Reliability and validity of uterine cancer death certificates in the municipality of Belém, Pará, Brazil

Belém, Pará State, Brazil, presents high mortality rates for uterine cervical cancer, thus justifying an analysis of the reliability and validity of data on this underlying cause of death. Death certificates for Belém residents who died in 1998-1999 from neoplasms of the uterine cervix, uterine body, or unspecified uterine site, or with mention of such a neoplasm on any line in the death certificate, were selected, amounting to 188 death certificates (DCs). All DCs were submitted to new coding, and reliability analysis was performed by simple agreement and Cohen's kappa. The underlying cause of death, established after review of medical records and/or histopathological findings, was considered the gold standard for analysis of criteria validity, based on the positive predictive value. We observed a simple agreement of 94.0% and kappa of 0.87, suggesting high reliability of the official system's coding of uterine cancer as the underlying cause of death. In the validity analysis, 120 of the 127 deaths originally considered as caused by cancer of the uterine cervix and 3 of the 4 coded as cancer of the uterine body were confirmed. An 11.2% increase in uterine cervical tumors and a reduction of 62.5% in unspecified uterine tumors were observed.     

Limitations of probiotic therapy in acute,severe dehydrating diarrhea

BACKGROUND: Recent studies have shown that probiotics, most commonly, may be useful in treating acute gastroenteritis. However, beneficial effects appear to be limited to a modest decrease in the duration of diarrhea. No studies have evaluated this therapy in moderate to severe dehydrating diarrhea in a metabolic facility. METHODS: Male children less than 2 years of age were admitted to a metabolic unit of the Department of Pediatrics at the Federal University of Bahia, Brazil, with moderate dehydration and were randomized in a double-blind, placebo-controlled fashion. Oral rehydration solution (ORS) was administered per protocol and either placebo or was given in combination with the ORS. Output of urine, stool, and vomitus was recorded along with stool weight, nude body weight, and standard laboratory assessments for hydration. RESULTS: There was no significant reduction in diarrhea duration and stool output in the group. However, Kaplan-Meier survival analysis demonstrated that, even in moderate to severe diarrhea, resolution of the illness occurred so rapidly, that statistically significant benefits of probiotic therapy could not be demonstrated. CONCLUSION: Our data implies that colonization must occur before benefits of probiotics can be realized. Probiotics are, therefore, likely to be of limited benefit in treating diarrheal illnesses of short duration such as viral enteritis. The beneficial effects of probiotics may be limited to prophylactic usage in high-risk populations.     

Electromyographic evaluation of the adductor pollicis muscle of elderly patients carriers of removable partial prosthesis when using acrylic devices adapted to the handle of toothbrush

The aim of this study was to evaluate the muscular activity of the adductor pollicis muscle, by electromyography, when using a device made of acrylic resin adapted to the handle of toothbrush. 10 patients of both sexes from the Clinic of Removable Partial Dentures of the Dental School--USP, with a mean age of 65 years, were selected. Electromyographic records were obtained with patients in clinical conditions of Initial Rest and under conditions of claw apprehension and dental brushing. The mean results obtained, in mV, were: sat men: 2.97 for rest (R); 11.55 for free closure (FC); 35.80 for strained closure (SC); 29.30 for simulated brushing (SB); 55.00 for brushing (B); 26.87 for simulated brushing with the device (SBA); 69.70 for brushing with the device (BA); 3.72 for post exercise rest (PR). Standing: 2.27 for rest (R); 13.92 for free closure (FC); 45.85 for strained closure (SC); 28.40 for simulated brushing (SB); 72.07 for brushing with the device (BA); 1.42 for postexercise rest (PR). Sat women: 9.78 for rest (R); 22.71 for free closure (FC); 41.48 for strained closure (SC); 26.45 for simulated brushing (SB); 52.78 for brushing (B); 17.00 for simulated brushing with the adapter (SBA); 42.38 for brushing with the adapter (BA); 14.40 for postexercise rest (PR). Standing: 5.26 for rest (R); 17.81 for free closure (FC); 46.55 for strained closure (SC); 40.61 for simulated brushing (SB); 61.71 for brushing (B); 26.08 for simulated brushing with the adapter (SBA); 54.06 for brushing with the adapter (BA); 3.46 for postexercise rest (PR). The adductor pollicis muscle showed a higher electromyographic activity, considered statistically similar to each other, in 3 clinical conditions analyzed: brushing (B), brushing with the adapter (BA) and strained closure (SC). The adductor pollicis muscle showed lower electromyographic activity, considered statistically similar, in 5 clinical conditions analyzed: simulated brushing (SB), simulated brushing with the adapter (SBA), free closure (FC), rest (R) and postexercise rest (PR).     

Control of lead emissions from a battery repair shop in the city of Rio de Janeiro using the air as indicator

Lead levels in the air surrounding a battery repair shop (BRS) located in the Olaria neighborhood (Rio de Janeiro, Brazil) were monitored from April to July 1999. Most of the samples collected within 25 meters of the BRS exceeded the limit of 1.5 micro g.Pb.m-3 established by the United States Environmental Protection Agency (EPA). These results were published in a previous article (Quiterio et al., 2001). In the current study, installation of a Venture ventilation system and some changes in the operational procedure were proposed. After the modifications in the BRS, a new monitoring campaign was performed (August and September, 2000). Three points were selected for air collection, corresponding to the most critical points found in the previous assessments. The new concentrations ranged from 0.8 to 17.6 micro g.Pb.m-3, showing that lead emissions into the environment had decreased adequately. However, concentration at the chimney exhaust was still higher than EPA limits, and further improvements in the installations and procedures are definitely needed.