Courtship and Reproduction of the Whitetip Reef Shark Triaenodon obesus (Carcharhiniformes: Carcharhinidae) in an Ex Situ Environment, with a Description of the Late Embryonic Developmental Stage.

Elasmobranchs represent a group of species under considerable anthropic pressure because of the scale of industrial and artisanal fisheries and the loss of essential areas for nursery and feeding, which are causing substantial population losses around the world. Reproduction in an ex situ environment enables a healthy population to be built and maintained in networks of public aquariums, increasing our knowledge of elasmobranch reproductive biology and offering the opportunity for reintroductions in areas where native populations have been removed. The study reports two successful pregnancies of the whitetip reef shark Triaenodon obesus, considered a vulnerable species by the International Union for the Conservation of Nature. Copulation and gestation data are provided, including ultrasound recordings of the late stage of embryo development. Ultrasonography was performed with the GE Logiq and convex transducer and revealed a fetus with defined fins and organogenesis, with definition of eyes, gills, liver, a heart with individualized chambers, partially defined kidneys, and a well-defined spiral intestine. A cartilaginous skeleton forming a posterior acoustic shadow was detailed, as well as a moving fetus with a biparietal diameter of 6.47 cm and a heart rate of 62 Beats Per Minute on spectral Doppler. This is the first successful reproduction of T. obesus in an aquarium in Brazil.

New Occurrences of the Tiger Shark (Galeocerdo cuvier) (Carcharhinidae) off the Coast of Rio de Janeiro, Southeastern Brazil: Seasonality Indications.

The tiger shark Galeocerdo cuvier (Péron & Lesueur, 1822) (Carcharhinidae) is classified as near-threatened along the Brazilian coast, in line with its global categorization. Although Rio de Janeiro, located in southeastern Brazil, is internationally identified as a priority shark conservation area, many shark species, including tiger sharks, are landed by both industrial and artisanal fisheries in this state. However, there is a lack of detailed information on the species capture pressures and records for the state of Rio de Janeiro. Therefore, the aims of this study were to expand the tiger shark record database and to improve upon future conservation and management strategies. Tiger shark records from four coastal Rio de Janeiro regions were obtained by direct observation. The information obtained from fishery colonies/associations, environmental guards, researchers, and scientific articles, totaling 23 records, resulted in an approximately 5-fold increase in the number of tiger shark records off the coast of the state of Rio de Janeiro. A possible seasonality pattern concerning the size of the captured/observed animals was noted, emphasizing the need to consider the coast of Rio de Janeiro as an especially relevant area for at least part of the life history of tiger sharks.

Use of a species-rich and highly eutrophic tropical estuary in the South Atlantic by Pleuronectiformes (Teleostei: Acanthopterygii) / Uso de um estuário tropical rico em espécies e altamente eutrofizado no Atlântico Sul por Pleuronectiformes (Teleostei: Acanthopterygii)

Abstract: A total of 1,471 specimens of 16 species of flatfishes (Pleuronectiformes) were caught during 48 sampling campaigns between July 2005 and June 2007 at ten stations in Guanabara Bay, Rio de Janeiro, Brazil. Paralichthyidae was the dominant family, with Etropus crossotus as the dominant species. The outer stations, especially those on the western side of the lower estuary, were distinguished as a result of their higher abundance of flatfishes and number of species. The spatial distribution of E. crossotus and its population structure indicate that this species is an estuarine resident despite the apparent reduction in its area of occupation within the estuarine complex. Among the other species, nine were classified as marine stragglers (Achirus declivis, Bothus ocellatus, Cyclopsetta chittendeni, Etropus longimanus, Paralichthys orbignyanus, P. patagonicus, Syacium micrurum, Symphurus diomedeanus and Trinectes paulistanus) and three as estuarine opportunists (Bothus robinsi, Citharichthys macrops and Syacium papillosum); another three could not be classified due to the small number of captures or lack of previous data (S. tessellatus, A. lineatus and C. spilopterus).

Resumo: Um total de 1.471 espécimes de 16 espécies de linguados (Pleuronectiformes) foram capturados durante 48 campanhas de amostragem entre julho de 2005 e junho de 2007 em dez estações na Baía de Guanabara, Rio de Janeiro, Brasil. Paralichthyidae foi a família dominante, com Etropus crossotus como a espécie dominante. As estações externas, especialmente aquelas no lado ocidental do baixo estuário, foram distinguidas como resultado de sua maior abundância de linguados e número de espécies. A distribuição espacial de E. crossotus e sua estrutura populacional indicam que esta espécie é uma residente estuarina, apesar da aparente redução em sua área de ocupação dentro do complexo estuarino. Dentre as outras espécies, nove foram classificadas como migrantes marinhos (Achirus declivis, Bothus ocellatus, Cyclopsetta chittendeni, Etropus longimanus, Paralichthys orbignyanus, P. patagonicus, Syacium micrurum, Symphurus diomedeanus e Trinectes paulistanus) e três como oportunistas estuarinos (Bothus robinsi, Citharichthys macrops e Syacium papillosum); outras três não puderam ser classificados devido ao pequeno número de capturas ou falta de dados prévios (S. tessellatus, A. lineatus e C. spilopterus).

Implementation of a multifaceted sepsis education program in an emerging country setting: clinical outcomes and cost-effectiveness in a long-term follow-up study.

PURPOSE: To evaluate whether a multifaceted, centrally coordinated quality improvement program in a network of hospitals can increase compliance with the resuscitation bundle and improve clinical and economic outcomes in an emerging country setting. METHODS: This was a pre- and post-intervention study in ten private hospitals (1,650 beds) in Brazil (from May 2010 to January 2012), enrolling 2,120 patients with severe sepsis or septic shock. The program used a multifaceted approach: screening strategies, multidisciplinary educational sessions, case management, and continuous performance assessment. The network administration and an external consultant provided performance feedback and benchmarking within the network. The primary outcome was compliance with the resuscitation bundle. The secondary outcomes were hospital mortality, hospital and ICU length of stay, quality-adjusted life year (QALY) gain, and cost-effectiveness. RESULTS: The proportion of patients who received all the required items for the resuscitation bundle improved from 13% [95% confidence interval (CI) 8-18%] at baseline to 62% (95% CI 54-69%) in the last trimester (p < 0.001). Hospital mortality decreased from 55% (95% CI 48-62%) to 26% (95% CI 19-32%, p < 0.001). Full compliance with the resuscitation bundle was associated with lower risk of hospital mortality (propensity weighted corrected risk ratio 0.74; 95% CI 0.56-0.94, p = 0.02). There was a reduction in the total cost per patient from 29.3 (95% CI 23.9-35.4) to 17.5 (95% CI 14.3-21.1) thousand US dollars from baseline to the last 3 months (mean difference -11,815; 95% CI -18,604 to -5,338). The mean QALY increased from 2.63 (95% CI 2.15-3.14) to 4.06 (95% CI 3.58-4.57). For each QALY, the full compliance saves US$5,383. CONCLUSIONS: A multifaceted approach to severe sepsis and septic shock patients in an emerging country setting led to high compliance with the resuscitation bundle. The intervention was cost-effective and associated with a reduction in mortality.

Clinical significance in non-cystic fibrosis bronchiectasis followed in a real practice / Relevância clínica em não fi brose cística bronquiectasia seguida em uma prática real

INTRODUCTION: Bronchiectasis is a chronic disorder characterized by permanent dilation of the bronchi and bronchioles accompanied by inflammatory changes in the walls of these structures and adjacent lung parenchyma. OBJECTIVE: The aim of the present study was to perform a clinical and functional characterization of adult patients with non-cystic fibrosis bronchiectasis. METHODS: A clinical, descriptive, retrospective, case-series study was carried out involving 232 patients with non-cystic fibrosis bronchiectasis treated at a lung ambulatory between 2004 and 2012. RESULTS: The sample consisted of 232 patients (134 females; mean age: 52.9 years ± 17.7; body mass index: 23.5 kg/m² ± 4.4). The predominant symptoms were cough (91.4%), expectoration (85.8%) and dyspnea (76.3%). The majority of cases were of a non-tuberculosis etiology (64.7%). Regarding lung function, the obstructive breathing pattern was predominant (43.5%). The most common comorbidities were of a cardiovascular origin (51.0%). CONCLUSIONS: Adult patients with non-cystic fibrosis bronchiectasis (mainly post-infection or post-tuberculosis in origin) are characterized by a low educational level, excessive cough, sputum, dyspnea, muscle fatigue, an obstructive breathing pattern with frequent hypoxemia and multiple comorbidities, mainly of a cardiovascular origin. However, our patients have a low index of exacerbations and hospitalizations that can be assigned to a clinical protocol for monitoring.

INTRODUÇÃO: Bronquiectasia é uma doença crônica caracterizada pela dilatação permanente dos brônquios e bronquíolos acompanhada por alterações inflamatórias nas paredes dessas estruturas e parênquima pulmonar adjacente. OBJETIVO: O objetivo do presente estudo é realizar uma caracterização clínica e funcional de pacientes adultos com bronquiectasias e fibrose não cística. Métodos: Um estudo clínico descritivo e retrospectivo foi realizado com pacientes com bronquiectasias e fibrose não cística atendidos em um ambulatório de pulmão entre 2004 e 2012. RESULTADOS: A amostra foi composta por 232 pacientes (134 mulheres, idade média: 52,9 anos ± 17,7, índice de massa corporal: 23,5 ± 4,4 kg/m2). Os sintomas predominantes foram tosse (91,4%), expectoração (85,8%) e dispneia (76,3%). A maioria dos casos foi de etiologia não tuberculosa (64,7%). Em relação à função pulmonar, o padrão de respiração obstrutiva foi predominante (43,5%). As comorbidades mais comuns foram de origem cardiovascular (51,0%). CONCLUSÕES: pacientes adultos com bronquiectasias de fibrose não cística (principalmente pós-infecção ou pós-tuberculose de origem) são caracterizados por um baixo nível de escolaridade, tosse excessiva, expectoração, dispneia, fadiga muscular, um padrão de respiração obstrutiva com hipoxemia frequente e múltiplas comorbidades, essencialmente de origem cardiovascular. No entanto, nossos pacientes têm um baixo índice de exacerbações e hospitalizações que podem ser atribuídos a um protocolo clínico para o acompanhamento.

Reclassificando o espectro de pacientes septicos com o uso do lactato: sepse grave, choque criptico, choque vasoplegico e choque disoxico / Reclassifying the spectrum of septic patients using lactate: severe sepsis, cryptic shock, vasoplegic shock and dysoxic shock

Objetivo: A definição atual de sepse grave e choque séptico inclui um perfil heterogêneo de pacientes. Embora o valor prognóstico de hiperlactatemia seja bem estabelecido, ela está presente em pacientes com ou sem choque. Nosso objetivo foi comparar o prognóstico de pacientes sépticos estratificando-os segundo dois fatores: hiperlactatemia e hipotensão persistente. Métodos: Este estudo é uma análise secundária de um estudo observacional conduzido em dez hospitais no Brasil (Rede Amil - SP). Pacientes sépticos com valor inicial de lactato das primeiras 6 horas do diagnóstico foram incluídos e divididos em 4 grupos segundo hiperlactatemia (lactato >4mmol/L) e hipotensão persistente: (1) sepse grave (sem ambos os critérios); (2) choque críptico (hiperlactatemia sem hipotensão persistente); (3) choque vasoplégico (hipotensão persistente sem hiperlactatemia); e (4) choque disóxico (ambos os critérios). Resultados: Foram analisados 1.948 pacientes, e o grupo sepse grave constituiu 52% dos pacientes, seguido por 28% com choque vasoplégico, 12% choque disóxico e 8% com choque críptico. A sobrevida em 28 dias foi diferente entre os grupos (p<0,001), sendo maior para o grupo sepse grave (69%; p<0,001 versus outros), semelhante entre choque críptico e vasoplégico (53%; p=0,39) e menor para choque disóxico (38%; p<0,001 versus outros). Em análise ajustada, a sobrevida em 28 dias permaneceu diferente entre os grupos (p<0,001), sendo a maior razão de risco para o grupo choque disóxico (HR=2,99; IC95% 2,21-4,05). Conclusão: A definição de pacientes com sepse inclui quatro diferentes perfis, se considerarmos a presença de hiperlactatemia. Novos estudos são necessários para melhor caracterizar pacientes sépticos e gerar conhecimento ...

Objective: The current definition of severe sepsis and septic shock includes a heterogeneous profile of patients. Although the prognostic value of hyperlactatemia is well established, hyperlactatemia is observed in patients with and without shock. The present study aimed to compare the prognosis of septic patients by stratifying them according to two factors: hyperlactatemia and persistent hypotension. Methods: The present study is a secondary analysis of an observational study conducted in ten hospitals in Brazil (Rede Amil - SP). Septic patients with initial lactate measurements in the first 6 hours of diagnosis were included and divided into 4 groups according to hyperlactatemia (lactate >4mmol/L) and persistent hypotension: (1) severe sepsis (without both criteria); (2) cryptic shock (hyperlactatemia without persistent hypotension); (3) vasoplegic shock (persistent hypotension without hyperlactatemia); and (4) dysoxic shock (both criteria). Results: In total, 1,948 patients were analyzed, and the sepsis group represented 52% of the patients, followed by 28% with vasoplegic shock, 12% with dysoxic shock and 8% with cryptic shock. Survival at 28 days differed among the groups (p<0.001). Survival was highest among the severe sepsis group (69%, p<0.001 versus others), similar in the cryptic and vasoplegic shock groups (53%, p=0.39), and lowest in the dysoxic shock group (38%, p<0.001 versus others). In the adjusted analysis, the survival at 28 days remained different among the groups (p<0.001) and the dysoxic shock group exhibited the highest hazard ratio (HR=2.99, 95%CI 2.21-4.05). Conclusion: The definition of sepsis includes four different profiles if we consider the presence of hyperlactatemia. Further studies are needed to better characterize septic patients, to understand the etiology and to design adequate targeted treatments. .

Reclassifying the spectrum of septic patients using lactate: severe sepsis, cryptic shock, vasoplegic shock and dysoxic shock.

OBJECTIVE: The current definition of severe sepsis and septic shock includes a heterogeneous profile of patients. Although the prognostic value of hyperlactatemia is well established, hyperlactatemia is observed in patients with and without shock. The present study aimed to compare the prognosis of septic patients by stratifying them according to two factors: hyperlactatemia and persistent hypotension. METHODS: The present study is a secondary analysis of an observational study conducted in ten hospitals in Brazil (Rede Amil - SP). Septic patients with initial lactate measurements in the first 6 hours of diagnosis were included and divided into 4 groups according to hyperlactatemia (lactate >4mmol/L) and persistent hypotension: (1) severe sepsis (without both criteria); (2) cryptic shock (hyperlactatemia without persistent hypotension); (3) vasoplegic shock (persistent hypotension without hyperlactatemia); and (4) dysoxic shock (both criteria). RESULTS: In total, 1,948 patients were analyzed, and the sepsis group represented 52% of the patients, followed by 28% with vasoplegic shock, 12% with dysoxic shock and 8% with cryptic shock. Survival at 28 days differed among the groups (p<0.001). Survival was highest among the severe sepsis group (69%, p<0.001 versus others), similar in the cryptic and vasoplegic shock groups (53%, p=0.39), and lowest in the dysoxic shock group (38%, p<0.001 versus others). In the adjusted analysis, the survival at 28 days remained different among the groups (p<0.001) and the dysoxic shock group exhibited the highest hazard ratio (HR=2.99, 95%CI 2.21-4.05). CONCLUSION: The definition of sepsis includes four different profiles if we consider the presence of hyperlactatemia. Further studies are needed to better characterize septic patients, to understand the etiology and to design adequate targeted treatments.

Flow injection photometric determination of NaCl, KCl and glucose in injectable drugs exploiting Schlieren signals.

A flow injection photometric system that exploits Schlieren signals for analytical measurement is described. The system was designed to be used as a new strategy for determining the contents of sodium chloride, potassium chloride and glucose, each respectively in injectable drugs. The proposed methodology was based on the difference between the refractive indices of the sample zone and of the carrier stream. With this perspective, a lab-made photometer based on LED-phototransistor technology was employed as a detection system to investigate the different analytical profiles related to the Schlieren effect in low flow rate conditions. The parameters of the flow system, such as flow-rate, optical path length, and sampling loop, were adjusted in order to obtain suitable Schlieren profiles for the measurements. Data evaluation was performed with the application of partial least squares regression (PLS-1). The obtained results demonstrated the predictive ability of the constructed PLS models, and the predicted concentration values were in agreement with the reference values, with a 95% confidence level.

Levantamento randomizado sobre a prevalência de tabagismo nos maiores municípios do Brasil / Random sample survey on the prevalence of smoking in the major cities of Brazil

OBJETIVO: Divulgar os dados de um estudo transversal randomizado, realizado em 2001, pelo Centro Brasileiro de Informações sobre Drogas Psicotrópicas. MÉTODOS: A população pesquisada neste levantamento incluiu indivíduos com 12-65 anos de idade, residentes nos 107 maiores municípios do Brasil (com mais de 200 mil habitantes), o que representou 27,7 por cento da população brasileira na época, estimada em 169.799.170 habitantes. Foram realizadas no total 8.589 entrevistas. Utilizou-se o questionário Substance Abuse and Mental Health Services Administration, que foi traduzido e adaptado para o uso no Brasil. RESULTADOS: Do total, 41,1 por cento dos entrevistados disseram já ter utilizado produtos derivados de tabaco alguma vez na vida. A prevalência de uso diário de tabaco foi de 17,4 por cento da amostra (20,3 por cento entre os homens e 14,8 por cento entre as mulheres). Observou-se que 9 por cento da população (10,1 por cento entre os homens e 7,9 por cento entre as mulheres) são dependentes da nicotina, segundo os critérios do National Household Surveys on Drug Abuse. CONCLUSÕES: A prevalência do uso diário de tabaco, nos maiores municípios brasileiros, é significativamente menor na presente década do que a prevalência nacional ao final do século passado.

OBJECTIVE: To provide access to the results of a randomized cross-sectional study conducted by the Brazilian Center for Information on Psychotropic Drugs in 2001. METHODS: This survey involved a random sample of individuals ranging from 12 to 65 years of age and residing in the 107 largest cities (over 200,000 inhabitants) in Brazil, which represented 27.7 percent of the Brazilian population, estimated to be 169,799,170 inhabitants at the time. A total of 8,589 interviews were conducted. The Substance Abuse and Mental Health Services Administration questionnaire, translated and adapted for use in Brazil, was used in the interviews. RESULTS: Of the sample as a whole, 41.1 percent of the interviewees reported having experimented with tobacco products. The prevalence of daily smokers was 17.4 percent (20.3 percent among males and 14.8 percent among females). We found that 9 percent of the sample (10.1 percent of the men and 7.9 percent of the women) were nicotine-dependent, according to the criteria of the National Household Survey on Drug Abuse. CONCLUSIONS: The prevalence of current smoking in the 107 largest cities of Brazil is significantly lower in this decade than was the national prevalence at the end of last century.

A 10-year single-center prospective study of endovascular abdominal aortic aneurysm repair with the talent stent-graft.

PURPOSE: To report a 10-year prospective study of patients submitted to endovascular treatment for infrarenal abdominal aortic aneurysms (AAA). METHODS: Between June 1997 and June 2007, 337 patients (284 men; mean age 72.5+/-7.4 years, range 52-89) with AAA underwent endovascular aneurysm treatment (EVAR) with implantation of Talent stent-grafts. The mean AAA diameter was 59.0+/-14.4 mm. All patients were clinically followed using computed tomography in the immediate post surgery period (15-30 days), after 6 months, and yearly thereafter. Plain abdominal radiography was performed yearly to assess the metallic components of the stent-grafts. Data concerning endoleaks, secondary procedures, and aneurysm diameter behavior were evaluated. Survival was evaluated using Kaplan-Meier estimates. RESULTS: Endoprosthesis implantations were successful in 99.1% (334/337). There were 2 surgical conversions, and the delivery system could not be inserted in 1 female patient. The perioperative mortality was 3.9% (n = 13). Nineteen (5.7%) aneurysms showed endoleaks during the first 30 days (6 type I and 13 type II); 5 type I and 3 type II endoleaks were repaired (secondary clinical success of 92.6%). Another 15 late endoleaks were detected (4 type I, 5 type II, 3 type III, 1 type IV, 2 endotension), for a total of 34 (10.2%) endoleaks. Follow-up (mean 58.7 months, range 12-120) was available in 273 (81.0%) patients. During this time, there were 2 (0.7%) aneurysm ruptures, 1 due to type III endoleak and the other to endotension. Over the course of the study, 75 patients died; the estimated survival rates by the Kaplan-Meyer analysis were 67.3% after 5 years and 54.2% after 7 years. The mean AAA diameter decreased to 45.7+/-18.4 mm (p<0.001 versus mean postoperative diameter) at 60 months and to 37.8+/-15.0 mm at 120 months (p<0.019). CONCLUSION: Endovascular aneurysm treatment with the Talent stent-graft has proven to be effective in the prevention of AAA rupture into the long term.

[Random sample survey on the prevalence of smoking in the major cities of Brazil].

OBJECTIVE: To provide access to the results of a randomized cross-sectional study conducted by the Brazilian Center for Information on Psychotropic Drugs in 2001. METHODS: This survey involved a random sample of individuals ranging from 12 to 65 years of age and residing in the 107 largest cities (over 200,000 inhabitants) in Brazil, which represented 27.7% of the Brazilian population, estimated to be 169,799,170 inhabitants at the time. A total of 8,589 interviews were conducted. The Substance Abuse and Mental Health Services Administration questionnaire, translated and adapted for use in Brazil, was used in the interviews. RESULTS: Of the sample as a whole, 41.1% of the interviewees reported having experimented with tobacco products. The prevalence of daily smokers was 17.4% (20.3% among males and 14.8% among females). We found that 9% of the sample (10.1% of the men and 7.9% of the women) were nicotine-dependent, according to the criteria of the National Household Survey on Drug Abuse. CONCLUSIONS: The prevalence of current smoking in the 107 largest cities of Brazil is significantly lower in this decade than was the national prevalence at the end of last century.

A portable, inexpensive and microcontrolled spectrophotometer based on white LED as light source and CD media as diffraction grid.

A portable, microcontrolled and low-cost spectrophotometer (MLCS) is proposed. The instrument combines the use of a compact disc (CD) media as diffraction grid and white light-emitting diode (LED) as radiation source. Moreover, it employs a phototransistor with spectral sensitivity in visible region as phototransductor, as well as a programmable interrupt controller (PIC) microcontroller as control unit. The proposed instrument was successfully applied to determination of food colorants (tartrazine, sunset yellow, brilliant blue and allura red) in five synthetics samples and Fe(2+) in six samples of restorative oral solutions. For comparison purpose, two commercial spectrophotometers (HP and Micronal) were employed. The application of the t-paired test at the 95% confidence level revealed that there are not significant differences between the concentration values estimated by the three instruments. Furthermore, a good precision in the analyte concentrations was obtained by using MLCS. The overall relative standard deviation (R.S.D.) of each analyte was smaller than 1.0%. Therefore, the proposed instrument offers an economically viable alternative for spectrophotometric chemical analysis in small routine, research and/or teaching laboratories, because its components are inexpensive and of easy acquisition.

Smoking cessation guidelines--2008.

These guidelines are an up-to-date and comprehensive tool to aid health professionals in treating smokers, recommending measures and strategies for managing each case based on clinical evidence. Written in a simplified and objective manner, the text is divided into two principal sections: Evaluation and Treatment. The sections both present comments on and levels of evidence represented by the references cited, as well as some proposals for the reduction of damage and for intervening in specific and still poorly explored situations, such as relapse, passive smoking, physician smoking, and tobacco use in specific environments.

Profile of smokers seeking a smoking cessation program.

OBJECTIVE: To define the profile of smokers who seek professional assistance through a smoking cessation program and to compare smoker profiles among males, females and elderly people. METHODS: Two-hundred and three smokers were prospectively evaluated. The participants completed questionnaires related to smoking history, history of psychiatric disorders, depression, anxiety and nicotine dependence as well as a general self-report questionnaire. RESULTS: In this sample, 58.6% of the individuals were female (119). The mean age was 45.3 +/- 12.0 years, with no statistically significant difference between genders (p = 0.391). The majority of the individuals in the sample (84.2%) presented socioeconomic class C or above. Sixty-three percent had at least a high school education. Depression was more often referred to by women, and the difference between genders was borderline significant (p = 0.069). However, when depression was evaluated using the Beck Depression Inventory, there was no statistically significant difference between genders and between elderly and nonelderly people. CONCLUSIONS: In the profile of the smokers who sought assistance, we identified aspects (such as being female and having been diagnosed with depression) that are known predictors of treatment failure. This shows the importance of carrying out a complete pre-evaluation of the profile of a smoker who seeks a smoking cessation program. Thus, procedures can be adopted prior to and during the treatment of the smoker, with the objective of increasing treatment success rates.

Diretrizes para cessação do tabagismo: 2008 / Smoking cessation guidelines: 2008

Estas diretrizes constituem uma ferramenta atualizada e abrangente para auxiliar o profissional de saúde na abordagem do tabagista, recomendando atitudes baseadas em evidências clínicas como a melhor forma de conduzir cada caso. De forma reduzida e mais objetiva possível, o texto final foi agrupado em dois grandes itens: Avaliação e Tratamento. Os dois itens apresentam comentários e níveis de recomendação das referências utilizadas, bem como algumas propostas de abordagem, como por exemplo, redução de danos, em situações específicas ainda pouco exploradas, como recaídas, tabagismo passivo, tabagismo na categoria médica e uso de tabaco em ambientes específicos.

These guidelines are an up-to-date and comprehensive tool to aid health professionals in treating smokers, recommending measures and strategies for managing each case based on clinical evidence. Written in a simplified and objective manner, the text is divided into two principal sections: Evaluation and Treatment. The sections both present comments on and levels of evidence represented by the references cited, as well as some proposals for the reduction of damage and for intervening in specific and still poorly explored situations, such as relapse, passive smoking, physician smoking, and tobacco use in specific environments.

Perfil dos fumantes que procuram um centro de cessação de tabagismo / Profile of smokers seeking a smoking cessation program

OBJETIVO: Definir o perfil do fumante que procura um serviço de cessação do tabagismo e comparar os perfis observados em homens, mulheres e idosos. MÉTODOS: Foram avaliados, prospectivamente, 203 fumantes. Os indivíduos responderam questionários relacionados ao histórico tabagístico, antecedentes psiquiátricos, questionários específicos para depressão e ansiedade, questionário de dependência à nicotina e um questionário geral auto-aplicável. RESULTADOS: Nesta amostra, 58,6 por cento dos indivíduos eram do sexo feminino (119). A média de idade para a amostra foi 45,3 ± 12,0 anos, sem diferença significante entre os sexos (p = 0,391). A maioria da amostra estudada apresentou classificação econômica C ou superior (84,2 por cento). Sessenta e três porcento dos fumantes possuíam pelo menos o segundo grau completo. Depressão foi muito mais referida entre as mulheres com diferença estatística marginalmente significante (p = 0,069). Porém, avaliando-se depressão pelo Inventário Beck de Depressão, não houve diferença estatisticamente significante entre os sexos e entre idosos e não-idosos. CONCLUSÕES: Foram identificados aspectos no perfil dos fumantes que procuraram este serviço que já são reconhecidos na literatura especializada como preditores de insucesso no tratamento (como pertencer ao sexo feminino e diagnóstico de depressão). Isto demonstra a importância de se realizar uma completa avaliação prévia do perfil do fumante que procura um centro especializado, para que medidas possam ser tomadas antes e durante a abordagem do fumante, com o objetivo de se aumentar as taxas de sucesso no tratamento.

OBJECTIVE: To define the profile of smokers who seek professional assistance through a smoking cessation program and to compare smoker profiles among males, females and elderly people. METHODS:Two-hundred and three smokers were prospectively evaluated. The participants completed questionnaires related to smoking history, history of psychiatric disorders, depression, anxiety and nicotine dependence as well as a general self-report questionnaire. RESULTS: In this sample, 58.6 percent of the individuals were female (119). The mean age was 45.3 ± 12.0 years, with no statistically significant difference between genders (p = 0.391). The majority of the individuals in the sample (84.2 percent) presented socioeconomic class C or above. Sixty-three percent had at least a high school education. Depression was more often referred to by women, and the difference between genders was borderline significant (p = 0.069). However, when depression was evaluated using the Beck Depression Inventory, there was no statistically significant difference between genders and between elderly and nonelderly people. CONCLUSIONS: In the profile of the smokers who sought assistance, we identified aspects (such as being female and having been diagnosed with depression) that are known predictors of treatment failure. This shows the importance of carrying out a complete pre-evaluation of the profile of a smoker who seeks a smoking cessation program. Thus, procedures can be adopted prior to and during the treatment of the smoker, with the objective of increasing treatment success rates.

An inexpensive, portable and microcontrolled near infrared LED-photometer for screening analysis of gasoline.

A microcontrolled, portable and inexpensive photometer is proposed. It uses a near infrared light emitting diode (NIR LED) as radiation source, a PbSe photoresistor as infrared detector and a programmable interrupt controller (PIC) microcontroller as control unit. The detector system presents a thermoresistor and a thermoelectric cooling to control the detector temperature and keep the noise at low levels. The microcontroller incorporated total autonomy on the proposed photometer. As its components are inexpensive and of easy acquisition, the proposed NIR LED-photometer is an economical alternative for chemical analyses in small routine, research and/or teaching laboratories. By being portable and microcontrolled, it also allows carrying out field chemical analyses. The instrument was successfully applied on the screening analysis to verify adulteration in gasoline samples.

Six-year experience with talent stent-graft repair of abdominal aortic aneurysms.

PURPOSE: To report a long-term experience with the Talent Endoprosthesis for the treatment of abdominal aortic aneurysm (AAA). METHODS: In the period between June 1997 and June 2003, 193 patients (171 men; mean age 71.0+/-7.8 years, range 52-89) with AAA were treated with a Talent Endoprosthesis. Patients were clinically and radiologically followed in the postoperative period, at 30 days, and then annually up to 72 months. In addition to computed tomographic scans, a plain abdominal radiogram was also performed annually for structural assessment of the stent-graft. RESULTS: Implantation success was 99.0% (191/193). Delivery system introduction was the cause of 1 failure, and the other patient was converted to surgery for intraprocedural device migration. There were 10 (5.2%) endoleaks (3 type I, 7 type II) at 30 days; all type I and 3/7 type II endoleaks were treated (93.3% secondary clinical success). Seven (3.7%) patients died in the perioperative period, including the conversion. During follow-up, 18 (9.3%) additional deaths occurred, and 4 new endoleaks (1 type I, 2 type II, 1 type III) were encountered. In up to 6 years' follow-up, the Talent Endoprosthesis did not present signs of material fatigue, but 1 component disconnection at 42 months led to death. There was no aneurysm rupture. After an initial increase in the aortic neck (1.2+/-1.1 mm) in the postoperative period, the neck diameters continued to increase until after the third year. An average reduction of 5.6+/-4.1 mm in the aneurysm diameter at 1 year was noted; the reduction gradually reached 14.1+/-10.7 mm after 60 months. CONCLUSIONS: The Talent Endoprosthesis was an efficient alternative for managing AAAs, achieving low morbidity and mortality rates and a good long-term clinical outcome in this study. The Talent Endoprosthesis did not present signs of material fatigue over a 6-year follow-up.