Development of the concept of spatial-temporal mask for testing effects of discharge from well-drilling activities on biological communities.

This paper describes the use of Bayesian spatial models to develop the concept of a spatial-temporal mask for the purpose of identifying regions in which before and after drilling effects are most clearly defined and from which the consequences of exposure of macrofauna and meiofauna to the release of drilling discharges can be evaluated over time. To determine the effects of drilling fluids and drill-cuttings on the marine benthic community, it is essential to know not only where discharged materials ended up within the possible impact area, but also the chemical concentrations to which biota were exposed during and after drilling. Barium and light hydrocarbons were used as chemical tracers for water-based and non-aqueous-based fluids in a shallow water site in the Campos Basin, off the coast of Brazil. Since the site showed evidence of exposure to waste material from earlier drilling, the analysis needed to take into account the background concentrations of these compounds. Using the Bayesian models, concentrations at unsampled sites were predicted and regions altered and previously contaminated were identified.

Effects of non-aqueous fluids-associated drill cuttings discharge on shelf break macrobenthic communities in the Campos Basin, Brazil.

This paper assesses the effects of non-aqueous fluids (NAF)-associated drill cuttings discharge on shelf break macrobenthic communities in the Campos Basin, off the southeast Brazilian coast, Rio de Janeiro State. Samples were taken with a 0.25-m2 box corer from surrounding two oil and gas wells on three monitoring cruises: before drilling, three months after drilling, and 22 months after drilling. Statistical methodologies used Bayesian geostatistical and analysis of variance models to evaluate the effects of the NAF-associated drill cuttings discharge and to define the impact area. The results indicated that marked variations were not observed in the number of families between cruises, though there were changes in the fauna composition. The changes seen in biological descriptors in both control and background situation areas were not considered significant, showing a temporal homogeneity in means. The impact area presented changes in biological descriptors of communities and trophic structure during the three cruises and such changes were correlated to chemical and physical variables related to the drilling activities, as a result of the mix of drill cuttings and sediment and the anoxic conditions established in the substrate. In that area, three months after drilling, a decrease in diversity and an increase in density, motile deposit-feeders and Pol/Crp ratio, and dominance of opportunistic organisms, such as the capitellid Capitella sp., were observed and, 22 months after drilling, an increase of diversity, reduction of dominance of capitellid polychaete, changes in the fauna composition, and a dominance of opportunistic burrowing and tube-building organisms were observed, indicating an ecological succession process.

Genetic biomonitoring of an urban population exposed to mutagenic airborne pollutants.

Biomonitoring studies have increased as a consequence of risks and effects to human health on exposure to environmental contaminants, mainly air pollutants. Genetic biomarkers are useful tools for the early assessment of exposure to occupational and environmental pollution. The objective of the present study was to investigate genotoxic effects on people residing and/or working downwind from an oil refinery in southern Brazil and the mutagenic activity of airborne particulate matter (PM10). Samples of peripheral blood and buccal mucosa cells were evaluated using the single-cell gel electrophoresis assay (comet assay) and the micronucleus (MN) assay, respectively. PM10 samples were collected in the target site and the organic matter extraced with dichloromethane was assessed for mutagenic activity in the Salmonella/microsome assay. The exposed group (n=37) was compared to a reference group (n=37) of subjects living in an urban area with limited traffic and industrial influence, located far from the main industrial areas. All PM10 organic extracts showed mutagenic positive responses and the effect decreased in the presence of S9 mix indicating that the predominant compounds present were direct-acting mutagens. The responses of YGs strains are consistent with aromatic amines and nitroarenes being present in the PM10 extracts. The group in the area under the influence of the oil refinery (exposed group) showed significantly higher DNA damage in lymphocytes than the reference group. The MN frequencies in buccal mucosa were very low for both groups and no difference between groups was observed. No association was found between age and tobacco smoking habit and level of DNA damages measured by the comet assay. The results indicate that the comet assay was a sensitive tool to detect DNA damage in subjects under the influence of an oil refinery, with marked genotoxic activity in the atmospheric environment.

Laparoscopy versus laparotomy for benign ovarian tumour.

BACKGROUND: Over the last 10 years laparoscopy and minilaparotomy have become increasingly common approaches for the surgical removal of benign ovarian tumours. However, in the event that a tumour is found to be malignant, laparotomy is the appropriate procedure. Careful preoperative assessment including transvaginal ultrasound with morphological scoring, colour doppler assessment of vascular quality, and serum cancer antigen 125 (CA 125) level is desirable. OBJECTIVES: To determine the benefits, harms, and cost of laparoscopy or minilaparotomy compared with laparotomy in women with benign ovarian tumours. SEARCH STRATEGY: We searched electronic databases, trial registers, and reference lists of published trial reports. Reference lists from trials and review articles were searched. SELECTION CRITERIA: All randomised controlled trials comparing either laparoscopy or minilaparotomy with laparotomy for benign ovarian tumours. DATA COLLECTION AND ANALYSIS: Eight review authors independently assessed the eligibility and quality of each study and extracted the data. MAIN RESULTS: The results of nine randomised controlled trials (N = 482 women) showed that laparoscopic surgery was associated with fewer adverse events of surgery (surgical injury or postoperative complications including fever or infection) (OR 0.3, 95% CI 0.2 to 0.5), less postoperative pain (VAS score WMD -2.4, 95% CI -2.7 to -2.0), greater likelihood of being pain free after two days (OR 7.42, 95% CI 4.86 to 11.33), and fewer days in hospital (WMD -2.88, 95% CI -3.1 to -2.7) than with laparotomy.In one study that reported costs, laparoscopy was associated with a significant reduction in costs compared to laparotomy (WMD - USD 1045, 95% CI -1348 to -742) in 1993. Very high levels of heterogeneity made it inappropriate to pool data on duration of surgery.Three RCTs compared laparoscopy versus minilaparotomy and found that laparoscopy was associated with reduced odds of any adverse event (surgical injury or postoperative complications) (OR 0.10, 95% CI 0 to 0.8) and lower VAS scores for pain (WMD -1.0, 95% CI -1.6 to -0.45). Duration of hospital stay ranged between 1 and 2.2 days, with substantial heterogeneity. AUTHORS' CONCLUSIONS: In women undergoing surgery for benign ovarian tumours, laparoscopy was associated with a reduction in fever, urinary tract infection, postoperative complications, postoperative pain, number of days in hospital, and total cost. These findings should be interpreted with caution since only a small number of studies were identified. These included a total of only 769 women and not all of the important outcomes were reported in each study.

Fluoride characterization by principal component analysis in the hydrochemical facies of Serra Geral Aquifer System in Southern Brazil

Principal component analysis is applied to 309 groundwater chemical data information from wells in the Serra Geral Aquifer System. Correlations among seven hydrochemical parameters are statistically examined. A four-component model is suggested and explains 81 percent of total variance. Component 1 represents calcium-magnesium bicarbonated groundwaters with long time of residence. Component 2 represents sulfated and chlorinated calcium and sodium groundwaters; Component 3 represents sodium bicarbonated groundwaters; and Component 4 is characterized by sodium sulfated with high fluoride facies. The components' spatial distribution shows high fluoride concentration along analyzed tectonic fault system and aligned on northeast direction in other areas, suggesting other hydrogeological fault systems. High fluoride concentration increases according to groundwater pumping depth. The Principal Component Analysis reveals features of the groundwater mixture and individualizes water facies. In this scenery, it can be determined hydrogeological blocks associated with tectonic fault system here introduced.

A Análise de Componentes Principais foi aplicada em 309 dados químicos de águas subterrâneas de poços do Sistema Aqüífero Serra Geral. Correlações entre sete parâmetros hidroquímicos foram examinadas através da estatística. O modelo de quatro componentes foi utilizado por explicar 81 por cento da variância total. A Componente 1 é representada por águas cálcio-magnesianas com longo tempo de residência, a Componente 2 representa águas bicarbonatadas sulfatadas e cloretadas, a Componente 3 representa águas bicarbonatadas sódicas e a Componente 4 é caracterizada por águas de fácies sódica e sulfatada com alto fluoreto. A distribuição espacial das componentes mostra águas com concentrações anômalas ao longo dos sistemas tectônicos de falhas, analisados e alinhados a NE em algumas áreas, sugerindo outros sistemas de falhas hidrogeológicos. As concentrações de fluoreto aumentam de acordo com a profundidade de bombeamento das águas. A Análise de Componentes Principais revelou feições de mistura e individualizou diferentes fácies de águas subterrâneas. Neste cenário, é possível determinar blocos hidrogeológicos associados com os sistemas tectônicos de falhas introduzidos no presente trabalho.

Fluoride characterization by principal component analysis in the hydrochemical facies of Serra Geral Aquifer System in Southern Brazil.

Principal component analysis is applied to 309 groundwater chemical data information from wells in the Serra Geral Aquifer System. Correlations among seven hydrochemical parameters are statistically examined. A four-component model is suggested and explains 81% of total variance. Component 1 represents calcium-magnesium bicarbonated groundwaters with long time of residence. Component 2 represents sulfated and chlorinated calcium and sodium groundwaters; Component 3 represents sodium bicarbonated groundwaters; and Component 4 is characterized by sodium sulfated with high fluoride facies. The components' spatial distribution shows high fluoride concentration along analyzed tectonic fault system and aligned on northeast direction in other areas, suggesting other hydrogeological fault systems. High fluoride concentration increases according to groundwater pumping depth. The Principal Component Analysis reveals features of the groundwater mixture and individualizes water facies. In this scenery, it can be determined hydrogeological blocks associated with tectonic fault system here introduced.

Correlation between drug treatment adherence and lithium treatment attitudes and knowledge by bipolar patients.

BACKGROUND: Non-adherence should always be investigated when there is a failure in bipolar treatments, since it is known that reported non-adherence rates in bipolar disorder treatment for long-term prophylactic pharmacotherapy range from 18% to 52%, with a median prevalence of 44.7%. Several factors are related to the poor adherence and reduction of medication efficiency, such as the different types of bipolar disorder, the presence of side effects, medication interactions, level of patient's knowledge about the disorder and their attitude towards treatment, complexity of medical regimens and the doctor-patient relationship. METHODS: Bipolar disorder outpatients under lithium treatment from the Hospital de Clínicas and Materno Infantil Presidente Vargas of Porto Alegre were recruited. All the patients had bipolar disorder and gave informed consent to participate in a clinical interview (106), answered the Lithium Attitudes Questionnaire (LAQ), Lithium Knowledge Test (LKT), Medication Adherence Rating Scale (MARS) and had plasma and red blood cells lithium measurements to assess their medication adherence and the factors that influenced it. RESULTS: 85.6% of bipolar disorder were adherent to lithium treatment showing plasma lithium between 0.6 and 1.2 mmol/L. There was an inverted correlation between the total LAQ score with plasma and red blood cells, a positive correlation between LKT and MARS with plasma and red blood cell lithium. CONCLUSION: These results confirmed that knowledge level is directly correlated to treatment adherence and patients' attitudes, lower adherence, general opposition to prophylaxis, fear of side effects, denial of therapeutic effectiveness and illness severity.

Decreases in procalcitonin and C-reactive protein are strong predictors of survival in ventilator-associated pneumonia.

INTRODUCTION: This study sought to assess the prognostic value of the kinetics of procalcitonin (PCT), C-reactive protein (CRP) and clinical scores (clinical pulmonary infection score (CPIS), Sequential Organ Failure Assessment (SOFA)) in the outcome of ventilator-associated pneumonia (VAP) at an early time point, when adequacy of antimicrobial treatment is evaluated. METHODS: This prospective observational cohort study was conducted in a teaching hospital. The subjects were 75 patients consecutively admitted to the intensive care unit from October 2003 to August 2005 who developed VAP. Patients were followed for 28 days after the diagnosis, when they were considered survivors. Patients who died before the 28th day were non-survivors. There were no interventions. RESULTS: PCT, CRP and SOFA score were determined on day 0 and day 4. Variables included in the univariable logistic regression model for survival were age, Acute Physiology and Chronic Health Evaluation (APACHE) II score, decreasing DeltaSOFA, decreasing DeltaPCT and decreasing DeltaCRP. Survival was directly related to decreasing DeltaPCT with odds ratio (OR) = 5.67 (95% confidence interval 1.78 to 18.03), decreasing DeltaCRP with OR = 3.78 (1.24 to 11.50), decreasing DeltaSOFA with OR = 3.08 (1.02 to 9.26) and APACHE II score with OR = 0.92 (0.86 to 0.99). In a multivariable logistic regression model for survival, only decreasing DeltaPCT with OR = 4.43 (1.08 to 18.18) and decreasing DeltaCRP with OR = 7.40 (1.58 to 34.73) remained significant. Decreasing DeltaCPIS was not related to survival (p = 0.59). There was a trend to correlate adequacy to survival. Fifty percent of the 20 patients treated with inadequate antibiotics and 65.5% of the 55 patients on adequate antibiotics survived (p = 0.29). CONCLUSION: Measurement of PCT and CRP at onset and on the fourth day of treatment can predict survival of VAP patients. A decrease in either one of these marker values predicts survival.

The Portuguese language version of social phobia and Anxiety Inventory: analysis of items and internal consistency in a Brazilian sample of 1,014 undergraduate students

Objective: theoretical and empirical analysis of items and internal consistency of the Portuguese-language version of Social Phobia and Anxiety Inventory (SPAI-Portuguese). Methods: social phobia experts conducted a 45-item conted analysis of the SPA-Portuguese administered to a sample of 10.14 university students. Item discrimination was evaluated by Student's t test; inter-item, mean and item-to-total correlations, by Pearson coefficient; reliability was estimated by Cronbach´s alpha. Results: there was 100 porcent agreement among experts conserning the 45 items. On the SPAI-Portuguese 43 items were discriminative (p<0,05). A few inter-item correlations between both subscales were below 0,2. The mean inter-item correlation were: 0,41 on social phobia subscale; 0.32 on agoraphobia subscale and 0,32 on the SPAI-Portuguese. Item-to-total correlation werw all higher then 0.3(p<0,001). Cronbach´s alphas were: 0.95 on the SPAI-Portuguese; 0.96 on social phobia subscale; 0.85 on agoraphobia subscale. Conclusion: the 45-item content analysis revealed appropriateness conserning the underlynig construct of the SPAI-Portuguese (social phibia, agoraphobia) with good discriminative capacity on 43 items. The mean inter-item correlations and reliability coeficients demonstrated the SPAI-Portuguese and subscales internal consistency and multdimensionality. No item was suppressed in the SPAI-Portuguese but the authors suggest that a shortened SPAI, in its diferent versions, could be an even more useful tool for research settings in social phobia.

Desenvolvimento da versão em português do Social Phobia and Anxiety Inventory (SPAI) / Development of the Brazilian Portuguese-language version of the Social Phobia and Anxiety Inventory (SPAI)

OBJETIVO: O objetivo do estudo foi desenvolver a versão em português do Social Phobia and Anxiety Inventory (SPAI), adaptada à cultura brasileira. MÉTODOS: Após aprovação de seus autores, foram realizadas: a) tradução, retrotradução e discussão entre os tradutores e os autores norte-americanos para elaboração de versão final do SPAI Português; b) validade de face por avaliação de peritos; c) equivalência lingüística através de estudo da correlação entre teste e o reteste dos escores das versões em português e inglês, aplicados alternadamente, em amostra de 18 voluntários bilíngües, ambos os gêneros e d) estudo de praticidade (aceitabilidade) e utilidade (aplicabilidade) do SPAI Português através das taxas de adesão e de preenchimento inadequado em amostra populacional de 365 universitários, ambos os gêneros. RESULTADOS: A versão final do SPAI Português apresenta equivalência lingüística, semântica e técnica, e validade de face plenamente satisfatórias. A equivalência lingüística foi testada através dos coeficientes de correlação de Pearson e intraclasse para o escore diferencial (total) de 0,87 (IC 95 por cento 0,64-0,96) 0,87 (IC 95 por cento 0,63-0,95), respectivamente (p < 0,0001). O percentual de adesão ao SPAI Português foi de 95,7 por cento da amostra estudada (n = 365). Entre os respondentes (n = 347), a taxa de preenchimento inadequado foi de 4 por cento, 14 indivíduos. CONCLUSÕES: Demonstrou-se a adequação da tradução para o português do SPAI. A validade de face do SPAI Português foi considerada plenamente satisfatória. Os resultados de praticidade e utilidade recomendam seu uso como escala de rastreamento de fobia social em amostras brasileiras de bom nível educacional, após estudos de validação em amostras brasileiras.

A interaçäo social na brincadeira de faz-de-conta: uma análise da dimensäo metacomunicativa / Social interaction in pretend play: a metacommunicative analysis

Metacomunicaçäo e organizaçäo do grupo foram investigadas na brincadeira social de faz-de-conta com 12 tríades de crianças com média de 5 anos e 2 meses. Cada tríade brincou por 10 minutos, aleatoriamente com brinquedos ou sucata, numa sala da própria pré-escola. As sessöes de brinquedo foram filmadas e as verbalizaçöes das crianças transcritas, tendo sido codificadas as categorias de metacomunicaçäo e de organizaçäo de grupo presentes durante 10 minutos. As análises usando modelos log-lineares e de correspondência indicaram que tanto meninos quanto meninas brincaram mais tempo em trios do que em duplas e que as categorias metacomunicativas escolhidas pelas crianças variaram conforme brincassem com sucata ou com brinquedos. Tais resultados säo discutidos em termos dos padröes metacomunicativos emergentes na análise: com sucata, as crianças precisaram transformar o contexto inespecífico e comunicar uma às outras tais transformaçöes e, com brinquedos, agiram conforme o padräo de açäo tradicionalmente relatado na literatura para meninos e meninas. O espaço virtual de interaçäo foi o que sustentou a interaçäo triádica entre as crianças, sendo papel da metacomunicaçäo mantê-lo

A interacao social na brincadeira de faz-de-conta: uma analise da dimensao metacomunicativa

Metacomunicacao e organizacao do grupo foram investigadas na brincadeira social de faz-de-conta em 12 triades de criancas com media de idade de 5 anos e 2 meses. Cada triade brincou por 10 minutos, aleatoriamente com brinquedos ou sucata, numa sala da propria pre-escola. As sessoes de brinquedo foram filmadas e as verbalizacoes das criancas transcritas, tendo sido codificadas as categorias de metacomunicacao e de organizacao do grupo presentes durante 10 minutos. As analises usando modelos log-lineares e de correspondencia indicaram que tanto meninos quanto meninas brincaram mais tempo em trios do que em duplas e que as categorias metacomunicativas escolhidas pelas criancas variaram conforme brincassem com sucata ou com brinquedos. Tais resultados sao discutidos em termos dos padroes metacomunicativos emergentes na analise: com sucata, as criancas precisaram transformar o contexto inespecifico e comunicar umas as outras tais transformacoes e, com brinquedos, agiram conforme o padrao de acao tradicionalmente relatado na literatura para meninos e meninas. O espaco virtual de interacao foi o que sustentou a interacao triadica entre as criancas, sendo papel da metacomunicacao mante-lo.