Synergic effect of oral contraceptives, GSTP1 polymorphisms, and high-risk HPV infection in development of cervical lesions.

Human papillomavirus (HPV) infection is considered a risk factor for cervical cancer. Even if the high-risk HPV (HR-HPV) infection is necessary, environmental co-factors and genetic susceptibility also play an important role in cervical cancer development. In this study, a possible association of rs1695 GSTP1 polymorphisms, HR-HPV infection, and oral contraceptive use with cancer lesion development in women was investigated. The study population comprised 441 Brazilian women from the Northeast region including 98 HPV-infected women with high-grade squamous intraepithelial lesions, 77 HPV-infected women with low-grade squamous intraepithelial lesions, and 266 HPV-negative women with no lesion, used as a control. Our data did not show a significant association between the GSTP1 polymorphism A/G (rs1695) and any HPV-related cervical abnormalities. However, considering the use of oral contraceptives, the GSTP1 rs1695 polymorphism was associated with higher susceptibility to the development of cervical lesions in HR-HPV-infected women. Our study suggests a synergic effect of oral contraceptive use, GSTP1 polymorphisms, and HR-HPV infection in the development of cervical lesions. Together, these risk factors may induce neoplastic transformation of the cervical squamous epithelium, setting conditions for secondary genetic events leading to cervical cancer.

Central versus peripheral arterial cannulation and neurological outcomes after thoracic aortic surgery: meta-analysis and meta-regression of 4459 patients.

BACKGROUND: Thoracic aortic surgeries remain with high mortality rates, often associated with postoperative neurological complications. The choice of the right cannulation site is extremely important for suitable blood supply and maintenance of vital functions, especially of the central nervous system. OBJECTIVES: To compare the influence of central versus peripheral arterial cannulation on neurological outcomes in patients undergoing thoracic aortic surgery through systematic review and meta-analysis. METHODS: MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS and reference lists of relevant articles were searched for clinical studies that reported in-hospital neurological outcomes after central or peripheral arterial cannulation during thoracic aortic surgery procedures until December 2013. The principal summary measures were Odds Ratio (OR) for central compared to peripheral arterial cannulation with 95% confidence interval (CI) and p-values considered statistically significant when <0.05. The ORs were combined across studies, using the DerSimonian-Laird random effects model and fixed effects model using the Mantel-Haenszel model--both models were weighted. The meta-analysis was completed using the software Comprehensive Meta-Analysis version 2 (Biostat Inc., Englewood, NJ). RESULTS: Six studies were identified and included a total of 4459 patients (1180 for central and 3279 for peripheral cannulation). There was no significant difference between the central and peripheral groups regarding neurological outcomes. The meta-regression evidenced no relationship between neurological outcomes and the variables age, sex, previous coronary event, previous neurological event, urgency surgery, cardiopulmonary bypass time, activated clotting time and esophageal temperature with p > 0,05. CONCLUSION: When it comes to neurological outcomes in patients undergoing thoracic aortic surgery, there was no evidence that argues in favor of any choice of arterial cannulation site, which makes us reject any superiority of one approach over the other in this regard.

Exigência nutricional de proteína bruta para codornas japonesas (Coturnix coturnix japonica) na fase de postura / Nutritional requirement of crude protein for japanese quail (Coturnix coturnix japonica) in the production phase

O objetivo do trabalho foi determinar o melhor nível de proteína bruta na alimentação de codornas japonesas em fase de produção. Foram utilizadas 300 codornas com 16 semanas de idade, alojadas em gaiolas, em um delineamento inteiramente casualizado, com cinco tratamentos, seis repetições e dez aves por unidade experimental. Os níveis avaliados foram 14, 17, 20, 23 e 26 por cento de proteína bruta, e as dietas foram formuladas para serem isoenergéticas. Foi verificado efeito quadrático para consumo de ração, peso de ovo, massa de ovo, ingestão de energia, eficiência energética por dúzia de ovo, coeficiente de digestibilidade de nitrogênio, retenção de nitrogênio, peso de gema, casca e albúmen. Efeito linear foi verificado para produção de ovos, ingestão de proteína, conversão alimentar por massa de ovos, eficiência energética por massa de ovo em kg, peso final e gravidade específica. Não houve efeito significativo para conversão alimentar por dúzia e concentração sérica de ácido úrico. Recomenda-se nível de 20 por cento de proteína bruta para codornas japonesas em fase de postura...

The aim of this study was to determine the best level of crude protein in the diet of Japanese quails in the production phase. A total of 300 quails at 16 weeks of age in cages, in a completely randomized design with five treatments and six replicates of ten birds per experimental unit was used. The levels evaluated were 14, 17, 20, 23 and 26 percent crude protein and diets were formulated to be isoenergetic. A quadratic effect was observed for feed intake, egg weight, egg mass, energy intake, energy efficiency per dozen eggs, nitrogen digestibility, shell percentage, nitrogen retention, weight of yolk, albumen and shell. A linear effect was observed for egg production, protein intake, feed conversion by egg mass, energy efficiency per egg mass in kg, final weight and yolk percentage and specific gravity. There was no significant effect on feed conversion per dozen, percentage of albumen, shell thickness and serum uric acid. The recommendation is of a 20 percent crude protein level for Japanese quail during the laying phase...

Níveis de cloro da ração sobre parâmetros sanguíneos e ósseos de codornas italianas destinadas à produção de carne / Chlorine levels of diet on blood parameters and bone in meat production of Italian quail

Avaliaram-se diferentes níveis de cloro da ração sobre os parâmetros sanguíneos e o desenvolvimento ósseo de codornas destinadas à produção de carne. Foram utilizadas 384 codornas italianas de um a 49 dias de idade, distribuídas em delineamento inteiramente ao acaso, com seis tratamentos e oito repetições de oito aves. Os tratamentos consistiram de rações isonutrientes, exceto para o nível de cloro, que foram: 0,07; 0,12; 0,17; 0,22; 0,27 e 0,32%. Aos 49 dias, foram selecionadas duas aves por parcela para as coletas do sangue e das tíbias. Foram avaliados o pH e as concentrações de Na, Cl e K no sangue, bem como o comprimento, o diâmetro, o peso, o teor de matéria seca e cinzas, o índice de Seedor e a resistência à quebra e deformidade da tíbia. Os níveis de cloro da ração não influenciaram significativamente o pH, as concentrações de Na, Cl, K no sangue, assim como o comprimento, o diâmetro, o peso, o índice de Seedor, o teor de matéria seca e cinzas e a resistência à quebra e deformidade da tíbia. Conforme os resultados, o nível de cloro pode variar de 0,07 até 0,32%, sem alterar o pH e as concentrações de Na, Cl e K no sangue e sem prejuízos na qualidade óssea.

We evaluated different levels of chlorine in the feed on the blood parameters and bone development of quail for meat production. 384 Italian quails were used at 1-49 days of age, distributed in a completely randomized design with six treatments and eight replicates of eight birds. The treatments consisted of isonutrient diets, except for the level of chlorine, which were 0.07, 0.12, 0.17, 0.22, 0.27 and 0.32%. After 49 days, two birds were selected per plot for the collection of blood and tibia. The pH and the concentration of Na, K and Cl in the blood and the length, diameter, weight, dry matter and ash, Seedor index, breaking strength and deformity of the tibia were evaluated. The chlorine levels in the diet did not significantly influence the pH, the concentrations of Na, Cl, K blood, length, diameter, weight, Seedor index, dry matter and ash, crack resistance and deformity of the tibia. As the results, the level of chloride can range from 0.07 to 0.32%, without changing the pH and the concentrations of Na, K and Cl in the blood and without a loss in bone quality.

Is there any difference between blood and crystalloid cardioplegia for myocardial protection during cardiac surgery? A meta-analysis of 5576 patients from 36 randomized trials.

OBJECTIVE: To compare the efficacy of blood versus crystalloid cardioplegia for myocardial protection in patients undergoing cardiac surgery. METHODS: MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles were searched for clinical studies that reported in-hospital outcomes after blood or crystalloid cardioplegia for myocardial protection during cardiac surgery procedures from 1966 to 2011. The principal summary measures were risk ratio (RR) for blood compared to crystalloid cardioplegia with 95% Confidence Interval (CI) and P values (considered statistically significant when <0.05). The RRs were combined across studies using the DerSimonian-Laird random effects model and fixed effects model using the Mantel-Haenszel model - both models were weighted. The meta-analysis was completed using the software Comprehensive Meta-Analysis version 2 (Biostat Inc., Englewood, New Jersey). RESULTS: Thirty-six studies (randomized trials) were identified and included a total of 5576 patients (2834 for blood and 2742 for crystalloid). There was no significant difference between the blood and crystalloid groups in the risk for death (risk ratio [RR] 0.951, 95% CI 0.598 to 1.514, P=0.828, for both effect models) or myocardial infarction (RR 0.795, 95% CI 0.547 to 1.118, P=0.164, for both effect models) or low cardiac output syndrome (RR 0.765, 95% CI 0.580 to 1.142, P=0.094, for the fixed effect model; RR 0.690, 95% CI 0.480 to 1.042, P=0.072, for the random effect model). It was observed that there was no publication bias or heterogeneity of effects about any outcome. CONCLUSION: We found evidence that argues against any superiority in terms of hard outcomes between blood or crystalloid cardioplegia for myocardial protection during cardiac surgery.

Uma reflexão sobre o impacto da pouca abrangência dos serviços públicos de saúde brasileiros na vida de crianças diagnosticadas com câncer / A reflection on the impact of the lack of comprehensiveness of Brazilian public health services in the lives of children diagnosed with cancer

INTRODUÇÃO: Os brasileiros diagnosticados com câncer tem disponível uma rede pública de saúde integral, universal e gratuita formada por unidades e centros de alta complexidade em oncologia que tem sido mantida e aperfeiçoada ao longo dos anos para tratara doença de forma cada vez mais eficaz. Entretanto, apesar de sua amplitude, o Sistema Público de Saúde brasileiro (SUS) ainda não consegue cobrir muitas localidades, principalmente nas regiões norte e nordeste do país. Percebemos no estado do Ceará (nordeste), por exemplo, que existe no sistema público tratamento completo de câncer em apenas três cidades. Este número tem se mantido desde a realização de nossa pesquisa realizada entre os anos de 2004 e 2005. Por seu caráter grave, crônico, mutilador e potencialmente letal, o câncer é uma doença capaz de trazer uma série de transformações na vida daqueles que recebem seu diagnóstico. O impacto de um câncer desestrutura a criança emocional e socialmente de forma a mudar as estruturas de suas relações. Além disso, em se tratando de localidades desprovidas de centros de tratamento especializado no sistema público de saúde, a criança é obrigada a se deslocar para grandes centros urbanos, intensificando o rompimento simbólico após o diagnóstico e ao longo do tratamento. A teoria do rito de passagem facilitou o entendimento dos processos de desconstrução das relações familiares, comunitárias, escolares e a construção de novos vínculos na casa de apoio e no hospital a partir do olhar da criança participante do processo ritual. OBJETIVO: Este trabalho analisa a trajetória de crianças de 7 a 12 anos em tratamento contra o câncer, institucionalizadas temporariamente em uma casa de apoio localizada em Fortaleza/Ceará/Brasil. MATERIAL E MÉTODO: A metodologia utilizada foi a etnografia, aliada a entrevistas semiestruturadas. RESULTADOS: Os dados da pesquisa foram apresentados primeiramente em 2005, através de um trabalho monográfico. CONCLUSÃO: Desde então, pouco mudou no interior do Ceará no tocante à oferta de tratamento do câncer infantil. Atualmente, trazemos uma releitura dos dados com novas discussões para o assunto, demonstrando principalmente que muitas das implicações do diagnóstico do câncer na vida das crianças ­desde a mudança na forma de comer até a completa transformação na estrutura familiar ­estão diretamente relacionadas à falta de um sistema público de saúde melhor distribuído nas regiões brasileiras.

INTRODUCTION: The Brazilians people diagnosed with cancer have available a complete public health, universal and free formed by units and centers of high complexity in oncology that has been maintained and improved over the years to treat disease in an ever more effective. However, despite its breadth, the Brazilian Public Health System (SUS) still can not cover many localities, especially in the north and northeast. We realize the state of Ceará (Northeast), for example, that there is in the public thorough treatment of cancer injust three cities. This number has remained since the completion of our survey conducted between 2004 and 2005. Because it is severe, chronic, crippling and potentially deadly, cancer is a disease capable of bringing a series of transformations in the lives of those who receive their diagnosis. The impact of cancer disrupts the child emotionally and socially in order to change the structures of their relationships. Moreover, when it comes to places without treatment centers specializing in public health system, the child is forced to move to large urban centers, intensifying the symbolic break after diagnosis and during treatment. The theory of the rite of passage facilitated the understanding of the processes of deconstruction of family relationships, community, school and construction of new bonds in the house and support the hospital through the eyes of children participating in the ritual process. OBJECTIVE: This paper examines the trajectory of children 7-12 years in cancer treatment, institutionalized temporarily in a support house located in Fortaleza / Ceará / Brazil. The methodology used was ethnography, coupled with semi-structured interviews. MATERIAL E MÉTODOS: The survey data were first presented in 2005 by a monograph. Since then, little has changed in the interior of Ceará regarding the provision of treatment of childhood cancer. CONCLUSION: Today, we bring a re-reading of the data with further discussion to the subject, showing mainly that many of the implications of a diagnosis of cancer in children's lives -from the change in the way of eating until the complete transformation in family structure -are directly related to lack of a public health system better distributed in the Brazilian regions.

Helminthological records of six-banded armadillos Euphractus sexcinctus (Linnaeus, 1758) from the Brazilian semi-arid region, Patos county, Paraíba state, including new morphological data on Trichohelix tuberculata (Parona and Stossich, 1901) Ortlepp, 1922 and proposal of Hadrostrongylus ransomi nov. comb. / Registros helmintológicos em tatus-peba Euphractus sexcinctus (Linnaeus, 1758) do semi-árido brasileiro, município de Patos, Paraíba, com dados acerca da morfologia de Trichohelix tuberculata (Parona and Stossich, 1901) Ortlepp, 1922 e proposição de Hadrostrongylus ransomi nov. comb.

This work aimed to evaluate the gastrointestinal helminthfauna composition of six-banded armadillos from the Brazilian semi-arid region. Gastrointestinal contents of six road-killed adult animals from Patos County, Paraíba State, were analyzed. Six species of nematodes, comprising five genera and four families, were recovered from the analyzed animals. New morphological data on Trichohelix tuberculata is given, along with a new taxonomical proposal for Hadrostrongylus ransomi (Travassos, 1935) n. comb. This is the first record for parasitic helminths in this host from the Brazilian semi-arid.

Este trabalho teve como objetivo avaliar a composição da helmintofauna gastrintestinal de tatus-peba da região semi-árida brasileira. Conteúdos gastrintestinais de seis animais adultos atropelados nas rodovias do município de Patos, Paraíba, foram analisados. Seis espécies de nematódeos agrupados em cinco gêneros e quatro famílias foram obtidas. Novos dados morfológicos de Trichohelix tuberculata são relatados, e ainda é proposto Hadrostrongylus ransomi (Travassos, 1935) n. comb. Este é o primeiro relato de helmintos parasitas deste hospedeiro no semi-árido brasileiro.

Isoenzyme electrophoretic patterns in discus fish (Symphysodon aequifasciatus Pellegrin, 1904 and Symphysodon discus Heckel, 1840) from the Central Amazon.

The discus is a very popular and expensive aquarium fish belonging to the family Cichlidae, genus Symphysodon, formed by three Amazon basin endemic species: Symphysodon aequifasciatus, S. discus and S. tarzoo. The taxonomic status of these fish is very controversial, with a paucity of molecular research on their population genetic structure and species identification. Information on molecular genetic markers, especially isoenzymes, in search of a better understanding of the population genetic structure and correct identification of fish species, has been receiving more attention when elaborating and implementing commercial fishery management programs. Aiming to contribute to a better understanding of the species taxonomic status, the present study describes the isoenzymatic patterns of 6 enzymes: esterase (Est - EC 3.1.1.1), lactate dehydrogenase (Ldh - EC 1.1.1.27), malate dehydrogenase (Mdh - EC 1.1.1.37), phosphoglucomutase (Pgm - EC 5.4.2.2), phosphoglucose isomerase (Pgi - EC 5.3.1.9), and super oxide dismutase (Sod - EC 1.15.1.1) extracted from skeletal muscle specimens and analyzed by starch gel electrophoresis. Monomorphic patterns, presumably controlled by 11 loci: Est-1, Est-2, Est-3, Ldh-1, Ldh-2, Mdh-1, Mdh-2, Pgi-1, Pgi-2, Pgm-1, and Sod-1 were fixed for the same alleles: Est-1(1), Est-2(1), Est-3(1), Ldh-1(1), Ldh-2(1), Mdh-1(1), Mdh-2(1), Pgi-1(1), Pgi-2(1), Pgm-1(1), and Sod-1(1), respectively, and detected in all 60 specimens examined (27 S. aequifasciatus from Manacapuru and 33 S. discus from Novo Airão, Central Amazon). The failure in the present study to detect diagnostic loci, which could be very useful for differentiating S. aequifasciatus from S. discus species, and polymorphic loci, which could also be applied for possible identification and delimitation of their stocks, does not rule out the possibility of there existing in other isoenzyme gene loci to be analyzed in the future.

Propriedades psicométricas da versão brasileira da escala de qualidade de vida específica para acidente vascular encefálico: aplicação do modelo Rasch / Psychometric properties of the Brazilian version of the Stroke Specific Quality of Life Scale: application of the Rasch model

CONTEXTUALIZAÇÃO: O acidente vascular encefálico (AVE) produz déficits importantes na qualidade de vida (QV) dos indivíduos. Medidas específicas de QV são necessárias para compreender e quantificar o impacto dessa patologia. OBJETIVO: O objetivo desse estudo foi adaptar transculturalmente o Stroke Specific Quality of Life Scale (SSQOL) para o Português (Brasil) e avaliar suas propriedades psicométricas. MATERIAIS E MÉTODOS: O SSQOL foi traduzido e adaptado seguindo instruções padronizadas e submetido a exame de confiabilidade teste-reteste (10 hemiplégicos). As propriedades psicométricas foram investigadas pela análise Rasch em 50 hemiplégicos. RESULTADOS: Foram detectados coeficientes de confiabilidade de 0,92 para itens e indivíduos. O índice de separação dos hemiplégicos foi 3,34 e dos itens, 3,36, ou seja, os itens separaram as pessoas em pelo menos três níveis de QV e em três níveis de QV - baixa, média e alta. Dos 49 itens, quatro não se enquadram no modelo, o que compromete a validade de constructo do instrumento, embora o padrão errático dos itens se justifique na amostra examinada. CONCLUSÕES: O instrumento mostrou-se clinicamente útil na população avaliada. Novos estudos em populações com outras características já estão em andamento.

BACKGROUND: Stroke results in important deficits, which reduce individuals' quality of life (QOL). Specific QOL measurements are necessary to understand and quantify the impact of this pathological condition. OBJECTIVE: The aim of this study was to make a transcultural adaptation of the Stroke Specific Quality of Life Scale (SSQOL) into Brazilian Portuguese and to assess its psychometric properties. METHODS: The SSQOL was translated and adapted in accordance with standardized procedures and was subjected to test-retest reliability analysis with 10 hemiplegic subjects. The psychometric properties were investigated using Rasch analysis on 50 hemiplegics. RESULTS: Reliability coefficients of 0.92 were found for items and subjects. The separation index for the hemiplegics was 3.34, while, for the items, it was 3.36. These results indicated that the items separated the subjects into at least three levels of QOL: Low, medium, and high. Of the 49 items, four did not fit into the model, which partially invalidated the construct validity of the instrument, although the erratic patterns of these items could also be explained in the present sample. CONCLUSIONS: The instrument was shown to be clinically useful for the assessed population and other studies in populations with other characteristics are now underway.

Assimetria e desempenho funcional em hemiplegicos cronicos antes e apos programa de treinamento em academia / Asymmetriy and functional performance among chronic hemiplegic individuals before and after a training program in a fitness center

E bem documentado que hemiplegicos apresentam assimetria, fraqueza muscular e baixa tolerancia ao exercicio. Tradicionalmente, programas de reabilitacao procuram focar a melhora da simetria corporal como objetivo do tratamento, entretanto, os ganhos funcionais que isso representa nao sao bem estabelecidos. Objetivo: avaliar os comportamentos da simetria e do desempenhofuncional e a relacao entre o grau de assimetria e de desempenho funcional antes e apos o treinamento de hemiplegicos utilizando a musculacao e o condicionamento aerobico. Metodos: trinta participantes com media de idade de 56,36+-10,86 anos e tempo de evolucao pos-AVC variando de 1 a 14 anos foram avaliados antes e apos o treinamento. As medidas de simetria foram obtidas em ortostatismo, durante o movimento de passar de sentado para de pe e durante a marcha pelo Balance Master, enquanto o desempenho funcional foi avaliado por meio da velocidade natural da marcha e da habilidade para subir escadas. Estatistica descritiva, testes de normalidade, testes t pareados e coeficientes de correlacao de Pearson foram utilizados para essa analise. Resultados: apos o treinamento, melhoras significativas foram observadas apenas nas medidas de desempenho funcional (p<0,001), sem alteracao significativa de nenhum dos valores de simetria. Alem diss, nao foram observadas correlacoes significativas entre as variaveis funcionais e de simetria (r=0,12-0,27). Conclusoes: os achados indicaram que medidas de simetria nao se mostraram sensiveis para demonstrar mudancas associadas ao treinamento, sugerindo que esse parametro pode ser um desfecho relevante no processo de reabilitacao para obter ganhos funcionais em hemiplegicos cronicos

Musculacao e condicionamento aerobico em hemiplegicos: impacto no desempenho motor / Strengthening and aerobic conditioning in stroke: impact on motor performance

O objetivo deste estudo foi avaliar o impacto de um programa de condicionamento aerobico e fortalecimento muscular utilizando a musculacao como recurso, no desempenho motor de individuos emiplegicos cronicos. trinta participantes (17 homens e 13 mulheres) com media de idade de 56,36+-10,86 anos, com tempo medio de evolucao pos-AVC variando de 1 a 14 anos, foram avaliados antes e apos treinamento. O programa de treinamento, de 30 sessoes (3 vezes/semana), consisitiu em sessoes supervisionadas de exercicios subdivididas em periodos de aquecimento, exercicios aerobicos, fortalecimento por meio da musculacao e rsefriamento. Medidas de toque dos principasi grupos musculares dos membros inferiores e tronco, de espaticidade do quadriceps, flexores plantares e flexores do cotovelo e punho e medidas de simetria foram utilizadas para avaliar o impacto do programa. Apos o treinamento, foram observados valores de torque significativamente maiores que os iniciais em todos os grupos musculares avaliados, sendo os ganhos observados no lado afetado (35,85 por cento) maiores que os do lado naoa fetado (27,42 por cento) sem aumento concomitante do grau de espasticidade. Alem disso, foi observada melhora significativa (p=0,019) na simetria na posicao ortostatica. A musculacao mostrou-se alternativa viavel na melhora do desempenho motor em pacientes hemiplegicos cronicos

Synthesis of metal-oxide matrix with embedded nickel nanoparticles by a bottom-up chemical process.

Here we describe a new chemical route for obtaining highly dispersed nanometric Ni particles embedded in different matrices based on Al2O3, MgO, and TiO2 and in the heterogeneous matrices CeO2-doped Al2O3 and MgO-doped Al2O3. The synthesis method is based on a modification of the polymeric precursor method. The Ni nanoparticles (particles in the range of 1-40 nm) were obtained in a single process, without the use of an external reducing agent (hydrogen atmosphere).

Molecular weight and antitumour activity of Zymomonas mobilis levans.

Levans produced by several Zymomonas mobilis strains were classified by their viscosity average molecular weight and tested against sarcoma 180. Measurements of the samples' polydispersity were carried out to characterise the molecular weight distribution. The antitumour activities of levan samples were plotted against the viscosity average molecular weight and a maximum value of this activity was found at Mv = 210,000 (Mw = 456,900 and PD = 16.2). The results indicate that levan antitumour activities depend on the polysaccharide molecular weight and that a specific class of molecular weight may be responsible for this effect.

[Association between individual and socioeconomic characteristics and work-related accidents in Pelotas, Southern Brazil]. / Associação entre as características individuais e sócio-econômicas e os acidentes do trabalho em Pelotas, Rio Grande do Sul, Brasil.

A case-control study was conducted to study the association between individual and socioeconomic characteristics and occupational accidents. Cases were 264 workers who had suffered a "typical" occupational accident registered at the National Institute of Social Security in the city of Pelotas in 1996. Workers were interviewed in their homes with a standardized questionnaire. Two fatal accidents were excluded, as were those leading to absence from work for less than seven days. For each case, three controls were selected: a colleague from the same workplace, a neighbor, and a population control. These were matched to cases by age (+/-5 years) and sex and had not suffered a work-related accident in the preceding month. All cases and controls had formal employment contracts and were residents in the urban area. Conditional logistic regression was used in the data analyses. Schooling and monthly income were the main determinants of occupational accidents. Effects of age, skin color, smoking, alcohol dependence (CAGE questionnaire), and stressful life events disappeared after adjustment for schooling and income.

Analysis of Usnea fasciata crude extracts with antineoplastic activity.

Different fractions, isolated from the lichen Usnea fasciata, were analyzed by PC, TLC, and RP-HPLC. Analysis of the organic phases, mainly containing phenolics, revealed that usnic acid is the main product from secondary metabolites, whereas the polysaccharides isolichenin and raffinose are the most abundant water-soluble carbohydrates. Fractions containing usnic acid, as well as those containing isolichenin, showed moderate activity against sarcoma 180 and Ehrlich tumor cells. High antitumoral activity, near 90% inhibition, was found associated with the fraction containing raffinose.

Sympathoadrenal function during cardiac operations in infants with the technique of surface cooling, limited cardiopulmonary bypass, and circulatory arrest.

The sympathoadrenal response to surface cooling, limited cardiopulmonary bypass, and deep hypothermic circulatory arrest was investigated in 22 infants undergoing correction of congenital heart defects. Surface cooling to 26 degrees C was associated with a significant rise in plasma epinephrine and norepinephrine levels. Both levels fell during the period of core cooling on bypass, presumably because of hemodilution. Following the period of circulatory arrest there was a rise in both catecholamine levels that correlated nonlinearly with the duration of circulatory arrest. The catecholamine levels remained high after rewarming until the chest was closed. The results suggest that this type of surgical procedure produces severe sympathoadrenal stress. The extremely high values found in the postarrest period in some patients, who had had a long period of arrest (greater than 40 minutes), may indicate hypoxic stress. The biological effect of high circulating plasma catecholamines during hypothermia is difficult to assess. The heart rate response to plasma catecholamine levels tended to diminish on cooling in our patients.

Spontaneous development of paraplegia after repair of coarctation of the aorta.

This report describes the case of a 19-month-old boy in whom paraplegia developed spontaneously 2 days after a technically uncomplicated coarctation of the aorta repair.

Double-inlet ventricle: morphologic analysis and surgical implications in 32 cases.

We analyzed, using a sequential segmental approach, 32 cases of double-inlet ventricle to assess the feasibility of surgical "correction" by either ventricular septation or a modified Fontan procedure. Twenty-two hearts had two atrioventricular valves, connected to a left ventricle in 19, a right ventricle in two, and a solitary indeterminate ventricle in one. Septation was possible in only 13. In contrast, the Fontan procedure seemed feasible in 20. The remaining 10 specimens had double inlet via a common valve to the left ventricle in two, the right ventricle in six, and an indeterminate ventricle in two. Seven of these had right atrial isomerism. Ventricular septation was not considered a possibility in these hearts. The Fontan procedure combined with atrial septation was a possibility in seven cases. From the morphologic stance, although the modified Fontan procedure seemed suitable in most cases, a significant number of hearts with two atrioventricular valves were suitable for ventricular septation.

Causas de morte em cirurgia cardiovascular com circulacao extracorporea / Causes of death in cardiovascular surgery with extracorporeal circulation

As causas de morte e possivel influencia do sexo, idade, peso, tipo de oxigenador, perfusato, temperatura do perfusato, tempo de perfusao e procedimentos realizados foram estudados numa serie consecutiva de 1800 operacoes cardiovasculares realizadas entre abril de 1960 e marco de 1980 no Hospital das Clinicas da Universidade Federal de Pernambuco e no Instituto de Doencas do Torax do Recife, com auxilio de circulacao extracorporea. A analise estatistica foi realizada utilizando-se o teste do "qui-quadrado" e o teste de correlacao de Person