Protective Barriers and Radiant Exposure Delivered from Light-curing Units.

OBJECTIVE: To evaluate the influence of different protective barriers as a function of the photoactivation distances on the radiant exposure of several light-curing units (LCU). The influence of the protective barriers on the degree of conversion of an adhesive resin was also evaluated. METHODS: Five LCUs were evaluated: Valo Cordless-used in standard mode (Ultradent, South Jordan, USA); Radii-cal-used in continuous mode (SDI, Bayswater, AU); Emitter D-used in continuous mode (Schuster, Santa Maria, BR); Bluephase N-used in high-intensity mode (Ivoclar Vivadent, Schaan, LI); and Rainbow Curing Light-used in continuous mode (Axdent, Guangdong, CN). For each LCU, radiant exposure was measured with a spectrometer (MARC Resin Calibrator) using three different protective barriers (low-density polyethylene, polyvinyl chloride, or Radii-cal barrier sleeves) and five photoactivation distances (0, 2, 5, 10, and 20 mm). The degree of conversion of an adhesive resin (Adper Scotchbond Multi-Purpose, 3M ESPE, St. Paul, USA) was measured through Fourier-transform infrared spectroscopy. The translucency parameter of protective barriers was measured with a spectrophotometer. For all statistical tests, a significance level of α = 0.05 was set. RESULTS: For all LCUs tested, radiant exposure was found to be significantly influenced by both protective barriers and curing distance (p≤0.001). In general terms, all the protective barriers significantly decreased the radiant exposure. Radii-cal barrier sleeves were the protective barrier that most decreased the radiant exposure. Irrespective of the protective barrier used, none of the LCU equipment reached the required minimum radiant exposure of 16 J/cm2 at 10 mm of curing distance. The degree of conversion was not effected by either LCU or a protective barrier (p≥0.211). CONCLUSIONS: Protective barriers and photoactivation distance reduced the radiant exposure emitted by different LCUs.

APOA5 polymorphisms associated with lipid metabolism in Brazilian children and adolescents.

Single nucleotide polymorphisms in the APOA5 gene have been studied for their association with metabolic syndrome. Thus, elucidating the effect of the mechanism involved in APOA5 gene polymorphisms on lipid metabolism is of great importance. In this study we aimed to determine the allelic and genotypic frequencies of -1131T>C, Ser19Trp, and intergenic APOA4/A5 and to evaluate the association between these variants with plasma lipid levels in children and adolescents from Brazil. This study included 524 healthy children and adolescents from Mother and Child Hospital in Recife, Pernambuco, Brazil. Data were obtained on medical history, drug intake, lifestyle variables, and demography. DNA from collected samples was extracted and genotyped for the three polymorphisms. In this studied population, triglycerides and very low-density protein levels were significantly high in subjects carrying the 19WW genotype (P < 0.001), demonstrating the presence of this genetic risk factor in children and adolescents.

Abdominal wall fat index in neonates: correlation with birth size.

Low birth weight is associated with obesity in later life and a more central fat distribution has a positive correlation with cardiovascular disease. However, the correlation between visceral adiposity in newborns and birth size is unknown. We measured the visceral adiposity in 118 newborns using the abdominal wall fat index (AFI), ratio between the maximum thickness of preperitoneal and the minimum thickness of subcutaneous fat evaluated by ultrasound. There was a weak negative correlation between AFI and birth weight (r = -0.197; P = 0.033) but not with birth length (r = -0.118; P = 0.201), body mass index (r = -0.138; P = 0.176) and abdominal circumference (r = 0.063; P = 0.497). In conclusion, we suggest that AFI is a useful parameter for evaluating the fat distribution in newborns and that visceral adiposity has a weak negative correlation with birth weight.

Examining life-course influences on chronic disease: the importance of birth cohort studies from low- and middle- income countries. An overview.

The objectives of this overview are to describe the past and potential contributions of birth cohorts to understanding chronic disease aetiology; advance a justification for the maintenance of birth cohorts from low- and middle-income countries (LMIC); provide an audit of birth cohorts from LMIC; and, finally, offer possible future directions for this sphere of research. While the contribution of birth cohorts from affluent societies to understanding disease aetiology has been considerable, we describe several reasons to anticipate why the results from such studies might not be directly applied to LMIC. More than any other developing country, Brazil has a tradition of establishing, maintaining and exploiting birth cohort studies. The clear need for a broader geographical representation may be precipitated by a greater collaboration worldwide in the sharing of ideas, fieldwork experience, and cross-country cohort data comparisons in order to carry out the best science in the most efficient manner. This requires the involvement of a central overseeing body--such as the World Health Organization--that has the respect of all countries and the capacity to develop strategic plans for 'global' life-course epidemiology while addressing such issues as data-sharing. For rapid progress to be made, however, there must be minimal bureaucratic entanglements.

Examining life-course influences on chronic disease: the importance of birth cohort studies from low- and middle- income countries. An overview

The objectives of this overview are to describe the past and potential contributions of birth cohorts to understanding chronic disease aetiology; advance a justification for the maintenance of birth cohorts from low- and middle-income countries (LMIC); provide an audit of birth cohorts from LMIC; and, finally, offer possible future directions for this sphere of research. While the contribution of birth cohorts from affluent societies to understanding disease aetiology has been considerable, we describe several reasons to anticipate why the results from such studies might not be directly applied to LMIC. More than any other developing country, Brazil has a tradition of establishing, maintaining and exploiting birth cohort studies. The clear need for a broader geographical representation may be precipitated by a greater collaboration worldwide in the sharing of ideas, fieldwork experience, and cross-country cohort data comparisons in order to carry out the best science in the most efficient manner. This requires the involvement of a central overseeing body - such as the World Health Organization - that has the respect of all countries and the capacity to develop strategic plans for `global' life-course epidemiology while addressing such issues as data-sharing. For rapid progress to be made, however, there must be minimal bureaucratic entanglements.

Factors associated with sickle cell disease mortality among hospitalized Angolan children and adolescents.

BACKGROUND: Sickle cell disease complications are an important mortality cause in children mainly in Africa and India. Notwithstanding the magnitude of the problem on the African continent, studies identifying factors related to the adverse outcomes of sickle cell disease in the pediatric population are still scarce. OBJECTIVE: To identify prognostic factors associated with mortality in children and adolescent aged under fifteen years with diagnosis of sickle cell disease. METHODS: Patients meeting inclusion criteria were listed and randomly selected. Clinical and laboratory data collected at time of admission were collected from medical records through the use of standard forms. The association between mortality and explanatory variables was tested using univariable and multivariable analysis. RESULTS: The overall mortality rate was 64 (12.9%), and bacterial infections 26 (40.1%) were the most common cause of death. Place of residence out of Luanda, lack of outpatient follow-up, symptoms onset more than three days, disease manifestation before age of eighth months and hemoglobin level of < 7 g/dl were independent risk factors related to death. In the study population, sickle cell related deaths were related to quality of health care and access to care. CONCLUSION: The creation of regional sickle cell disease centers to support those afflicted by the disorder and their families would contribute to reduce the burden associated with the disease.

APOA1/C3/A4 gene cluster variability and lipid levels in Brazilian children.

Genetic studies have suggested that polymorphisms of genes coding for apolipoproteins are significant determinants of serum lipoprotein and lipid levels in adults. However, only a few studies have investigated the association of these polymorphisms in children. Therefore, in the present investigation we studied the distribution of APOA1 -75 G>A, +83 C>T, APOC3 -482 C>T, -455 T>C and 3238 C>G, and APOA4 Q360H and T347S polymorphisms and their influence on plasma lipoprotein levels in children from a Brazilian northeastern admixed population. The seven polymorphic sites were genotyped in 414 children aged 5 to 15 years (mean 8.9 +/- 2.9). The genotypes of the seven polymorphic sites were assessed by PCR-RFLP methods. The frequencies of the less common alleles were, in general, intermediate among parental populations, as expected. Strong linkage disequilibrium was detected between polymorphisms at the APOA1, APOC3 and APOA4 loci in this admixed population sample. Overall the genotype effects seen in adults were weaker or absent in children. The APOC3/-455 and APOA4 T347S variants showed significant effects on HDL cholesterol in girls (P = 0.033 and P = 0.016, respectively). Significantly higher plasma total (P = 0.003) and LDL cholesterol (P = 0.004) levels were observed in boys who were carriers of the 3238G allele at the APOC3/3238 C>G site. These results disclosed an overall absence of associations between these polymorphisms and lipids in children. This finding is not unexpected because expression of the effect of these polymorphisms might depend on the interaction with environmental variables both internal and external to the individual.

APOA1/C3/A4 gene cluster variability and lipid levels in Brazilian children

Genetic studies have suggested that polymorphisms of genes coding for apolipoproteins are significant determinants of serum lipoprotein and lipid levels in adults. However, only a few studies have investigated the association of these polymorphisms in children. Therefore, in the present investigation we studied the distribution of APOA1 -75 G>A, +83 C>T, APOC3 -482 C>T, -455 T>C and 3238 C>G, and APOA4 Q360H and T347S polymorphisms and their influence on plasma lipoprotein levels in children from a Brazilian northeastern admixed population. The seven polymorphic sites were genotyped in 414 children aged 5 to 15 years (mean 8.9 ± 2.9). The genotypes of the seven polymorphic sites were assessed by PCR-RFLP methods. The frequencies of the less common alleles were, in general, intermediate among parental populations, as expected. Strong linkage disequilibrium was detected between polymorphisms at the APOA1, APOC3 and APOA4 loci in this admixed population sample. Overall the genotype effects seen in adults were weaker or absent in children. The APOC3/-455 and APOA4 T347S variants showed significant effects on HDL cholesterol in girls (P = 0.033 and P = 0.016, respectively). Significantly higher plasma total (P = 0.003) and LDL cholesterol (P = 0.004) levels were observed in boys who were carriers of the 3238G allele at the APOC3/3238 C>G site. These results disclosed an overall absence of associations between these polymorphisms and lipids in children. This finding is not unexpected because expression of the effect of these polymorphisms might depend on the interaction with environmental variables both internal and external to the individual.

Partitioning of whey proteins, bovine serum albumin and porcine insulin in aqueous two-phase systems.

Partitioning of the proteins from cheese whey, bovine serum albumin and porcine insulin were analysed using aqueous two-phase systems (ATPS) prepared with PEG-phosphate, PEG-citrate and PEG-maltodextrin (MD). Proteins were quantified through one of the following methods: FPLC, Bradford and spectrophotometry at 280 nm. Results showed that whey proteins partitioned unevenly on the phases of the systems used, with alpha-lactoalbumin (alpha-La) concentrated in the upper phase and beta-lactoglobulin (beta-Lg) in the lower. Albumin in PEG-MD systems concentrated in the MD-rich lower phase. Porcine insulin showed great affinity with the PEG-rich phase, its partition coefficient was always over 10 and increases with PEG molecular mass.

[Systolic and diastolic blood pressure levels of healthy newborn infants] / Níveis de pressão arterial sistólica e diastólica.

OBJECTIVE: To identify normative blood pressure (BP) levels for Brazilian newborn infants and to define a cut-off point for high systolic and diastolic BP in this population.METHODS: 634 healthy term neonates, aged 12 to 36 hours, who were born in the Instituto Materno Infantil de Pernambuco (IMIP) were included in this survey. An oscillometric method was used to acess the neonates BP. To identify high BP levels the Second Task Force definition was applied.RESULTS AND CONCLUSIONS: The normative BP values for the study sample was 82.0 -/+ 7.5 mmHg for systolic and 41.7 -/+ 5.8 mmHg for diastolic blood pressure. The cut-off points for high blood pressure were >/= 95 mmHg and >/= 52 mmHg for systolic and diastolic blood pressure respectively. These results are similar to those reported in other surveys done in other countries.

Fetal influences on neonatal blood pressure.

OBJECTIVE: To identify if there is a relationship between some newborn variables (baby's sex, Apgar score, postnatal age, birth weight, birth length, and head circumference) and blood pressure (BP) in healthy term newborns. STUDY DESIGN: A cross-sectional hospital-based study was carried out to determine BP levels and a cutoff point for hypertension in healthy term newborns. Afterward, a comparative study was conducted to identify fetal factors that could influence BP in this specific group. RESULTS: According to the cutoff point (95th percentile), 34 infants were considered to be hypertensive. During the univariate analyses, infants with higher BP were heavier, longer, and had larger head circumference. After the multivariate analyses, birth weight was the only variable associated with higher BP in babies. Other newborn variables analyzed (baby's sex, Apgar score, and postnatal age) showed no influence on the babies' BP. CONCLUSION: There is a positive relationship between birth weight and BP in healthy term newborns.

Transfontanelle ultrasonography in infants: comparative study with cranial computed tomography.

The findings of transfontanelle ultrasonography, undertaken in 36 infants with clinical evidence of central nervous system (CNS) disorders, were compared with the findings of cranial computed tomography (CT). Considering the CT scan findings as gold standard, cranial ultrasonography had a sensitivity of 82 per cent and a specificity of 75 per cent in identifying cerebral pathology. The positive predictive value was 92 per cent and negative predictive value was 45 per cent.

Tratamento da anemia ferropriva com hidróxido de ferro polimaltosado: estudo multicêntrico comparativo entre tratamento ministrado com e sem alimentaçäo concomitante

O objetivo do presente estudo foi analisar a interferência da ingestäo concomitante de alimentos, na absorçäo de ferro, em pacientes anêmicos tratados com complexo de ferro polimaltosado. Em estudo multicêntrico foram observados 113 pacientes, randomicamente alocados em dois grupos. Todos os pacientes receberam ferro polimaltosado na dose equivalente a 2,5mg de ferro elementar por dia durante 90 dias. Dos pacientes tratados 53 foram alocados no grupo C e receberam o medicamento com alimentaçäo concomitante, enquanto 60 alocados no grupo S receberam-no longe do período das refeiçöes. A avaliaçäo da eficácia foi feita por parâmetros clínicos (escores de sinais e sintomas) e laboratoriais (contagem de eritrócitos, dosagem de hemoglobina sérica, entre outros). Ao término do estudo houve melhora, estatisticamente significante, tanto nos parâmetros clínicos como nos laboratoriais, em ambos os grupos. As diferenças entre os grupos C e S, que näo eram estatisticamente significantes ao início do estudo, assim se mantiveram ao final das observaçöes. A incidência de efeitos colaterais foi muito pequena em ambos os grupos. Conclui-se que o hidróxido de ferro polimaltosado é igualmente eficiente, quer quando ministrado, quer quando ministrado sem alimento concomitante

[Determination of the arm circumference in newborn infants as a method of verifying low birth weight]. / Avaliação do perímetro braquial em recém-nascidos, como método de verificação de baixo peso ao nascer.

The authors studied 1,024 newborns in Recife, Brazil, to determine the association between arm circumference and birth weight. A strong correlation between these two parameters was found (R = +0.78). Specificity and sensitivity of this measurement in detecting low birth weight were also high. The authors concluded that arm circumference can be used as an alternative method of detecting at-risk neonates in areas where birth weight cannot be measured accurately.

Evaluation of newborn arm circumference as an indicator of low birth weight.

A sample of 1,024 newborns in Recife, Brazil, was studied to help determine the precision with which arem circumference measurements could be used to indicate low birth weight. The results support the view that when birth weight data are unobtainable, arm circumference measurements may be of value in screening for newborns needing special care.