Factors affecting intention to breastfeed of a group of Brazilian childbearing women.

BACKGROUND: Knowing the intention of mothers is important to plan actions to improve exclusive breastfeeding rates. AIM: The objective of this retrospective study was to verify the intention to breastfeed and the intended breastfeeding duration of a group of women participating in a public prenatal dental care program in the city of Araçatuba, Brazil. METHODS: The records of 933 childbearing women were analyzed and their intention to breastfeed and intended breastfeeding duration were associated to women's age, ethnicity, marital status, education, employment, number of gestations, previous breastfeeding experience, previous breastfeeding guidance, presence of complications during pregnancy, and systemic diseases. Data were inserted into Epi Info 2000 and analyzed with Biostat, at a 5% level of significance, and confidence interval of 95%. FINDINGS: Participants mean age was 26.1±5.9years. The majority of women (96.5%) declared their intention to breastfeed their babies. The main variables to affect the intention to breastfeed were the number of gestations (p=0.001), previous breastfeeding experience (p=0.03), and previous breastfeeding guidance (p=0.01). Intended breastfeeding duration was significantly affected by women's age (p=0.04), employment (0.02), the number of gestations (p=0.001), and previous breastfeeding experience (p=0.04). CONCLUSIONS: Previous positive breastfeeding experience and guidance during prenatal examinations positively affected women's intention to breastfeed; while older, unemployed women in their second or more gestation and previous breastfeeding experience intended to breastfeed their children for longer periods of time.

Bioactivity of indigenous medicinal plants against the cotton whitefly, Bemisia tabaci.

Forty-one methanol extracts of 28 indigenous medicinal plant species were tested for their insecticidal bioactivity against cotton whitefly, Bemisia tabaci (Gennadius) (Hemiptera: Aleyrodidae), adults and second nymphal instars under controlled conditions. This study is within a bioprospection context, in the form of utilizing local plant species as an alternative in sustainable agriculture development. Eighteen and nine plant extracts caused a significant decrease in number of live adult and nymphal whiteflies, respectively, compared to the control. This is the first report for the potential effect on survival of insects for 22 out of 28 tested medicinal plant species. Whole plant extracts of Ranunculus myosuroudes Boiss. and Kotschy (Ranunculaceae), Achillea damascena L. (Asteraceae), and Anthemis hebronica Boiss. and Kotschy (Asteraceae) and leaf extracts of Verbascum leptostychum DC. (Scrophulariaceae) and Heliotropium rotundifolium Boiss. (Borangiaceae) caused both repellent and toxic effects against the adult and second nymphal instars, respectively. Extracts of leaves and stems of Anthemis scariosa Boiss. (Asteraceae) and Calendula palestina Pers. (Asteraceae) were found to be more bioactive against the adult and nymphal instars, respectively, than extracts of other plant parts, such as flowers. Thus, the bioactive extracts of these medicinal plants have the potential to lower whitefly populations in a comprehensive pest management program in local communities, pending cultivation of these medicinal plant species.

[Analysis of the quality of data issued from Beirut's hospitals in order to measure short-term health effects of air pollution]. / Analyse de la qualité des données issues des hôpitaux de Beyrouth Municipe pour mesurer les effets à court terme de la pollution atmosphérique.

BACKGROUND: The effects of air pollution on human health have been the subject of much public health research. Several techniques and methods of analysis have been developed. Thus, Beirut Air Pollution and Health Effects (BAPHE) was designed to develop a methodology adapted to the context of the city of Beirut in order to quantify the short-term health effects of air pollution. METHODS: The quality of data collected from emergency units was analyzed in order to properly estimate hospitalizations via these units. This study examined the process of selecting and validating health and pollution indicators. RESULTS: The different sources of data from emergency units were not correlated. BAPHE was therefore reoriented towards collecting health data from the emergency registry of each hospital. A pilot study determined the appropriate health indicators for BAPHE and created a classification methodology for data collection. CONCLUSION: In Lebanon, several studies have attempted to indirectly assess the impact of air pollution on health. They had limitations and weaknesses and offered no recommendations regarding the sources and quality of data. The present analysis will be useful for BAPHE and for planning further studies.

Prevalence of deciduous tooth erosion in childhood.

OBJECTIVES: The objective of this study was to estimate the prevalence of deciduous tooth erosion and to identify possible associations with sex, age and toothbrushing frequency in children aged 4-6 years. METHODS: The sample was drawn from attendants (n = 7058) of 57 public preschools in a Brazilian city. Tooth wear index was used to evaluate erosion. Descriptive statistical analysis consisted of the calculation of the prevalence of dental erosion; chi-squared and Fisher's exact tests were performed to verify the association between dental erosion and sex, age and toothbrushing frequency. RESULTS: Two thousand and seven hundred and fifty-nine preschool students were examined. Deciduous tooth erosion was observed in 0.6% of children and its incidence did not differ between sexes. The highest prevalence was observed in children aged 6 years (58.3%) and the most affected sextants were the fourth (22.86%) and sixth (20.00%), indicating that lingual and occlusal tooth surfaces were most frequently involved. The degree of involvement was classified as incipient in 54.29% of children and moderate in 45.71%. The significance level was set at 5%. No association was found between erosion and sex, age or toothbrushing frequency. CONCLUSIONS: The prevalence of deciduous tooth erosion was low in Brazilian children, and this disorder is not considered a public health problem in this part of the population.

Volatile aldehydes in the mainstream smoke of the narghile waterpipe.

Very little is known about the quality and quantity of toxicants yielded by the narghile, a subject of increasing importance as this method of tobacco smoking has become popular all over the world. This study is concerned with the identification and quantification of volatile aldehydes in the gas and particle phases of mainstream narghile smoke generated using a popular type of flavored ma'ssel tobacco mixture. These compounds were analyzed based on a modified version of the Environmental Protection Agency compendium method TO-11A. Using a standardized smoking machine protocol consisting of 171 puffs, 2.6s puff duration and 17s inter puff interval, the average yields of formaldehyde, acetaldehyde, acrolein, propionaldehyde and methacrolein were 630, 2520, 892, 403, and 106 microg/smoking session, respectively. The results showed that none of the aldehydes identified in this study are found in the particulate phase of the smoke, except for formaldehyde for which the partitioning coefficient was estimated as Kp = 3.3 x 10(-8) microg/m3. Given previously reported lung absorption fractions of circa 90% for volatile aldehydes, the yields measured in this study are sufficient to induce various diseases depending on the extent of exposure, and on the breathing patterns of the smokers.

El consentimiento informado en la clínica odontológica

El consentimiento informado (CI) es la aprobación del individuo expresada a él en lenguaje accesible, antes de empezar el tratamiento, teniendo como base sus aspectoséticos-legales el Código de Ética dontológica, Civil y Penal y la Resolución 196/96. Aunque sea importante como modo de protección judicial para el cirujano-dentista, difícilmente se utiliza en la clínica odontológica. Fue objeto de este estudio elevaluar el conocimiento y prácticas de los cirujanos-dentistas sobre el CI, verificarse la presentación y decisión del tratamiento propuestas al paciente y clase de documento utilizado por cirujanos-dentistas en la clínica odontológica. Los sujetos de esta encuesta eran todos cirujanos-dentistas del municipio de Lucélia, São Paulo, Brasil. Como instrumento de colecta de datos, se elaboró un cuestionario conteniendo 11 cuestiones discursivas y de elección múltiple, dividido en tres partes temáticas: el CI, el contrato de prestación de servicios y el plan de tratamiento. Para interpretación de cuestiones discursivas, fue preconizada la técnica de Análisis de Contenido. Los resultados sugieren que la mayoría de los cirujanos-dentistaspresenta deficiencia al que se refiere al conocimiento acerca del CI, mientras otrosdesconocen totalmente el tema. Su aplicación no se realiza de manera satisfactoria, yla autorización es el documento más utilizado en la clínica odontológica. El tratamiento a realizarse depende de la decisión conjunta del paciente y profesional, presentándoselo al cliente de manera clara. De esa manera, se hacen necesarias la sensibilización y capacitación de los profesionales para la práctica del CI como rutina en la clínica odontológica.

Microcephaly, cutis verticis gyrata of the scalp, retinitis pigmentosa, cataracts, sensorineural deafness, and mental retardation in two brothers.

We describe the cases of two brothers with microcephaly, primary cutis verticis gyrata of the scalp, prominent supraorbital ridges, large nose, hypertelorism, exotropia, progressive retinitis pigmentosa, cataracts, sensorineural hearing loss, kyphoscoliosis, and mental retardation. A review of the literature focusing on the major clinical findings suggests that our cases may represent a hitherto unreported new syndrome.

Bone mineral density of the Lebanese reference population.

We determined the bone mineral density (BMD) of normal Lebanese subjects and compared results with US/European reference data. The investigation was conducted at one center, and included 858 women and 165 men aged 20-79 years. Spine, femoral and radial BMD measurements were made using dual-energy X-ray absorptiometry. Age-related changes in BMD were similar in form to those of US/European reference data. However, BMD values of Lebanese were generally lower than US/European values. Spine BMD of Lebanese women was about 8% lower than US/European values between ages 20 and 59 years, and 5-6% lower for ages 60-79 years. Femoral neck BMD values for Lebanese women were 8% lower in the young adult years (age 20-39 years), but only 2-3% lower in the postmenopausal years, compared with US/European women. There were smaller postmenopausal decreases in femoral and radial BMD in Lebanese women compared with US/European women, which led to a convergence of BMD after age 70 years. The BMD of Lebanese men was 5-8% lower than US/European values throughout the age range (20-79 years). The effect of weight on BMD ranged from 0.2% to 0.4% per kilogram. Height was not significantly associated with BMD when both height and weight were entered in multiple regression analyses. The prevalence of osteoporosis appeared to be overestimated if the US/European reference data, rather than Lebanese reference data, were used to calculate T-scores.

[Epitheliomas of the piriform sinus. Therapeutic orientation. Apropos of 642 patients]. / Epithéliomas du sinus piriforme. Orientation thérapeutique. A propos de 642 malades.

On the basis of 642 patients treated and followed up since 1961 at Laennec Hospital, the authors compare the results of radiotherapy, of surgery and of surgery with subsequent radiotherapy. Surgery followed by radiotherapy gives the best 3 and 5 year survival rates and the lowest local and lymph node recurrence rates. The introduction since 1970 of induction chemotherapy shows an improvement in local prognosis and 5 year survival. There has been a more marked improvement since the introduction of cisplatinum and the use of continuous infusions of cisplatinum and of fluoro-5-uracil with or without bleomycin.

[Unusual zones of osteitis detected during salvage tympanoplasty]. / Zones d'ostéite insolites découvertes lors de retouches de tympanoplastie.

Three patients were noted to have unusual zones of osteitis during salvage myringoplasty. The first case involved the whole upper wall of the bony canal and was camouflaged by a weeping mucopolypoid carpet. In the second case there was a wide zone of osteitis of the posterosuperior angle of the canal and another smaller zone in the anteroinferior tympanic region. The osteitis in the third case had invaded the total mastoid cortex producing a vast plaque of superficial osteitis which could be removed without difficulty. Diffuse osteomatous reaction of the wall of the canal had resulted. In all three cases a salvage myringoplasty was possible after elimination of the osteitic lesions, although a glue ear persisted with a punctiform perforation in one patient, suggesting tubal dysfunction.

[Early diffuse hypertrophic osteitis recurrence. Unexpected and consternating development after a large évidement cavity. Apropos of 15 cases]. / La rechute ostéitique diffuse hypertrophique précoce (R.O.D.H.P.). Evolution inattendue et consternante après vaste cavité d'évidement. A propos de 15 cas.

The authors report 15 cases collected over a period of 13 years (1972 - 1984) of a particularly serious eventuality affecting certain evacuation cavities: Early recurrence of diffuse hypertrophic osteitis (E.R.D.H.O.). This is a rare complication, occurring in 1.5% of cases of chronic otitis. However, the fact of having operated upon 7 cases in 1984 alone, whilst during the previous 12 years, only 8 had been seen, raised the alarm. The classical pattern of this complication occurs in 3 stages, each involving surgical operation: at the outset, chronic otitis with cholesteatoma or osteitis, most often mixed, for which an "inadequate" surgical procedure is performed. then, after a variable period which may exceed 10 years, a very large evacuation cavity was created by the authors. finally, 3rd and final stage: within 6 months, this cavity filled progressively and, at operation, the authors discovered a cavity virtually completely filled with a "fantastic" "moist sugar" osteitis, requiring a new evacuation cavity, even larger than that created before. In all cases, a successful result was obtained within a varying period, sometimes accompanied by spectacular improvement in general condition. The most plausible etiopathogenic hypothesis advanced to attempt to explain this phenomenon is that of secondary infection by a varied microbial flora, including, on the one hand, aerobic organisms usually discovered in such cases (pseudomonas pyocyaneus, proteus mirabilis) and, secondly, this being of essential importance, "anaerobic" bacteria, the bacteriological diagnosis of which requires application of a strict protocol. The authors have taken three decisions following their bibliographic investigations.(ABSTRACT TRUNCATED AT 250 WORDS)

[Involvement of the tympanic bone in chronic otitis (44 cases)]. / Les atteintes du tympanal dans le cadre de l'otite chronique (44 observations).

44 cases of tympanic involvement in the context of chronic otitis are described. 34 occurred during active chronic otitis. This is a rare possibility (approximately 4% of our own cases of chronic otitis). The following may be mentioned amongst them: 21 cases of osteitis, for which the following concepts should be borne in mind: the extreme severity of the chronic otitis responsible, in most instances, ears which had undergone multiple surgery (17/21), lesions exclusively of osteitis, but very extensive in 2/3 of cases (14/21). 7 cases of osteolytic disease, occurring severe or atypical cholesteatomatous chronic otitis and quite often involving associated osteolysis affecting the main VII, the promontory, the bulb of the internal jugular vein, or even the carotid canal. 4 cases of diffuse sub-obstructive osteomatous disease of the walls of the E.A.M., "progressive" development of which over several months was noted in 3 cases. Finally, 2 cases of mixed disease: (osteitis--osteomatoma and osteitis--osteolysis). 8 cases occurred following myringoplasty: this is a rare eventuality (approximately 1%), 1 case only of osteolysis due to iatrogenic cholesteatoma, 7 cases of osteitis, either highly localized and not preventing further myringoplasty (4 cases), or very extensive, finally resulting in a vast evacuation cavity. In 2 cases, a malformation is the origin of involvement of the tympanic at the origin of chronic otitis was felt probable, without it being possible to reach any definite conclusion concerning auriculobranchial fistula or Huschke foramen.

[Rare diseases of the ear: fibrous dysplasia of the tympanic bone, extensive papillomatosis, ceruminoma, aspergilloma, spontaneous évidement of the tympanic bone]. / Quelques affections rares de l'oreille: dysplasie fibreuse du tympanal, papillomatose extensive, céruminome, aspergillome, évidement spontané du tympanal.

The authors report six cases of rare ear diseases: fibrous dysplasia of the tympanum mimicking an partially obstructive osteoma of the external auditory canal. The authors draw a parallel between the rarity of these monostotic forms of the temporal bone which are strictly localised to a single region (tympanum-mastoid-atrium) and the diffuse forms which involve several regions at the same time; extensive papillomatosis of the external and middle ear, a rare condition with serious repercussions; two ceruminomas with very different clinical presentations and outcomes; an atrial pseudo-tumoral aspergilloma which was easily excised ans repaired with a myringoplasty with a good long term result; hypoplasia of the tympanum, which constituted a spontaneous évidement, discovered at operation for an attic cholesteatoma. This finding was sufficiently unusual to warrant reporting.

[Role of tubal insufflation in the postoperative follow-up of évidement cavities]. / La place des insufflations tubaires dans les suites opératoires des cavités d'évidement.

The authors report their experience of tubal insufflation in the post-operative care of cavity évidement. Their indications consist of évidement cavities with persistent residual muco-purulent otorrhoea or "glue ear" from the atrial area which remains thickened, while the rest of the cavity is healed (about 15% in their statistics). The technique is simple, consisting essentially of insufflations of air by means of an Itard catheter, which are repeated at regular intervals for a variable period of time. In some cases, drugs, in particular corticosteroids, are injected into the cavity via the catheter. In a series of 17 operated patients, the authors report: 9 excellent results in which drying of the cavity was obtained in record time; 4 good results in which drying of the cavity required numerous insufflations associated with systemic treatment (vaccine therapy, crenotherapy); 1 moderate result with transient persistent otorrhoea; 3 failures.

[Cranial and cervical metastases of vascular nature in thyroid cancer. Apropos of 2 cases]. / Les métastases crâniennes et cervicales à caractère vasculaire des cancers thyroïdiens. A propos de 2 cas.

Vesicular and papillovesicular thyroid cancers provoke metastases in bone, but also of the pseudo-aneurysmal lymph node type. When the latter develop in the craniocervical region, they are often diagnosed as vascular tumors (arteriovenous malformation, glomus tumor). It is now possible, by embolization, to excise these lesions although this involves therapeutic audacity. Surgery is not always sufficient, and complementary 131-Iodine treatment should be used routinely, but it is justified for this type of metastasis as shown by survival rate in these patients.

[Diagnostic problems of tuberculoid cervical adenitis. Apropos of 70 cases]. / Problèmes diagnostiques des adénites cervicales tuberculoides. A propos de 70 observations.

Pathologic criteria in tuberculoid adenitis enable differentiation between follicular adenitis with or without caseous necrosis and that involving suppurative necrosis. The absence of specific etiology is emphasized. Seventy cases of tuberculoid adenitis are analyzed. Of the 62 cases of adenitis labelled tuberculous, bacterial confirmation was obtained in only 22 (35%), suggesting probable diagnosis by excess for the remaining 40 cases. Related bacteriologic problems concern isolation of B.K. of the 3 cases classified as sarcoidosis, it was important to obtain data from broncho-alveolar lavage and serum conversion enzyme assay. Four patients with adenitis were diagnosed as having cat-scratch disease from positive specific intradermal reactions, the probable discovery of the responsible agent thus providing a bacteriologic diagnosis.