Maternal morbidity and near miss in the community: findings from the 2006 Brazilian demographic health survey.

OBJECTIVE: To obtain an estimate of the prevalence of potentially life-threatening maternal conditions and near-miss events in Brazil, and to explore the factors associated with these complications. DESIGN: A demographic health survey (DHS) focusing on reported maternal complications. SETTING: Data from the five geographical regions of Brazil. POPULATION: A total of 5025 women with at least one live birth in the 5-year reference period preceding their interview in the DHS. METHODS: A secondary analysis of the 2006 Brazilian DHS database was carried out using a validated questionnaire to evaluate the occurrence of maternal complications and related key interventions. According to a pragmatic definition, any woman reporting the occurrence of eclampsia, hysterectomy, blood transfusion or admission to the intensive care unit was considered as having experienced a near-miss event. Associations between the sociodemographic characteristics of the women and severe maternal morbidity were evaluated. MAIN OUTCOME MEASURES: Proportions and ratios of complications and related interventions defined as maternal near miss in pregnancy, and estimated risk factors for maternal morbidities. RESULTS: Around 22% of women reported complications during pregnancy. The prevalence of maternal near miss in Brazil, using the pragmatic definition, was 21.1 per 1000 live births. An increased risk of severe maternal morbidity was found in women aged ≥40 years and in those with low levels of education. CONCLUSIONS: Nearly 70,000 maternal near-miss cases and approximately 750,000 cases with potentially life-threatening conditions are estimated to occur in Brazil per year. A pragmatic definition of maternal near miss was useful to obtain more reliable information at the community level. This approach could be used to gather information on maternal morbidity in settings in which such data are not routinely collected.

Fat-Soluble Substance Flow During Symbiotic Fungus Cultivation by Leaf-Cutter Ants.

Leaf-cutter ants perform a series of specialized behaviors in preparing plant substrates for their symbiotic fungus. This process may be related to contamination of workers by substances such as insecticides, leading us to hypothesize that substances are spread among workers through behaviors they perform to grow the fungus. To test this hypothesis, we analyzed the behavioral acts of workers during the processing of the pellets by using a fat-soluble tracing dye, since the active ingredient that composes toxic baits, used for control of leaf-cutter ants, is fat-soluble. The frequencies of performed behaviors were recorded and the number of dyed workers was assessed after fungus cultivation. The most frequent behavior is allogrooming and corresponds to 45.87% of the contamination process in workers, followed by holding, licking, and cutting pellets, which account for 40.22% of the process. After pellet processing, the workers had their external and internal morphological structures marked by the tracing dye-93.75% and 79.25%, respectively. These results confirm that behaviors performed during fungus cultivation contribute to dispersing substances such as insecticides, causing the contamination of workers.

Do Workers from Subspecies Acromyrmex subterraneus Prepare Leaves and Toxic Baits in Similar Ways for Their Fungus Garden?

Toxic baits are the most efficient method to control leaf-cutter ants in eucalyptus forests for paper and cellulose production. For the proper use of these baits, insecticide compounds must reach workers and contaminate them. Thus, understanding how these baits are processed inside the nests is vital for a successful control, especially when it comes to genus Acromyrmex. Lack of information on toxic baits and on contamination of Acromyrmex workers raises the question: do workers from subspecies Acromyrmex subterraneus (Forel) prepare leaves and toxic baits in similar ways for their fungus garden? To answer it, this study described and analyzed the behavioral repertoire executed by A. subterraneus workers during the preparation of leaf disks and baits and their incorporation into the fungus garden. Results show that the act of licking the substrate was the most frequently executed behavior, regardless of subspecies or size categories. Moreover, additional behaviors have been observed when workers processed the baits, such as licking and scraping their jaws on the surface of the bait pellet, as well as licking and biting fragments of bait pellets, moistening them. Thus, it is concluded that the preparation of baits is different from that of leaves; baits are more processed and can therefore contribute to contaminating workers via insecticides.

Contamination Route of Leaf-Cutting Worker Ants Analyzed Through a Fat-Soluble Tracer Dye in Toxic Bait.

Our study seeks to discover contamination routes of leaf-cutting worker ants during chemical control by formicide baits. To do so, toxic baits containing fat-soluble tracer dye were provided to colonies of three subspecies of Acromyrmex under laboratory conditions, in order to assess the proportion of dyed workers by size category, as well as dyed internal morphological structures. Results showed that nearly 50% of the workers come into contact with the active ingredient, since the internal structures of their bodies are dyed by the fat-soluble tracer dye within the first 24 h from contact with the toxic bait. In addition, the three subspecies of leaf-cutting ants present a similarity as to the contamination of their workers, probably due to their specialized behavior performed during the growth of the fungus garden with the baits. We conclude that the workers' pattern of behavior during fungus garden growth was the main means for dispersion of a fat-soluble substance among approximately half of the nest mates in our experiments, serving as a model for further studies on contamination of worker ants with insecticides.

Use of Seeds as Fungus Garden Substrate Changes the Organization of Labor Among Leaf-Cutting Ant Workers.

Seeds of different plant species constitute an alternative but also significant substrate that leaf-cutting ants use to cultivate their fungus garden. However, how they are processed inside the nest and if their use implies differential allocation of worker size classes are still poorly known. Using laboratory colonies of Acromyrmex subterraneus (Forel) as a model, the behaviors related to the processing of three different seeds (sesame, guava, and grape) as fungus substrate were listed. At the same time, we measured how each worker size class contributed to the execution of these behaviors by registering their respective frequency. It was found that medium-sized (1.2 > head width < 1.6 mm) and minimum-sized (head width <1.1 mm) workers assumed the role of incorporation for sesame and grape seeds, respectively. Major-sized workers (head width >1.7 mm) were concentrated on licking and holding guava seeds. Tegument removal was the only task observed that differs between treatment of seeds and treatment of leaves before their incorporation, as described in the literature. It was verified that different species of seeds imply a differential allocation of worker size classes and the inclusion or exclusion of some tasks from the behavioral repertoire. Regardless of the substrate type, leaf-cutting ant workers follow a coordinated and specialized procedure to cultivate the fungus garden but always maintain a high degree of cooperation.

DNA image cytometric analysis of differentiated thyroid adenocarcinoma specimens.

A total of 117 differentiated thyroid adenocarcinomas that had been removed by total thyroidectomy were studied. Seventy (60%) were papillary, 36 (30%) were follicular, and 11 (10%) were Hürthle cell adenocarcinomas. The mean length of follow-up was 57.7 months. Adverse prognostic factors according to multivariate analysis were adjacent tissue infiltration (p = 0.0004), histologic type (p = 0.0049), and patient age (p = 0.033). The nuclear DNA content of tumor cells and of morphologically normal adjacent tissue was assessed by image cytometry, and correlations between nuclear DNA content and prognostic factors were examined. Fifty-four (75%) adenocarcinomas were classified as aneuploid, 9 (13%) as diploid, and 9 (12%) as borderline. Thirty-four (60%) specimens of morphologically normal adjacent tissue were classified as aneuploid, 18 (32%) as diploid, and 5 (8%) as borderline. The correlation between tumor ploidy and selected prognostic factors was statistically significant for patient age (p = 0.004) and histologic type (p = 0.033). Despite the fact that ploidy could not be identified as a prognostic factor, we suggest that, because of its correlation with age and histologic type, it might prove prognostic if the number of patients were increased. We also emphasize the importance of evaluating morphologically normal adjacent tissue because of the high rates of aneuploidy in these areas.

The influence of the scout upon the decision-making process of recruited workers in three Acromyrmex species (Formicidae: Attini).

We examined how the information communicated by a scout worker influences the plant species transported by recruited workers in Acromyrmex balzani, Acromyrmex rugosus, and Acromyrmex crassispinus, three species of leaf-cutting ant that have different substrate and habitat preferences. We verified that certain plant species were more likely to be transported than others and that recruitment occurs. We found that recruited workers were more likely to transport non-preferred plant species when they were recruited to these by scout workers. The results suggest that the scout worker can communicate information about plant identity to recruited workers, but that recruited workers integrate the information communicated with their own experience during the decision-making process.

Radiographic aspects and angioarchitectural arrangements in corrosion casts of the blood supply to the human sternocleidomastoid muscle by the sternocleidomastoid branch of the occipital artery.

The contribution of the sternocleidomastoid branch of the occipital artery (superior arterial pedicle-SAP) to the irrigation of the sternocleidomastoid muscle (SCM) was evaluated in fresh human cadavers by injecting radiological dye and a resin for microvasculature corrosion casts. From its insertion in the mastoid process of the temporal bone, the SCM was divided into superior, medium, and inferior thirds. In most of the SCM, The SAP are formed by two longitudinal parallel branches. In all specimens, the radiological dye injected into the SAP reached or trespassed the middle part of the studied SCM. The SAP was poorly distributed in the lowermost region of the inferior third of the SCM, suggesting the contribution of other arteries or pedicles. The corrosion casts of the microvasculature showed a profuse network of microscopic vessels in those levels where the SAP was detected.

"In vitro" study on release of cyclic AMP and thyroid hormone in autonomously functioning thyroid nodules.

The TSH effect on slice and the incubation medium cyclic AMP levels and T3 and T4 released from 8 autonomously functioning thyroid nodules (AFTN) and their respective perinodular (PN) tissues were examined. The thyroid slices were incubated in Eagle's Medium containing TSH (5 to 100 mU/ml) for 60 min and 300 min for tissue cyclic AMP generation and for cyclic AMP, T3 and T4 release, respectively. Basal cyclic AMP levels were not different either in AFTN and in PN slices or into the incubation medium. In both tissues TSH produced a similar cyclic AMP generation. In contrast, cyclic AMP released into the incubation medium was significantly higher in AFTN than in PN tissues, after TSH stimulation. Basal T3 values and TSH-stimulated T3 release in AFTN were not different from PN tissue. However, basal T4 levels were significantly higher in AFTN than in PN tissue as well as T4 released in response to TSH. In addition, T3/T4 ratio was lower in AFTN than in PN tissues. The cyclic AMP released into the incubation medium correlated with both T3 and T4 release in PN tissue but in the AFTN tissue no correlations were found. These findings suggest that the adenylate cyclase-cyclic AMP system is more sensitive to TSH-stimulation in AFTN when compared with PN tissue and that AFTN tissue has a preferential T4 secretion.