In vitro comparison of one-step, two-step, and three-step polishing systems on the surface roughness and gloss of different resin composites.

OBJECTIVES: This laboratory study evaluated the effect of three polishing systems on the surface roughness and gloss of resin composites. MATERIALS AND METHODS: Thirty specimens (6 mm Ø × 8 mm) were fabricated from each of three resin composites: Z 350 XT (nanofill), Harmonize (nanohybrid), and Estelite Omega (supranonofill). All specimens were photopolymerized using a multi-peak LED curing unit (VALO-Standard mode), having a exitance irradiance of approximately 1000 mW/cm2 against a polyester strip (PS). 2 mm was then removed from the irradiated end (finished) using #320 abrasive paper (F). Specimens were then randomly polished (P) using a one-step (1S) (OneGloss), two-step (2S) (EVE Diacomp Twist Basic CA), or 3-step (3S) (Astropol P) system (n = 10). For PS, F, and P groups, surface roughness (Ra) was measured using a surface roughness tester, and surface gloss was measured with a glossmeter. For each specimen, the percent recovery to the PS value (%R) of surface roughness and surface gloss were calculated. Data were analyzed using two-way ANOVA, followed by Tukey's test. Surface roughness and gloss values were submitted to Pearson's correlation test (α = 0.05). All statistical testing was performed using a pre-set alpha of 0.05. RESULTS: The interaction term [resin composite × polishing system] was significant for both surface roughness (p = 0.001) and gloss (p = 0.0001). For all resin composites, the 2S and 3S systems provided a higher %R of surface roughness and gloss compared to those of the 1S system. There was a negative correlation between surface roughness and gloss, but only a few combinations showed strong correlations. CONCLUSIONS: The 2S and 3S polishing systems provided surfaces having greater smoothness and gloss compared to the 1S system. The ability to recover surface roughness and gloss was dependent on type of resin composite filler classification. CLINICAL SIGNIFICANCE: The 3S and 2S polishing systems were more effective in achieving PS values than was the 1S system for all tested resin composites. However, individual polishing systems performed differently depending on type of resin composite.

Expansion of the Distance Modality in Brazilian Higher Education: Implications for Quality and Equity.

With globalization and the knowledge society, the expansion of higher education has become an 'object of desire' among governments to bolster both economic growth and social development. In recent decades, just as in other countries, Brazil has expanded the system and become the fourth largest in the world in enrollment numbers, significantly increasing distance education at for-profit private institutions. However, massification without the necessary attention to quality and equity may present undesired consequences. Thus, considering Brazil has created one of the largest information databases that allow for studies with huge samples, we statistically analyzed performance in a wide scale national examination (Enade) with approximately 222,000 students, disaggregated by background and education modalities. The results back the argument that learning possibilities and performance in distance education are inferior in relation to in-person modalities and that the expansion based on distance education at for-profit private institutions may be reproducing inequalities within the higher education system in one of the most unequal nations in the world.

Effect of gastric acid on the surface roughness and bacterial adhesion of bulk-fill composite resins.

The purpose of this in vitro study was to evaluate the effect of gastric acid on the surface roughness and biofilm formation of bulk-fill composite resins. Twenty-seven samples of each composite resin were obtained: G1: Filtek Z250 XT (Z250), G2: Filtek Bulk Fill (FTK), G3: Tetric N-Ceram Bulk Fill (TTC), and G4: Aura Bulk Fill (AUR). The samples were quantitatively analyzed for surface roughness (Ra) using a roughness tester (n=15) and for biofilm formation (Cn) by the counting of colony-forming units (CFUs/mL) (n=9) in three different moments: after polishing (Ra0 and Cn0), after gastric acid immersion (Ra1 and Cn1), and after gastric acid and simulated tooth brushing (Ra2 and Cn2). Qualitative analysis through surface topography (n=3) was evaluated by scanning electron microscopy (SEM). Ra values were subjected to two-way repeated measures ANOVA, followed by Tukey's test. Cn values were subjected to Kruskal-Wallis analysis, followed by multiple comparisons analysis (α=0.05). Z250 and FTK showed significant increases in surface roughness at Ra1. There were fewer CFUs/mL on TTC and AUR in relation to those of Z250 and FTK for Cn0, Cn1 and Cn2. The SEM images showed that gastric acid increased the formation of cracks, exposure of fillers and micro cavities for all composite resins. After tooth brushing, the topographical changes were more evident but did not influence biofilm formation. The gastric acid promoted both degradation of the surfaces and bacterial adhesion for all composite resins.

Effect of gastric acid on the surface roughness and bacterial adhesion of bulk-fill composite resins

Abstract The purpose of this in vitro study was to evaluate the effect of gastric acid on the surface roughness and biofilm formation of bulk-fill composite resins. Twenty-seven samples of each composite resin were obtained: G1: Filtek Z250 XT (Z250), G2: Filtek Bulk Fill (FTK), G3: Tetric N-Ceram Bulk Fill (TTC), and G4: Aura Bulk Fill (AUR). The samples were quantitatively analyzed for surface roughness (Ra) using a roughness tester (n=15) and for biofilm formation (Cn) by the counting of colony-forming units (CFUs/mL) (n=9) in three different moments: after polishing (Ra0 and Cn0), after gastric acid immersion (Ra1 and Cn1), and after gastric acid and simulated tooth brushing (Ra2 and Cn2). Qualitative analysis through surface topography (n=3) was evaluated by scanning electron microscopy (SEM). Ra values were subjected to two-way repeated measures ANOVA, followed by Tukey's test. Cn values were subjected to Kruskal-Wallis analysis, followed by multiple comparisons analysis (α=0.05). Z250 and FTK showed significant increases in surface roughness at Ra1. There were fewer CFUs/mL on TTC and AUR in relation to those of Z250 and FTK for Cn0, Cn1 and Cn2. The SEM images showed that gastric acid increased the formation of cracks, exposure of fillers and micro cavities for all composite resins. After tooth brushing, the topographical changes were more evident but did not influence biofilm formation. The gastric acid promoted both degradation of the surfaces and bacterial adhesion for all composite resins.

Resumo O objetivo deste estudo in vitro foi avaliar o efeito do ácido gástrico na rugosidade superficial e na formação do biofilme nas resinas compostas de incremento único. Vinte e sete amostras de cada resina composta foram confeccionadas: G1: Filtek Z250 XT (Z250), G2: Filtek Bulk Fill (FTK), G3: Tetric N-Ceram Bulk Fill (TTC), and G4: Aura Bulk Fill (AUR). As amostras foram analisadas quantitativamente quanto à rugosidade da superfície (Ra) usando um rugosímetro (n=15) e para formação de biofilme (Cn) pela contagem de unidades formadoras de colônias (UFC/mL) (n=9) em três diferentes momentos: após polimento (Ra0 and Cn0), após imersão em ácido gástrico (Ra1 and Cn1), e após ácido gástrico e simulação de escovação (Ra2 and Cn2). Análise qualitative da topografia superficial (n=3) foi avaliada por meio de microscopia eletrônica de varredura (MEV). Os valores de Ra foram analisados pela ANOVA de duas vias para amostras pareadas, seguido do teste de Tukey. Os valores de Cn foram submetidos ao teste de Kruskal-Wallis, seguido da análise de comparações múltiplas (α=0,05). Z250 e FTK tiveram aumento significativo na rugosidade superficial em Ra1. Houve menos CFUs/mL para TTC e AUR em relação à Z250 e FTK em Cn0, Cn1 and Cn2. As imagens em MEV mostraram que o ácido gástrico aumentou a formação de fendas, exposição das partículas e mcrocavidades para todas as resinas compostas. Após escovação, as mudanças topográficas foram mais evidentes, mas não influenciou na formação do biofilme. O ácido gástrico promoveu degradação da superfície e adesão bacteriana para todas as resinas compostas.

Immediate dentin sealing influences the fracture strength of ultrathin occlusal veneers made of a polymer-infiltrated ceramic network.

OBJECTIVE: The objective of this laboratory study was to assess the effect of immediate dentin sealing (IDS) on the fracture strength of teeth restored with ultrathin occlusal veneers made of a polymer-infiltrated ceramic network (PICN - Vita Enamic) with different fissure/cusp thicknesses. METHODS: Forty third molars were identically prepared in the dentin and allocated into four groups (n = 10) according to the fissure/cusp thickness of the occlusal veneers (0.3/0.6 mm or 0.6/0.9 mm) and the application or not of the IDS technique. Ten sound third molars were used as the control group. IDS was performed using a universal adhesive system (Single Bond Universal). The prepared teeth were scanned (Cerec software, version 4.1), and the occlusal veneers were shaped following the occlusal anatomy of a right second molar. Blocks of PICN were milled in the unit inLab MC XL. Following luting with Single Bond Universal and RelyX Ultimate, the fracture strength of the specimens was obtained with a universal testing machine. The fractures were classified as reparable or irreparable. Fracture strength values were analyzed with 2-way and 1-way ANOVA (α = 0.05) and Tukey's test. RESULTS: Only the IDS factor was significant (p = 0.001). The teeth restored with IDS (2875 ± 508 N) achieved significantly higher fracture strength than the teeth restored without IDS (2263 ± 354 N) (p < 0.05). The fracture strength of the specimens with IDS did not differ significantly from that of the sound teeth (3230 ± 620 N). The fractures were predominantly reparable. CONCLUSION: IDS improved the fracture strength of ultrathin occlusal veneers made of PICN.

Schistosoma mansoni miracidia: revisiting motility and survival parameters for improved computational modelling.

Schistosoma mansoni is the main causative agent of intestinal schistosomiasis which affects millions of people worldwide. At the larval stage, miracidia are released into bodies of water where they utilize their motility to successfully infect their intermediate host, snails. Here, we revisit the motility and survival of S. mansoni miracidia throughout its life span. Briefly, miracidia motility was monitored at 30-min and 60-min intervals under the presence/absence of natural/artificial light. Based on a subjective evaluation of activity, body shape and transparency, 6 categories of miracidia activity were established from its fully active stage to its immobile larva stage. The estimated life span of miracidia was 5.8 and 3.5 h in the experiments with 60-min and 30-min observation intervals, respectively. Death was defined by an absence of cilia and body movement. When mobility was used as a proxy for infectivity, infective miracidia were detected at 2.5 and 4.5 h, respectively. The present miracidia motility and survival re-evaluation supports parameters optimization for computational modelling of schistosomiasis transmission dynamics. Target control interventions, especially at late stages next to transmission interruption, may greatly benefit from improved modelling studies.

Use of Schistosoma mansoni soluble egg antigen (SEA) for antibody detection and diagnosis of schistosomiasis: The need for improved accuracy evaluations of diagnostic tools.

Many antigens for use in antibody-detection systems for schistosomiasis have been investigated over the past 40 years. In particular, soluble egg antigens (SEA) are still widely used in enzyme-linked immunosorbent assays (ELISAs) for detection of immunoglobulin classes and subclasses. Here, we conducted a literature review to examine accuracy evaluations of SEA-Immunoglobulin G (IgG)-ELISAs performed to detect Schistosoma mansoni infections and published between 1979 and 2019. S. mansoni is the main causative agent for intestinal schistosomiasis in many countries in Africa and Central and South America. After retrieving 214 relevant abstracts from the PubMed database, we selected 15 publications to undergo a full review. Sensitivity and specificity values varied from 71 to 99%, and from 6 to 100%, respectively. In addition, 11/15 studies did not state confidence intervals. Therefore, the findings from this review indicate that after four decades, we still do not have consistent evaluation estimates of SEA-IgG-ELISAs. Antigen mass per well and dilution of test sera in these articles varied from 0.018 µg to 1.5 µg, and from 1:50 to 1:500, respectively. Most of the reported accuracy evaluations used control sera which were selected based on parasitological examinations for egg detection, although ill-defined criteria were also noted. The number and composition of control serum panels was considered not adequate in approximately half of the studies. It is also noteworthy that among more than 30 diagnostic antigen preparations under development since the 1970s, most were not validated in the field and they failed to reach populations in need. Thus, attention to guidelines for standardization, estimations of accuracy, and reporting of results is needed to facilitate coordinated efforts aimed at schistosomiasis control and elimination.

Fracture load of CAD/CAM ultrathin occlusal veneers luted to enamel or dentin.

OBJECTIVES: To evaluate, in vitro, the fracture load of IPS e.max CAD occlusal veneers at thicknesses of either 0.3 or 0.6 mm luted to enamel or dentin. MATERIALS AND METHODS: Fifty human molars were randomly distributed into five groups (n = 10): G1 - healthy teeth (control); G2-0.3-mm-thick veneers luted to enamel; G3-0.6-mm-thick veneers luted to enamel; G4-0.3-mm-thick veneers luted to dentin; and G5-0.6-mm-thick veneers luted to dentin. After the luting procedures, the specimens were immersed in distilled water at 37°C for 24 hours and then subjected to mechanical loading (106 cycles at 200 N load). The specimens were subjected to a fracture load test in a universal testing machine. Two-way ANOVA and Tukey's test (α = 0.05) were used to analyze data. RESULTS: Only the thickness factor was significant (P = .002). Values of fracture load followed by distinct letters represent significant differences (P < .05): G1 (3204 N ± 730)ab ; G2 (3144 N ± 729)ab ; G3 (2489 N ± 606)b ; G4 (3591 N ± 776)a ; and G5 (2770 N ± 598)ab . CONCLUSION: IPS e.max ultrathin occlusal veneers luted to enamel or dentin obtained fracture load comparable to that of the healthy tooth. CLINICAL SIGNIFICANCE: IPS e.max CAD ultrathin occlusal veneers at 0.3 or 0.6-mm-thick seem to provide good perspectives in relation to the clinical use.

Análise dos fatores associados à decisão familiar sobre a doação de córneas / Analysis of factors associated with family decision on corneal donation

Resumo Objetivo: analisar a influência da escolaridade e do grau de parentesco na decisão familiar pela doação de córneas para transplantes. Método: desenho quantitativo, transversal e retrospectivo com amostra composta por 291 fichas das entrevistas realizadas com familiares de potenciais doadores de córneas de janeiro de 2015 a dezembro de 2017 de um hospital público, geral e de grande porte localizado no município de Porto Alegre, Rio Grande do Sul, Brasil. Resultados: entre os potenciais doadores deste tecido, 53,3% são do sexo masculino com idade média de 57 anos (57±11); 55,7% são casados e o turno mais frequente da ocorrência do óbito é o noturno com 29,6% dos casos. Em relação à decisão familiar, 60,8% dos entrevistados decidiram favoravelmente à doação. Existe associação entre doação e turno da entrevista, sendo a madrugada o menos favorável (p=0,04). O tempo médio entre o óbito e a realização da entrevista é de 1:39 (±1:20) e não influenciou na decisão familiar (p=0,63). Dos familiares entrevistados, 58,8% são do sexo feminino e 53,3% são descendentes do potencial doador. O parentesco descendente decide sobre a doação com maior frequência do que ascendentes, laterais ou cônjuges. A faixa etária do familiar entrevistado (41±13) tem diferença estatística em relação a do potencial doador. Há diferença entre decisão de doação e nível de escolaridade (p=0,03) sendo que familiares com maior escolaridade decidem com maior frequência favoravelmente a doação. Conclusões: escolaridade do familiar, grau de parentesco e turno da entrevista influenciam na decisão positiva para a doação de córneas para transplantes.

Abstract Objective: analyzing the influence of schooling and kinship on families' decision to donate corneas for transplants. Method: quantitative, cross-sectional and retrospective study whose sample comprised 291 records of interviews conducted with family members of potential corneal donors from January 2015 to December 2017, who were treated in a public, general and large-sized hospital in Porto Alegre City, Rio Grande do Sul State, Brazil. Results: 53.3% of the potential corneal donors were male at mean age of 57 years (57 ± 11); 55.7% were married and 29.6% of them died during the night shift, which was the shift when death took place more often. With respect to families' decision, 60.8% of interviewees decided for donation. There was association between donation and interview shift; dawn was the least favorable time (p = 0.04). The mean time between patients' death and the interview with family members was 1:39 (± 1: 20) and it did not influence families' decision (p = 0.63). Among the interviewed family members, 58.8% were women and 53.3% were descendants of the potential donor. Descendants decide about the donation more often than ascendants, siblings or spouses. The age group of the interviewed family members (41 ± 13) was statistically different from that of potential donors. There was association between schooling and decision to donate (p = 0.03); family members with higher schooling were more often favorable towards donation. Conclusions: Family members' schooling, degree of kinship and interview shift had positive influence on individuals' decision to donate corneal tissue for transplants.

Criteria for identification of Schistosoma mansoni eggs in faecal sediments prepared with the Helmintex method and stained by ninhydrin.

Helmintex is a sensitive method used for detecting Schistosoma mansoni eggs. Here, we describe the observed frequency of six proposed criteria associated with the identification of S. mansoni eggs prepared with the Helmintex method and stained with ninhydrin. The efficacy of these criteria in classifying S. mansoni eggs when applied in various combinations was also examined. Nine observers registered the presence or absence of 6 different criteria in 100 eggs using a microscope at 100x magnification. Ninhydrin purple, which was frequently observed, was the criterion associated with the lowest inter-observer variability. At least three criteria were associated with a significantly better performance in egg identification. In conclusion, ninhydrin staining and a combination of criteria are recommended for microscope examination of faecal sediments.

Evaluation of the Use of a Force Diagram in the Management of Temporomandibular Joint Sounds: A Prospective Cross-sectional Study.

CONTEXT: Occlusal splints are widely used in clinical practice as a noninvasive treatment for patients with temporomandibular disorders (TMDs) and for reduction of TMD-related symptoms. A force diagram allows a health care professional to evaluate the interactions of loads caused by muscular effort, which are sensed by the teeth and the temporomandibular joint during the protrusive movement of the mandible. OBJECTIVE: To evaluate the efficacy of occlusal splints combined with occlusal adjustment (OA) based on a force diagram in the management of joint sounds (clicking and crepitation). METHODS: Patients were examined clinically and administered a questionnaire for the diagnosis of TMD and orofacial pain. Patients were then assigned to 1 of 2 splint therapies: (1) an anterior bite plane of the front-plateau type (FP) or (2) a maxillary muscle relaxation appliance (MRA), both combined with OA based on a force diagram performed at 6 visits, with an interval of 24 to 48 hours between each visit. To measure the effects of treatment, at each of the 6 visits, patients also rated the severity of their TMD-related symptoms on a visual analog scale. Data were dichotomized into presence and absence of symptoms and compared using the McNemar test. RESULTS: A total of 199 patients were included in the study. At baseline, 38 patients (19.1%) had crepitation and 161 (80.9%) had clicking. A total of 150 patients were treated with FP+OA, with a statistically significant reduction in the number of patients reporting clicking (42.6%, P<.001) and crepitation (42.9%, P<.001). Among patients treated with MRA+OA (n=49), there was a statistically significant reduction in the number of patients reporting clicking (50%, P<.001). All 3 patients with crepitation in the MRA+OA group reported total remission (P>.05). CONCLUSION: The 2 treatment strategies, FP+OA and MRA+OA, improved both clicking and crepitation. Both strategies prioritize the concept of mutually protected occlusion, in which all jaw and temporomandibular joint movements must synchronize, which may be conveniently done using the force diagram.

Criteria for identification of Schistosoma mansoni eggs in faecal sediments prepared with the Helmintex method and stained by ninhydrin

Helmintex is a sensitive method used for detecting Schistosoma mansoni eggs. Here, we describe the observed frequency of six proposed criteria associated with the identification of S. mansoni eggs prepared with the Helmintex method and stained with ninhydrin. The efficacy of these criteria in classifying S. mansoni eggs when applied in various combinations was also examined. Nine observers registered the presence or absence of 6 different criteria in 100 eggs using a microscope at 100x magnification. Ninhydrin purple, which was frequently observed, was the criterion associated with the lowest inter-observer variability. At least three criteria were associated with a significantly better performance in egg identification. In conclusion, ninhydrin staining and a combination of criteria are recommended for microscope examination of faecal sediments.

Study of diagnostic accuracy of Helmintex, Kato-Katz, and POC-CCA methods for diagnosing intestinal schistosomiasis in Candeal, a low intensity transmission area in northeastern Brazil.

Control initiatives have successfully reduced the prevalence and intensity of schistosomiasis transmission in several localities around the world. However, individuals that release low numbers of eggs in their feces may not be detected by classical methods that are limited by low sensitivity. Given that accurate estimates of prevalence are key to implementing planning control actions for the elimination of schistosomiasis, new diagnostic tools are needed to effectively monitor infections and confirm transmission interruption. The World Health Organization recommends the Kato-Katz (KK) thick smear as a parasitological test for epidemiological surveys, even though this method has been demonstrated to underestimate prevalence when egg burdens are low. The point-of-care immunodiagnostic for detecting schistosome cathodic circulating antigen (POC-CCA) method has been proposed as a more sensitive substitute for KK in prevalence estimations. An alternative diagnostic, the Helmintex (HTX) method, isolates eggs from fecal samples with the use of paramagnetic particles in a magnetic field. Here, a population-based study involving 461 individuals from Candeal, Sergipe State, Brazil, was conducted to evaluate these three methods comparatively by latent class analysis (LCA). The prevalence of schistosomiasis mansoni was determined to be 71% with POC-CCA, 40.% with HTX and 11% with KK. Most of the egg burdens of the individuals tested (70%) were < 1 epg, thereby revealing a dissociation between prevalence and intensity in this locality. Therefore, the present results confirm that the HTX method is a highly sensitive egg detection procedure and support its use as a reference method for diagnosing intestinal schistosomiasis and for comparative evaluation of other tests.

Termos Mentais na Contação de Histórias e a Teoria da Mente das Crianças / Mental Terms in the Context of Telling Stories and Children's Theory of Mind

RESUMO A literatura destaca a potencialidade das histórias para favorecer conversas sobre estados mentais, aspectos que contribuem para o desenvolvimento da teoria da mente. O objetivo deste estudo é verificar a relação entre a teoria da mente e o discurso narrativo de mães quanto ao emprego de termos mentais, no contexto da contação de histórias. A amostra foi constituída por 25 duplas de mães e crianças, de nível socioeconômico médio, tendo as crianças idades entre quatro e cinco anos. Os resultados mostraram que o emprego de cognições clarificadas pelas mães em suas narrativas apresenta relação significativa com a teoria da mente das crianças. A contação de histórias parece desempenhar um papel interessante na estimulação da conversação sobre termos mentais e, assim, no desenvolvimento sociocognitivo infantil.

ABSTRACT The literature highlights the potentiality of stories in favoring conversations about mental states, aspects that contribute to the development of a theory of mind. The aim of this study is to evince the relationship between a theory of mind and mothers' narrative discourse as regards to the use of mental terms in the context of telling stories. Twenty-five middle-class mothers and their four to five old children composed the dyads used as sample. Results showed that the mothers' use of clarifying cognitions in their narratives related significantly with the children's theory of mind. Telling stories seems to be an effective tool to stimulate the conversation about mental states, thereby resulting in the social cognitive development of children.

Morse Fall Scale: tradução e adaptação transcultural para a língua portuguesa / Morse fall scale: traducción y adaptación a la lengua portuguesa / Morse fall scale: translation and transcultural adaptation for the portuguese language

Estudo realizado com o objetivo de traduzir e adaptar a Morse Fall Scale da língua inglesa para a portuguesa. Foi realizado em sete etapas: autorização pela autora da escala; tradução para o português do Brasil; avaliação e estruturação da escala traduzida; tradução reversa para o inglês; avaliação e validação da escala pelo comitê de especialistas; avaliação da clareza dos itens e definições operacionais por 45 profissionais e avaliação da concordância entre avaliadores e confiabilidade da reprodutibilidade, quanto aos dados referentes à avaliação de 90 pacientes, por quatro avaliadores/juízes. Quanto à clareza da escala, as proporções foram consideradas muito satisfatórias, com intervalo de confiança entre 73% a 100% na opção muito claro. Quanto à concordância das respostas, os resultados apresentaram coeficientes Kappa em torno de 0,80 ou superiores. Concluiu-se que o processo de adaptação da escala foi bem sucedido, indicando que seu uso é apropriado para a população de pacientes brasileiros hospitalizados.

Estudio efectuado objetivando traducir y adaptar la Morse Fall Scale del inglés al portugués. Fue realizado en siete etapas: autorización de la autora; traducción al portugués brasileño; evaluación y estructuración de la escala traducida; traducción revertida; evaluación y validación de la escala por comité de especialistas; evaluación de claridad de ítems y definiciones operativas por 45 profesionales y evaluación de concordancia entre evaluadores y confiabilidad de la reproductibilidad; en cuanto a los datos referentes a la evaluación de 90 pacientes, por parte de cuatro evaluadores/jueces. Respecto a la claridad de la escala, las proporciones fueron consideradas muy satisfactorias, con intervalo de confianza entre 73% y 100% para muy claro. Acerca de la concordancia de respuestas, los resultados presentaron coeficientes Kappa de aproximadamente 0,80 o superiores. Se concluye en que el proceso de adaptación fue exitoso, indicando que su uso es apropiado para la población de pacientes brasileños hospitalizados.

The study aimed to translate and adapt the Morse Fall Scale from English into the Portuguese language. This was performed in seven steps: authorization by the author of the scale; translation into Portuguese; evaluation and structuring of the translated scale; reverse translation into English; evaluation and validation of the scale by a committee of experts; evaluation of clarity of items and operational definitions with 45 professionals; evaluation of agreement between raters and the reliability of reproducibility, related to data from the evaluation of 90 patients, performed by four evaluators/judges. The clarity of the scale was considered very satisfactory, with a confidence interval of 73.0% to 100% in the option very clear. For the concordance of responses, the results showed Kappa coefficients of approximately 0.80 or higher. It was concluded that the adaptation of the scale was successful, indicating that its use is appropriate for the population of Brazilian patients.

[Morse Fall Scale: translation and transcultural adaptation for the Portuguese language]. / Morse Fall Scale: tradução e adaptação transcultural para a língua portuguesa.

The study aimed to translate and adapt the Morse Fall Scale from English into the Portuguese language. This was performed in seven steps: authorization by the author of the scale; translation into Portuguese; evaluation and structuring of the translated scale; reverse translation into English; evaluation and validation of the scale by a committee of experts; evaluation of clarity of items and operational definitions with 45 professionals; evaluation of agreement between raters and the reliability of reproducibility, related to data from the evaluation of 90 patients, performed by four evaluators/judges. The clarity of the scale was considered very satisfactory, with a confidence interval of 73.0% to 100% in the option very clear. For the concordance of responses, the results showed Kappa coefficients of approximately 0.80 or higher. It was concluded that the adaptation of the scale was successful, indicating that its use is appropriate for the population of Brazilian patients.

Comparison of the Kato-Katz and Helmintex methods for the diagnosis of schistosomiasis in a low-intensity transmission focus in Bandeirantes, Paraná, southern Brazil.

The diagnosis of schistosomiasis is problematic in low-intensity transmission areas because parasitological methods lack sensitivity and molecular methods are neither widely available nor extensively validated. Helmintex is a method for isolating eggs from large faecal samples. We report preliminary results of a comparative evaluation of the Helmintex and Kato-Katz (KK) methods for the diagnosis of schistosomiasis in a low-intensity transmission area in Bandeirantes, Paraná, southern Brazil. Eggs were detected by both methods in seven patients, whereas only Helmintex yielded positive results in four individuals. The results confirm the previously demonstrated higher sensitivity of the Helmintex method compared with the KK method.

Comparison of the Kato-Katz and Helmintex methods for the diagnosis of schistosomiasis in a low-intensity transmission focus in Bandeirantes, Paraná, southern Brazil

The diagnosis of schistosomiasis is problematic in low-intensity transmission areas because parasitological methods lack sensitivity and molecular methods are neither widely available nor extensively validated. Helmintex is a method for isolating eggs from large faecal samples. We report preliminary results of a comparative evaluation of the Helmintex and Kato-Katz (KK) methods for the diagnosis of schistosomiasis in a low-intensity transmission area in Bandeirantes, Paraná, southern Brazil. Eggs were detected by both methods in seven patients, whereas only Helmintex yielded positive results in four individuals. The results confirm the previously demonstrated higher sensitivity of the Helmintex method compared with the KK method.

Desempenho reprodutivo de novilhas acasaladas aos 26 meses de idade submetidas a sincronização de estros com pgf2 alfa administrado por via intramuscular ou intravulvar / Comportamiento reproductivo de novillas copuladas a los 26 meses de edad sometidas a sincronización de estros con pgf2 alfa administrado por vía intramuscular o intravulvar / Reproductive performance of beef heifers mating at 26 months-old using an artificial insemination protocol with a pgf2 alfa agonist injected in the muscle or vulvo

O objetivo do presente trabalho foi avaliar a resposta reprodutiva de novilhas, aos 26 meses de idade, submetidas à inseminação artificial em estro, observado ao início da estação de acasalamento, seguida de estro induzido por um análogo sintético da PGF2 α administrado por via intramuscular ou intravulvar. Foram utilizadas 271 novilhas de corte com base racial britânica, acasaladas aos 26 meses de idade e submetidas ao protocolo de inseminação artificial (IA) padrão da propriedade, que consiste de oito dias de IA com observação de estros sem tratamento hormonal, sendo que, no oitavo dia, as novilhas não inseminadas recebem 90µg de um análogo sintético de PGF2 α e são inseminadas por mais cinco dias conforme a observação de estros. O grupo I (n=86) foi formado pelas novilhas inseminadas nos primeiros oito dias, enquanto os grupos II-M (n=102) e II-V (n=83) foram formados pelas novilhas submetidas à indução de estro com PGF2 α, divididos conforme a via de aplicação do hormônio (intramuscular e intravulvar, respectivamente). Os parâmetros analisados foram: peso ao início do acasalamento (PIA), taxa de inseminação (TI), tempo de resposta à aplicação do hormônio (RH). O peso ao início do acasalamento (PIA) foi maior (p<0,01) para o grupo I (304,88 kg) em relação aos grupos II-M (292,83 kg) e II-V (295,59 kg), que não diferiram entre si (p>0,05). A TI foi de 49% e 53%, enquanto a RH foi de 68,9 e 76,7 horas respectivamente para II-M e II-V, não apresentando diferenças significativas (p>0,05). A TP foi maior (p<0,05) para o grupo I (96,5%) em relação ao aos grupos II-M (86,3%) e II-V (81,9%), que não diferiram entre si (p>0,05). Novilhas do grupo I foram mais pesadas ao início da estação de acasalamento do que as demais, sendo inseminadas mais cedo e obtendo maior taxa de prenhez em relação às novilhas dos grupos II-M e II-V. A via de aplicação do análogo de PGF2 α (intramuscular ou intravulvar) não exerceu influência sobre a resposta reprodutiva das novilhas submetidas ao tratamento hormonal.

The objective of this research was to evaluate the reproductive performance of 26-months-old beef heifers inseminated after estrus, it was observed at the beginning of the breed season and after that using an artificial insemination protocol with a PGF2α agonist injected in the muscle or volvo. Two hundred and seventy one beef heifers were inseminated for 8 days through estrus observation. In the 8th day the non-inseminated heifers received 90µg of a PGF2 α agonist. After that heifers were inseminated during five days through estrus observation. Group I (n=86) was composed by the heifers inseminated at the first eight days and Groups II-M (n=102) and II-V (n=83) were composed by the heifers that received the injections of PGF2 α agonist in the muscle or vulvo, respectively. Beginning weight (BW) insemination rate (IR), hours between PGF2α injection and estrus observation (HE), and pregnancy rate (PR) were the analyzed parameters. Group I reached higher BW (304.88 kg, p<0.01) than Group II-M (292.83 kg) and II-V (295.59 kg) (p>0.05). IR (49% and 53%) and HE (68.9 and 76.7 hours for Group II-M and II-V) (p<0.05), respectively, were similar. Group I reached higher (p<0.01) PR (96.5%) than II-M (86.3%) and II-V (81.9%). Heifers from Group I were heaviest in the beginning of the breed season, being inseminated earlier and reaching higher PR than the other ones. The injection way of PGF2α (muscle or vulvo) did not change the reproductive performance.

El objetivo de la presente investigación fue evaluar la respuesta reproductiva de novillas, a los 26 meses de edad, sometidas a la inseminación artificial en estro, observado al inicio de la estación de cópula, seguida de estro inducido por un análogo sintético de PGF2 α administrado por vía intramuscular o intravulvar. Se utilizó 271 vaquillas con base racial británica, copuladas a los 26 meses de edad y sometidas al protocolo de inseminación artificial (IA) estándar de la propiedad, que consiste en ocho días de IA con observación de estros sin tratamiento hormonal, siendo que, en el octavo día, las novillas no inseminadas reciben 90µg de un análogo sintético de PGF2 α y son inseminadas por más cinco días conforme la observación de estros. El grupo I (n=86) se han formado por las novillas inseminadas en los primeros ocho días, mientras los grupos II-M (n=102) y II-V (n=83) se han formado por las novillas sometidas a la inducción de estro con PGF2α, divididos conforme la vía de aplicación de hormona (intramuscular e intravulvar, respectivamente). Los parámetros analizados fueron: peso al inicio de la cópula, índice de inseminación, tiempo de respuesta a la aplicación de hormona. El peso al inicio de la cópula fue mayor (p<0,01) para el grupo I (304,88 kg) en relación a los grupos II-M (292,83 kg) y II-V (295,59 kg), que no difirieron entre sí (p>0,05). El índice de inseminación fue de 49% y 53%, mientras el tiempo de respuesta a la aplicación de hormona fue de 69,9 y 76,7 horas respectivamente para II-M y II-V, no presentando diferencias significativas (p>0,05). La TP fue mayor (p<0,05) para El grupo I (96,5%) en relación a los grupos II-M (86,3%) y II-V (81,9%), que no difirieron entre sí (p>0,05). Novillas del grupo I fueron más pesadas al inicio de la estación de cópula del que las demás, siendo inseminadas más temprano y obteniendo mayor índice de preñez en relación a las novillas de los grupos II-M y II-V. La vía de aplicación del análogo de PGF2 α (intramuscular o intravulvar) no ejerció influencia sobre la respuesta reproductiva de las novillas sometidas al tratamiento hormonal.

Asthma mortality in southern Brazil: is there a changing trend?

BACKGROUND: Mortality from asthma increased during the last decades but is now declining in some countries. Little is known about this trend in Brazil. OBJECTIVE: The objective of the study was to determine the trends in asthma mortality in Southern Brazil. METHODS: We reviewed death certificates of 566 people in the state of Rio Grande do Sul, Brazil, between 5 and 39 years of age in whom asthma was reported to be the underlying cause of death during the period of 1981-2003. Population data were available in 5-year age groups. Mortality rates were submitted to linear and quadratic regression procedures. RESULTS: Among children and teenagers (5-19 years), there were 170 asthma deaths, ranging from 4 to 13 deaths each year with rates of 0.154/100,000 to 0.481/100,000. In young adults (20-39 years), 396 asthma deaths occurred, ranging from 9 to 32 each year, with rates from 0.276/100,000 to 1.034/100,000. There was an initial increase in rates, with later stabilization, and then the start of a decline beginning in the late 1990s and the early part of this decade. This trend occurred in both age subgroups examined but was more evident in males. CONCLUSIONS: Asthma mortality in southern Brazil remains low and appears to be decreasing after reaching a peak in the mid-1990s. The reason for these trends remains unknown.