[Determinant factors in the variations of perinatal mortality rates]. / Fatores determinantes nas variacoes das taxas de mortalidade perinatal.

PIP: A comparative study on the gestational, neonatal, and perinatal death rates between September 1979-August 1980 and September 1980-August 1981 at the University Hospital, Federal University of Santa Maria was conducted. A significant difference was found between these 2 periods with regard to gestational and perinatal death rates. There were more deaths, gestational and neonatal, in fetuses less thann 38 weeks gestation. The majority of neonatal deaths occurred within 72 hours after birth (75.0%). Apgar scores of 7 at the 1st and 5th minutes were registered for 70.3 and 59.5% of the infants, respectively. Autopsy was not performed in the 1st study period while 70.0% of the cases in the 2nd period were examined postmortem. The number of perinatal deaths from those among the previous controls was significantly lower than from those patients otherwise treated. The increase in the number of outpatient cases, the adoption of new routines, as well as the reformulation of existing ones, the purchase of equipment to better evaluate fetal well-being, as well as other changes during the 2nd phase, are responsible for the lowering of perinatal mortality. (author's modified)^ieng

Fatores determinantes nas variacoes das taxas de mortalidade perinatal. / Determinant factors in the variations of perinatal mortality rates

Os autores estudaram, de forma comparativa os coeficientes de mortalidade gestacional neonatal e perinatal nos periodos de setembro de 1979 a agosto de 1980 e de setembro de 1980 a agosto de 1981, no Hospital Universitario da Universidade Federal de Santa Maria. Houve diferenca significante entre os dois periodos, nos coeficientes de mortalidade gestacional e perinatal. Foi observado um obituario mais elevado, tanto gestacional como neonatal, em conceptos com idade inferior a 38 semanas. A grande maioria dos obitos neonatais ocorreram antes das 72 horas (75%). Os neomortos, ao nascimento tiveram indice de Apgar < 7 no 1o. e 5o. minutos, em 70,3% e 59,5% respectivamente. Nao houve estudo de necropsia no primeiro periodo enquanto que no segundo 70,0% dos casos foram a necropsia. O numero de obitos perinatais de pacientes que realizaram controle pre-natal foi significativamente inferior as que nao realizaram. O aumento da capacidade de atendimento ambulatorial, a implantacao de novas rotinas bem como a reformulacao das ja existentes, a aquisicao de equipamentos possibilitando uma melhor avaliacao fetal, entre outras modificacoes ocorridas no segundo periodo, sao responsabilizadas pelas diferencas nos indices de mortalidade perinatal

Acao do estriol sobre a atrofia vaginal de pacientes pos-menopausicas. / Action of oestriol upon the vaginal atrophy of postmenopausal women

Vinte pacientes pos-menopausicas apresentando atrofia vaginal foram tratadas com creme vaginal contendo estriol durante tres semanas. Os resultados obtidos apos o periodo de observacao demonstraram que houve melhora estatisticamente significativa do trofismo vaginal em 14 pacientes (70%), do indice menopausico de Kupperman em todas as pacientes (100%), da filancia do muco cervical em 19 paicentes (95%) e da cristalizacao do muco cesrvical em 14 pacientes (70%).Nao foram observados efeitos colaterais significantes

Quantitative evaluation of joint motion sensation in an aging population.

Fifty-two neurologically normal subjects from 61 to 84 years in age were evaluated for sensitivity of perception of joint motion. Right and left metacarpophalangeal and metatarsophalangeal joints were passively moved in an ever-increasing amplitude in a sinusoidal flexion-extension mode. Precise measurements of the amplitude of the angle of deviation where the subjects felt motion were made and stored with the help of a computer. A younger cohort 19 to 34 years in age was also tested. The older subjects did less well in perceiving motion at the lowest frequency in the metatarsophalangeal joints. When the older cohort was separated in semidecades and compared to each other, as well as the younger cohort, all differences of motion threshold perception lost significance. It is concluded that there is no major decline in joint motion sensation with aging.

Quantitation of motion perception in the digits: a psychophysical study in normal human subjects.

Threshold perception of motion of the digits was obtained in 14 normal subjects. The metacarpophalangeal joint of the index and the fifth finger of each hand and the metatarsophalangeal joint of the hallux of each foot were passively moved up and down with respect to a horizontal plane defined by the palmar or plantar surface. The motion was sinusoidal at frequencies of 0.5 and 5.0 Hz. A mpdified von Békésy paradigm similar to that used in audiometry was utilized to yield threshold levels of motion sensation. There was little difference in the thresholds obtained for the different joints. The difference between high- and low-frequency stimulation, however, was significant (p less than 0.001): the 0.5 Hz threshold was found to range from 0.8 to 1.0 degree, whereas the 5.0 Hz threshold varied from 0.4 to 0.6 degree. It is thought that motion sense is largely dependent on joint receptor contributions, but muscle and cutaneous receptors may also contribute to this proprioceptive sensation.

Neurological manifestations of aging.

A group of 51 socially active, self-declared neurologically normal subjects ranging from 61 to 84 years of age were studied with a battery of clinical neurological examinations and a semiquantitative vibration perception test. None of the subjects showed a consistent pattern of neurological deficit that could be identified as pathological. On review of systems, the most frequent complaints were difficulty remembering names, numbness and tingling of fingers and toes, and headaches. In the neurological examination, the most commonly observed abnormalities were positive palmomental reflex, snout reflex, abnormalities in pursuit eye movements, convergence insufficiency, and minor mistakes in perception of light touch. There was no apparent trend of worsening of symptoms and signs with advancing age. In the semiquantitative testing of vibration perception, there was a slight trend toward worsening of vibration perception in the upper and lower extremities with advancing age. Motor abnormalities were absent, and there were relatively few subjects who showed reflex abnormalities. This study confirms the previously reported diminution of vibration perception with aging. Caution must be exercised before attributing myotatic reflex and motor abnormalities to the aging process alone.

[Spontaneous and induced abortion. An epidemiological study]. / Abortamento espontaneo e provocado. Estudo epidemiologico.

PIP: 514 women, who were hospitalzed for abortion in a Brazilian hospital 783 times in 1970-1974, were studied. In the same period, there were 2872 deliveries (3.6 deliveries for each abortion). The abortions were divided approximately equally between married and single women (50.6% and 47.3%, respectively). 434 abortions (55.4%) were classified as spontaneous, 152 (19.5%) as induced, and 197 (25.1%) unspecified. The study showed 15.1 spontaneous and 5.2 induced abortions per 100 deliveries; it is pointed out, however, that these figures only reflect hospital cases, and the actual total number of induced abortions in the area studied is estimated to be 3 times as high. The number of abortions increased by 51.08% from 1972 to 1973, and by 20.14% form 1973 to 1974. The average duration of hospitalization was 2.8 days. In 1973-1974, 73 out of 306 cases (23.8%) required blood transfusions (average 870 ml). Complications were present in 21 cases (2.68%), without any fatal cases. The average cost of hospitalization (excluding professional personnel costs) was Cr$330.74 over the 4-year period, and the total cost at the time of publication is estimated as approximately 1000 cruzeiros.^ieng