Search

Aim: To use Remote Sensing imagery and techniques to differentiate categories of Burgundian vineyards.Methods and results: A sample of 201 vine plots or “climats” from the Côte d’Or region in Burgundy was selected, consisting of three vineyard categories (28 Grand Cru, 74 Premier Cru, and 99 Communale) and two grape varieties (Pinot Noir and Chardonnay). A mask formed by the polygons of these vine plots was made and projected on four satellite images acquired by the ASTER sensor, covering the Côte d’Or region in years 2002, 2003 (winter image), 2004 and 2006. Mean reflectances were extracted from pixels within each polygon for each of the nine spectral bands (visible and infrared) covered by ASTER. The database had a total of 797 reflectance spectra assembled over the four images. Statistical discriminant analysis of percentage classification accuracy was made separately for Côte de Nuits and Côte de Beaune, and for each year. Results showed that for individual years and Côtes, classification accuracy for vineyard category was as high as 73.7% (Beaune 2002) and as low as 66.7% (Beaune 2003). There were no significant differences in accuracy between spring, summer and winter images. Classification accuracy for grape variety in Côte de Beaune over the four study years was between 73.5% for Pinot Noir climats in 2004 and 91.9% for Chardonnay climats in 2006, including the winter image. Concerning the vegetation index NDVI, there were no significant differences between vineyard categories.Conclusions: Satellite data is shown to be functional to reveal vineyard quality. Spectral differences between categories of Burgundian vineyards are at least partially due to terroir characteristics, which are transmitted to vine and vine canopy.Significance and impact of the study: This work indicates that Remote Sensing techniques can be used as an auxiliary tool for the monitoring of vineyard quality in established viticultural regions and for the study of quality potential in new regions.

Aim: To test the use of Remote Sensing imagery and techniques to differentiate between conventional and organic vineyards.Methods and results: Conventional and organic vineyards were identified on three satellite images acquired by the ASTER sensor of the Loire Valley. A sample of 46 conventional and 12 organic plots was used; grape varieties were Chenin Blanc (33 plots) and Cabernet Franc (25 plots). Mean reflectances were extracted from pixels inside each plot for the nine spectral bands (visible and infrared) of ASTER. A statistical discriminant analysis was performed. The vegetation index NDVI was also analysed. Results showed that all 12 organic plots, and 41 out of 46 conventional plots were correctly separated, a 91.4% success rate. Also, 23 out of 25 Cabernet, and 30 out of 33 Chenin plots were also correctly identified, also a 91.4% success rate. Regarding NDVI, there are no differences between conventional and organic vineyards within a 5% significant level. Analyses focused on the influences of chemical treatments on vineyard colors and on the effects of light reflected by inter-row spaces, suggested that both processes introduce spectral changes in conventional vineyards, mainly in short-wave infrared. Results also indicate that infrared information is essential to spectral discrimination.Conclusion: The use of chemicals, typical to conventional viticulture, has an impact on leaf composition and cell structure, being an important factor to imprint a characteristic reflectance pattern to these vineyards; the contribution to the integrated reflectance from inter-row vegetation is probably also a differentiating factor. Both causes act synergistically to build a significant spectral difference between conventional and organic vineyards.Significance and impact of the study: Remote Sensing techniques can be used as a first approach to vineyard monitoring, producing relevant information on viticultural methods, which can be used as early indicators of the need for field inspection or conventional laboratory analysis.

Investigar los efectos causados por la polución atmosférica, ozono, en la morbidez por enfermedades respiratorias en niños entre 2005 y 2008. Fueron obtenidos los datos diarios de atención por enfermedades respiratorias para niños en unidades de salud en el Sistema Único de Salud (SUS) en el municipio de Campo Grande. Niveles diarios de concentración de ozono fueron obtenidos con el Departamento de Física de la UFMS. Datos diarios de temperatura y humedad relativa del aire fueron fornecidos por la Empresa de Pesquisa Agropecuaria-Ganado de Corte. Para verificar la relación existente entre enfermedades respiratorias y concentración de ozono, se realizaron análisis descriptivo de las variables cuantitativas descriptas por medio de tendencia central (media, mediana) y de dispersión (desvío patrón) y el coeficiente de variación (CV) y posteriormente modelaje vía Modelos Lineares Generalizados (MLG) utilizando el Modelo Múltiple de Regresión de Poisson. Los resultados indican que la concentración de ozono de superficie promueve efectos adversos para la salud de los niños, aun cuando los niveles del contaminante está inferior al que determina la legislación.

The purpose of the present study was to evaluate the polycyclic aromatic hydrocarbons (PAHs) in fine (PM2.5) and coarse particles (PM2.5–10) in an urban and industrial area in the Metropolitan Area of Porto Alegre (MAPA), Brazil. Sixteen U.S. Environmental Protection Agency (EPA) priority polycyclic aromatic hydrocarbons (PAHs) were measured. Filters containing ambient air particulate were extracted with dichloromethane using Soxhlet. Extracts were later analyzed, for determining PAH concentrations, using a gaseous chromatograph coupled with a mass spectrometer (GC-MS). The polycyclic aromatic hydrocarbons (PAHs) were more concentrated in PM2.5 with an average of 70% of total PAHs in the MAPA. The target PAH apportionment among the main emission sources was carried out by diagnostic PAH concentration ratios, and principal component analysis (PCA). PAHs with higher molecular weight showed higher percentages in the fine particles in the MAPA. Based on the diagnostic ratios and PCA analysis, it may be concluded that the major contribution of PAHs was from vehicular sources (diesel and gasoline), especially in the PM2.5 fraction, as well as coal and wood burning. The winter/summer ratio in the PM2.5 and PM2.5–10 fractions in the MAPA was 3.1 and 1.8, respectively, revealing the seasonal variation of PAHs in the two fractions. The estimated toxicity equivalent factor (TEF), used to assess the contribution of the carcinogenic potency, confirms a significant presence of the moderately active carcinogenic PAHs BaP and DahA in the samples collected in the MAPA.

Lichens are considered bioindicators and, as such, are widely used for air quality monitoring, especially in urban-industrial areas. The present paper proposes an evaluation of lichen communities in urban areas. The corticolous lichen community was assessed at 29 sampling stations in the city of Porto Alegre, in addition to a reference area located in the State Park in the city of Viamao, southern Brazil. The rubber band method was used for lichen mapping; three hundred host-trees were analyzed, at 11 different height levels. Lichens were evaluated in terms of composition, richness, cover and diversity, and sampling stations were classified based on the Index of Atmospheric Purity (IAP) complemented by the Environmental Classification Factor (ECF). The inclusion of ECF as a complement to the original IAP formula is proposed in the present study and not only richness and cover components are considered, but also data on the lichenized mycota composition (considering its different morphological forms). One hundred and thirty-one (131) taxa have been identified, out of which 13 specimens may be considered as indicators of urban areas, and the predominance of taxa belonging to the crustose and foliose morphological group was verified. The sampling stations were classified into five zones, ranging from lichen-free zones to optimal zones for lichen development. The use of lichen proved to be efficient to both evaluate air quality and identify alterations of urban microclimates. The application of an ECF-based correction factor is expected to complement the use of IAP, making it a more sensitive index, since an analysis of a multivaried information profile was deemed necessary, especially in regions where specimen diversity is higher.

OBJETIVO: Desenvolver um modelo preditivo de óbito hospitalar com base nos dados do Sistema de Informações Hospitalares do Sistema Único de Saúde. MÉTODOS: Estudo transversal com dados de 453.515 autorizações de internação de 332 hospitais do Rio Grande do Sul no ano de 2005. A partir da razão entre óbitos observados e óbitos esperados elaborou-se um ranking ajustado dos hospitais que foi comparado ao ranking bruto da taxa de mortalidade. Utilizou-se regressão logística para desenvolvimento do modelo preditivo de probabilidade para óbito hospitalar segundo sexo, idade, diagnóstico e uso de unidade de terapia intensiva. Foram obtidos os intervalos com 95% de confiança para 206 hospitais com mais de 365 internações por ano. RESULTADOS: Obteve-se um índice de risco para mortalidade hospitalar. A ordenação dos hospitais utilizando apenas a taxa de mortalidade bruta diferiu da ordenação quando se utiliza o ranking ajustado pelo modelo preditivo de probabilidade. Dos 206 hospitais analisados, 40 hospitais apresentaram mortalidade observada significativamente superior à esperada e 58 hospitais com mortalidade significativamente inferior à esperada. Uso de unidade de terapia intensiva apresentou maior peso para a composição do índice de risco, seguida pela idade e diagnóstico. Quando os hospitais atendem pacientes com perfis muito diferentes, o ajuste de risco não resulta numa indicação definitiva sobre qual prestador é o melhor. Os hospitais de grande porte apresentaram, no conjunto, maior número de óbitos do que seria esperado de acordo com as características das internações. CONCLUSÕES: O índice de risco de óbito hospitalar mostrou-se preditor adequado para o cálculo dos óbitos esperados, podendo ser aplicado na avaliação do desempenho hospitalar. Recomenda-se que, ao comparar hospitais, seja utilizado o ajuste pelo modelo preditivo de probabilidade de risco, estratificando-se pelo porte do hospital. OBJECTIVE: To develop a hospital mortality prediction model based on data from the Hospital Information System of the Brazilian National Health System. METHODS: This was a cross-sectional study using data from 453,515 authorizations for hospital admission relating to 332 hospitals in Rio Grande do Sul, Southern Brazil in the year 2005. From the ratio between observed and expected deaths, the hospitals were ranked in an adjusted manner, and this was compared with the crude ranking of the mortality rate. Logistic regression was used to develop a predictive model for the likelihood of hospital mortality according to sex, age, diagnosis and use of an intensive care unit. Confidence intervals (95%) were obtained for the 206 hospitals with more than 365 hospital admissions per year. RESULTS: An index for the risk of hospital mortality was obtained. Ranking the hospitals using only the crude mortality rate differed from the ranking when it was adjusted according to the predictive likelihood model. Among the 206 hospitals analyzed, 40 of them presented observed mortality that was significantly greater than what was expected, while 58 hospitals presented mortality that was significantly lower than expected. Use of an intensive care unit presented the greatest weight in making up the risk index, followed by age and diagnosis. When the hospitals attended patients with widely differing profiles, the risk adjustment did not result in a definitive indication regarding which provider was best. Among this group of hospitals, those of large size presented greater numbers of deaths than would be expected from the characteristics of the hospital admissions. CONCLUSIONS: The hospital mortality risk index was shown to be an appropriate predictor for calculating the expected death rate, and it can be applied to evaluate hospital performance. It is recommended that, in comparing hospitals, the adjustment using the predictive likelihood model for the risk should be used, with stratification according to hospital size. OBJETIVO: Desarrollar un modelo predictivo de óbito hospitalario con base en los datos del Sistema de Informaciones Hospitalarios del Sistema Único de Salud de Brasil. MÉTODOS: Estudio transversal con datos de 453.515 autorizaciones de internación de 332 hospitales de Rio Grande do Sul (Sur de Brasil) en el año 2005. A partir de la tasa de óbitos observados y óbitos esperados se elaboró un ranking ajustado de los hospitales que fue comparado al ranking bruto de la tasa de mortalidad. Se utilizó regresión logística para desarrollo del modelo predictivo de probabilidad para óbito hospitalario según sexo, edad, diagnóstico y uso de unidad de terapia intensiva (UTI). Se obtuvieron los intervalos con 95% de confianza para los 206 hospitales con más de 365 internaciones por año. RESULTADOS: Se obtuvo un índice de riesgo para mortalidad hospitalaria. La ordenación de los hospitales utilizando sólo la tasa de mortalidad bruta difirió de la ordenación al utilizarse el ranking ajustado por el modelo predictivo de probabilidad. De los 206 hospitales analizados, 40 hospitales presentaron mortalidad observada significativamente superior a la esperada y 58 hospitales con mortalidad significativamente menor a la esperada. El uso de UTI presentó mayor peso para la composición del índice de riesgo, seguida por la edad y diagnóstico. Cuando los hospitales atienden pacientes con perfiles muy diferentes, el ajuste de riesgo no resulta en una indicación definitiva sobre cual prestador es mejor. Los hospitales de gran porte presentaron, en conjunto, mayor número de óbitos del que sería esperado de acuerdo con las características de las internaciones. CONCLUSIONES: El índice de riesgo de óbito hospitalario se mostró predictivo adecuado para el cálculo de los óbitos esperados, pudiendo ser aplicado en la evaluación del desarrollo hospitalario. Se recomienda que, al comparar hospitales, sea utilizado el ajuste por el modelo predictivo de probabilidad de riesgo, estratificándose por el porte del hospital.

This paper describes the use of Bayesian spatial models to develop the concept of a spatial-temporal mask for the purpose of identifying regions in which before and after drilling effects are most clearly defined and from which the consequences of exposure of macrofauna and meiofauna to the release of drilling discharges can be evaluated over time. To determine the effects of drilling fluids and drill-cuttings on the marine benthic community, it is essential to know not only where discharged materials ended up within the possible impact area, but also the chemical concentrations to which biota were exposed during and after drilling. Barium and light hydrocarbons were used as chemical tracers for water-based and non-aqueous-based fluids in a shallow water site in the Campos Basin, off the coast of Brazil. Since the site showed evidence of exposure to waste material from earlier drilling, the analysis needed to take into account the background concentrations of these compounds. Using the Bayesian models, concentrations at unsampled sites were predicted and regions altered and previously contaminated were identified.

This paper assesses the effects of non-aqueous fluids (NAF)-associated drill cuttings discharge on shelf break macrobenthic communities in the Campos Basin, off the southeast Brazilian coast, Rio de Janeiro State. Samples were taken with a 0.25-m2 box corer from surrounding two oil and gas wells on three monitoring cruises: before drilling, three months after drilling, and 22 months after drilling. Statistical methodologies used Bayesian geostatistical and analysis of variance models to evaluate the effects of the NAF-associated drill cuttings discharge and to define the impact area. The results indicated that marked variations were not observed in the number of families between cruises, though there were changes in the fauna composition. The changes seen in biological descriptors in both control and background situation areas were not considered significant, showing a temporal homogeneity in means. The impact area presented changes in biological descriptors of communities and trophic structure during the three cruises and such changes were correlated to chemical and physical variables related to the drilling activities, as a result of the mix of drill cuttings and sediment and the anoxic conditions established in the substrate. In that area, three months after drilling, a decrease in diversity and an increase in density, motile deposit-feeders and Pol/Crp ratio, and dominance of opportunistic organisms, such as the capitellid Capitella sp., were observed and, 22 months after drilling, an increase of diversity, reduction of dominance of capitellid polychaete, changes in the fauna composition, and a dominance of opportunistic burrowing and tube-building organisms were observed, indicating an ecological succession process.

Biomonitoring studies have increased as a consequence of risks and effects to human health on exposure to environmental contaminants, mainly air pollutants. Genetic biomarkers are useful tools for the early assessment of exposure to occupational and environmental pollution. The objective of the present study was to investigate genotoxic effects on people residing and/or working downwind from an oil refinery in southern Brazil and the mutagenic activity of airborne particulate matter (PM10). Samples of peripheral blood and buccal mucosa cells were evaluated using the single-cell gel electrophoresis assay (comet assay) and the micronucleus (MN) assay, respectively. PM10 samples were collected in the target site and the organic matter extraced with dichloromethane was assessed for mutagenic activity in the Salmonella/microsome assay. The exposed group (n=37) was compared to a reference group (n=37) of subjects living in an urban area with limited traffic and industrial influence, located far from the main industrial areas. All PM10 organic extracts showed mutagenic positive responses and the effect decreased in the presence of S9 mix indicating that the predominant compounds present were direct-acting mutagens. The responses of YGs strains are consistent with aromatic amines and nitroarenes being present in the PM10 extracts. The group in the area under the influence of the oil refinery (exposed group) showed significantly higher DNA damage in lymphocytes than the reference group. The MN frequencies in buccal mucosa were very low for both groups and no difference between groups was observed. No association was found between age and tobacco smoking habit and level of DNA damages measured by the comet assay. The results indicate that the comet assay was a sensitive tool to detect DNA damage in subjects under the influence of an oil refinery, with marked genotoxic activity in the atmospheric environment. Keywords: Genotoxicity, Biomonitoring, Air pollution, Micronucleus assay, Comet assay, Salmonella/microsome assay

Neste artigo são analisados os fatores possivelmente associados à mortalidade infantil nos 496 municípios do Rio Grande do Sul, Brasil, com base em dados acumuladas entre os anos de 2001 a 2004, obtidos pela análise de regressão utilizando modelagem inteiramente bayesiana como alternativa para superar a autocorrelação espacial e a instabilidade dos estimadores clássicos, como a taxa bruta e a SMR (Standardised Mortality Ratio). Foram comparadas diferentes especificações de componente espacial e covariáveis, provenientes dos blocos do Índice de Desenvolvimento Sócio-econômico da Fundação de Economia e Estatística (IDESE/FEE-2003). Verificou-se que o modelo que utiliza a estrutura espacial além da covariável educação apresenta melhor desempenho, quando comparado pelo critério DIC (Deviance Information Criterion). Comparando as estimativas das SMR com os riscos relativos obtidos pela modelagem inteiramente bayesiana, foi possível observar um ganho substancial na interpretação e na detecção de padrões de variação do risco de mortalidade infantil nos municípios do Rio Grande do Sul ao utilizar essa modelagem. A região da Serra Gaúcha destacou-se com baixo risco relativo e estimativas muito homogêneas.

PurposeTo identify the presence of factors associated with treatment outcome in patients under group cognitive-behavioral therapy (GCBT) for obsessive-compulsive disorder (OCD).Subjects and methodsThis study evaluated 181 patients with OCD that attended a 12-session weekly GCBT program. Response criteria were: ≥35% reduction in Y-BOCS scores and global improvement score of the Clinical Global Impression (CGI) ≤ 2 at post-treatment evaluation. Sociodemographic data, OCD characteristics, and treatment data were studied.ResultsIn the bivariate analysis, the following variables showed statistical significance (p < 0.20) to enter the regression model: being woman (p = 0.074), greater insight (p = 0.017) and better quality of life (QOL) in all domains before treatment (p = 0.053), overall severity of disease according to the CGI (p = 0.007), number of associated comorbidities (p = 0.063), social phobia (p = 0.044), and dysthymia (p = 0.072). In the final regression model, these variables were associated with response to GCBT: female gender (p = 0.021); WHOQOL-BREF psychological domain (p = 0.011); insight (p = 0.042); and global improvement score of the CGI severity-scale before therapy (p = 0.045).ConclusionSpecial attention should be paid to patients with poor insight, increasing the cognitive aspects of the therapy in an attempt to modify the rigidity and fixity of their beliefs. In addition, male patients should be more observed, since they showed lower chance of response to GCBT when compared to women. Patients with more severe global symptoms (CGI) are poorer responders to GCBT, which indicates that not only obsessive-compulsive symptoms (OCS) should be evaluated, since other symptoms, such as depression and anxiety, may affect the treatment; therefore, an attempt to reduce these symptoms, prior to the treatment of OCD, should be considered as an option in some cases.

Weekly and seasonal variations of surface ozone and their precursors – nitrogen oxides, carbon monoxide-associated with meteorological parameters (wind direction, temperature, solar radiation) – are reported. Measurements were performed continuously during 2006 at two sampling stations located in the metropolitan area of Porto Alegre, Brazil. Results have shown that O3 concentrations remained almost constant between weekdays. Levels of NOx precursors decreased especially on Sundays, due to lighter traffic. The seasonal variation has shown a maximum O3 concentration during summer and spring while NOx and NO2 have maxima at the colder months. The daily cycle of highest ozone concentrations reveals a lower nightly level and an inverse relation between O3 and NOx, evidencing the photochemical formation of O3. There are seasonal variation and source heterogeneity.

The aim of this study was to assess the impact of oral status on the daily performances of civil servants from the Public Works and Waste Management Department of the city of Porto Alegre, located in Southern Brazil. A cross-sectional study was conducted on a representative sample composed of 276 civil servants with ages ranging from 35 to 44 years. The Oral Impacts on Daily Performances index developed was employed to measure impacts caused by oral clinical conditions. Oral examinations were performed after the interviews. Multinomial Logistic Regression Analysis was used. After adjusting for sex and educational level, the results showed that the subjects with high DMFT scores were 5.8 times (95% CI = 2.1-16.1) more likely to have high impacts on their everyday life than those with low DMFT scores. Subjects that presented some coronal caries were 4.3 times (95% CI = 1.9-9.8) more likely to have high impacts on their everyday life than those with no coronal caries. Dental status assessed through the DMFT index and coronal caries are important indicators of impacts on the everyday life of the studied population.

Water and sediment were studied to assess the impact of wastes from an area used for a disposal area of treated petrochemical effluents in Rio Grande do Sul, Brazil. The study was performed using the Daphnia magna (Straus 1820) for chronical evaluations, mutagenesis in Salmonella/microsome assays, and micronuclei induction in cultures of V79 cell to assess genotoxicity. Six sites were defined for chronic and genotoxic tests by micronuclei induction with liquid and sediment samples. Long-term tests were planned in semi-static flow, with microcrustaceans 2 to 26 h old in the beginning of assays. The minimum level of reproduction required to maintain the species was not reached. There are delays for the beginning of the reproductive process. Survival was also affected in some samples. The reproductive responses were more sensitive on identifying environmental quality than the survival rate. The study of mutagenicity by Salmonella/microsome assay made it possible to define the seasonality of the components showing greater frequency in winter. The predominant event was the frameshift mutation in assays with the presence of metabolism. However, the cytotoxic activity, although present in all seasons, was less frequent in winter. The genotoxicity analysis in V79 cells exposed to liquid samples from the area also showed that cytotoxicity was the most frequent event. This may have interfered in the detection of a potential micronuclei induction. The results showed that, even after treatment, effluents disposed on the soil continue with active pollutants interfering in cladoceran’s quality of life, cellular physiology, and DNA integrity.

This paper assesses the effects of non-aqueous fluids (NAFs-type III) cuttings discharge from exploratory drilling activities on deep-sea macrobenthic communities in the Campos Basin, off the southeastern Brazilian coast, Rio de Janeiro State. One hundred and fifty nine sediment samples were taken with a 0.25 m2 box corer at a depth of 902 m on three monitoring cruises: first cruise—before drilling (April 2001), second cruise—after drilling (July 2001), and third cruise—one year after drilling (July 2002). The results indicated no significant changes in values of density, number of families and functional groups related to drilling activities in the reference area (2500 m distance), and biological variations may be result from the natural variability of the fauna. Evidence indicates that drilling activities led to measurable effects on the community structure related to NAF cuttings discharge but were limited to a 500 m radius from the drilling well. Such effects were much more evident at isolated sites in the impact area (WBF and WBF+NAF areas) and are characterized as localized impacts. One year after drilling, a recolonization was observed, with the probable recovery of the macrobenthic community in most of the study area; only at part of the WBF+NAF area (stations 05, 24 and 36) was the community still undergoing recovery.

Toxic drilling fluids and cutting discharges from oil and gas wells adversely affect local environment near the well site. To determine their effects on benthic communities, it is essential to know both the fate of the discharged materials and the chemical concentrations to which biota were exposed during and after drilling. This paper describes a mapping procedure using Bayesian spatial models to define the deposition area of drilling cuttings and fluids from an exploratory well in a deep-sea site in the Campus Basin, RJ, Brazil, taking into account the concentrations of barium and light hydrocarbons used as chemical tracers. The statistical procedures used allow comparisons between sampled sites and the prediction of results at unsampled sites, as well as the delineation of affected areas. The probable impact of the use of non-aqueous fluid (NAF) was measured through observed changes in sea-floor sediments by using Before–After Control-Impact comparisons in a study with three moments: one before drilling and two after drilling.

The lack of standardized instruments to evaluate communication disorders related to the right hemisphere was verified. A new evaluation tool was developed: Protocole Montréal d'Évaluation de la Communication – Protocole MEC, adapted to Brazilian Portuguese – Bateria Montreal de Avaliação da Comunicação – Bateria MAC (Montreal Evaluation of Communication Battery). The purpose was to present stratified normative data by age and educational level, and to verify the reliability parameters of the MEC Battery. 300 individuals, between the ages of 19 and 75 years, and levels of formal education between 2 and 35 years, participated in this study. They were divided equally into six normative groups, according to three age categories (young adults, intermediary age, and seniors) and two educational levels (low and high). Two procedures were used to check reliability: Cronbach alpha and reliability between evaluators. Results were established at the 10th percentile, and an alert point per task for each normative group. Cronbach's alpha was, in general, between .70 and .90 and the average rate of agreement between evaluators varied from .62 to .94. Standards of age and education were established. The reliability of this instrument was verified. The psychometric legitimization of the MEC Battery will contribute to the diagnostic process for communicative disorders.

Bom Jardim brook is a small stream that flows through an area under the influence of a Petrochemical Complex, demanding control over its quality, so a genotoxic evaluation was performed. This study was conducted in situ, based on previous analysis on the same subject. These were performed both in vitro, with Salmonella typhimurium and human lymphocytes, and in vivo, using bioassays with fish exposed to water from the study area. The purpose of this research was to assess the quality of the aquatic environment and possible effects from petrochemical pollution to surrounding native populations. Micronuclei (MNE) and nuclear abnormalities (NA) frequencies in peripheral blood of Astyanax jacuhiensis, a native fish species collected from the study area, were used as biomarkers. Study period was from summer/99 to spring/2001, using samples obtained seasonally at two ponds upstream from the industrial area (BJN and BJPa) and two sites in Bom Jardim brook (BJ002 and BJ000), which are subject to Complex influence. MNE and NA frequencies found in individuals from BJ002 and BJ000 were similar, showing positive genotoxic responses related to control sites BJN and BJPa. No differential sensitivity could be verified for micronuclei induction between genders of A. jacuhiensis in the studied population. This study showed that sites subject to petrochemical influence were under higher genotoxic impact. Biomarkers adequacy to the case and the sensitivity of A. jacuhiensis for water monitoring could be also inferred.

To determine the efficacy, safety, and cost of laparoscopic surgery compared with laparotomy in women with ovarian tumors assumed to be benign. This study is a systematic review. We searched (MEDLINE, EMBASE, LILACS, and COCHRANE LIBRARY) trials registers and reference lists of published trial reports. Six randomized controlled trials were identified involving 324 patients. Duration of surgery, adverse effects of surgery, pain, length of hospital stay, and economic outcomes were compared. The mean duration of surgery was longer in the laparoscopy group overall (weighted mean difference 11.39, 95% CI 0.57–22.22). The pooled estimate for febrile morbidity decreased for laparoscopy (Peto OR 0.34, 95% CI 0.13–0.88). The odds of any adverse effect were decreased after laparoscopic procedures (Peto OR 0.26, 95% CI 0.12–0.55). The odds of being pain free were significantly greater for the laparoscopy group (Peto OR 7.35, 95% CI 4.3–12.56). Mean length of hospital stay was shorter in the laparoscopy group with reduction of 2.79 days (95% CI −2.95 to −2.62). In economic outcomes, there was a significant reduction of US$1045 (95% CI −1361 to −726.97) in the laparoscopy group. Laparoscopy is associated with a reduction in the following: febrile morbidity, urinary tract infection, postoperative complications, postoperative pain, days in hospital, and total cost. These findings should be interpreted with caution as only a small number of studies were identified including a total of only 324 women

The aim was to evaluate the effect of control selection on risk factor analysis for extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBL-KP) infections. Four contemporaneous case-control studies were conducted prospectively with 372 patients: Study 1 (ESBL-KP-infected vs non-infected); Study 2 (ESBL-KP-infected vs non-ESBL-KP-infected); Study 3 (all KP-infected vs non-infected); Study 4 (non-ESBL-KP-infected vs non-infected). Time at risk (TAR, i.e. duration of hospital stay) was the most significant risk factor [Study 1: odds ratio (OR): 5.74 (95% CI: 2.26-14.59; P

Background Non-adherence should always be investigated when there is a failure in bipolar treatments, since it is known that reported non-adherence rates in bipolar disorder treatment for long-term prophylactic pharmacotherapy range from 18% to 52%, with a median prevalence of 44.7%. Several factors are related to the poor adherence and reduction of medication efficiency, such as the different types of bipolar disorder, the presence of side effects, medication interactions, level of patient's knowledge about the disorder and their attitude towards treatment, complexity of medical regimens and the doctor–patient relationship. Methods Bipolar disorder outpatients under lithium treatment from the Hospital de Clinicas and Materno Infantil Presidente Vargas of Porto Alegre were recruited. All the patients had bipolar disorder and gave informed consent to participate in a clinical interview (106), answered the Lithium Attitudes Questionnaire (LAQ), Lithium Knowledge Test (LKT), Medication Adherence Rating Scale (MARS) and had plasma and red blood cells lithium measurements to assess their medication adherence and the factors that influenced it. Results 85.6% of bipolar disorder were adherent to lithium treatment showing plasma lithium between 0.6 and 1.2 mmol/L. There was an inverted correlation between the total LAQ score with plasma and red blood cells, a positive correlation between LKT and MARS with plasma and red blood cell lithium. Conclusion These results confirmed that knowledge level is directly correlated to treatment adherence and patients' attitudes, lower adherence, general opposition to prophylaxis, fear of side effects, denial of therapeutic effectiveness and illness severity.

The detection of telomerase activity in cervix may provide information on cervical carcinogenesis and may be a marker to monitor cervical intraepithelial neoplasia transition. A quantitative systematic review was performed to estimate the accuracy of telomerase assay in cervical lesions. Studies that evaluated the telomerase test (telomerase repeated amplification protocol) for the diagnosis of cervix lesions and compared it to paraffin-embedded sections as the diagnostic standard were included. Ten studies were analyzed, which included 1069 women. The diagnostic odds ratio (DOR) for a positive telomerase test for low-grade squamous intraepithelial lesions (Lo-SIL) vs normal or benign lesions was 3.2 (95% CI, 1.9–5.6). The DOR for a positive telomerase test for high-grade squamous intraepithelial lesions (Hi-SIL) vs Lo-SIL, normal or benign lesions was 5.8 (95% CI, 3.1–10). For cervix cancer vs Hi-SIL, the DOR for a positive telomerase test was 8.1 (95% CI, 3.2–20.3) and for cervix cancer vs Lo-SIL, normal or benign lesions, it was 40.9 (95% CI, 18.2–91). Our data support the current hypothesis that telomerase may activate an early event in cervical carcinogenesis that could be associated with the initiation and progression of cervical lesions

O uso de preservativos pelos jovens aumentou, o que não significa que sejam utilizados em todas as relações sexuais; além disso, seu uso varia durante a trajetória afetivo-sexual. Estudou-se a prevalência e fatores associados ao uso de preservativo na iniciação sexual e na última relação sexual, para moças e rapazes de 18-24 anos. Os dados são da Pesquisa GRAVAD, um estudo transversal com amostra probabilística estratificada, através de entrevistas domiciliares, em três capitais brasileiras. Na análise, utilizou-se regressão logística multinomial seguindo modelo hierarquizado. A prevalência de uso de preservativo na iniciação, dentre os usuários de métodos contraceptivos, foi 80,7% pelas moças e 88,6% pelos rapazes. Este uso cai para 38,8% e 56%, respectivamente, na última relação. Nos dois eventos, o uso de preservativo esteve associado, para ambos os sexos, ao pertencimento social e à idade da iniciação. A utilização do preservativo na iniciação determina o uso na última relação (OR = 2,42 para os rapazes e 1,89 para as moças). O maior uso de preservativo entre os jovens não implica uso continuado. As moças utilizaram menos preservativo, comparadas aos rapazes, nos eventos estudados.Condom use has increased among Brazilian youth, although condoms are not used in all sexual relations; in addition, their use varies over the course of an individual's affective and sexual history. This study focused on the prevalence and factors associated with condom use during sexual initiation and in the most recent sexual relations in young men and women (18-24 years of age). The data are from the GRAVAD Research Project, a cross-sectional study with a stratified probabilistic sample using household interviews in three Brazilian State capitals. The analysis used multinomial logistic regression with a hierarchical model. Prevalence of condom use in first sexual intercourse among individuals who used any contraceptive method was 80.7% for females and 88.6% for males. This proportion dropped to 38.8% and 56%, respectively, for the most recent intercourse. In both events, and for both genders, condom use was associated with social belonging and age at initiation. Condom use at sexual initiation was correlated with use in the most recent intercourse (OR = 2.42 for males and 1.89 for females). Increased condom use among youth does not mean continuing use. Women used condoms less than men in the events studied here.

The scope of the present study is to identify and quantify the main sources of polycyclic aromatic hydrocarbons (PAHs) in the Candiota region, Rio Grande do Sul, Brazil. Four sampling sites at a distance of 50 km from the emission source were selected: Acegua, Aeroporto, 8 de Agosto and Pedras Altas. Samples were collected from February 2001 to October 2001, using an HV PM 10 sampler for high volumes during a continuous period of 24 h every 15 days. The filters containing the particulate matter were extracted with dichloromethane in soxhlet and later analyzed by gas chromatography/mass spectrometry (GC/MS). The average concentrations of PAHs varied from 0.051 to 1.791 ng m −3 . The analysis of their distribution amongst the main emission sources was done through the diagnosis of concentration ratios of PAHs, as well as using statistical methods like factor analysis. The statistical analysis separated the 13 compounds studied in 3 Factors, grouping under Factor 1 emissions from the combustion of coal and wood, under Factor 2 vehicular emissions from the combustion of diesel oil and gasoline and under Factor 3 emissions from unburned diesel oil and gasoline.

The purpose of the present study is to analyse the chemical composition of bulk and wet atmospheric deposition samples in the Guaiba Hydrographic Basin (GHB), in south Brazil. Samples of bulk and wet deposition were analysed during a 1-year's period (January to December 2002) at three different stations, i.e., 8∘ Distrito and CEASA stations in the city of Porto Alegre, and Charqueadas station, in Charqueadas city. Conductivity, pH, Cl−, NO3−, F−, SO42 −, Na+, K+, Mg2 +, NH4+ and Ca2 + were determined. The pH presented an average value between 4.75 and 7.45. Enrichment factor was characterised based on groups of acid (pH 5.65) samples. For most of the studied ions, EF in bulk deposition was higher in alkaline samples, while in wet deposition there was little difference between acid and alkaline samples. The Multivariate Analysis technique, i.e. the Canonical Correlation Analysis (CCA), determined relationships between the two different data set (chemical and meteorological), identified the source (anthropogenic or natural) of the studied variables.

OBJETIVO: El objetivo del estudio ha sido desarrollar la version en portugues, adaptada a la cultura brasilena, del Social Phobia and Anxiety Inventory (SPAI). METODOS: Tras aprobacion de sus autores, se realizaron: a) la traduccion, retrotraduccion y discusion entre los traductores y autores estadounidenses para elaboracion de la version final del SPAI Portugues; b) validez de cara por evaluacion de peritos; c) equivalencia linguistica a traves de estudio de la correlacion entre la prueba y la reprueba de los escores de las versiones en portugues e ingles, aplicados alternadamente, en muestra de 18 voluntarios bilingues de ambos generos y d) estudio de practicidad (aceptabilidad) y utilidad (aplicabilidad) del SPAI Portugues a traves de las tasas de adhesion y de llenado adecuado en muestra poblacional de 365 universitarios de ambos generos. RESULTADOS: La version final del SPAI Portugues presenta equivalencia linguistica, semantica y tecnica, y validez de cara plenamente satisfactoria. La equivalencia linguistica hay sido probada a traves de los coeficientes de correlacion de Pearson e intraclase para el escore diferencial (total) de 0,87 (IC 95% 0,64-0,96) 0,87 (IC 95% 0,63-0,95), respectivamente (p < 0,0001). El porcentaje de adhesion al SPAI Portugues fue de 95,7% de la muestra estudiada (n = 365). Entre los que contestaron (n = 347), la tasa de llenado inadecuado fue de 4%, 14 individuos. CONCLUSIONES: Se demostro la adecuacion de la traduccion para el portugues del SPAI. La validez de cara del SPAI Portugues fue considerada plenamente satisfactoria. Los resultados de practicidad y utilidad recomiendan su uso como escala de rastreo de fobia social en muestras brasilenas de buen nivel educacional, despues de estudios de validacion en muestras brasilenas.

A monitoring program was performed to investigate heavy metal content alteration due to exploratory drilling for oil using non-aqueous fluids (NAFs) in Brazilian offshore, 900 m deep. Fourteen elements were monitored in 54 sites and it was verified that after drilling activities the average Ba concentration was remarkably increased with respect to background level, even 1 year after the activity. A minor increase in Mn and a moderate increase in Al concentrations were verified. The Cd, Cr, Ni, As, Co, Cu, Pb, V, and Zn concentrations were at the background levels, ca. 1 year after the NAFs drilling materials deposition on the seafloor. The Al, Ba, Cd, Cr, Cu, Ni and Zn mean concentrations were significantly different ( P −1 ).

The present study investigated the chemical composition of wet and bulk atmospheric precipitation samples in the Candiota region, in South Brazil. The samples were analyzed from January to December 2001 at four different stations located 50 km from the emission source. Bulk and wet precipitation were analyzed for conductivity, pH, alkalinity, Cl−, NO3−, F−, SO42−, Na+, K+, Mg2+, NH4+, Ca2+ and Zn, Ni, Cu, Fe, Al, Mn. The average pH value was 5.4 for the region and wet precipitation samples showed higher acid pH values than those of bulk precipitation did. The major ions in wet and bulk atmospheric precipitation showed high NH4+, Ca2+, SO42−, Na+ and Cl− concentrations. Factor Analysis applied to the studied variables allowed identifying the major sources. For major ions, the study identified association of three groups: Mg, Na, Cl and Ca, related to the origins of soil and sea salts; NH4+, K+, SO42− and NO3−, related to local anthropogenic sources (coal burning, agriculture, biomass burning), and H+ and F−, related to the influence of the coal-fired power plant. As for Ni, Zn, Cu, Mn, Al, and Fe it indicated origin from local anthropogenic activities and from the soil, respectively.

The present paper has as objective to apply a sequential Cluster Analysis to the atmospheric particles: Hierarchical Cluster Analysis followed by Nonhierarchical Cluster Analysis. The hierarchical cluster analysis results were used as start point for the nonhierarchical cluster analysis as an agglomerative technique. These particles were taken from two areas of the metropolitan region of Porto Alegre, Charqueadas and Sapucaia do Sul., from may /97 to may/98, using a High Volume Sampler (Hi-Vol). Around 10,000 particles were analysed by Scanning Electron Microscope with Energy-Dispersive X-Ray microanalysis (SEM-EDS). The Hierarchical Cluster Analysis allowed the identification of five groups of particles, whose amounts were differentiated according to the summer and the winter campaigns. The abundance of each type of particles inside each group according to the different sections was verified by the Nonhierarchical Cluster Analysis, resulting in information about the emissions sources. The groups of particles of Si/Al and Si and of Fe/Zn and Fe for Charqueadas were more significant in section 2 and 3 (NW and W wind directions) and in section 1 (SE wind direction), evidencing the influence of the coal power plant and steel industry, respectively located in these quadrants. In Sapucaia do Sul the data were more heterogeneous, causing a certain difficulty to identify the source as anthropogenic. Nevertheless the group of particles containing Fe was found in sectors of NW/W wind directions which shows the influence of the steel plant.

Objetivo: Avaliar os possíveis riscos reprodutivos em uma região próxima a pólo petroquímico situado no Rio Grande do Sul. Métodos: Foram analisados 17.113 registros de nascimentos ocorridos no principal hospital da região, localizado no município de Montenegro, RS, desde 1983 até 1998. Foram selecionados três diferentes grupos de casos: (1) recém-nascidos portadores de malformações congênitas maiores; (2) recém-nascidos com baixo peso ao nascer (500 g). Para cada caso, foi atribuído um controle específico, que foi a primeira criança nascida viva, pesando 2.500 g ou mais, com ausência de malformações e tendo o mesmo sexo que o caso em questão. A residência materna durante a gravidez foi utilizada como um parâmetro para exposição. Para a análise estatística, foram usados os testes qui-quadrado ou Fisher, “odds ratio”, nível de significância de 0,05 e intervalo de confiança de 95%. Resultados: Foi encontrada correlação positiva para baixo peso ao nascer e para proximidade geográfica da residência materna ao Pólo Petroquímico [“odds ratio” (OR) = 1,66; 95% confidence interval (CI) = 1,01-2,72] ou residência na direção preferencial do vento [“odds ratio” (OR) = 1,62; 95% confidence interval (CI) = 1,03-2,56]. Quando outras variáveis foram incluídas na análise de regressão logística condicional (fumo, doenças crônicas e idade materna), essa associação desapareceu. Conclusões: Apesar de os resultados finais terem sido negativos, o baixo peso ao nascer pode ser um bom parâmetro para medir a contaminação ambiental, mas deve ser monitorado na região estudada. Objective: To evaluate possible adverse reproductive outcomes in an area adjacent to a petrochemical plant in southern Brazil. Methods: A review of 17,113 birth records of the main hospital of the municipality of Montenegro, southern Brazil, from 1983 to 1998 was carried out. Three groups of cases were selected: (1) newborns with major congenital malformations; (2) newborns with low birth weight (500 g). A control was assigned to each case. Controls were the first newborns weighing ≥2,500 g without malformations and of case-matching sex. Mother’s residence during pregnancy was used as an exposure parameter. Statistical analyses were performed using Chi-square test or Fisher test, odds ratio, 0.05 significance level, and 95% confidence interval. Results: For unadjusted analysis, it was found a correlation between low birth weight and geographical proximity of mother’s residence to the petrochemical plant (OR = 1.66; 95% CI = 1.01–2.72) or residence on the way of preferential wind direction (OR = 1.62; 95% CI = 1.03–2.56). When other covariates were added in the conditional logistic regression (maternal smoking habits, chronic disease and age), there was no association. Conclusions: Despite final results were negative, low birth weight could be a good parameter of environmental contamination and should be closely monitored in the studied area.

The present work aims to study the contamination of the sediments in areas impacted by coal processing and steel industry activities from the Baixo Jacui Region, in the Rio Grande do Sul state, Brazil. Sediments were collected in the rivers (Jacui and Taquari) and streams (Conde and Ratos) for 7 months in 15 sites. Total and partial extractions were applied to the sample of sediments The accuracy was evaluated for total extraction using the Canada certified reference material (STDS-3, 4). Results of the total extraction in comparison to the background values showed higher metallic elements concentration for some sediment samples, however these results are unable to establish information on the existence of anthropogenic contribution in the sites. Partial extraction applied to the samples allowed the evaluation of the labile available fraction indicating contamination of sediment in some sites. Higher and lower mobilities were verified for Mn and Cr, respectively. The other elements studied presented intermediate to weak mobility. Factor analyzes applied to the variables studied emphasized the differences in the separation of the sites in relation to the variables type and concentration for total extraction, as well as to the mobility and labile available fraction from sediment samples for partial extraction. The variables Fe, C, S and Ni, Co, Zn, Mn were characterized in the Conde stream, indicating contamination by coal. Cr and Cu were found in the Jacui river in the sites nearest to the steel industry.

This work aims to characterize residues from coal processing and steel industry activities by means of physical–chemical analyses. The deposits were selected according to the field descriptions which aimed at the generic characterization of each deposit, mainly in relation to type/aspect and to the particle size range predominant in each deposit. Total extraction, as well as leaching and solubilization tests were applied to samples of coal waste, ash and residues from the steel industry. Results of the characterization indicated that the pollutant potential is more significant in coal waste than in ashes. Some metallic elements, such as Fe, showed high concentrations in the total extraction but they were not necessarily the most mobile when leaching and solubilization tests were conducted. Mn followed by Pb and Zn presented a more significant concentration in the extract of the tests mentioned earlier and a consequent higher mobility. The application of factor analysis to the variables studied emphasized the differences in the mobility of metallic elements regarding the tests used. These differences can be attributed to the association of metals to different mineral fractions (sulfides, carbonates and silicates) within coal.

Introdução: A perda de informações é um problema frequente em estudos realizados na área da Saúde. Na literatura essa perda é chamada de missing data ou dados faltantes. Através da imputação dos dados faltantes são criados conjuntos de dados artificialmente completos que podem ser analisados por técnicas estatísticas tradicio¬nais. O objetivo desse artigo foi comparar, em um exemplo baseado em dados reais, a utilização de três técnicas de imputações diferentes. Método: Os dados utilizados referem-se a um estudo de desenvolvimento de modelo de risco cirúrgico, sendo que o tamanho da amostra foi de 450 pacientes. Os métodos de imputação empregados foram duas imputações únicas e uma imputação múltipla (IM), e a suposição sobre o mecanismo de não-resposta foi MAR (Missing at Random). Resultados: A variável com dados faltantes foi a albumina sérica, com 27,1% de perda. Os modelos obtidos pelas imputações únicas foram semelhantes entre si, mas diferentes dos obtidos com os dados imputados pela IM quanto à inclusão de variáveis nos modelos. Conclusões: Os resultados indicam que faz diferença levar em conta a relação da albumina com outras variáveis observadas, pois foram obtidos modelos diferentes nas imputações única e múltipla. A imputação única subestima a variabilidade, gerando intervalos de confiança mais estreitos. É importante se considerar o uso de métodos de imputação quando há dados faltantes, especialmente a IM que leva em conta a variabilidade entre imputações para as estimativas do modelo. Introduction: It is common for studies in health to face problems with missing data. Through imputation, complete data sets are built artificially and can be analyzed by traditional statistical analysis. The objective of this paper is to compare three types of imputation based on real data. Methods: The data used came from a study on the development of risk models for surgical mortality. The sample size was 450 patients. The imputation methods applied were: two single imputations and one multiple imputation and the assumption was MAR (Missing at Random). Results: The variable with missing data was serum albumin with 27.1% of missing rate. The logistic models adjusted by simple imputation were similar, but differed from models obtained by multiple imputation in relation to the inclusion of variables. Conclusions: The results indicate that it is important to take into account the relationship of albumin to other variables observed, because different models were obtained in single and multiple imputations. Single imputation underestimates the variability generating narrower confidence intervals. It is important to consider the use of imputation methods when there is mis¬sing data, especially multiple imputation that takes into account the variability between imputations for estimates of the model.

OBJETIVO: Avaliar a mortalidade hospitalar por meio de análise multinível utilizando dados disponíveis no Sistema de Informações Hospitalares do Sistema Único de Saúde. MÉTODOS: Estudo transversal com dados de internações obtidas das Autorizações de Internação Hospitalar do Rio Grande do Sul no ano de 2005. A modelagem foi realizada por meio de regressão logística multinível, utilizando variáveis do nível individual (internações) e do nível contextual (hospitais). Analisou-se a variabilidade causada por variáreis individuais no nível hospitalar, bem como a participação do perfil dos hospitais na taxa de mortalidade hospitalar. RESULTADOS: A taxa bruta de mortalidade calculada para o conjunto de hospitais foi de 6,3%. As variáveis uso de Unidade de Terapia Intensiva e idade foram os principais preditores para óbito hospitalar no nível individual. As variáveis de contexto que se relacionaram mais intensamente com o óbito hospitalar foram: porte do hospital, natureza jurídica e média de permanência. A chance de óbito em hospital de grande porte é 1,85 vezes a chance do hospital de pequeno porte e no hospital de médio porte é 1,69 vezes a chance do hospital de pequeno porte. Os hospitais públicos apresentam 67% mais chances de óbito hospitalar do que os privados. CONCLUSÕES: O perfil hospitalar tem papel importante na mortalidade hospitalar do Sistema de Informações Hospitalares do Sistema Único de Saúde. A análise multinível deve ser empregada para a estimação da contribuição do perfil dos hospitais na mortalidade hospitalar. OBJECTIVE: To use a multilevel analysis methodology to evaluate hospital mortality from the data available in the Hospital Information System of the National Unified Health System. METHODS: Cross-sectional study with data obtained from Authorization Forms for Hospital Admissions in Rio Grande do Sul, Brazil in 2005. The modeling was performed using multilevel logistic regression, with variables from the individual level (hospital admissions) and the context level (hospital profile). The variability originated from individual variables was analyzed as well as the participation of the profile of hospitals in the rate of hospital mortality. RESULTS: The crude death rate calculated for all hospitals was 6.3%. The variables "Use of Intensive Care Unit" followed by "Patient Age" were the main predictors for hospital death at the individual level. The context variables that were related most closely to hospital death (outcome) were: size of hospital, legal nature, and average length of stay. The OR for deaths at large hospitals was 1.85 times the odds for small hospitals and the OR for medium hospitals was 1.69 times the odds for small ones. The chance of deaths in public hospitals was 67% higher than in private ones. CONCLUSIONS: The hospital profile has an important role in hospital mortality in the Hospital Information System of the National Unified Health System. Multilevel analysis should be used to estimate the contribution of the profile of mortality in hospitals.

Objetivo: averiguar a existência de relações entre o desempenho em testes de processamento auditivo e em tarefas cognitivas. Métodos: participaram 12 adolescentes com desenvolvimento típico, estudantes de terceiro ano do Ensino Médio de escolas privadas do estado do Rio Grande do Sul, Brasil, examinados com uma bateria de testes de PA(C) e com o Instrumento de Avaliação Neuropsicológica Breve Neupsilin. Foram realizadas análises de correlação de Pearson e análises qualitativas intertestes para comparação do desempenho na avaliação do PA(C) e na avaliação neuropsicológica. Resultados: da bateria de testes PA(C), os Testes SSI – MCI – Teste de Sentenças Sintéticas com mensagem competitiva ipsilateral, SSW - Teste de Dissílabos Alternados e o teste Dicóticos de Dígitos apresentaram correlação forte significativa positiva (coeficiente de correlação de Pearson) com os subtestes do Neupsilin: atenção – contagem inversa, percepção de faces, linguagem oral automática e repetição, memória verbal episódica e memória de trabalho – span auditivo de palavras em sentenças. Alguns testes do PA(C) apresentaram maior frequência de dissociações com subtestes neuropsicológicos. As correlações encontradas indicam que os testes de PA(C) e as tarefas neuropsicológicas parecem examinar algumas habilidades cognitivas subjacentes em comum. As dissociações observadas sugerem que os processamentos auditivo e neuropsicológico são relativamente independentes e a análise intertestes do desempenho dos participantes na avaliação do PA(C), comparada ao desempenho na avaliação neuropsicológica, confirma os resultados encontrados para as questões anteriores. Conclusão: ressalta-se a necessidade de se pensar o contexto da administração dos testes de PA(C), considerando-se a relação de complementaridade da avaliação neuropsicológica e do exame de processamento auditivo. Purpose: to check if there is a relation between the performance in auditory processing tests and in cognitive tasks. Methods: the sample was made up by 12 teenagers in typical development, all of them high-school students (third year) in private schools from Rio Grande do Sul, Brazil. They were evaluated through an auditory processing battery as well as with the Brazilian Brief Neuropsychological Assessment Battery NEUPSILIN. Data analyses included Person’s correlation and qualitative interests interpretation towards a comparison of the performance in (C)AP’s battery and in the neuropsychological assessment. Results: regarding (C)AP’s battery, SSI – MCI – Synthetic Sentence Test with ipsilateral competitive message, SSW - Test of Alternated Disyllables and Digit Dicotics tests showed a significant strong positive correlation with NEUPSILIN’s subtests that follows: attention – reverse counting, face perception, oral language – automated language and repetition, episodic verbal memory and working memory – auditory word span in sentences. Some (C)AP’s tests presented a greater frequency of dissociation when compared to neuropsychological tasks. Correlation index suggest that (C)AP’s tests and neuropsychological tasks seem to evaluate some common basic cognitive abilities. The observed dissociation suggest that auditory and neuropsychological processing are partially independent on each other. The interests analysis confirms these results. Conclusion: there is a need to rethink about the administration of (C)AP’s tests, when it comes to the addition relation between neuropsychological assessment and auditory processing examination.

Infant mortality is considered a sensitive health indicator, and knowledge of its geographical profile is essential for formulating appropriate public health policies. Disease mapping aims to describe the geographical distribution of disease incidence and mortality rates. Due to the heavy instability of crude rates in small areas, methods involving Bayesian smoothing of rates are used, drawing on information for the whole area or neighborhood to estimate the event rate. The current study compares empirical Bayesian (EB) and fully Bayesian (FB) methods for infant mortality rates (accumulated data from 2001 to 2004) in Rio Grande do Sul State, Brazil. This study highlights the advantages of Bayesian estimators for viewing and interpreting maps. For the problem at hand, EB and FB methods showed quite similar results and had the great advantage of easy use by health professionals, since they evenly highlight the main spatial patterns in the mortality rate in the State during the target period.

To develop a hospital mortality prediction model based on data from the Hospital Information System of the Brazilian National Health System.This was a cross-sectional study using data from 453,515 authorizations for hospital admission relating to 332 hospitals in Rio Grande do Sul, Southern Brazil in the year 2005. From the ratio between observed and expected deaths, the hospitals were ranked in an adjusted manner, and this was compared with the crude ranking of the mortality rate. Logistic regression was used to develop a predictive model for the likelihood of hospital mortality according to sex, age, diagnosis and use of an intensive care unit. Confidence intervals (95%) were obtained for the 206 hospitals with more than 365 hospital admissions per year.An index for the risk of hospital mortality was obtained. Ranking the hospitals using only the crude mortality rate differed from the ranking when it was adjusted according to the predictive likelihood model. Among the 206 hospitals analyzed, 40 of them presented observed mortality that was significantly greater than what was expected, while 58 hospitals presented mortality that was significantly lower than expected. Use of an intensive care unit presented the greatest weight in making up the risk index, followed by age and diagnosis. When the hospitals attended patients with widely differing profiles, the risk adjustment did not result in a definitive indication regarding which provider was best. Among this group of hospitals, those of large size presented greater numbers of deaths than would be expected from the characteristics of the hospital admissions.The hospital mortality risk index was shown to be an appropriate predictor for calculating the expected death rate, and it can be applied to evaluate hospital performance. It is recommended that, in comparing hospitals, the adjustment using the predictive likelihood model for the risk should be used, with stratification according to hospital size.

BACKGROUND Over the last ten years laparoscopy has become an increasingly common approach for the surgical removal of benign ovarian tumours. There remains uncertainty as to the value of this intervention. This review has been undertaken to assess the available evidence for the benefits and harms of laparoscopic surgery for benign ovarian tumours compared to laparotomy. OBJECTIVES To determine the efficacy, safety and cost of laparoscopic surgery compared with laparotomy in women with ovarian tumours assumed to be benign. SEARCH STRATEGY We searched electronic databases, trials registers and reference lists of published trial reports. Review articles were also searched. SELECTION CRITERIA All randomised controlled trials comparing laparoscopy versus laparotomy for benign ovarian tumours. DATA COLLECTION AND ANALYSIS Three reviewers independently assessed each study's eligibility and quality and extracted data. MAIN RESULTS Six randomised controlled trials were identified involving 324 patients. Three subgroups of ovarian tumours were considered: any histological type of benign ovarian tumour, dermoid cysts and endometriomata. Surgical outcomes: The mean duration of surgery was longer in the laparoscopy group compared to the laparotomy group overall (WMD 11.39; 95% CI 0.57 to 22.22). However, heterogeneity was present with substantial inconsistency (I(2)=87%) . The heterogeneity found in these analyses was likely to reflect differences in the patient populations. Adverse effects of surgery: The pooled estimate for febrile morbidity decreased for laparoscopy compared to laparotomy (Peto OR 0.34; 95% CI 0.13 to 0.88). The odds of any adverse effect of surgery (total number of complications - surgical injury and/or post operative complications) were decreased after laparoscopic procedures (Peto OR 0.26; 95% CI 0.12 to 0.55). Short-term recovery: VAS pain scores favoured laparoscopy (WMD -2.36; 95% CI -2.07 to -2.03) andt he odds of being pain free were significantly greater for the laparoscopy group compared to laparotomy (Peto OR 7.35; 95% CI 4.3 to 12.56). Mean length of hospital stay was shorter in the laparoscopy group with reduction 2.79 days (95% CI -2.95 to -2.62) compared to laparotomy. Economic outcomes: There was a significant reduction of US$1045 (95% CI -1361 to -726.97) in the laparoscopy group compared to the laparotomy group in one trial of women with any type of benign ovarian tumour. AUTHORS' CONCLUSIONS In women undergoing surgery for benign ovarian tumours, laparoscopy is associated with a reduction in the following; febrile morbidity, urinary tract infection, post operative complications, post operative pain, days in hospital and total cost. These findings should be interpreted with caution as only a small number of studies were identified including a total of only 324 women and not all of the important outcomes were reported in each study.