Aquatic macrophytes and trophic interactions: a scientometric analyses and research perspectives / Macrofitas aquáticas e interações tróficas: análise cienciométrica e perspectivas nas pesquisas

Abstract Aquatic macrophytes have a recognized role in ecosystem structuring and an important position in trophic cascades interactions, whose understanding is to improve water quality. In recent years, the number of studies on the role of aquatic macrophytes in trophic webs and interactions has increased, but South America has made little progress in research in the area. In this study, we investigated the main gaps and perspectives for future studies on macrophytes and trophic interactions, analyzing global publications, especially those conducted by South American researchers. We accessed publications using an international database (Thomson Reuters ISI-Web of Knowledge-(formerly Institute for Scientific Information)) from 1980 to 2015. We ranked each article by ecosystem and study approach, biological organization and interacting taxonomic groups (phytoplankton, periphyton, zooplankton, aquatic invertebrates, fish and birds), countries publishing in cooperation and affiliations. The results showed that published studies (n = 242) emphasizing aquatic plants in trophic interactions increased in 35 years. Comparing the contributions of the 32 countries investigated, those from South America as first affiliation, had few publications (n = 26) and in cooperation (n = 7). The largest volume of articles indexed by the researchers dealt with the dynamics and structure of aquatic assemblages, webs and trophic interactions. Ecosystems such reservoirs and wetlands have received little attention. Large numbers of studies have encompassed community-wide aquatic approaches, including in South American studies, the interactions between macrophytes, zooplankton and phytoplankton were the second most studied interactions of all indexed articles. Knowledge about trophic cascade and interactions has been successfully enhanced in several countries with the purpose of restructuring communities and restore water quality of many ecosystems. In summary, we conclude that studies in the area of trophic interactions mediated by macrophytes may be directed in a way to attenuate international asymmetries, encouraging the increase of scientific productivity in South America.

Resumo Macrófitas aquáticas tem reconhecida função na estruturação de ecossistemas e importante papel nas interações tróficas em cascata, cujo entendimento é chave para melhorar a qualidade da água. Nos últimos anos, o número de estudos sobre o papel das macrófitas aquáticas nas interações e teia trófica aumentaram mas, a América do Sul progrediu pouco em pesquisas na área. Nesse estudo investigamos as principais lacunas e perspectivas para estudos futuros sobre macrófitas e interações tróficas analisando publicações mundiais, especialmente aquelas conduzidas por pesquisadores sul-americanos. Acessamos publicações usando base de dados internacional (Thomson Reuters ISI Web of Knowledge) entre 1980 a 2015. Computamos para cada artigo a organização biológica e grupos taxonômicos em interação (fitoplâncton, perifíton, zooplâncton, invertebrados aquáticos, peixes e aves), ecossistema estudado e abordagem de pesquisa, a cooperação entre países da América do Sul e demais, além das filiações. Os resultados mostraram que estudos publicados (n = 242) enfatizando plantas aquáticas em interações tróficas cresceram em 35 anos. Comparando as contribuições dos 32 países investigados, aqueles da América do Sul apresentaram baixo número de indexações (n= 26), poucos em cooperação (n= 7). O maior volume de publicações indexadas pelos pesquisadores trataram sobre a dinâmica e estrutura das assembléias aquáticas, teias e interações tróficas. Reservatórios e áreas alagadas têm recebido pouca atenção. Grande número de estudos compreeenderam abordagems de toda comunidade aquática e interações entre macrófitas, fitoplâncton, zooplâncton e peixes. Em síntese, concluimos que estudos enfatizando as interações tróficas mediadas pelas macrófitas poderão ser direcionados de maneira a atenuar assimetrias internacionais, encorajando o aumento da produtividade científica na América do Sul. O conhecimento sobre as interações tróficas em cascata tem sido desenvolvido com sucesso em diversos países cujas finalidades tem sido reestruturar comunidades e restaurar a qualidade da água de muitos ecossistemas.

Aquatic macrophytes and trophic interactions: a scientometric analyses and research perspectives.

Aquatic macrophytes have a recognized role in ecosystem structuring and an important position in trophic cascades interactions, whose understanding is to improve water quality. In recent years, the number of studies on the role of aquatic macrophytes in trophic webs and interactions has increased, but South America has made little progress in research in the area. In this study, we investigated the main gaps and perspectives for future studies on macrophytes and trophic interactions, analyzing global publications, especially those conducted by South American researchers. We accessed publications using an international database (Thomson Reuters ISI-Web of Knowledge-(formerly Institute for Scientific Information)) from 1980 to 2015. We ranked each article by ecosystem and study approach, biological organization and interacting taxonomic groups (phytoplankton, periphyton, zooplankton, aquatic invertebrates, fish and birds), countries publishing in cooperation and affiliations. The results showed that published studies (n = 242) emphasizing aquatic plants in trophic interactions increased in 35 years. Comparing the contributions of the 32 countries investigated, those from South America as first affiliation, had few publications (n = 26) and in cooperation (n = 7). The largest volume of articles indexed by the researchers dealt with the dynamics and structure of aquatic assemblages, webs and trophic interactions. Ecosystems such reservoirs and wetlands have received little attention. Large numbers of studies have encompassed community-wide aquatic approaches, including in South American studies, the interactions between macrophytes, zooplankton and phytoplankton were the second most studied interactions of all indexed articles. Knowledge about trophic cascade and interactions has been successfully enhanced in several countries with the purpose of restructuring communities and restore water quality of many ecosystems. In summary, we conclude that studies in the area of trophic interactions mediated by macrophytes may be directed in a way to attenuate international asymmetries, encouraging the increase of scientific productivity in South America.

Adapted optimization model for planning regional wastewater systems: case study.

Wastewater systems are of crucial importance to the promotion of sustainable development. Through an integrated planning approach, the costs can be minimized and the resulting benefits maximized. A planning approach at regional level exploits the economies of scale, while achieving a better environmental performance. In this paper we set out a decision support approach for the planning of regional wastewater systems. Optimization models are used, aimed at finding optimal configurations for the location, type and size of the system's infrastructure: sewers, pump stations, and wastewater treatment plants. Solutions are evaluated in terms of the cost of installing, operating and maintaining the infrastructure, and the water quality in the river that receives the treated wastewater. The river water quality varies in accordance with the effluent discharges, and is assessed using environmental parameters. The models are solved with a simulated annealing algorithm complemented by a local improvement procedure. Its application is illustrated through a case study in the Una river basin region, in Brazil.

Aquatic macrophytes and trophic interactions: a scientometric analyses and research perspectives

Abstract Aquatic macrophytes have a recognized role in ecosystem structuring and an important position in trophic cascades interactions, whose understanding is to improve water quality. In recent years, the number of studies on the role of aquatic macrophytes in trophic webs and interactions has increased, but South America has made little progress in research in the area. In this study, we investigated the main gaps and perspectives for future studies on macrophytes and trophic interactions, analyzing global publications, especially those conducted by South American researchers. We accessed publications using an international database (Thomson Reuters ISI-Web of Knowledge-(formerly Institute for Scientific Information)) from 1980 to 2015. We ranked each article by ecosystem and study approach, biological organization and interacting taxonomic groups (phytoplankton, periphyton, zooplankton, aquatic invertebrates, fish and birds), countries publishing in cooperation and affiliations. The results showed that published studies (n = 242) emphasizing aquatic plants in trophic interactions increased in 35 years. Comparing the contributions of the 32 countries investigated, those from South America as first affiliation, had few publications (n = 26) and in cooperation (n = 7). The largest volume of articles indexed by the researchers dealt with the dynamics and structure of aquatic assemblages, webs and trophic interactions. Ecosystems such reservoirs and wetlands have received little attention. Large numbers of studies have encompassed community-wide aquatic approaches, including in South American studies, the interactions between macrophytes, zooplankton and phytoplankton were the second most studied interactions of all indexed articles. Knowledge about trophic cascade and interactions has been successfully enhanced in several countries with the purpose of restructuring communities and restore water quality of many ecosystems. In summary, we conclude that studies in the area of trophic interactions mediated by macrophytes may be directed in a way to attenuate international asymmetries, encouraging the increase of scientific productivity in South America.

Resumo Macrófitas aquáticas tem reconhecida função na estruturação de ecossistemas e importante papel nas interações tróficas em cascata, cujo entendimento é chave para melhorar a qualidade da água. Nos últimos anos, o número de estudos sobre o papel das macrófitas aquáticas nas interações e teia trófica aumentaram mas, a América do Sul progrediu pouco em pesquisas na área. Nesse estudo investigamos as principais lacunas e perspectivas para estudos futuros sobre macrófitas e interações tróficas analisando publicações mundiais, especialmente aquelas conduzidas por pesquisadores sul-americanos. Acessamos publicações usando base de dados internacional (Thomson Reuters ISI Web of Knowledge) entre 1980 a 2015. Computamos para cada artigo a organização biológica e grupos taxonômicos em interação (fitoplâncton, perifíton, zooplâncton, invertebrados aquáticos, peixes e aves), ecossistema estudado e abordagem de pesquisa, a cooperação entre países da América do Sul e demais, além das filiações. Os resultados mostraram que estudos publicados (n = 242) enfatizando plantas aquáticas em interações tróficas cresceram em 35 anos. Comparando as contribuições dos 32 países investigados, aqueles da América do Sul apresentaram baixo número de indexações (n= 26), poucos em cooperação (n= 7). O maior volume de publicações indexadas pelos pesquisadores trataram sobre a dinâmica e estrutura das assembléias aquáticas, teias e interações tróficas. Reservatórios e áreas alagadas têm recebido pouca atenção. Grande número de estudos compreeenderam abordagems de toda comunidade aquática e interações entre macrófitas, fitoplâncton, zooplâncton e peixes. Em síntese, concluimos que estudos enfatizando as interações tróficas mediadas pelas macrófitas poderão ser direcionados de maneira a atenuar assimetrias internacionais, encorajando o aumento da produtividade científica na América do Sul. O conhecimento sobre as interações tróficas em cascata tem sido desenvolvido com sucesso em diversos países cujas finalidades tem sido reestruturar comunidades e restaurar a qualidade da água de muitos ecossistemas.

Phytoplankton composition of the water and gastrointestinal tract of the mussel Diplodon enno (Ortmann, 1921) from São Francisco river (Bahia, Brazil) / Composição fitoplanctônica da água e do trato gastrointestinal do molusco Diplodon enno (Ortmann) do rio São Francisco (BA - Brasil)

Abstract The knowledge on diet composition of the freshwater mussel Diplodon enno (Ortmann) would aid in its culture and propagation allowing, this way, the replacement of natural endangered populations in Brazil. Microalgae are the main food source for captive mussels and unionids have displayed an ability to sort algae based on the cellular characteristics prior to ingestion. The main objective of the present work is to analyze the phytoplankton composition of the water from and of the gastrointestinal contents of the mussel D. enno, as an initial step for development of a suitable rearing diet. Therefore, water samples and bivalve specimens were collected from S. Francisco River, city of Paulo Afonso, Bahia, Brazil. The microalgal composition found in water and stomach/gut content samples was very diverse being represented by the following divisions: Cyanophyta, Chlorophyta, Dinophyta and Heterokontophyta (Diatoms). Concerning the relative abundance of microalgae divisions, it is possible to state, for the water and gastrointestinal contents, that Cyanophyta represents 15% and 14%, Chlorophyta 54% in both, Heterokontophyta 31% and 27% and Dinophyta 0% and 5%, respectively. According to the Brazilian CETESB criteria for phytoplankton species classification, 50% of Cyanophyta and 15% of Chlorophyta species observed in the water samples were classified as “very frequent”, as were 68% of Heterokontophyta and 33% of Chlorophyta species in the gut/stomach tract samples. Focusing at a species level, although in the water only Coelastrum sp. and Chroococcus sp. were observed in 100% and 75% of the samples, respectively, in the gastrointestinal tract the species Staurastrum sp., Aulacoseira sp., Scenedesmus sp. and Fragilaria crotonensis occurred in 80% to 100% of the samples. The present results showed that D. enno feeds not only on small chlorophytes microalgae, due to their convenient size that facilitates higher feeding rates, but also on large size diatoms, due to a possible nutritional advantage for the bivalves. Thus, a diet composed by large diatoms and small chlorophytes microalgae may be considered as the most reasonable for the maintenance of D. enno populations.

Resumo O conhecimento da composição da dieta do molusco de água doce Diplodon enno é de extrema importância para a sua cultura e propagação, permitindo desta forma a recuperação de populações em perigo de extinção no Brasil. As microalgas são a principal fonte de alimento para moluscos filtradores e os uniónidos sendo selecionadas por estes com base nas suas características celulares. O principal objectivo deste trabalho é analisar a composição fitoplanctônica da água e do conteúdo gastrointestinal do molusco D. enno, de forma a desenvolver uma dieta apropriada ao seu cultivo. Para isso, amostras de água e espécimes de bivalves foram recolhidos do rio São Francisco, cidade de Paulo Afonso, Bahia, Brasil. A composição de microalgas encontrada na água e no conteúdo do estômago/intestino foi muito diversa, sendo representada pelas seguintes divisões: Cyanophyta, Chlorophyta, Dinophyta e Heterokontophyta (diatomáceas). Atendendo à abundância relativa de cada divisão de microalgas, podemos afirmar que na água e no trato gastrointestinal Cyanophyta representa 15% e 14%, Chlorophyta 54% em ambos, Heterokontophyta 31% e 27% e Dinophyta 0% and 5%, respectivamente. De acordo com o critério CETESB de classificação de espécies de fitoplâncton, 50% das espécies de Cyanophyta e 15% das de Chlorophyta observadas nas amostras de água foram classificadas como “muito frequentes”, tal como aconteceu para 68% das espécies de Heterokontophyta e 33% das de Chlorophyta nas amostras do conteúdo do trato gastrointestinal. Realçando as espécies presentes, apesar de apenas Coelastrum sp. e Chroococcus sp. terem sido observadas em 100% e 75% das amostras de água, respectivamente, nas amostras de trato gastrointestinal Staurastrum sp., Aulacoseira sp., Scenedesmus sp. e Fragilaria crotonensis foram identificadas em entre 80% e 100% das amostras. Os resultados deste estudo mostram que D. enno se alimenta não apenas de pequenas microalgas clorófitas, devido ao seu pequeno tamanho que possibilita maiores taxas de filtração, como também de diatomáceas maiores, devido a uma possível vantagem nutricional para os bivalves. Assim sendo, uma dieta composta por diatomáceas e pequenas clorófitas poderá ser considerada a mais indicada para a manutenção de populações de D. enno.

Phytoplankton composition of the water and gastrointestinal tract of the mussel Diplodon enno (Ortmann, 1921) from São Francisco river (Bahia, Brazil).

The knowledge on diet composition of the freshwater mussel Diplodon enno (Ortmann) would aid in its culture and propagation allowing, this way, the replacement of natural endangered populations in Brazil. Microalgae are the main food source for captive mussels and unionids have displayed an ability to sort algae based on the cellular characteristics prior to ingestion. The main objective of the present work is to analyze the phytoplankton composition of the water from and of the gastrointestinal contents of the mussel D. enno, as an initial step for development of a suitable rearing diet. Therefore, water samples and bivalve specimens were collected from S. Francisco River, city of Paulo Afonso, Bahia, Brazil. The microalgal composition found in water and stomach/gut content samples was very diverse being represented by the following divisions: Cyanophyta, Chlorophyta, Dinophyta and Heterokontophyta (Diatoms). Concerning the relative abundance of microalgae divisions, it is possible to state, for the water and gastrointestinal contents, that Cyanophyta represents 15% and 14%, Chlorophyta 54% in both, Heterokontophyta 31% and 27% and Dinophyta 0% and 5%, respectively. According to the Brazilian CETESB criteria for phytoplankton species classification, 50% of Cyanophyta and 15% of Chlorophyta species observed in the water samples were classified as "very frequent", as were 68% of Heterokontophyta and 33% of Chlorophyta species in the gut/stomach tract samples. Focusing at a species level, although in the water only Coelastrum sp. and Chroococcus sp. were observed in 100% and 75% of the samples, respectively, in the gastrointestinal tract the species Staurastrum sp., Aulacoseira sp., Scenedesmus sp. and Fragilaria crotonensis occurred in 80% to 100% of the samples. The present results showed that D. enno feeds not only on small chlorophytes microalgae, due to their convenient size that facilitates higher feeding rates, but also on large size diatoms, due to a possible nutritional advantage for the bivalves. Thus, a diet composed by large diatoms and small chlorophytes microalgae may be considered as the most reasonable for the maintenance of D. enno populations.

Abatement vs. treatment for efficient diffuse source water pollution management in terrestrial-marine systems.

Marine ecosystems are affected by water pollution originating from coastal catchments. The delivery of water pollutants can be reduced through water pollution abatement as well as water pollution treatment. Hence, sustainable economic development of coastal regions requires balancing of the marginal costs from water pollution abatement and/or treatment and the associated marginal benefits from marine resource appreciation. Water pollution delivery reduction costs are, however, not equal across abatement and treatment options. In this paper, an optimal control approach is developed and applied to explore welfare maximizing rates of water pollution abatement and/or treatment for efficient diffuse source water pollution management in terrestrial-marine systems. For the case of diffuse source dissolved inorganic nitrogen water pollution in the Tully-Murray region, Queensland, Australia, (agricultural) water pollution abatement cost, (wetland) water pollution treatment cost and marine benefit functions are determined to explore welfare maximizing rates of water pollution abatement and/or treatment. Considering partial (wetland) treatment costs and positive water quality improvement benefits, results show that welfare gains can be obtained, primarily, through diffuse source water pollution abatement (improved agricultural management practices) and, to a minor extent, through diffuse source water pollution treatment (wetland restoration).

Distribuição espacial de acidentes escorpiônicos em Belo Horizonte, Minas Gerais, 2005 a 2009 / Spatial distribution of scorpion sting accidents in Belo Horizonte, Minas Gerais, 2005 to 2009

Acidentes por escorpião constituem problema de saúde pública em Belo Horizonte. Realizou-se um estudo epidemiológico observacional retrospectivo para analisar a frequência e distribuição espacial dos acidentes escorpiônicos em Belo Horizonte, entre 2005 e 2009, e associá-las às categorias de risco classificadas pelo Índice de Vulnerabilidade à Saúde (IVS), um índice socioeconômico regional composto. Foram utilizados dados de notificação do Sistema Nacional de Agravos de Notificação (SINAN) e Sistema de Vigilância Epidemiológica (SISVE), referentes aos anos de 2008 e 2009. Para o período de 2005 a 2007, foi necessário o resgate de dados das fichas clínicas do Hospital João XXIII (HPSJXXIII) correspondentes às variáveis encontradas no SINAN e SISVE, uma vez que os mesmos não estavam digitalizados nos referidos sistemas de informação. Para georreferenciamento e análise espacial, foi utilizada a base geográfica EndGeo, o aplicativo de mapeamento MapInfo versão 10.0 e os programas Hotspot Detective e SatScan. Entre 2005 e 2009, ocorreram em Belo Horizonte 2.769 casos de acidentes por escorpião, o que representa uma incidência média de 22,4 casos por 100.000 habitantes. Do total de casos, 1.924 (69,5 porcento) foram georreferenciados e houve predomínio de incidência em dois Distritos Sanitários (DS), com grande concentração de casos nas regiões de cemitérios do município. Foram detectados dois "clusters" no período, sendo um em 2005, nos DS Noroeste e Oeste, e outro entre 2006 e 2007, nos DS Noroeste e Nordeste. Não houve associação entre as áreas de maior incidência de escorpionismo e as áreas de maior risco à saúde classificadas pelo IVS. Com base nos resultados, conclui-se que há necessidade de melhorias no processo de notificação do agravo e que o mapeamento dos casos é uma ferramenta relevante capaz de embasar o direcionamento das ações educativas de controle para as áreas prioritárias de Belo Horizonte...

Scorpion sting accidents are a public health problem in Belo Horizonte and veterinarians play an important role in its control program when based on capture, mapping of cases and educational actions with the population. A retrospective epidemiological study was done to analyze the frequency and spatial distribution of scorpion sting cases in Belo Horizonte, between 2005 and 2009, and to associate them with the Health Vulnerability Index (IVS), a regional and composed socio-economic index. Notification data of scorpion sting accidents were used from the National System of Notifiable Diseases (SINAN) and Epidemiological Surveillance System (SISVE) for years 2008 and 2009. For the period between 2005 and 2007 it was necessary to retrieve data from the clinical records of João XXIII Hospital (HPSJ XXIII) which were not digitalized in the referred information systems. For georeference and spatial analysis, geographic base EndGeo and features of the programs MapInfo version 10.0, Hotspot Detective and SatScan were used. Between 2005 and 2009 2769 cases of scorpionism, occurred in Belo Horizonte which represents an average incidence of 22.4 cases per 100,000 inhabitants. Among 1924 (69.5 percent) georeferenced cases, the highest incidence was observed in two Sanitary District (DS). A large concentration of cases was also observed in the areas of the city cemeteries. Two clusters were detected during this period, one in 2005, located in the Northwest and West DS, and another between 2006 and 2007 in the Northwest and Northeast DS. There was no association between higher incidence areas of scorpionism in Belo Horizonte and the areas of higher health risk classified by IVS. It is necessary to improve the reporting process regarding scorpion sting accidents. Another conclusion is that the mapping of cases is a relevant tool to base the targeting of educative actions to the priority areas of Belo Horizonte...

A two steps solution approach to solving large nonlinear models: application to a problem of conjunctive use.

This article describes a solution method of solving large nonlinear problems in two steps. The two steps solution approach takes advantage of handling smaller and simpler models and having better starting points to improve solution efficiency. The set of nonlinear constraints (named as complicating constraints) which makes the solution of the model rather complex and time consuming is eliminated from step one. The complicating constraints are added only in the second step so that a solution of the complete model is then found. The solution method is applied to a large-scale problem of conjunctive use of surface water and groundwater resources. The results obtained are compared with solutions determined with the direct solve of the complete model in one single step. In all examples the two steps solution approach allowed a significant reduction of the computation time. This potential gain of efficiency of the two steps solution approach can be extremely important for work in progress and it can be particularly useful for cases where the computation time would be a critical factor for having an optimized solution in due time.

Induction of cell migration and activation in mice by the freshwater sponge Drulia uruguayensis Bonetto & Ezcurra de Drago, 1968 (Porifera: Metaniidae)

Freshwater sponges are abundant in the Amazon region and they have been known to cause dermatitis (acute inflammation) since the beginning of the 20th century. To determine whether additional constituents, besides their body spicules, cause dermatological reactions in humans, an experimental study was developed and carried out using mice and Drulia uruguayensis prepared in three different forms: intact sponges (IS), macerated sponges (MS) or isolated spicules - megascleres (ISM). The cells most commonly involved in inflammatory reactions (mast cells, eosinophils and neutrophils), as well as intraepithelial lymphocytes and degranulated mast cells, were counted so that they could be used as parameters to determine which of the sponge preparations induced the greatest reaction. The effects of the sponge on the skin were then determined by histological analysis. The results obtained showed that IS caused the greatest inflammatory reaction (p = 0.000005), activating mainly mast cells (p = 0.0018). The histopathological analysis revealed a slight loss of continuity of the epidermis when ISM or IS were applied. These findings allow us to conclude that a structurally intact sponge can cause a greater inflammatory reaction in the first contact because of its ability to perforate the skin and allow inflammatory agents to enter. Other proteins present in dried sponge bodies could induce allergic but not toxic responses (in contact with the entire sponge, a large number of pharmacologically inert proteins may be introduced, with a potential allergen).

Optimal estuarine sediment monitoring network design with simulated annealing.

An objective function based on geostatistical variance reduction, constrained to the reproduction of the probability distribution functions of selected physical and chemical sediment variables, is applied to the selection of the best set of compliance monitoring stations in the Sado river estuary in Portugal. These stations were to be selected from a large set of sampling stations from a prior field campaign. Simulated annealing was chosen to solve the optimisation function model. Both the combinatorial problem structure and the resulting candidate sediment monitoring networks are discussed, and the optimal dimension and spatial distribution are proposed. An optimal network of sixty stations was obtained from an original 153-station sampling campaign.

Optimal space-time coverage and exploration costs in groundwater monitoring networks.

A method to determine the optimal subset of stations from a reference level groundwater monitoring network is proposed. The method considers the redundancy of data from historical time series, the times associated with the total distance required to run through the entire monitoring network, and the sum of the times for each monitoring station. The method was applied to a hypothetical case-study consisting of a monitoring network with 32 stations. Cost-benefit analysis was performed to determine the number of stations to include in the new design versus loss of information. This optimisation problem was solved with simulated annealing. Results showed that the relative reduction in exploration costs more than compensates for the relative loss in data representativeness.

Knowledge, attitudes and status of oral health in children at risk for infective endocarditis.

AIM: The purpose of this study was to assess the oral health status of 104 children (2-17 years of age) at risk for infective endocarditis attending the Paediatric Cardiology Service of the Martagão Gesteira Institute of Child Care and Paediatrics, Rio de Janeiro, Brazil, and their guardians' attitudes towards and knowledge about endocarditis risks. METHODS: A structured interview was carried out with guardians and an oral examination was performed on each child to determine scores for the plaque index (PI), gingival index (GI) and dmft/DMFT index. RESULTS: The percentage of guardians who understood the meaning of 'heart infection' was 9.6%, who knew the possibility of heart disease caused by dental procedures was 60.6%, who understood the requirement for antibiotic cover before dental treatment was 72.1%, and who understood the importance of good oral health to prevent infective endocarditis was 41.3%. As regards oral health behaviours, 46.1% of children brushed their teeth three times or more a day, 28.8% had never visited a dentist before, and only 24.3% attended the dentist for prevention. There was visible plaque in 98% and gingival bleeding in 99% of children in this study. The caries experience for primary dentition (dmft) was 2.62%, and 3.97 for permanent dentition (DMFT). CONCLUSIONS: Based on these results, we can conclude that the guardians' knowledge and attitudes about oral health were not good. This group at risk has poor oral health, which may give rise to a frequent bacteraemia under physiological conditions.

Anterior stromal puncture in the treatment of bullous keratopathy: six-month follow-up.

PURPOSE: This study was designed to evaluate the effect of anterior stromal puncture to treat patients with symptomatic bullous keratopathy. METHODS: Fourteen patients with bullous keratopathy who had decreased vision and were or were not awaiting penetrating keratoplasty were evaluated before and 1, 4, 12, and 24 weeks after anterior stromal punctures with a 25-gauge needle. The patients were questioned about pain intensity, foreign-body sensation, and photophobia. Biomicroscopy, esthesiometry, and pachymetry results were evaluated. The results before and after the punctures were compared using the McNemar test, Friedman test, and multiple comparison tests. RESULTS: The comparisons among before and 1, 4, and 12 weeks after the anterior stromal puncture of pain (p = 0.00000556), photophobia (p = 0.0252), foreign-body sensation (p = 0.0000743), and esthesiometry (p = 0.0243) showed significant statistical differences in terms of decreasing symptoms and corneal sensitivity. The average pachymetry did not show statistical difference among before and 1, 4, 12, and 24 weeks after the procedure (p = 0.956). We did not find important differences in terms of corneal neovascularization. CONCLUSION: Anterior stromal puncture is an effective, simple, and low-cost alternative for treating patients with symptomatic bullous keratopathy.

[Sport as integration factor of the physically handicapped in our society]. / Esporte como fator de integração do deficiente físico na sociedade.

The objective of this study was to make use of sports as a rehabilitation method, as well as to assess the physical, psychological, and social aspects of those present some physical handicap, particularly those who have some kind of chronic disease and are no longer taking part in any rehabilitation program. Thirty handicapped people were evaluated: fifteen started with basketball and fifteen with swimming, according either to the specific preference of each one of them or to the degree and kind of physical impairment. They were submmited to the following evaluations: clinical examination, physiotherapy assessment, social interview and use of the Rivermead Social Scale, functional classification of the sport, use of the Barthel and Rivermead Functional Scales, and the psychological profile test (POMS). After two years, no relevant change in the moving evolution of the athletes were reported. Concerning the POMS psychological test, both basketball and swimming groups presented with high vigor and low depression levels. Considering the social aspects, both groups presented substantial improvement, specially regarding their relationship to one person or more people and also in the everyday activities (be it social, leisure, or domestic), thus leading them to better social integration. This essay shows that sport can bring people who are physically impaired a better social integration and physical conditions.

Spinal muscular atrophy type II (intermediary) and III (Kugelberg-Welander). Evolution of 50 patients with physiotherapy and hydrotherapy in a swimming pool.

We added hydrotherapy to 50 patients with spinal muscular atrophy (SMA) who were being treated with individual conventional physiotherapy. Hydrotherapy performed at an approximate temperature of 30 degrees Celsius, twice a week, for thirty minutes in children and forty-five minutes in adults during a 2-year period. The outcome derived from this combined modality of treatment was rated according to physiotherapeutic evaluations, the MMT (Manual Muscular Test), and the Barthel Ladder. Patients were reevaluated at 2-month intervals. After two years of ongoing treatment, we were able to observe that the deformities in hip, knee and foot were progressive in all SMA Type II patients, and in some Type III. Muscle strength stabilized in most SMA Type III patients, and improved in some. MMT was not done in SMA Type II. In all patients we were able to detect an improvement in the Barthel Ladder scale. This study suggests that a measurable improvement in the quality of daily living may be obtained in patients with SMA Types II and III subjected to conventional physiotherapy when associated with hydrotherapy.

Obstruction of the nasolacrimal duct by Ascaris lumbricoides.

Although Ascaris lumbricoides infestation is extremely prevalent in some populations, the nematode is an extremely rare cause of nasolacrimal duct obstruction. Obstruction of the nasolacrimal duct in a 4-year-old Brazilian girl by a young adult A. lumbricoides is reported. In contrast to previously reported cases, the nematode involved the inferior, rather than superior, canaliculus and punctum.