistance.

Mucosal and systemic immune responses in Senegalese sole (Solea senegalensis Kaup) bath challenged with Tenacibaculum maritimum: A time-course study.

Tenacibaculosis, caused by Tenacibaculum maritimum, continues to inflict substantial losses among cultured marine species, particularly in the Senegalese sole. However, the immune mechanisms in fish involved in fighting against this disease are still poorly understood. Thus, the present study aimed to investigate the skin mucus's terminal carbohydrate composition, several immune-related enzymes (i.e. lysozyme, peroxidase, proteases and antiproteases), the haemolytic activity of complement and the bactericidal activity in the skin mucus and plasma of the Senegalese sole in a time-course study following a bath challenge with T. maritimum. The haematological profile and the kinetics of cell migration post-infection were also considered. The bath challenge induced slight variations in the terminal carbohydrate composition of Senegalese sole skin mucus. In general, results from this study showed a delay in the mucosal immune response compared to that found at the systemic level (i.e. blood and plasma). For instance, a significant increase in the skin mucus's lysozyme, complement, protease and antiprotease activities were observed at the end of the experiment (14 d post-challenge). Interestingly, the higher activity of these enzymes could be related to the skin mucus's bactericidal capacity and haemolytic complement activity, suggesting that these enzymes play an important role in the defence against Gram-negative bacteria. The haematological profile revealed a significant increase in circulating neutrophils in challenged fish after 48 and 72 h, which was positively correlated to the increments observed in peroxidase and lysozyme activities, respectively, in the plasma of challenged fish at the same time. Although the route of entry and the survival strategy of T. maritimum are still not fully elucidated, results from the present study will contribute to this endeavour through the study of the mucosal immune responses of fish against this particular pathogen.

Use of reflectance confocal microscopy to evaluate 5-fluorouracil 0.5%/salicylic acid 10% in the field-directed treatment of subclinical lesions of actinic keratosis: subanalysis of a Phase III, randomized, double-blind, vehicle-controlled trial.

BACKGROUND: Actinic keratosis (AK) is a common skin disorder that can progress to invasive squamous-cell carcinoma. AK can present as clinical (visible) or subclinical (invisible) lesions within areas of chronic sun damage. The importance of treating subclinical AK is gaining support. We present a subanalysis of a previously published Phase III, double-blind, vehicle-controlled study (NCT02289768), to assess 5-fluorouracil (5-FU) 0.5%/salicylic acid 10% treatment of subclinical AK lesions, based on reflectance confocal microscopy (RCM). OBJECTIVE: To determine the efficacy of 5-FU 0.5%/salicylic acid 10% as field-directed treatment for subclinical AK lesions using RCM. METHODS: For inclusion in this subanalysis, patients had to have at least three subclinical AK lesions within a 25 cm2 area of skin. Subclinical AK lesions were diagnosed according to the presence of three key RCM criteria: architectural disarray; keratinocyte atypia and pleomorphism at the basal, spinous and granular layer. Subclinical AK lesions were evaluated by RCM at baseline, after 4, 6 and 12 weeks of 5-FU 0.5%/salicylic acid 10% treatment or vehicle, and 8 weeks following the end of treatment. RESULTS: Twenty-seven patients were included: 17 [mean age = 72.2 years, standard deviation (SD) = 6.3] received 5-FU 0.5%/salicylic acid 10% treatment and 10 (mean age = 76.4 years, SD = 3.9) received vehicle. Eight weeks following the end of treatment, the mean number of subclinical lesions declined (from 3.0 at baseline) to 0.3 (95% confidence interval [CI] 0.06-0.57) for the 5-FU 0.5%/salicylic acid 10% group and 1.6 (95% CI 0.52-2.68) in the vehicle group (reductions of 90% [95% CI 72.1-107.1] vs. 47% [95% CI 24.8-69.5], respectively; P = 0.005). The proportion of patients receiving 5-FU 0.5%/salicylic acid 10% showing complete clearance of three preselected subclinical AK lesions was numerically greater than in the vehicle group (69% vs. 40%, respectively; P = 0.183). CONCLUSION: To the best of our knowledge, this is the first randomized, vehicle-controlled study investigating 5-FU 0.5%/salicylic acid 10% treatment for subclinical AK lesions. The present data suggest some treatment efficacy for subclinical AK lesions detected using RCM. However, this subanalysis was not sufficiently powered and should be reproduced in a larger, subsequent cohort.

Local immune response of two mucosal surfaces of the European seabass, Dicentrarchus labrax, fed tryptophan- or methionine-supplemented diets.

Immune responses relies on an adequate provision of multiple nutrients that sustain the synthesis of key effector molecules. These needs are depicted in the already reported increase of circulating free amino acids in fish under stressful conditions. Since aquaculture and the inherent fish welfare are an emergent call, the immunomodulatory effects of amino acids on gut- and skin-associated lymphoid tissues of the European seabass (Dicentrarchus labrax) were studied under unstressed conditions and after an inflammatory insult. To achieve this goal, fish were distributed in duplicate tanks (fifteen fish per tank) and were fed for 14 days with methionine or tryptophan-supplemented diets at 2× dietary requirement level (MET and TRP, respectively) or a control diet meeting the amino acids requirement levels (CTRL). Afterwards, samples of skin and posterior gut were collected from 6 fish per dietary treatment for the assessment of the immune status while the remaining animals were intraperitoneally-injected with inactivated Photobacterium damselae subsp. piscicida and subsequently sampled either 4 or 24 h post-injection. The immune status of both mucosal surfaces was poorly affected, although a tryptophan effect was denoted after bacterial inoculation, with several immune-related genes up-regulated in the gut at 4 h post-injection, which seems to suggest a neuroendocrine-immune systems interaction. In contrast, skin mucosal immunity was inhibited by tryptophan dietary supplementation. Regarding methionine, results were often statistically non-significant, though increasing trends were denoted in a few parameters. Overall, dietary methionine did not significantly affect neither gut nor skin immunity, whereas tryptophan supplementation seems to induce modulatory mechanisms that might be tissue-specific.

Treatment monitoring of 0.5% 5-fluorouracil and 10% salicylic acid in clinical and subclinical actinic keratoses with the combination of optical coherence tomography and reflectance confocal microscopy.

BACKGROUND: Reflectance confocal microscopy (RCM) and high-definition optical coherence tomography (HD-OCT) allow the observation in vivo of dynamic changes in response to non-surgical treatment of actinic keratosis and field of cancerisation. OBJECTIVE: To non-invasively assess the pharmacodynamic changes induced by treatment with low dose 5-fluorouracil and 10% salicylic acid by means of RCM and high-definition OCT in field cancerization and actinic keratosis. METHODS: Twenty patients aged >50 years with diagnosis of actinic keratosis on the head and face and indication for treatment with 0.5% 5-fluorouracil and 10% salicylic acid were enrolled. An area of 25 cm² including visible type I and II AK and subclinical AK was treated once daily during 6 weeks and examination was performed with RCM and HD-OCT before treatment and 2 weeks after the end of treatment RESULTS: High-definition optical coherence tomography results at baseline of mean thickness of the stratum corneum and epidermis were in AK 10.4 (SD = 4.99) and 43.3 (SD = 24.01) µm respectively and in subclinical AK 3.7 (SD = 2.15) and 30.05 (SD = 16.85) µm. At week 8 (2 weeks after the end of treatment) measurements of stratum corneum and epidermis were significantly reduced in AK and subclinical AK for stratum corneum and epidermis. In RCM at week 8 scaling, detached corneocytes, atypical honeycomb, round nucleated cells in the spinosum granulosum layer, round vessels (dermal papillae), inflammatory cells and total AK score were significantly reduced in AK and subclinical AK. CONCLUSIONS: Evaluation of AK and subclinical AK by RCM and HD-OCT showed objective improvement after treatment with 5-fluorouracil and 10% salicylic acid. These methods allowed the study of dynamic changes in the tissue at a subclinical level.

A suite of microsatellite markers for genetic management of captive cracids (Aves, Galliformes).

Cracids are medium to large frugivorous birds that are endemic to the Neotropics. Because of deforestation and overhunting, many species are threatened. The conservation of several species has relied on captive breeding and reintroduction in the wild, but captive populations may be inbred. Microsatellite tools can permit the construction of genetic pedigrees to reduce inbreeding, but only a few loci are available for this group of birds. Here, we present 10 novel polymorphic microsatellite loci and the cross-amplification of these and of 10 additional loci available in the literature in a panel of 5 cracid species, including 3 species with high conservation concern. We provide the first polymorphic loci for the jacutinga, Aburria jacutinga (N = 8), and red-billed curassow, Crax blumenbachii (N = 9), and additional loci for bare-faced curassow, C. fasciolata (N = 8), Alagoas curassow, Pauxi mitu (N = 5), and razor-billed curassow, P. tuberosa (N = 5). The average number of alleles was 2.9 for A. jacutinga, 2.7 for C. blumenbachii, 3.5 for C. fasciolata, 2.6 for P. mitu, and 5.7 for P. tuberosa. The mean expected heterozygosities were 0.42, 0.40, 0.48, 0.37, and 0.59, respectively. The average probabilities that the set of loci would not exclude a pair of parents of an arbitrary offspring were 2.9% in A. jacutinga, 1% in C. blumenbachii, 0.5% in C. fasciolata, 0.4% in P. mitu, and 0.002% in P. tuberosa suggesting that these loci may be adequate for parentage analysis and to implement ex situ genetic management plans.

Determination of herb authenticity by low-field NMR.

The safe use of herbal medicines requires prior authentication of the raw materials used to make them. This is an important step, since the ingestion of herbal preparations or extracts can cause serious health problems. Among the different analytical techniques, nuclear magnetic resonance (NMR) spectroscopy has the advantage of being non-invasive and therefore suitable for the characterization of natural products such as medicinal plants. This work presents a characterisation study of the samples of the popular plant Maytenus ilicifolia, obtained from different commercial producers. This plant is used for the treatment of gastrointestinal disorders, as it possesses antitumorigenic, analgesic, anti-inflammatory and antioxidant properties. The differences in the chemical structure and molecular organisation detected by thermogravimetric analysis (TGA), infrared spectroscopy (FTIR) and nuclear magnetic resonance spectroscopy (NMR) were also investigated by proton nuclear magnetic resonance relaxometry, in particular by fast field cycling (FFC) relaxometry, and relaxometry in the rotating frame. All results confirmed the similarity between the control sample and only one of the plant investigated. The differences detected between the samples could be related to their non-authenticity, due to the non recognise the plant due to the leaves similarity among plants from the same family and/or contamination, due to addition of similar other plants parts to the commercial ones, as they are mixed together this difficulties the acceptation of the plant.

Rapid analyses of oil and fat content in agri-food products using continuous wave free precession time domain NMR.

Time-domain nuclear magnetic resonance (TD-NMR) is one of the most popular solutions for quality control in the food industry. Despite the recognized success of TD-NMR in quality control and quality assurance, the speed by which samples can be characterized by TD-NMR techniques is still a concern, primarily when considering online or high-throughput applications. Therefore, to enhance the speed of TD-NMR analysis, we developed rapid methods based on steady-state free precession of nuclear spins, which we denoted continuous wave free precession (CWFP). CWFP substantially increases the sensitivity of TD-NMR compared with free induction decay or spin-echo detection, which are traditionally used. The objective of this paper was to present the physical background of CWFP and review its recent developments and applications in fat and oil quantifications in agri-food products.

Structural and ultra-structural features of the first mandibular molars of young rats submitted to pre and postnatal protein deficiencies.

The effects of protein malnutrition, both in utero and prior to weaning, on formation of the first mandibular molars were evaluated by phase-contrast and electron microscopy in rats. The nourished group (GI) received a diet that included 20% casein, while the malnourished group (GII) received 5% casein. The first mandibular molars from GII exhibited low density of cells and odontoblasts, which lacked regular organization compared with molars from GI. In addition, a difference in collagen type was observed between the groups, with a prevalence of Type III collagen fibers detected in the dentin, periodontal ligament, and alveolar bone of GII, and a prevalence of Type I collagen fibers in GI. Finally, examination of surface area in molar sagittal sections indicated 30% less dentin in GII, compared with GI. Our results suggest that structural and ultra-structural features of the dentin-pulp complex and periodontal components of rat molars are affected by protein deficiency.

Design and implementation of injury prevention curricula for elementary schools: lessons learned.

OBJECTIVES: Project objectives were to: (1) design and produce an easy-to-use, replicable comprehensive injury prevention curriculum for elementary schools; (2) pilot the program to determine instructors' ease in teaching the material and its usefulness in enhancing student knowledge and behavior change; (3) present material in subject-integrated, grade-specific lessons that would meet state and national student learning objectives; and (4) submit and obtain adoption of the curriculum by the State Department of Education. METHODS: A pilot program was developed, implemented, and evaluated in six intervention and six control schools. The curriculum was revised and implemented in five other schools and finalized according to evaluation results and teachers' and parents' suggestions. Community resources such as police, fire, and county health departments participated in program implementation. RESULTS: The program showed a significant increase from 21% to 36% in seatbelt use during the school year in program schools compared with a 1% decrease in control schools. Bicycle helmet use increased from 0% to 10% in the program schools. Pre-test and post-test results showed significant differences in student knowledge, attitudes, and behaviors within the program schools, and in comparing the program and control schools. On a Likert scale of 1 (poor) to 7 (excellent), teachers rated lesson content, exercises, and the usefulness of materials and resources as 5.8, 5.5, and 5.4, respectively. Evaluations for the revised curricula ranged from 5.7 to 6.2. CONCLUSIONS: The favorable evaluation results resulted in the adoption of the curriculum as a state textbook, and widespread teaching of the curriculum. The product is appropriate and efficacious in these elementary schools and their communities.

Contribuiçäo ao estudo da anatomia do sistema de canais radiculares de caninos inferiores utilizando-se de cortes macroscópicos e da diafanizaçäo / Anatomy study of root system of lower canines using macroscopic cuts and clarifying technique

A anatomia dos canais radiculares tem sido tema de estudos desde 1942 e mesmo com as diversas observaçöes descritas por vários autores, permaneceu-se dúvidas a respeito dos aspectos morfológicos internos de vários grupos de dentes. O presente trabalho utilizou-se de 103 (cento e três) caninos interiores extraídos, onde se analisou os aspectos macroscópicos da cavidade pulpar, utilizando-se de cortes sagital, frontal e transversais, assim como da diafanizaçäo. Notamos que, em 100 po cento dos espécimes haviam uma raiz e um único canal radicular, sendo que em 83 por cento das amostras evidenciou-se permeabilidade dentinária. Os canais secundários foram verificados em 47 por cento dos dentes, assim com 3 por cento de canais laterais, 1 por cento canal acessório e 15 por cento co delta apical. fator importante que observamos também foi que, em 42 dos espécimes o forame apical coincidia-se com o ápice radicular; 23 por cento, abria-se para vestibular, 8 por cento, para distal; 8 por cento, para mesial e 4 por cento para lingual

Flow sensitivity and coherence in steady-state free spin precession.

Steady-state free precession (SSFP) of nuclear spins in the presence of a magnetic field gradient is known to be very sensitive to flow. We present a theoretical and experimental study of flow sensitivity in a regime where the spacing of the radio-frequency pulses is extremely short compared with the free induction decay time and the relaxation times. Under these rather drastic conditions, a truly continuous wave free precession (CWFP) regime is established, in which, unlike standard SSFP, a large degree of coherence is preserved. This leads to a quite different flow sensitivity, which is significant even when very small magnetic field gradients are present. The unspoiled coherence is predicted to cause different flow effects which we confirmed experimentally. Tailored flow sensitivity can be achieved by adjusting the frequency offset from resonance, which plays a dominant role in the CWFP regime.

The structure of the bilaminar zone in the human temporomandibular joint: a light and scanning electron microscopy study in young and elderly subjects.

The bilaminar zone (BZ) in the human temporomandibular joint (TMJ) of toothed adults (GI) and toothless, elderly humans (GII) were analysed using light and scanning electron microscopy (SEM). In both groups the BZ consists of an upper and a lower stratum of connective tissue separated by a vascularized middle region. The superior stratum contains bundles of collagen fibres disposed in different directions. The fibres are fairly thick and transversely oriented immediately posterior to the TMJ disc. The initial part of the inferior stratum contains curved bundles of collagen fibres oriented anterio-posteriorly. From the middle to the posterior part of the inferior stratum, the fibres are right-aligned in GI and clearly sinuous in nature in GII. In both groups, the middle and posterior portions of the middle region are distinguished by the presence of vessels and vascular spaces. Loosely arranged connective and adipose tissues are also evident. The vascular spaces are wider in GII than in GI. The predominance of type I collagen fibres is clear in all regions of the BZ in both groups. The elastic fibres lie parallel to the collagen fibres in both groups and they are thicker and more abundant in GI, apparently decreasing in GII.

The structure of the bilaminar zone in the human temporomandibular joint: a light and scanning electron microscopy study in young and elderly subjects / Estrutura da zona bilaminar na articulação temporomandibular humana: um estudo leve e microscopia eletrônica de varredura e assuntos antigos

The bilaminar zone (BZ) in the human temporomandibular joint (TMJ) of toothed adults (GI) and toothless, elderly humans (GII) were analysed using light and scanning electron microscopy (SEM). In both groups the BZ consists of an upper and a lower stratum of connective tissue separated by a vascularized middle region. The superior stratum contains bundles of collagem fibres disposed in diferent directions. The fibres are fairly thick and transversely oriented immediately posterior to the TMJ disc. The initial part of the inferior stratum contains curved bundles of collagem fibres oriented anterio-posteriorly. From the middle to the posterior part of the inferior stratum, the fibres are right-aligned in GI and clearly sinuous in nature in GII. In both groups, the middle and posterior portions of the middle region are distinguished by the presence of vessels and vascular spaces. Loosely arranged conective and adipose tissues are also evident. The vascular spaces are wider in GII than in GI. The predominance of type I collagen fibres is clear in all regions of the BZ in both groups. The elastic fibres lie parallel to the collagen fibres in both groups and they are thicker and more abundant in GI, apparently decreasing in GII

The arrangement of the trabecular bone in the vestibular surface of the human fetus mandible. A scanning electron microscopy study.

The characteristics of trabecular bone in human fetuses at seven to nine months of intra-uterine life were studied in the vestibular surface of the mental and body portions of the mandible. In the mental portion, many circular trabeculae joined by "bridges" were observed in the alveolar region (AR). In the 8-month old fetus are trabeculae with tortuous disposition in the medium region (MR). Oblique trabeculae with superior and inferior dispositions defining a triangular area (future mental fossae) are verified in 9-month old fetuses. Trabeculae circularly disposed and vascular foramina are present close to the apex of this area. In the basilar region (BR) some trabeculae obliquely oriented are observed disposed near to the mandibular symphysis. The longitudinal bundles of collagen fibers assume an antero-posterior direction. At 9-month age the vascular foramina range from 6 to 20 microns and the osteocyte lacunae ranging from 1 to 4 microns diameter, are present in mandibles from all ages examined. In the body portion the presence of circular trabeculae joined by "bridges" is the main characteristic of the AR. In the MR most of the trabeculae are circular and the longitudinal trabeculae of this region assume an antero-posterior direction. The laminar, antero-posterior and juxtaposed trabeculae lying parallel to mandible base are a characteristic of the BR. The bundles of collagen fibers exhibit the same pattern of the trabeculae. The vascular foramina of the BR are smaller than that of the precedent regions. In the body portion of the mandible from all ages examined the osteocyte lacunae range from 1 to 4 microns in diameter.

[Perception on and registration of alcohol abuse and alcohol-related diseases at a university general hospital]. / Percepção e registro de abuso de álcool e de doenças relacionadas num hospital geral universitário.

BACKGROUND: The high frequency of alcohol related problems highlights the importance of its approach. The association of both the alcohol-abuse and alcohol related diseases has been pointed in the literature and are often the main reason for hospitalization. Physicians use different tools to detect abusive drinkers, and one of them is the CAGE-test, validated by Mayfield et al. in 1974. OBJECTIVES: To study the association between the result of the CAGE-test and the perception and registration of alcohol abuse by the medical staff and the nurses in charge of inpatients of Hospital de Clínicas de Porto Alegre, southern Brazil. MATERIAL AND METHOD: The design involved three phases. First, the application of the CAGE-test to the 385 eligible patients. Second, review of all 51 CAGE-positive patients' records as well the controlled evaluation of 51 randomized CAGE-negative patients, to seek alcoholic habits and alcohol-related diseases. Third, interview with the medical staff to find out their perception about these subjects. RESULTS: We found 51 patients CAGE-positive (prevalence = 13%). When evaluated through the registration and through a standardized interview, medical staff and nurses were not aware of more than half of CAGE-positive patients. No significant differences were found between medical staff registration and perception; the prevalence of alcohol related diseases was the same for both: 26 and 27% (p = .861). The prevalence of alcohol related diseases was higher among CAGE-positive patients (p = .0003). CONCLUSIONS: In spite of the high prevalence among our patients, alcohol abuse is not pursued by our health teams as it should be. As for the future, there is reason to envision a continuing alcoholism rapprochement.

Percepçäo e registro de abuso de álcool e de doenças relacionadas num hospital geral universitário / Perception and registration of alcohol abuse and alcohol related diseases by nurses and medical staff of an university general hospital

Objetivo. Avaliar a associaçao entre o resultado do teste CAGE aplicado em pacientes internados num hospital geral universitário (Hospital de Clínicas de Porto ALegre - HCPA) e a percepçao e registro de abuso de álcool e de doenças relacionadas pelas equipes de saúde. Pacientes e Métodos. O delineamento envolveu três fases: a) aplicaçao do teste CAGE aos 385 pacientes adultos e adolescentes internados considerados elegíveis para o estudo; b) revisao dos prontuários dos pacientes CAGE-positivo e de um número igual de pacientes CAGE-negativo, estratificados por área de internaçao e sorteados, para identificar hábitos alcoólicos e a presença de doenças relacionadas ao uso de álcool; c) entevista com os membros das equipes médicas responsáveis para avaliar sua percepçao sobre o hábito alcoólico em seu paciente. As diferenças encontradas foram analisadas através do teste Qui-quadrado e do teste t de Student, com significância estatística em nível de 5 por cento bicaudal. Resultados. Foram encontrados 51 pacientes CAGE-positivo (13 por cento). A equipe médica registrou abuso de álcool no prontuário de 51 por cento dos pacientes CAGE-positivo e 10 por cento dos CAGE-negativo, e a equipe de enfermagem fez este registro no prontuário de 31 por cento dos pacientes CAGE-positivo e 8 por cento dos CAGE-negativo (p=.724). Nao houve diferença entre o registro e a percepçao da equipe médica (p=.184). A prevalência de doenças relacionadas ao abuso de álcool foi 27 por cento quando se examinou os prontuários médicos e 26 por cento quando se entrevistou a equipe médica (p=.861), sendo maior entre os pacientes CAGE-poistivo (43 por cento) do que entre os CAGE-negativo (10 por cento) (p=.0003). Conclusoes. O abuso de bebidas alcoólicas e a presença de doenças associadas ao mesmo sao condiçoes prevalentes nos pacientes admitidos ao HCPA. Entretanto, mais de metade dos casos nao foram detectados pela equipe de saúde, havendo correspondência entre os registros de prontuário e a entrevista.

The arrangement of the trabecular bone in the vestibular surface of the human fetus mandible. I. A scanning electron microscopy study (1).

The characteristics of trabecular bone in human fetuses at three to six months intra-uterine life were studied in the vestibular surface of the mental and body portions of the mandible. Rounded trabeculae disposed vertically were observed in the alveolar region of the mental portion until 3 months of age. Bundles of collagen fibers were present longitudinally in the alveolar region of the mandibular body: laminar and longitudinal trabeculae lying parallel to the mandible base were seen in the basilar region. In 4 to 6-month old fetuses rounded trabeculae were observed in the alveolar region of the mental portion; in the medium region, the trabeculae were oblique while in the basilar region they were longitudinal and parallel to mandible base. In the alveolar region of the mandibular body, trabeculae with a rounded aspect were seen: in the medium region, they were straight, oblique and longitudinal to the mandible ramus: in the basilar region, the trabeculae were longitudinal and parallel to mandible base. The alveolar foramina exhibit differing diameters and shapes in the mental and body portions: thick bundles of collagen fibers and osteocyte lacunae of varying diameters were present in the bone surface.

[Evaluation of umbilical cord pH and its relationship with Apgar score in term newborn infants]. / Avaliação do pH de sangue de cordão umbilical e sua relação com o escore de Apgar em recém-nascidos a termo.

The value of the Apgar score as an index of birth asphyxia has been recently questioned. The purpose of the present study is to evaluate the relationship between cord blood pH and Apgar score in term newborn infants.A cross-sectional study involving 76 term newborn infants was performed from March through September 1995 at the Obstetric Unit of Hospital de Clínicas de Porto Alegre. The blood samples were obtained from umbilical cord artery and vein at the moment of delivery. Infants were divided in three different groups according to the Apgar score: Group A (n=60): >or=7 at one and five minutes; Group B (n=13): < 7 at one minute and >or=7 at five minutes; Group C (n=3): < 7 at one and five minutes. The frequency of acidemia in Group A was 18.3% (11 newborn infants) considering arterial pH < 7.20 and 5% considering arterial pH or= 7.20 and nine (56.2%) had arterial pH > 7.10. None of the newborn infants in Group C had arterial pH > 7.10. The sensitivity and specificity values for Apgar score less than 7 at one minute for detection of fetal acidemia were, respectively, 54.1% and 94.1%. This study confirms a poor correlation between Apgar score and umbilical blood cord pH, even in a term newborn, and emphasizes the importance of obtaining umbilical cord pH to consider the diagnosis of perinatal asphyxia.