Ankle torque steadiness and gait speed after a single session of robot therapy in individuals with chronic hemiparesis: a pilot study.

Background: Anklebot therapy has proven to be effective in improving hemiparetic gait. However, neither ankle torque steadiness nor the relationship between changes in force control and functional tasks after therapy with Anklebot were described.Objective: To assess whether a single session of robotic therapy promotes short-term ankle adaptations that influence ankle torque steadiness and walking speed in individuals with chronic hemiparesis.Methods: A sample of participants who had residual hemiparesis deficits (hemiparesis group; n = 13) and age- and sex-matched healthy control participants (control group; n = 13). For sample characterization, balance, mobility, sensorimotor impairment, and daily living activities performance were measured.Results: Differences in functional tests were identified only when the control and hemiparesis groups (F = 29.1; p = .001) were compared during the 10-metre Walking Test. Regarding the pre- and post-robotic assistance session, no significant difference was observed for any comparison (p > .05), except for the steadiness test, as demonstrated by the standard deviation (F = 7.10; p = .01) and coefficient of variation (F = 6.20; p = .02). The hemiparesis group showed better torque steadiness during dorsiflexion post-robotic assistance therapy (p ≥ 0.02) when compared with pre-robotic assessment. Correlations were identified between steadiness and walking speed variables.Conclusion:  People with chronic hemiparesis presented short-term performance gains in torque steadiness, especially during dorsiflexion, after a single robotic therapy session. The robotic therapy did not influence the walking speed, although low to moderate correlations between torque steadiness variables and walking speed were observed.

New evidence for refinement of anesthetic choice in procedures preceding the forced swimming test and the elevated plus-maze.

Previous studies indicated that some general anesthetics induce long-term antidepressant and/or anxiolytic-like effects. This raises the concern about the use of anesthesia in surgeries that precede psychopharmacological tests, since it may be a potential bias on results depending on the experimental design used. Thus, we evaluated whether general anesthetics used in surgeries preceding psychopharmacological tests would affect rats behavior in tests predictive of antidepressant or anxiolytic-like effects. We tested if a single exposure to sub-anesthetic or anesthetic doses of tribromoethanol, chloral hydrate, thiopental or isoflurane would change rats behavior in the forced swimming test (FST) or in the elevated plus-maze (EPM) test, at 2 h or 7 days after their administration. We also evaluated whether prior anesthesia would interfere in the detection of the antidepressant-like effect of imipramine or the anxiolytic-like effect of diazepam. Previous anesthesia with the aforementioned anesthetics did not change rats behaviors in FST per se nor it changed the antidepressant-like effect induced by imipramine treatment. Rats previously anesthetized with tribromoethanol or chloral hydrate exhibited, respectively, anxiogenic-like and anxiolytic-like behaviors in the EPM. Prior anesthesia with thiopental or isoflurane did not produce any per se effect in rats behaviors in the EPM nor disturbed the anxiolytic-like effect of diazepam. Our results suggest that, in our experimental conditions, tribromoethanol and chloral hydrate are improper anesthetics for surgeries that precede behavioral analysis in the EPM. Isoflurane or thiopental may be suitable for anesthesia before evaluation in the EPM or in the FST.

Avaliação de diferentes vias vacinais para vacinação contra o vírus da doença de Newcastle em aves de fundo de quintal / Assessment of different vaccination approaches against Newcastle disease virus in domestic backyard poultry

Foram avaliadas três vias de aplicação vacinal contra o vírus da doença de Newcastle em aves de criatório de fundo de quintal (AFQ) jovens e adultas. Um total de 135 AFQ foram distribuídas em tratamentos distintos de acordo com a via vacinal: via ocular (VO), água de bebida (VAB) e alimentar (VA). Cada tratamento foi representado por 40 aves (20 jovens e 20 adultas) e utilizou-se um grupo-controle de 15 aves não vacinadas. O programa de vacinação estabelecido constou de uma primovacinação e dois reforços vacinais, utilizando-se a cepa La Sota. Para aves jovens, os títulos obtidos pelas VO e VAB não diferiram aos 15, 45 e 140 dias, mas houve diferenças nos títulos das aves vacinadas pela VA. Nas aves adultas, a vacinação pela VO apresentou resultados mais elevados que as vacinações pelas VAB e VA na primeira resposta, aos 15 dias. Aos 45 dias, os títulos obtidos pela VAB foram mais baixos que os obtidos pela VO, e, aos 140 dias, não houve diferença entre as três vias avaliadas. Concluiu-se que as vacinações pelas VO e VAB constituem alternativas eficazes para vacinação de AFQ jovens e adultas.

Three ways of vaccination against Newcastle Disease Virus (NDV) were evaluated in young and adults domestic backyard poultry (DBP). A total of 135 DBP was submitted to three different administration routes of ND vaccine: eye-drop, drinking water, and feed. Each treatment consisted of 40 birds (20 young and 20 adult) and a control group of 15 unvaccinated birds. The treatment consisted of a first vaccination and two boosters, using La Sota strain. For young birds, the eye-drop and drinking water vaccinations presented no differences at 15, 45, and 140 days, differing from the titers obtained by birds treated by feed vaccination method. In the adult birds, the eye-drop administration presented higher titers than by drinking water and feed approaches in the first response to the vaccination at 15 days. At 45 days, the results obtained by the drinking water had lower titers than those from the eye-drop. The three vaccination methods presented no difference at 140 days. In conclusion, the vaccination by eye-drop and drinking water methods constituted an efficient alternative of vaccination for adult and young DBP against Newcastle virus.

[Women and contraception: knowledge and use of contraceptive methods]. / Mulher e anticoncepção: conhecimento e uso de métodos anticoncepcionais.

This article analyzes knowledge and use of contraceptive methods in women ages 10 to 49 years residing in the southern region of the city of São Paulo in 1992. A total of 1,157 childbearing-age women were studied, focusing on variables that might define them as to: knowledge in the use of contraceptive methods and reasons for choosing a given method. We observed that 86% of the women referred knowledge of some contraceptive method, while the most common was the pill (95.3%), followed by condoms (92.6%). Meanwhile, 14% of the interviewees denied knowledge of any contraceptive method. Of the sexually active women (66.4%), 34.9% reported never having used contraceptive methods. Of those who had, 35.3% used the pill, while 42.9% had resorted to sterilization. Only 5.2% used condoms. Despite the high level of knowledge concerning contraceptive methods, especially oral contraceptives and condoms, we observed limited use of same as compared to the high sterilization rate around the age of 27, thus leaving contraception limited to the pill and female sterilization.

[Female mortality in the Municipality of São Paulo: quality of medical death certificates]. / Mortalidade feminina na região Sul do Município de São Paulo: qualidade da certificação médica dos óbitos.

OBJECTIVE: To evaluate the quality of the medical certification of deaths of 10-49 year-old women, resident in the Southern region of the city of S. Paulo METHODS: The Puffer methodology was utilized to investigate the causes of death of all 10-49 year-old women, resident in the region, and deceased in the year 1989 (664 deaths in the total). The main causes of death in the original death certificates and the "new" causes of death arisen from the research were compared. The sensitivity and the kappa index were calculated. RESULTS: In some chapters of the International Classification of Diseases and Causes of Death, 9th Revision (CID-9), a high sensitivity was found: "Diseases of the Circulatory System" (91.9%), "Neoplasms" (89.7%) and "External Causes" (84.1 %). In some others, a very low sensitivity was found. The chapter "Mental Illnesses", with a 34.3 percent sensitivity only, must be mentioned. From 11 deaths originally classified in this chapter, 32 cases were found. In most of these "new" cases, the main cause of death was found to be alcoholism. The chapter "Complications of Pregnancy, Delivery and the Puerperium", also showed a low sensitivity (44.9%). The kappa index was found to be 0.63, which indicated a regular concordance. DISCUSSION: The quality of the medical certification of causes of death is still unsatisfactory in the studied area. This poor quality may affect negatively the interventions in the area of women's health, masking the severity of important problems

[Prevalence of use of medicines during pregnancy and its relationship to maternal factors]. / Prevalência do uso de medicamentos na gravidez e relações com as características maternas.

INTRODUCTION: There is in Brazil a growing use of industrially produced medicines even during the female reprodutive cycle. During pregnancy two organisms are exposed to the effects of medicines but in the foetus this may result in toxicities with possible irreversible lesions. The present study aims at verifying the prevalence of the use of medicines during pregnancy in the studied population and its relationship with maternal characteristics, the pharmacological groups used and the source of prescription. METHODS: The use of medication was evaluated among 1,620 women that gave birth in five public, private and contracted hospitals in the city of S. Paulo between July and September 1993. RESULTS AND CONCLUSIONS: The relation between maternal schooling and kind of assistance in hospitals has revealed social inequality in the access to the several kinds of delivery assistance services. The prevalence of use of at least one medicine was 97.6% with an average of 4.2 drugs per woman. The prevalence of use of drugs by medical prescription and self-medication were 94.9% and 33.5%, respectively. The most used medications, excluding vitamins, mineral salts and vaccines, were analgesics, antacids, antispasmodics and antemetics. Users of the largest number of medicines were, characteristically, over 29, married, of university level, salaried workers and had access to private health services. Medical assistance had a facilitating role in access to the use of drugs during the gestational period of the population studied. Women need to be made aware of the potential risks they expose their foetuses to when using so many medicines. Physicians should reflect on their role in contributing to the solution to this problem.

Mid-upper arm circumference in pregnant women and its relation to birth weight.

OBJECTIVE: In order to determine the relationship between some maternal anthropometric indicators and birth weight, crown-heel length and newborn's head circumference, 92 pregnant women were followed through at the prenatal service of hospital in S. Paulo, Brazil. MATERIAL AND METHOD: The following variables were established for the mother: weight, height, mid-upper arm circumference, pre-pregnancy weight, gestational weight gain and Quetelet's index. For the newborn the following variables were recorded: birth weight, crown-heel length, head circumference and gestational age by Dubowitz's method. RESULTS: Significant associations were noted between gestational age and newborn variables. In addition, maternal mid-arm circumference (MUAC) and pre-pregnancy weight were found to be positively correlated to birth weight (r = 0.399; r = 0.378, respectively). The multivariate linear regression shows that gestational age, mother's arm circumference and pre-pregnancy weight continue to be significant predictors of birth weight. On the other hand, only gestational age and mother's age was associated with crown-heel length. Similarly MUAC was significantly associated with crown-heel length (r = 0.306; P = 0.0030). CONCLUSION: Maternal mid-upper arm circumference is a potential indicator of maternal nutritional status. It could be used in association with other anthropometric measurements, instead of pre-pregnancy weight, as an alternative indicator to assess women at risk of poor pregnancy outcome.

Retardo de crecimiento intrauterino: un desafío para la salud pública / Intrauterine growth retardation: challenge for the public health

Este artículo es una revisión de la literatura más reciente con respecto al Retardo de Crecimiento Intra-uterino. Este trabajo se propuso verificar los avances en relación al conocimiento de la etiología, prevención, diagnóstico y tratamiento del Retardo de Crecimiento Intra-uterino; así como, identificar los aspectos aún no estudiados.

[Pregnancy in adolescents: a comparative study]. / Gravidez na adolescência: estudo comparativo.

A population of 349 women who gave birth, in an Obstetric Clinic in Greater S. Paulo, Brazil, during the period from 01/05/86 to 31/07/86 were studied. The results show that the group of pregnant adolescents (22.2%) received inadequate prenatal assistance, as the large majority of them (70.6%) started consultations during the second trimester of their pregnancy, and had an average of two consultations. During pregnancy this group presented a lower incidence of pathological disorders leading to out-patient and hospital treatment (39.3% and 7.9%, respectively) than did the adult pregnant women (44.4% and 14.7%, respectively). With regard to the type of delivery, the adolescents underwent a larger proportion of surgical deliveries, 25.7% of forceps births and 22.9% of cesarean sections, as compared with 14.7% and 19.7%, respectively, for the adult pregnant women. A larger proportion of intra-parturition intercurrencies was registered for the pregnant adolescents (12.9%, as against 8.2% for the adult pregnant women), hemorrhage and toxemia being the most important. During the puerperium there were complications in 15.7% of the pregnant adolescents and 11.8% of the adults post partum anemia, toxemia and puerperal infection being the commonest disorders.

[Maternal and perinatal health status in the State of São Paulo, Brazil]. / Situação de saúde materna e perinatal no Estado de São Paulo, Brasil.

The assistance offered during pregnancy and labour as also to the newborn child, and its relationship to maternal and perinatal mortality in the State of S. Paulo in 1984, is analysed on the basis of official available data. With respect to prenatal care the number of visits per woman was considered to be "sufficient" though of doubtful quality. The proportion of cesarean sections was very high (46.2%). Maternal mortality was found to be 4.86 deaths per 10,000 live births, but despite its being high, this figure is certainly too low and the correct figure is probably twice as high. The principal cause of maternal deaths is toxemia in pregnancy, followed by hemorrhage and abortion. Most of these deaths could have been avoided with care during pregnancy and labour. The rate of perinatal mortality was found to be 29.2 deaths per thousand births in 1984. This figure is also very high. The analysis of the causes of death for this period showed that the disorders which arose during the perinatal period were responsible for 90 per cent of the total number of deaths. The main causes of death in this group were the intra-uterine hypoxias and anoxias, asphyxia, respiratory distress syndrome and massive aspiration syndrome. These data bring to light the poor quality of the care offered to this group. The authors trust that the new policy of the Decentralized and Unified System of Health will take the quality of care as much as the integration of services into consideration with a view to overcoming the precarious maternal and perinatal health situation in S. Paulo.

[Maternal mortality in Brazil, 1980]. / Mortalidade materna no Brasil, 1980.

PIP: The authors studied Brazilian maternal mortality by examining official statistics from the country's various geographical regions, including the state of Sao Paulo, Brazil. 1980 was selected because of the possibility of working with data from the Population Census of that year. The principal causes of death in Brazil were hypertension, hemorrhage, puerperal infection, and abortion. In Sao Paulo, where the 4th digit of the IDC is used, the main cause of death was eclampsia. The 2nd was hemorrhage, and the 3rd was infection, whether due to or associated with pregnancy. As for age, the lowest maternal mortality rate occurred in the 20-29 year old age group, the rate was slightly higher for those ages 15-19, and increasing gradually in those ages 30-39 and 40-49. It was not possible to analyze the rates for those ages 10-14 and over age 50 because of lack of data on livebirths. However, there were 18 deaths and 4 deaths respectively in those groups which shows that at opposite poles of the reproductive span, there exists a considerably high mortality rate. In comparing these data with those of other countries, it was found that the majority of deaths are avoidable and that it should be possible to reduce the number considerably by means of better health care for women and by using techniques and resources which are already available. (author's modified)^ieng