bluuebunny/crossref_metadata_2025 huggingface dataset:
Facial profile esthetic preferences: perception in two Brazilian states
Authors: Oliveira Marina Detoni Vieira de , Silveira Bruno Lopes da , Mattos Cláudia Trindade , Marquezan Mariana
Published: July 2015

OBJECTIVE: The aim of this study was to assess the regional influence on the perception of facial profile esthetics in Rio de Janeiro state (RJ) and Rio Grande do Sul state (RS), Brazil. METHODS: Two Caucasian models, a man and a woman, with balanced facial profiles, had their photographs digitally manipulated so as to produce seven different profiles. First year dental students (laypeople) assessed the images and classified them according to their esthetic preference. RESULTS: The result of the t test for independent samples showed differences among states for certain facial profiles. The female photograph identified with the letter 'G' (mandibular retrusion) received higher scores in RS state (p = 0.006). No differences were found for male photographs (p > 0.007). The evaluators' sex seemed not to influence their esthetic perception (p > 0.007). Considering all evaluators together, ANOVA/Tukey's test showed differences among the profiles (p ≤ 0.05) for both male and female photographs. The female photograph that received the highest score was the one identified with the letter 'F' (dentoalveolar bimaxillary retrusion/ straight profile). For the male profiles, photograph identified with the letter 'E' (dentoalveolar bimaxillary protrusion/ straight profile) received the best score. CONCLUSION: Regional differences were observed regarding preferences of facial profile esthetics. In Rio de Janeiro state, more prominent lips were preferred while in Rio Grande do Sul state, profiles with straight lips were favored. Class III profiles were considered less attractive.
Treating dental crowding with mandibular incisor extraction in an Angle Class I patient
Authors: Machado Gislana Braga
Published: July 2015

Mandibular dental crowding often encourages patients to seek orthodontic treatment. The orthodontist should decide between protrusion of incisors or decrease in dental volume so as to achieve proper alignment and leveling. The present study reports the treatment of an Angle Class I malocclusion adolescent female brachyfacial patient with severe mandibular dental crowding, increased curve of Spee and deep overbite. The patient was treated with extraction of a mandibular incisor. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as a requirement for the title of certified by the BBO.
Indirect orthodontic bonding - a modified technique for improved efficiency and precision
Authors: Nojima Lincoln Issamu , Araújo Adriele Silveira , Alves Júnior Matheus
Published: July 2015

INTRODUCTION: The indirect bonding technique optimizes fixed appliance installation at the orthodontic office, ensuring precise bracket positioning, among other advantages. In this laboratory clinical phase, material and methods employed in creating the transfer tray are decisive to accuracy. OBJECTIVE: This article describes a simple, efficient and reproducible indirect bonding technique that allows the procedure to be carried out successfully. Variables influencing the orthodontic bonding are analyzed and discussed in order to aid professionals wishing to adopt the indirect bonding technique routinely in their clinical practice.
Crianças que sofrem: representações da infância em livros distribuídos pelo PNBE
Authors: Silveira Rosa Maria Hessel , Quadros Marta Campos de
Published: July 2015

Este artigo analisa as representações de infância/criança na literatura infantil brasileira contemporânea a partir do marco teórico metodológico dos estudos culturais em educação. Como recorte de um estudo mais amplo que tem buscado compreender os fatores envolvidos na recepção dos livros que compõem os acervos do Programa Nacional Biblioteca na Escola (PNBE) - Anos Iniciais do Ensino Fundamental, este texto aborda as representações de crianças que sofrem e as diferentes origens desse sofrimento sob três eixos temáticos: pobreza e trabalho infantil, dificuldades no convívio social e medos infantis. Configuram-se material de análise oito obras apenas de autores brasileiros que compõem os acervos do PNBE, referentes aos anos 2012 e 2014, e que contêm narrativas com texto verbal e ilustrações e somente com imagens.
"Tratado" e Exercício de ser criança: a infância entre versos, rimas e tintas
Authors: Silvestre Penha Lucilda de Souza , Martha Alice Áurea Penteado
Published: July 2015

A obra de arte, de modo geral, consiste em um evento significativo, visto que o leitor pode vivenciar diferentes mundos ficcionais, como também recuperar e articular as redes intertextuais, no ato da leitura. Assim, há a possibilidade de repensar a sua própria experiência e as condições sociais em que a criança está inserida. Nesse sentido, o nosso objetivo é realizar um percurso no universo poético, a partir da leitura dos textos Exercício de ser criança (1999), de Manoel de Barros, e Um pequeno tratado de brinquedos para meninos quietos (2009), de Selma Maria Kuasne, associando-os à produção plástica de Candido Portinari "Meninos soltando pipa" (de 1932), "Crianças brincando" (de 1938) e "Meninos brincando" (de 1955). Com efeito, essas obras nos permitem repensar como se dá a representação e a constituição da infância na arte e entendê-la nas tramas da poesia e da pintura, como também o ato de brincar, em um processo dialético.
Circuitos transnacionales de la literatura: João Gilberto Noll y el umbral de la convivência
Authors: Olcese Santiago
Published: July 2015

El propósito del presente trabajo es reflexionar, a través de un análisis sobre Berkeley em Bellagio y Lorde de Joao Gilberto Noll, sobre una inflexión contemporánea de la relación entre literatura y mercado, pensándola como una instancia relacional que posibilitaría y afianzaría el desarrollo de las propias prácticas artísticas al mismo tiempo que modificaría, alteraría y torcería los objetivos estrictamente comerciales casi insoslayables para el mercado. Pensar para la literatura (o el arte en general) un modo de coexistencia con el mercado que no implique aceptación o consentimiento con los dispositivos hegemónicos de la llamada industria de la cultura sino que, por el contrario, muestre la capacidad disruptiva que tienen todavía las prácticas artísticas en relación con los efectos niveladores (en términos culturales) de la lógica económica, pero desde una posición que asume positivamente tal relación.
O narrador e a paisagem: Milton Hatoum, Bernardo Carvalho e o fim do projeto de uma literatura nacional
Authors: Chagas Pedro Dolabela , Santos Dárley Suany Leite dos
Published: July 2015

Discute-se, a partir da observação de mudanças na construção do narrador e na representação da paisagem natural e social, o fim do projeto de literatura nacional no romance brasileiro. Para caracterizar as condições anteriores, parte-se da proposição de Echevarría segundo a qual o romance latino-americano já século XIX adotara a paisagem como símbolo identitário, sob a mediação interpretativa de discursos não ficcionais investidos de autoridade. Em seguida, apresenta-se a caracterização de Süssekind das figurações do narrador que consolidaram a paisagem em tal função no Brasil até o século XX. Em contraste, em Hatoum e Carvalho a multiplicação de vozes, a fragmentação das verdades e a auto-observação do narrador bloqueiam a mobilização da paisagem para a função identitária, num desvio dos pressupostos fundadores da literatura nacional que a inviabilizaria como projeto, o que implica uma transição histórica importante do romance brasileiro.
Representações da criança na literatura de autoria indígena
Authors: Bonin Iara Tatiana
Published: July 2015

A literatura indígena brasileira, que adquire notoriedade a partir dos anos 1990 no bojo de um movimento mais amplo de valorização das diferenças, configura-se como espaço de produção de narrativas híbridas, multimodais e interculturais. As obras escritas por autores de diferentes etnias são um registro privilegiado do contato entre povos, nelas se inscrevem marcas identitárias e se procede, por vezes, a uma contestação de visões monolíticas e representações estereotipadas sobre os índios. Neste texto, o objetivo é analisar representações da criança em sete obras escritas pelos autores indígenas Daniel Munduruku, Olívio Jekupé, Yaguerê Yamã e Wasiry Guará. A análise mostra a recorrência de três estratégias representacionais: a afirmação do pertencimento étnico das personagens; o posicionamento da criança como sujeito ativo e a afirmação da memória e do lugar social dos anciãos no aprendizado das crianças.
Abuso e repressão: fibras do mesmo fio na infância das meninas de Helena Parente Cunha
Authors: Lima Lílian Almeida de Oliveira
Published: July 2015

A produção narrativa da escritora brasileira Helena Parente Cunha é marcada pela presença de personagens femininas e pela problematização desse universo, abalando estruturas e padrões hegemônicos. Avultam em suas tramas personagens jovens e maduras; todavia, as meninas também tomam lugar na denúncia de dores e opressões impostas por moldes culturalmente estabelecidos. Neste artigo, são destacados contos dos livros Os provisórios, Cem mentiras de verdade e Falas e falares, analisando-se as situações de abuso e repressão a que as crianças são submetidas, vislumbrando também as demarcações de gênero aí presentes. Essas personagens encontram-se submetidas a uma série de descuidos que abalam a noção idealizada de infância como o paraíso perdido. No percurso de análise vêm à baila as ideias de Neil Postman acerca do estreitamento dos limites que diferenciam adultos e crianças, bem como a noção de "privatização da infância" apontada por Jacinto Sarmento.
Infância e errância: imagens da criança abandonada na ficção brasileira
Authors: Souza Licia Soares de
Published: July 2015

O presente texto apresenta o feixe semântico e mítico em torno da temática da infância, indicando os ideais de inocência e pureza que caracterizam o início de uma existência. Se tais ideais configuram o espaço edênico suscetível de determinar as relações positivas que seres infantes desenvolvem entre si e com o mundo adulto, em um regime noturno da imaginação, a escapada do espaço indica uma errância negativa, capaz de destruir seu estado de inocência. Essa errância é observada nas crianças delinquentes de Capitães da areia, de Jorge Amado, que, abandonadas nas ruas de Salvador, perdem seu mundo de pureza em busca de mecanismos de sobrevivência. Em seguida, procura-se averiguar a situação das crianças em Cidade de Deus, de Paulo Lins, cuja inocência é comprometida sob o jugo dos coronéis do tráfico de drogas, como Zé Miúdo/Pequeno. Finalmente, conclui-se que a obra de Amado indicou as anomalias de uma sociedade de exclusão que permitia o abandono de crianças nas ruas, como se estivesse prevendo que a situação pioraria se não houvesse políticas de inclusão com distribuição de renda, visando à qualidade de vida da população.
Bastardos e órfãos contemporâneos: a arqueologia da infância nos romances de filiação
Authors: Pajolla Alessandra Dalva de Souza
Published: July 2015

A reconstituição das origens configura uma dinâmica narrativa presente em diversas obras no campo literário atual: o retorno ao passado despido de nostalgia, marcado pela tentativa de explicar por meio das origens (reais e imaginárias) as lacunas identitárias. Os romances de filiação integram essa tendência e interrogam a ascendência como um mecanismo para resolver enigmas do presente. As obras Azul-corvo (2010), de Adriana Lisboa, Era meu esse rosto (2012), de Marcia Tiburi, e Chove sobre minha infância (2012), de Miguel Sanches Neto, expõem o percurso de narradores que voltam ao tempo da infância em busca de autoconhecimento e, sobretudo, pertencimento.
"Gente-grande": denúncia da pequenez dos adultos
Authors: Saraiva Juracy Assmann , Mügge Ernani
Published: July 2015

O presente artigo analisa o processo de representação instituído no conto Gente-grande", de Domingos Pellegrini, a partir da concepção de que o texto literário é o resultado de uma reflexão crítica do autor diante da realidade e um trabalho de exploração dos recursos da linguagem, atividades que encontram seu correlato na ação do leitor. A estrutura comunicacional em "Gente-grande" e suas estratégias narrativas induzem o leitor a compartilhar do drama das personagens infantis, gerado pela conflituosa separação dos pais; paralelamente, o conto mobiliza-o a identificar situações análogas no contexto contemporâneo, ao mesmo tempo em que o instiga a enfocar os elementos composicionais que instalam a articulação entre ficção e realidade. Na visão integradora que daí resulta, sobressai a imagem da criança estupefata diante da inconsequência dos adultos e se manifesta a denúncia da violação da harmonia familiar, a que a infância tem direito. Nesse sentido, o conto de Domingos Pellegrini exerce a função formadora da arte, visto que atua sobre o leitor, sensibilizando-o em face dos dramas humanos, particularmente o das crianças.
Narrativas del pasado y literatura infantil: continuidades y rupturas en los planteos críticos de Graciela Montes y Ana Maria Machado
Authors: García Laura Rafaela
Published: July 2015

Este trabajo propone continuar los estudios iniciados en otras instancias de investigación con el fin de explorar la literatura infanto-juvenil desde los estudios literarios y el impacto de la violencia política de las últimas dictaduras militares. El texto recorrerá las miradas del pasado a partir de la experiencia de dos autoras claves para la literatura infantil de Argentina y de Brasil, como son Graciela Montes y Ana Maria Machado. Por un lado, este estudio pretende profundizar en los modos en los que la violencia política de la última dictadura incidió en las prácticas intelectuales de estas autoras en los dos países. Esto nos permitirá establecer similitudes y diferencias entre ambos casos. Por otro lado, avanzaremos en el análisis de narrativas críticas entendidas como memorias fundamentales para la reconstrucción de las polémicas que definieron los principales planteos de la literatura para niños en los años noventa, dentro del contexto democrático. El posicionamiento crítico de las autoras con respecto a los movimientos de su campo y las características del contexto de cada país contribuye a profundizar en los modos desde los cuales la literatura participa de la infancia.
Isoenzyme activity in maize hybrid seeds harvested with different moisture contents and treated
Authors: Ferreira Thaís Francielle , Ferreira Valquíria de Fátima , Oliveira João Almir , Carvalho Marcos Vinícios de , Miguel Leonardo de Souza
Published: July 2015

Abstract: The analysis of isoenzyme activity is an important monitoring and characterization tool of the physiological quality of seeds and to understand the deterioration. The purpose of this work was to study the isoenzyme expression allied to the quality of maize hybrid seeds harvested at different moisture levels and subjected to chemical treatment. A completely randomized experimental design was used with four replicates, in a 3x2 factorial arrangement with three moisture levels (45%, 40% and 35%), and two forms of seeds tillage (with and without treatment). Seeds from maize hybrids, semi-hard BM 810 and dented BM 3061, were used. Seeds were manually gathered on ears. Chemical treatment was performed with commercial products Maxin(r) + K-obiol(r) + Actellic(r). Seed quality was assessed by moisture test, incidence of mechanicals damage, first count of germination, germination, emergence, emergence speed index, mean emergence time, accelerated aging, and electrical conductivity. Isoenzyme expressions were assessed by means of the systems superoxide dismutase (SOD), catalase (CAT), esterase (EST), alcohol dehydrogenase (ADH), malate dehydrogenase (MDH), peroxidase (PO) and α-amilase. Isoenzyme expressions are different, depending on moisture levels at harvest, the hybrid maize and seeds quality. Seeds treatment does not interfere in their isoenzymes expression.
Seeds treatment times in the establishment and yield performance of soybean crops
Authors: Brzezinski Cristian Rafael , Henning Ademir Assis , Abati Julia , Henning Fernando Augusto , França-Neto José de Barros , Krzyzanowski Francisco Carlos , Zucareli Claudemir
Published: July 2015

Abstract: The objective was to assess the early treatment effect of soybean seeds and pre-sowing with different combinations of chemicals on the establishment of plants and crop yield performance. The design was in randomized blocks in a 2x7 factorial arrangement, with two times for seed treatment and seven treatments (six chemical treatments and an untreated control). The treatments were: 1) fipronil + pyraclostrobin + thiophanate methyl; 2) imidacloprid + thiodicarb + carbendazin + thiram; 3) abamectin + thiamethoxam + fludioxonil + mefenoxam + thiabendazole; 4) carbendazin + thiram; 5) fludioxonil + mefenoxam + thiabendazole; 6) carboxin + thiram; and 7) untreated control (water only). The assessments were: seedling emergence, final stand, plant height and insertion of first pod, number of pods per plant, seeds per pod and per plant, thousand-seed weight and grain yield. Early treatment of soybean seeds (240 days prior to sowing) hinders the establishment of the crop, the thousand-seed weight and grain yield in relation to the pre-sowing treatment. Chemical treatments tested containing fungicides and insecticides associated favor the establishment of the crop, but do not alter the soybean yield performance.
Mobilization of reserves and vigor of soybean seeds under desiccation with glufosinate ammonium
Authors: Delgado Carolina Maria Luzia , Coelho Cileide Maria Medeiros de , Buba Gesieli Priscila
Published: July 2015

Abstract: The physiological quality of seeds depends on the cellular organization and their capacity to mobilize reserves. The goal of this study was to assess the germination and vigor of soybeans seeds of Benso1RR and NA 5909 RG cultivars from desiccated plants or not, by mobilizing reserves. Cultivars from desiccated plants or not, by mobilizing reserves. The plants were desiccated with glufosinate ammonium (GLA) in reproductive stage R7.1 or not (TST). The physiological seed quality was assessed by germination tests, accelerated aging and seedling length. For the mobilization of reserves were assessed within 48 hours of soaking: phytate, protein and soluble sugar contents. In 48 hours of soaking, seeds from desiccated plants in cultivar NA 5909 RG showed lower mobilization of soluble protein and soluble sugar, reflecting low vigor seedlings compared to their controls. For cultivar Benso1RR, in 48 hours of soaking, the application of GLA did not affect the mobilization of soluble protein when compared to control and did not differ as to vigor. It is concluded that the use of the desiccant has negatively influenced the mobilization of soluble protein and soluble sugar for cultivar NA 5909 RG, reflecting a low percentage of germination and low vigor.
Therapeutic play: preparing the child for the vaccine
Authors: Pontes Jéssica Etienne Dourado , Tabet Elaine , Folkmann Maria Áurea dos Santos , Cunha Mariana Lucas da Rocha , Almeida Fabiane de Amorim
Published: July 2015

ABSTRACT Objective: To identify and compare behaviors of children during vaccination, who were prepared or not for the procedure using an instructional therapeutic play. Methods: A quasi experimental study, with quantitative approach of 60 children aged 3 to 6 years. The child's reactions were recorded in a checklist. Data were analyzed using descriptive and inferential statistics and Fisher's test. Results: The main reactions in the experimental group were stay still (25;83%) and spontaneously collaborate (24;80%). In the control group, the main reactions were cries and cling to parents (15; 50%), flushing (11;36.67%) and moving the body/agitated (10;33.3%). Conclusion: The reactions of cooperation were more frequent in the experimental group, while low acceptance was observed only in the control group. Therapeutic play has proved an important tool in preparing for the vaccine.
Assessment of adherence to the guidelines for the management of nausea and vomiting induced by chemotherapy
Authors: França Monique Sedlmaier , Usón Junior Pedro Luiz Serrano , Antunes Yuri Philippe Pimentel Vieira , Prado Bernard Lobato , Donnarumma Carlos del Cistia , Mutão Taciana Sousa , Rodrigues Heloisa Veasey , Giglio Auro del
Published: July 2015

ABSTRACT Objective: To assess adherence of the prescribing physicians in a private cancer care center to the American Society of Clinical Oncology guideline for antiemetic prophylaxis, in the first cycle of antineoplastic chemotherapy. Methods: A total of 139 chemotherapy regimens, of 105 patients, were evaluated retrospectively from 2011 to 2013. Results: We observed 78% of non-adherence to the guideline rate. The main disagreements with the directive were the prescription of higher doses of dexamethasone and excessive use of 5-HT3 antagonist for low risk emetogenic chemotherapy regimens. On univariate analysis, hematological malignancies (p=0.005), the use of two or more chemotherapy (p=0.05) and high emetogenic risk regimes (p=0.012) were factors statistically associated with greater adherence to guidelines. Treatment based on paclitaxel was the only significant risk factor for non-adherence (p=0.02). By multivariate analysis, the chemotherapy of high emetogenic risk most correlated with adherence to guideline (p=0.05). Conclusion: We concluded that the adherence to guidelines is greater if the chemotherapy regime has high emetogenic risk. Educational efforts should focus more intensely on the management of chemotherapy regimens with low and moderate emetogenic potential. Perhaps the development of a computer generated reminder may improve the adherence to guidelines.
Check-up and cardiovascular risk progression: is there a room for innovation?
Authors: Conceição Raquel Dilguerian de Oliveira , Laurinavicius Antonio Gabriele , Kashiwagi Nea Miwa , Carvalho José Antonio Maluf de , Oliva Carlos Alberto Garcia , Santos Filho Raul Dias
Published: July 2015

ABSTRACT Objective: To evaluate the impact of traditional check-up appointment on the progression of the cardiovascular risk throughout time. Methods: This retrospective cohort study included 11,126 medical records of asymptomatic executives who were evaluated between January, 2005 and October, 2008. Variables included participants’ demographics characteristics, smoking habit, history of cardiovascular diseases, diabetes, dyslipidemia, total cholesterol, HDL, triglycerides, glucose, c-reactive protein, waist circumference, hepatic steatosis, Framingham score, metabolic syndrome, level of physical activity, stress, alcohol consumption, and body mass index. Results: A total of 3,150 patients was included in the final analysis. A worsening was observed in all risk factors, excepting in smoking habit, incidence of myocardial infarction or stroke and in the number of individuals classified as medium or high risk for cardiovascular events. In addition, a decrease in stress level and alcohol consumption was also seen. Conclusion: The adoption of consistent health policies by companies is imperative in order to reduce the risk factors and the future costs associated with illness and absenteeism.
Characteristics of an outpatient chronic hepatitis B virus infection cohort
Authors: Assis Danyenne Rejane de , Tenore Simone de Barros , Pinho João Renato Rebello , Lewi David Salomão , Ferreira Paulo Roberto Abrão
Published: July 2015

ABSTRACT Objective: To characterize a chronic hepatitis B cohort based on initial and follow-up clinical evaluations. Methods: A retrospective and descriptive analysis of clinical and laboratory data from chronic HBsAg adult carriers, without HIV, unexposed to treatment, with at least two outpatient visits, between February 2006 and November 2012. Fisher´s exact test, χ², Wilcoxon, Spearman, multiple comparisons and Kappa tests were applied, the level of significance adopted was 5%, with a 95% confidence interval. Results: 175 patients with mean age of 42.95±12.53 years were included: 93 (53.1%) were men, 152 (86.9%) were negative for hepatitis B e-antigen (HBeAg), 3 (1.7%) had hepatitis C coinfection, 15 (8.6%) had cirrhosis, and 2 (1.1%) had hepatocellular carcinoma. Genotype A predominated. Sixty-six patients (37.7%) had active hepatitis, 6 (3.4%) presented immune tolerance, and 38 (21.7%) were inactive carriers. Exacerbations and/or viral breakthrough were detected in 16 patients (9.1%). In 32 patients (18.3%), hepatitis B virus DNA remained persistently elevated and alanine aminotransferase levels were normal, whereas in 17 (9.7%), there was low hepatitis B virus DNA and alterated alanine aminotransferase. If only initial alanine aminotransferase and hepatitis B virus DNA values were considered, 15 cases of active hepatitis would not have been detected. Advanced fibrosis was more common in HBeAg-positive patients, and it was significantly associated with transaminases, hepatitis B virus DNA, and age. Conclusion: Many patients had active hepatitis, but almost 25%, who were HBeAg non-reactive, were only identified because of combined analyses of the hepatitis B virus DNA and transaminases levels, sometimes associated with histological data, after clinical follow-up.
One-year follow-up of neurological status of patients after cardiac arrest seen at the emergency room of a teaching hospital
Authors: Vancini-Campanharo Cássia Regina , Vancini Rodrigo Luiz , Lira Claudio Andre Barbosa de , Lopes Maria Carolina Barbosa Teixeira , Okuno Meiry Fernanda Pinto , Batista Ruth Ester Assayag , Atallah Álvaro Nagib , Góis Aécio Flávio Teixeira de
Published: July 2015

ABSTRACT Objective: To describe neurological status and associated factors of survivors after cardiac arrest, upon discharge, and at 6 and 12 month follow-up. Methods: A cohort, prospective, descriptive study conducted in an emergency room. Patients who suffered cardiac arrest and survived were included. A one-year consecutive sample, comprising 285 patients and survivors (n=16) followed up for one year after discharge. Neurological status was assessed by the Cerebral Performance Category before the cardiac arrest, upon discharge, and at 6 and 12 months after discharge. The following factors were investigated: comorbidities, presence of consciousness upon admission, previous cardiac arrest, witnessed cardiac arrest, location, cause and initial rhythm of cardiac arrest, number of cardiac arrests, interval between collapse and start of cardiopulmonary resuscitation, and between collapse and end of cardiopulmonary resuscitation, and duration of cardiopulmonary resuscitation. Results: Of the patients treated, 4.5% (n=13) survived after 6 and 12 months follow-up. Upon discharge, 50% of patients remained with previous Cerebral Performance Category of the cardiac arrest and 50% had worsening of Cerebral Performance Category. After 6 months, 53.8% remained in the same Cerebral Performance Category and 46.2% improved as compared to discharge. After 12 months, all patients remained in the same Cerebral Performance Category of the previous 6 months. There was no statistically significant association between neurological outcome during follow-up and the variables assessed. Conclusion: There was neurological worsening at discharge but improvement or stabilization in the course of a year. There was no association between Cerebral Performance Category and the variables assessed.
Analysis of epidemiology, lifestyle, and psychosocial factors in patients with back pain admitted to an orthopedic emergency unit
Authors: Gotfryd Alberto Ofenhejm , Valesin Filho Edgar Santiago , Viola Dan Carai Maia , Lenza Mario , Silva Joselito Adriano da , Emi Angélica Santos , Tomiosso Raylton , Piccinato Carla de Azevedo , Antonioli Eliane , Ferretti Mario
Published: July 2015

ABSTRACT Objective: To correlate epidemiological data, lifestyle, and psychosocial factors as predictors for clinical manifestation of back pain in patients treated at the orthopedic emergency unit of a Brazilian tertiary care hospital, and to evaluate their interest in participating in a hypothetical program for physical rehabilitation. Methods: This is an observational cross-sectional study. We evaluated 210 patients from the emergency department of a tertiary hospital with a major complaint of back pain. We used: epidemiological multiple-choice questionnaires developed for this study; Oswestry questionnaire for physical disability; Hospital Anxiety and Depression Scale (HAD) scale. Data analyses were performed using SAS - Statistical Analysis System (SAS Institute, 2001). Measurements were performed with the SAS functions Proc MEANS and Proc Freq. Results: The mean age was 39.1 years and there was no predominance between genders. The usual work activity was administrative (65.2% of cases). The mean body mass index was 26.0, indicating overweight. The majority (83.3%) of patients had low physical disability (Oswestry 0 – 40%). The number of medical visits in the previous 6 months (p=0.04) and the scores of anxiety and depression (p=0.05), independently, were correlated with physical disability. Most patients (77%) would agree to participate in a hypothetical program of physical rehabilitation for prevention of back pain. Conclusion: Patients with back pain complaints were predominantly young adults, sedentary or hypoactive, overweight, and with recurrent complaints of symptoms. Most participants had low levels of physical disability and would accept participation in a hypothetical physical rehabilitation program for the prevention of back pain.
Clinical aspects of influenza A(H1N1)pdm09 cases reported during the pandemic in Brazil, 2009-2010
Authors: Rossetto Érika Valeska , Luna Expedito José de Albuquerque
Published: July 2015

ABSTRACT Objective: To describe the clinical aspects of cases of influenza A(H1N1)pdm09 in Brazil. Methods: A descriptive study of cases reported in Sistema de Informação de Agravos de Notificação (SINAN), 2009-2010. Results: As the final classification, we obtained 53,797 (56.79%) reported cases confirmed as a new influenza virus subtype, and 40,926 (43.21%) cases discarded. Fever was the most common sign, recorded in 99.74% of the confirmed and 98.92% of the discarded cases. Among the confirmed cases, the presence of comorbidities was reported in 32.53%, and in 38.29% of the discarded cases. The case fatality rate was 4.04%; 3,267 pregnant women were confirmed positive for influenza A new viral subtype and 2,730 of them were cured. The case fatality rate of pregnant women was 6.88%. Conclusion: The findings suggested concern of the health system with pregnant women, and patients with comorbidities and quality of care may have favored a lower mortality. We recommend that, when caring for patients with severe respiratory symptoms, with comorbidities, or pregnant women, health professionals should consider the need for hospital care, as these factors make up a worse prognosis of infection by the pandemic influenza virus.
Design of an instrument to measure the quality of care in Physical Therapy
Authors: Cavalheiro Leny Vieira , Eid Raquel Afonso Caserta , Talerman Claudia , Prado Cristiane do , Gobbi Fátima Cristina Martorano , Andreoli Paola Bruno de Araujo
Published: July 2015

ABSTRACT Objective: To design an instrument composed of domains that would demonstrate physical therapy activities and generate a consistent index to represent the quality of care in physical therapy. Methods: The methodology Lean Six Sigma was used to design the tool. The discussion involved seven different management groups staff. By means of brainstorming and Cause & Effect Matrix, we set up the process map. Results: Five requirements composed the quality of care index in physical therapy, after application of the tool called Cause & Effect Matrix. The following requirements were assessed: physical therapist performance, care outcome indicator, adherence to physical therapy protocols, measure whether the prognosis and treatment outcome was achieved and Infrastructure. Conclusion: The proposed design allowed evaluating several items related to physical therapy service, enabling customization, reproducibility and benchmarking with other organizations. For management, this index provides the opportunity to identify areas for improvement and the strengths of the team and process of physical therapy care.
Fetoscopy for meningomyelocele repair: past, present and future
Authors: Bevilacqua Nicole Silva , Pedreira Denise Araujo Lapa
Published: July 2015

ABSTRACT Meningomyelocele is a malformation with high prevalence, and one of its main comorbidities is Arnold-Chiari malformation type II. The intrauterine repair of this defect has been studied to reduce the progressive spinal cord damage during gestation. The purpose of the present review was to describe the evolution of fetal surgery for meningomyelocele repair. Searches on PubMed database were conducted including articles published in the last 10 years. Twenty-seven articles were selected, 16 experimental studies and 11 studies in humans. A recent study demonstrated that the fetal correction results in better prognosis of neurological and psychomotor development, but open surgery, which has being used widely, has considerable maternal risks. Studies in animal and human models show that the endoscopic approach is feasible and leads to lower maternal morbidity rates. Two endoscopic techniques are currently under assessment - one in Germany and another in Brazil, and we believe that the endoscopic approach will be the future technique for prenatal repair of this defect.
Heart transplantation: review
Authors: Mangini Sandrigo , Alves Bárbara Rubim , Silvestre Odílson Marcos , Pires Philippe Vieira , Pires Lucas José Tachotti , Curiati Milena Novaes Cardoso , Bacal Fernando
Published: July 2015

ABSTRACT Heart transplantation is currently the definitive gold standard surgical approach in the treatment of refractory heart failure. However, the shortage of donors limits the achievement of a greater number of heart transplants, in which the use of mechanical circulatory support devices is increasing. With well-established indications and contraindications, as well as diagnosis and treatment of rejection through defined protocols of immunosuppression, the outcomes of heart transplantation are very favorable. Among early complications that can impact survival are primary graft failure, right ventricular dysfunction, rejection, and infections, whereas late complications include cardiac allograft vasculopathy and neoplasms. Despite the difficulties for heart transplantation, in particular, the shortage of donors and high mortality while on the waiting list, in Brazil, there is a great potential for both increasing effective donors and using circulatory assist devices, which can positively impact the number and outcomes of heart transplants.
Liver-specific magnetic resonance contrast medium in the evaluation of chronic liver disease
Authors: Reis Marcio Augusto Correia Rodrigues dos , Baroni Ronaldo Hueb
Published: July 2015

ABSTRACT The hepatobiliary-specific contrast medium (gadoxetic acid – Primovist®) is primarily used to improve detection and characterization of focal hepatic lesions, such as in chronic liver disease patients with suspected hepatocellular carcinoma. Since the contrast medium is selectively taken up by functioning hepatocytes in the late hepatobiliary phase, it helps to detect typical hepatocellular carcinoma, which show low signal intensity on this phase. This imaging feature also assists in differentiating regenerative/dysplastic nodules from early hepatocellular carcinomas (with over 90% accuracy), as well as hypervascular hepatocellular carcinomas from arterial pseudo-enhancement foci. Future perspectives include its use in quantification of hepatic function and fibrosis.
Pancreatic beta cell protection/regeneration with phytotherapy
Authors: Hosseini Azar , Shafiee-Nick Reza , Ghorbani Ahmad
Published: July 2015

Although currently available drugs are useful in controlling early onset complications of diabetes, serious late onset complications appear in a large number of patients. Considering the physiopathology of diabetes, preventing beta cell degeneration and stimulating the endogenous regeneration of islets will be essential approaches for the treatment of insulin-dependent diabetes mellitus. The current review focused on phytochemicals, the antidiabetic effect of which has been proved by pancreatic beta cell protection/regeneration. Among the hundreds of plants that have been investigated for diabetes, a small fraction has shown the regenerative property and was described in this paper. Processes of pancreatic beta cell degeneration and regeneration were described. Also, the proposed mechanisms for the protective/regenerative effects of such phytochemicals and their potential side effects were discussed.
Prevalence of methicillin-resistant Staphylococcus aureus in a University Hospital in the South of Brazil
Authors: Rodrigues Mônica de Abreu , Gindri Lívia , Silva Aniélen Dutra da , Guex Camille Gaube , Santos Silvana Oliveira dos , Hörner Rosmari
Published: July 2015

Methicillin-resistant Staphylococcus aureus (MRSA) stand out as one of the main agents causing nosocomial and community infections. This retrospective study aimed to analyze the MRSA predominance in a university hospital in the south of Brazil and it was carried out for five years (from 2007 to 2011). 616 MRSA (33,3% of the total) were isolated and an important reduction in the MRSA predominance was observed along the study. Although it was registered a reduction in the MRSA predominance, male adult patients (41-70 years old), who were in the Medical Clinic and Adult ICU, had the highest infection rates and concerning MRSA isolates rates, these were higher in blood and tracheal aspirates. In conclusion, studies of this type are becoming relevant to recognize pathogens like MRSA and to determine its predominance.
Titrimetric and spectrophotometric assay of diethylcarbamazine citrate in formulations using iodate and iodide mixture as reagents
Authors: Swamy Nagaraju , Prashanth Kudige Nagaraj , Basavaiah Kanakapura
Published: July 2015

One titrimetric and two spectrophotometric methods are proposed for the determination of diethylcarbamazine citrate (DEC) in bulk drug and in formulations using potassium iodate and potassium iodide as reagent. The methods employ the well-known analytical reaction between iodate and iodide in the presence of acid. In titrimetry (method A), the drug was treated with a measured excess of thiosulfate in the presence of unmeasured excess of iodate-iodide mixture and after a standing time of 10 min, the surplus thiosulfate was determined by back titration with iodine towards starch end point. Titrimetric assay is based on a 1:3 reaction stoichiometry between DEC and iodine and the method is applicable over 2.0-10.0 mg range. The liberated iodine is measured spectrophotometrically at 370 nm (method B) or the iodine-starch complex measured at 570 nm (method C). In both methods, the absorbance is found to be linearly dependent on the concentration of iodine, which in turn is related to DEC concentration. The calibration curves are linear over 2.5-50 and 2.5-30 µg mL-1 DEC for method B and method C, respectively. The calculated molar absorptivity and Sandell sensitivity values were 6.48×103 L mol-1 cm-1 and 0.0604 µg cm-2, respectively, for method B, and their respective values for method C are 9.96×103 L mol-1 cm-1 and 0.0393 µg cm-2. The intra-day and inter-day accuracy and precision studies were carried out according to the ICH guidelines. The methods were successfully applied to the analysis of DEC formulations.
Synthesis and DPPH scavenging assay of reserpine analogues, computational studies and in silico docking studies in AChE and BChE responsible for Alzheimer's disease
Authors: Yar Muhammad , Arshad Muhammad , Farooq Ariba , Gilani Mazhar Amjad , Ayub Khurshid , Ejaz Asma , Kumar Anupriya , Ninomiya Ichiya
Published: July 2015

Alzheimer's disease (AD) is a fast growing neurodegenerative disorder of the central nervous system and anti-oxidants can be used to help suppress the oxidative stress caused by the free radicals that are responsible for AD. A series of selected synthetic indole derivatives were biologically evaluated to identify potent new antioxidants. Most of the evaluated compounds showed significant to modest antioxidant properties (IC50 value 399.07 140.0±50 µM). Density Functional Theory (DFT) studies were carried out on the compounds and their corresponding free radicals. Differences in the energy of the parent compounds and their corresponding free radicals provided a good justification for the trend found in their IC50 values. In silico, docking of compounds into the proteins acetylcholinesterase (AChE) and butyrylcholinesterase (BChE), which are well known for contributing in AD disease, was also performed to predict anti-AD potential.
Studies on the formation and synthetic mechanism of related substance G in potassium clavulanate production
Authors: Jin Xiaoqing , Cao Guangxiang , Zhang Xiaoxiao , Chen Yuguo , Wang Liang , Zhong Chuanqing
Published: July 2015

The objective of this study was to investigate the formation and synthetic mechanism of related substance G in potassium clavulanate production. The impurity in the potassium clavulanate final product, with a retention time of 13.5 min, was confirmed as related substance G by high performance liquid chromatography-mass spectrometry/mass spectrometry. Related substance G analysis during the production of clavulanic acid showed that this impurity could be synthesized during fermentation, and the amount increased with the fermentation time. Studies on its synthetic mechanism showed that L-tyrosine and succinic acid were the precursors for biosynthesis of related substance G in vivo. The reaction was deduced to be catalyzed by an enzyme. The enzyme was a type of extracellular enzyme present in the fermentation supernatant.
Tretinoin-based formulations - influence of concentration and vehicles on skin penetration
Authors: Bagatin Edileia , Wagemaker Tais Aleriana Lucon , Aguiar Júnior Nelson dos Reis , Gianeti Mirela Donato , Gonçalves Erika Maria Berardo , Campos Patrícia Maria Berardo Gonçalves Maia
Published: July 2015

Tretinoin is used in the management of acne and it is part of a gold standard treatment for photoaging. It has also been reported as an agent for superficial chemical peeling in highly concentrated formulations with few considerations about skin penetration. The aim of this study was to evaluate the influence of drug concentration and vehicles currently used on skin penetration of tretinoin. In vitro permeation tests were carried out using Franz diffusion cells fitted with porcine ear skin and 10% aqueous methanol in the receptor compartment. Formulations studied, cream or hydroalcoholic dispersion, containing 0.25%, 1% and 5% of tretinoin were placed in the donor compartment for six hours. Tretinoin concentration in skin layers was measured by high performance liquid chromatography. The largest amount of tretinoin from both vehicles was detected in stratum corneum with significant differences among the three concentrations. The hydroalcoholic dispersion was the best vehicle. Significant amounts of tretinoin were found even in deep layers of epidermis. The formulation with 0.25% tretinoin showed better results when considered the amount of tretinoin on skin in terms of percentage. Finally, skin penetration of tretinoin was influenced by vehicle and concentration of this drug used in formulation.
A novel dosage form for buccal administration of bupropion
Authors: Almeida Nilsa Maria Galvão , Lima Renata , Alves Thaís Francine Ribeiro , Rebelo Márcia de Araújo , Severino Patrícia , Chaud Marco Vinícius
Published: July 2015

Bupropion is an antidepressant used in the treatment of smoking. The purpose of this study was to prepare controlled-release hydrogel films for buccal administration of bupropion and investigate its physicochemical and cytotoxic properties. The films were prepared from ultrapure sodium carboxymethylcellulose, hydroxypropylmethylcellulose K4M, and medium-viscosity chitosan. Evaluation of film physicochemical characteristics was based on scanning electron microscopy, bupropion content, mechanical strength (burst strength, relaxation, resilience, and traction), and cytotoxicity. Bupropion content in bilayer films was 121 mg per 9 cm2. The presence of bupropion modified film mechanical strength, but did not compromise the use of this pharmaceutical form. As shown by the cytotoxicity results, films containing bupropion did not cause cellular damage. Bupropion administration in the form of hydrogel films is a potentially useful alternative in the treatment of smoking.
Preparation, characterization and evaluation of the in vivo trypanocidal activity of ursolic acid-loaded solid dispersion with poloxamer 407 and sodium caprate
Authors: Eloy Josimar Oliveira , Saraiva Juliana , Albuquerque Sérgio de , Marchetti Juliana Maldonado
Published: July 2015

Ursolic acid is a promising candidate for treatment of Chagas disease; however it has low aqueous solubility and intestinal absorption, which are both limiting factors for bioavailability. Among the strategies to enhance the solubility and dissolution of lipophilic drugs, solid dispersions are growing in popularity. In this study, we employed a mixture of the surfactants poloxamer 407 with sodium caprate to produce a solid dispersion containing ursolic acid aimed at enhancing both drug dissolution and in vivo trypanocidal activity. Compared to the physical mixture, the solid dispersion presented higher bulk density and smaller particle size. Fourier Transform Infrared Spectroscopy results showed hydrogen bonding intermolecular interactions between drug and poloxamer 407. X-ray diffractometry experiments revealed the conversion of the drug from its crystalline form to a more soluble amorphous structure. Consequently, the solubility of ursolic acid in the solid dispersion was increased and the drug dissolved in a fast and complete manner. Taken together with the oral absorption-enhancing property of sodium caprate, these results explained the increase of the in vivo trypanocidal activity of ursolic acid in solid dispersion, which also proved to be safe by cytotoxicity evaluation using the LLC-MK2 cell line.
Effects of Hypericum perforatum on turning behavior in an animal model of Parkinson's disease
Authors: Vecchia Débora Dalla , Schamne Marissa Giovanna , Ferro Marcelo Machado , Santos Ana Flávia Chaves dos , Latyki Camila Lupepsa , Lara Danilo Vieira de , Ben Juliana , Moreira Eduardo Luiz , Prediger Rui Daniel , Miyoshi Edmar
Published: July 2015

Parkinson's disease (PD) is an age-related neurodegenerative disorder characterized by the slow and progressive death of dopaminergic neurons in the (substantia nigra pars compact). Hypericum perforatum (H. perforatum) is a plant widely used as an antidepressant, that also presents antioxidant and anti-inflammatory properties. We evaluated the effects of H. perforatum on the turning behavior of rats submitted to a unilateral administration of 6-hydroxydopamine (6-OHDA) into the medial forebrain bundle as an animal model of PD. The animals were treated with H. perforatum (100, 200, or 400 mg/kg, v.o.) for 35 consecutive days (from the 28th day before surgery to the 7th day after). The turning behavior was evaluated at 7, 14 and 21 days after the surgery, and the turnings were counted as contralateral or ipsilateral to the lesion side. All tested doses significantly reduced the number of contralateral turns in all days of evaluation, suggesting a neuroprotective effect. However, they were not able to prevent the 6-OHDA-induced decrease of tyrosine hydroxylase expression in the lesioned striatum. We propose that H. perforatum may counteract the overexpression of dopamine receptors on the lesioned striatum as a possible mechanism for this effect. The present findings provide new evidence that H. perforatum may represent a promising therapeutic tool for PD.