Biannual fluoride varnish applications and caries incidence in preschoolers: a 24-month follow-up randomized placebo-controlled clinical trial.

UNLABELLED: Sound evidence on the effectiveness of fluoride varnishes (FV) to reduce caries incidence in preschool children is lacking. OBJECTIVE: To assess whether the application of FV in preschool children at 6-month intervals decreases the incidence of caries and produces any adverse effects. METHODS: A randomized, examiner- and patient-blind, placebo-controlled, parallel-group design, clinical trial, comprising 1- to 4-year-old children, 100 in each group (FV or placebo varnish, PV), was conducted in Rio de Janeiro, Brazil. Two trained pediatric dentists performed the clinical examinations (kappa = 0.85). Dental caries was recorded at the d2 (cavitated enamel) and d3 (dentine) levels using the International Caries Diagnosis and Assessment System. RESULTS: At baseline, the mean age of the participants was 2.4 years (SD 0.9) and the mean d3mfs was 0.8 (SD 1.9). Most of the children brushed their teeth with fluoride toothpaste and consumed fluoridated tap water. After 24 months, 89 and 92 children of the test and the control groups were analyzed, respectively. A total of 32 (35.9%) children in the FV group and 43 (46.7%) in the PV group presented new dentine caries lesions (χ(2) test; p = 0.14), showing relative and absolute risk reductions of 23% (95% CI: -9.5 to 45.9) and 11% (95% CI: -3.5 to 25.0). The mean caries increment differences between the test and control groups were -0.8 (95% CI: -2.0 to 0.4) at the d2 level and -0.7 (95% CI: -1.9 to 0.4) at the d3 level. Only 2 minor complaints regarding the intervention were reported. CONCLUSION: Although safe and well accepted, twice-yearly professional FV application, during 2 years, did not result in a significant decrease in caries incidence.

Niche Overlap and Network Specialization of Flower-Visiting Bees in an Agricultural System.

Different resource use strategies manifest as differences in the realized niches of species. Niche segregation may involve several dimensions of the niche, such as diet, space, and time. We measured the level of redundancy and complementarity of a bee-plant interaction network in an agricultural system. Because flower resource diversity is high and resource abundance associated with flowering phenology varies throughout the year, we hypothesized that trophic overlap in the community would be low (i.e., high niche complementarity). In contrast, we expected a combination of physiological constraints and exploitation competition to create high temporal overlap, leading to high redundancy in the time of use of floral resources. Dietary overlap was low (NOih = 0.18): niches of 88% of species pairs had less than 30% overlap. In contrast, temporal overlap was intermediate (NOih = 0.49): niches of 65% of species pairs had 30% to 60% overlap. Network analysis showed that bees separated their dietary niches and had intermediate complementary specialization (H2' = 0.46). In terms of their temporal niches (H2' = 0.12), bees were generalists, with high temporal redundancy. Temperature was not a key factor in the determination of niche overlap, suggesting that environmental factors do not likely have a primary role in determining high redundancy in the temporal use of floral resources. Rather, temporal overlap is likely associated with the timing of nectar production by flowers. Our results suggest that bees partition a wide variety of available floral resources, resulting in low dietary overlap and intermediate temporal overlap.

Microbiological epidemiological history of meningococcal disease in Rio de Janeiro, Brazil.

The main objectives of the present study were to investigate the clinical and laboratory features of meningococcal disease in the city of Rio de Janeiro, Brazil, during the overlap of 2 epidemics in the 1990s. We conducted a study of a series of cases of meningococcal disease admitted in a Meningitis Reference Hospital. All clinical isolates available were analyzed by means of microbiological epidemiological markers. In 1990, Neisseria meningitidis serogroup B:4,7:P1.19,15, 1.7,1 sulfadiazine-resistant of the ET-5 complex emerged causing epidemic disease. Despite mass vaccination campaign (VaMengoc B+C®), the ET-5 clone remained hyperendemic after the epidemic peaked. In 1993 to 1995, an epidemic of serogroup C belonged to the cluster A4 overlapped, with a significant shift in the age distribution toward older age groups and an increase of sepsis. Serogroup C epidemics are a recurrent problem in Rio de Janeiro, which can be hindered with the introduction of a conjugate vaccine. We hope the data presented here brings useful information to discuss vaccines strategies and early management of suspected cases.

Avaliação da espalhabilidade e do teor de flavonoides em forma farmacêutica semissólida contendo extratos de Calendula officinalis L. (Asteraceae) / Evaluation of spreadability and flavonoid content in semisolid pharmaceutical form containing extracts of Calendula officinalis L. (Asteraceae)

O objetivo deste estudo foi avaliar a característica reológica (espalhabilidade) e quantificar os princípios ativos (flavonoides) de preparações semissólidas (pomadas) contendo extratos de Calendula officinalis L. (Asteraceae). A partir da droga vegetal dessa espécie, foram obtidos dois tipos de extratos preparados por percolação na proporção de 1:5 utilizando-se mistura hidroalcóolica (etanol:água 62:38) e hidroglicólica (propilenoglicol:água 9:1). As pomadas contendo esses extratos, além de excipientes lanolina e vaselina, foram preparadas por duas técnicas distintas: solução (a quente) e suspensão (a frio). Análises para determinar a espalhabilidade através das relações entre área, esforço limite e teor de flavonoides foram realizadas a partir de amostras das pomadas preparadas. Os resultados demonstraram que as pomadas contendo extratos hidroalcoólicos e hidroglicólicos, preparadas por suspensão (a frio), exibiram as maiores relações entre área e esforço limite (0,34 e 0,33 mm2 g-1, respectivamente). No entanto, as pomadas preparadas com extratos hidroalcoólicos por suspensão resultaram nos maiores valores de flavonoides totais (0,004% m/m calculados como hiperosídeos).

The aim of this study was to assess the rheological properties (spreadability) and assay the active ingredients (flavonoids) in semi-solid preparations (ointments) containing extracts of marigold (Calendula officinalis L. - Asteraceae). The herbal drug from this species was separated from the dried inflorescence and two types of extracts were prepared by percolation at a ratio of 1:5, one with an ethanol:water mixture (62:38) and the other with propylene glycol: water (9:1). Ointments were prepared from these extracts, lanolin and vaseline, by two different techniques: solution (hot) and suspension (cold). Samples of each ointment were analyzed, to determine the spreadability, as the ratio between area of spread and limiting applied weight, and the flavonoid content. The results showed that ointments prepared by cold suspension, containing hydroalcoholic and hydroglycolic extract, exhibited the highest area:limiting weight ratios (0.34 and 0.33 mm2 g-1 , respectively). Secondly, ointments prepared by suspension, with hydroalcoholic extracts, had the highest total flavonoid content (0.004% w/w, calculated as hyperoside).

Microbiological epidemiological history of meningococcal disease in Rio de Janeiro, Brazil

The main objectives of the present study were to investigate the clinical and laboratory features of meningococcal disease in the city of Rio de Janeiro, Brazil, during the overlap of 2 epidemics in the 1990s. We conducted a study of a series of cases of meningococcal disease admitted in a Meningitis Reference Hospital. All clinical isolates available were analyzed by means of microbiological epidemiological markers. In 1990, Neisseria meningitidis serogroup B:4,7:P1.19,15, 1.7,1 sulfadiazine-resistant of the ET-5 complex emerged causing epidemic disease. Despite mass vaccination campaign (VaMengoc B+C®), the ET-5 clone remained hyperendemic after the epidemic peaked. In 1993 to 1995, an epidemic of serogroup C belonged to the cluster A4 overlapped, with a significant shift in the age distribution toward older age groups and an increase of sepsis. Serogroup C epidemics are a recurrent problem in Rio de Janeiro, which can be hindered with the introduction of a conjugate vaccine. We hope the data presented here brings useful information to discuss vaccines strategies and early management of suspected cases.

Effectiveness of liposomes to transfect livestock fibroblasts

The development of an efficient transfection system in livestock cells is an important step towards investigating gene transfer and the functioning and production of transgenic animals. Important factors involved in cationic liposome mediated gene transfer were evaluated through in vitro transfection of bovine, caprine and ovine fibroblast cells. Transfection of plasmid DNA complexes of different commercially available liposomes (Lipofectamine, Lipofectin, Cellfectin and DMRIE-C; Gibco-BRL, USA) was evaluated utilizing the following parameters: DNA/liposome ratio, cell density, DNA conformation, and the effect of transfection time on the efficiency of bovine fibroblasts to express a reporter gene. The effects and concentrations of liposomes were also evaluated in caprine and ovine fibroblasts. Lipofectamine alone and Lipofectamine with Plus reagent induced high-frequency expression of beta-galactosidase and neo genes in all cells evaluated (47 and 88.3%, respectively). Regarding phenotype, chromosomal stability was similar in transfected and non-transfected cells. The parameters set in this study will establish a foundation for utilizing transfected fibroblast cells to generate transgenic animals through nuclear transfer technology and gene function studies.

Classification trees and logistic regression applied to prognostic studies: a comparison using meningococcal disease as an example.

The authors used logistic regression and classification trees to develop prediction models for fatal outcomes in meningococcal disease in a cohort of 829 children hospitalized for meningococcal disease during 1989-1990 in Rio de Janeiro. The area under the receiver operator characteristic (ROC) curve was 92 per cent for logistic regression and 88 per cent for classification trees. Logistic regression may be preferred when the main objective is to obtain explicit measures for statistical inference and measures of the force of the association between each variable and the outcome. However, estimation of the probability of dying for each patient involves manipulation of the logistic regression formula, which would not easily be done in an emergency room. Classification trees provided comparable discrimination between fatal and non-fatal outcomes, and yielded a graphical display of the results that is easier to understand and is straightforward to apply in clinical settings.

[Meningococcal disease: epidemiology and control of secondary cases]. / Doença meningocócica: epidemiologia e controle dos casos secundários.

Epidemiological features of meningococcal disease described as from the second half of the 80's inclusive, have motivated a revision of current guidelines for sporadic disease and outbreak control. The increase of disease among teenagers and linked cases involving schools are the two most significant aspects that have prompted the revision of control measures. Vaccination routines and advice for the disease management of clusters are also relevant features recently revised. This present paper describes the management and some epidemiological features of secondary cases.

Antibiotic regimen as an independent risk factor for disseminated fungal infections in neutropenic patients in Brazil.

In a cohort of 79 febrile episodes in 50 consecutive neutropenic patients seen at the University Hospital, Federal University of Rio de Janeiro, Brazil, between 1987 and 1991, it was observed that the cumulative incidence of disseminated fungal infections rose from 3% to 19% after the introduction of a new empirical antibiotic regimen. In order to identify risk factors, as well as to assess the impact of the new antibiotic regimen on the emergence of fungal infections, a nested case-control study was undertaken, in which 10 cases of disseminated fungal infections were compared with 30 randomly chosen controls, drawn from the same cohort. In a multiple logistic regression analysis, the predictive factors for disseminated fungal infection were younger age (odds ratio 0.85, 95% confidence interval 0.75-0.97) and use of the new antibiotic regimen (odds ratio 14.18, 95% confidence interval 1.05-191.80) The probable explanation for the emergence of fungal infections is that the new antibiotic regimen, by lowering the incidence of bacteraemia-related deaths, allowed patients to be at risk for the development of disseminated fungal infections.

[Prevalence of virus B infection in a hospital community]. / Prevalência da infecção pelo vírus B na comunidade hospitalar.

The authors studied the prevalence of HBV markers among health care personnel of the University Hospital of the Federal University of Rio de Janeiro. The aim of study was to identify the high risk groups, in order to counsel vaccination of those groups, in order to counsel vaccination of those groups at risk as a routine. As a control group, a group of office workers of the hospital were chosen. A significant difference of incidence of HBV markers, mainly in surgeons (40%) and hemodialysis unit personnel (36.4%) when compared to the control group, was observed (p less than 0.05). The incidence increased with age and the time spent in the profession. The authors concluded that vaccination is indicated in surgeons hemodialysis personnel, dentists and laboratory personnel.

Acao do verapamil como agente hipotensor - Analise da curva de pressao arterial em teste cicloergometrico. / Action of verapamil as hypotensive agent- analysis of the curve of arterial blood pressure in cycloergometric test

Vinte e nove pacientes com hipertensao arterial leve e/ou moderada, nao tratados ou sem uso de medicacao por prazo minimo de 90 dias, foram submetidos a 3 testes ergometricos com avaliacao de curva de pressao arterial. O primeiro teste foi realizado sem uso de qualquer substancia, caracterizando-se a presenca do quadro hipertensivo. No segundo e terceiro testes, foram administrados, alternadamente aos pacientes, verapamil em dose unica de 120 a 360 mg por via oral e placebo, 2 horas antes da prova, sendo medida a PA a cada 60 s durante o decorrer do esforco e repouso posterior. O verapamil teve efeito hipotensor significativo em 63% dos pacientes, em 29% nao houve qualquer modificacao da curva tensional nos 3 testes; 8% dos pacientes tiveram diminuicao de seus niveis tensionais com placebo. Sao analisados ainda os para-efeitos da droga, resultados gerais dos testes ergometricos e a validade do metodo na avaliacao da terapeutica anti-hipertensiva