[Medical audit: prenatal care program in a health center in Southern Brazil]. / Auditoria médica: programa de pré-natal em posto de saúde na região Sul do Brasil.

INTRODUCTION: A medical audit on the prenatal care program in the Vila Municipal Health Center, Pelotas, RS, Brazil, was described with the purpose of verifying the aspects of the medical process and improving the program's effectiveness. METHODS: Data from prenatal specific records were collected. Pregnant women with delivery due date in 1997 and in the first semester of 1998 were included in the study. Women registered in the program when they were 4-month pregnant and who had had at least 5 visits were also enrolled. Bivariate analysis was used to detect health care indicators. RESULTS: A total of 73 pregnant women were registered in the program in 1997 and 75 in 1998. In 1997, the average number of medical visits was 5.2, while in 1998 this average was 6.2. The difference between the means was statistically significant (p<0.05). Some medical process indicators were analysed to verify the quality of the care. CONCLUSION: The use of the epidemiological method to organize health services was discussed. This type of study requires few resources and time and it can provide guidelines to health service actions.

Contractions induced by sodium withdrawal in crab (Callinectes danae) muscle fibres.

A study was made of the effects of Na removal on the resting tension of single muscle fibres of the crab Callinectes danae. Reduction of [Na]o (replacement with Li, Tris or choline) below a threshold value, typical for each fibre, induced spontaneous, local contractions randomly dispersed along the fibres; this was followed by propagated contractile waves and tension oscillations. Sustained contractures were occasionally seen at threshold [Na]o and were consistently observed when [Na]o was further reduced. The Na withdrawal contractions depended on [Ca]o and were abolished in Ca-free media; they were restored within seconds after the addition of Ca (3-12 mM) or Sr (15-25 mM), but not Ba (10-100 mM), to the media. Caffeine (0.2-1.0 mM) facilitated, whereas La (2-5 mM), procaine (1 mM) or lidocaine (10 mM) inhibited the Na-withdrawal contractions. It is concluded that increased Ca influx across the sarcolemma and release of stored Ca from the sarcoplasmic reticulum are involved in the contractions induced by Na-deficient solutions in crab fibres.