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BACKGROUND: Human T-lymphotropic virus 1 (HTLV-1) is associated with the development of several pathologies and chronic infection in humans. The inefficiency of the available treatments and the challenge in developing a protective vaccine highlight the need to produce effective immunotherapeutic tools. The HTLV-1 basic leucine zipper (bZIP) factor (HBZ) plays an important role in the HTLV-1 persistence, conferring a survival advantage to infected cells by reducing the HTLV-1 proteins expression, allowing infected cells to evade immune surveillance, and enhancing cell proliferation leading to increased proviral load. METHODS: We have generated a recombinant Modified Virus Vaccinia Ankara (MVA-HBZ) and a plasmid DNA (pcDNA3.1(+)-HBZ) expressing a multiepitope protein based on peptides of HBZ to study the immunogenic potential of this viral-derived protein in BALB/c mice model. Mice were immunized in a prime-boost heterologous protocol and their splenocytes (T CD4+ and T CD8+) were immunophenotyped by flow cytometry and the humoral response was evaluated by ELISA using HBZ protein produced in prokaryotic vector as antigen. RESULTS: T CD4+ and T CD8+ lymphocytes cells stimulated by HBZ-peptides (HBZ42-50 and HBZ157-176) showed polyfunctional double positive responses for TNF-α/IFN-γ, and TNF-α/IL-2. Moreover, T CD8+ cells presented a tendency in the activation of effector memory cells producing granzyme B (CD44+High/CD62L-Low), and the activation of Cytotoxic T Lymphocytes (CTLs) and cytotoxic responses in immunized mice were inferred through the production of granzyme B by effector memory T cells and the expression of CD107a by CD8+ T cells. The overall data is consistent with a directive and effector recall response, which may be able to operate actively in the elimination of HTLV-1-infected cells and, consequently, in the reduction of the proviral load. Sera from immunized mice, differently from those of control animals, showed IgG-anti-HBZ production by ELISA. CONCLUSIONS: Our results highlight the potential of the HBZ multiepitope protein expressed from plasmid DNA and a poxviral vector as candidates for therapeutic vaccine.

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Introduction: New techniques, surgical protocols, dental implant designs, and prosthetic rehabilitation have been used in dentistry, most of which have yielded good results in the literature. This retrospective survey assessed the clinical results of patients rehabilitated with dental implants between January 2011 and December 2021. Load protocols (immediate and conventional), types of connections of the installed implants, external hexagon (EH), and cone morse (MC) were evaluated. Material and methods: Two evaluators were selected and calibrated to perform the analyses. The inclusion criteria were records with complete and legible information of patients rehabilitated with dental implants who were followed for at least 1 year after rehabilita-tion. The medical records were divided into two groups, G1 (implants with conventional load) and G2 (implants with immediate load), and further subdivided according to implant type. Information about the rehabilitation failures was noted and descriptive statistics of the results were obtained. Results: Among the 432 evaluated medical records of patients rehabilitated with implants, the study included 319 records: 223 from women and 96 from men, aged 20-79 years. In total, data were available on 1,227 implants with dimensions of 10-13 mm and diameters of 3.75-4 mm. The G1 (n=1.188) survival rates were 94.95% for EH implants and 99.5% for MC implants. In G2 (n=39), the survival rates were 93.75% for EH implants and 91.3% for MC implants. The implant survival rates were relatively high among all groups evaluated; however, the discrepancy between the number of implants in the groups may compromise the comparison between them. Understanding and respecting the biomechanical and technical principles of each protocol was the main factor influencing the success of rehabilitation. Conclusion: The results of this study showed that, according to medical records, rehabilitation with dental implants showed excellent results regardless of the connection type (EH or MC) or loading protocol (conventional or immediate). The two loading protocols and two connection types had excellent results and scientific support. Therefore, the choice should be based on the clinical needs of each patient.

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Introduction: In the rehabilitation of total edentulous patients, lack of bone availability in posterior maxillary regions is common due to pneumatization of the maxillary sinus and posterior mandible due to the presence of the lower alveolar nerve. And to rehabilitate this type of patient, one of them is the use of short implants. Methods: The work aims to evaluate the success rate of treatment of short implants through a literature review. The search was carried out in august 2020 in the Pubmed (MedLine), Scopus and Embase databases, using the keywords: extra short implants, short implants, survival rate, single implant, atrophic mandible. The keywords followed the AND or OR criteria previously elaborated by the PICO question. The inclu-sion criteria were: implants with a length of 4 to 8 mm, which were single and in the posterior region of atrophic mandible and which had 5 years of follow-up. Articles were excluded from the review where the implants were splinted, had a follow-up of less than 5 years and considered short implants larger than 8 mm. Results: After the search, 4 articles were separated, which totaled an n = 172 short implants obtaining a success rate of 93.47% in 5 years. After the search, 4 articles were separated, which totaled an n = 172 short implants obtaining a success rate of 93.47% in 5 years. Conclusion: We can conclude that the use of short implants, even in single prostheses, has a high success rate, which can provide the edentulous patient with little bone bioavailability for rehabilitation.

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The increasing demand for the elemental determination of petrochemical samples by inductively coupled plasma techniques requires the development of suitable sample preparation methods that permit high sample throughput and are in accordance with green chemistry recommendations. For this aim, the development of microwave-induced combustion (MIC) method has been attempted to completely digest petroleum coke samples and address quantitative determination of elements, such as Ag, Al, Ba, Ca, Cd, Co, Cu, Fe, Mg, Mn, Mo, Na, Ni, Pb, Sr, V and Zn, by inductively coupled plasma optical emission spectrometry (ICP OES). A sequential procedure to evaluate the sample mass and the solution to retain the analytes quantitatively was first conducted. Satisfactory results were obtained (residual carbon content in final solutions was lower than 0.5%) by digesting 400 mg of samples using 20 bar of oxygen and analytes were quantitatively retained in a dilute acid solution such as 4.2 mol L-1 HNO3. An agreement better than 87% was achieved using certified reference materials and the performance of the proposed method was also compared to that of the standard procedure recommended by the American Society of Testing and Materials ASTM D 5600. Despite both methods producing similar results, the proposed method by MIC was much simpler, offered a higher sample throughput and the digests were compatible with ICP OES measurements avoiding interferences in the determination step compared the ASTM D 5600 method. These results clearly demonstrated that the proposed MIC method in combination with ICP OES could be a promising alternative to obtain quantitative information about the elemental composition of petroleum coke.

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One strategy to improve the photovoltaic properties of nonfullerene acceptors (NFAs), employed in state-of-art organic solar cells, is the rational fluorination or chlorination of these molecules. Although this modification improves important acceptor properties, little is known about the effects on the triplet states. Here, we combine the polarizable continuum model with an optimally tuned range-separated hybrid functional to investigate this issue. We find that fluorination or chlorination of NFAs decreases the degree of the highest occupied molecular orbital-lowest unoccupied molecular orbital (HOMO-LUMO) overlap along these molecules. Consequently, the energy gap between T1 and S1 states, ΔEST = ES1 - ET1, also decreases. This effect reduces the binding energy of triplet excitons, which favors their dissociation into free charges. Furthermore, the reduction of ΔEST can contribute to mitigating the losses produced by the nonradiative deactivation of the T1 excitons. Interestingly, although Cl has a lower electronegativity than F, chlorination is more effective to reduce ΔEST. Since the chlorination of NFAs is easier than fluorination, Cl substitution can be a useful approach to enhance solar energy harvesting using triplet excitons.

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'Brejos de altitude' is an ecosystem that has been subjected to severe exploitation, leading to an intense reduction in Brazil. Understanding the patterns of bryophyte diversity and composition, particularly of specialized species such as the epiphylls, to anthropic and abiotic variables is crucial for implementing protection measures. We investigated the relationship between composition and diversity of epiphyllous bryophytes and anthropic (edge effects) and abiotic (altitude) variables at local (within each 'Brejo') and regional (set of three 'Brejos') scale. Abiotic and anthropic variables were correlated with alpha and beta diversity (decomposed into species replacement and richness differences) using GLM. Their effects on species composition were evaluated using PERMANOVA. The localities at higher elevations harboured a richer bryoflora and overall beta diversity patterns were associated with altitude and locality, which acted over different scales. Regionally, the contribution of richness differences was limited with increasing altitude. Yet, dissimilarities among localities were associated with richness differences and replacement, denoting the importance of local factors. The composition was explained by local factors interacting with the regional altitudinal gradient. Anthropic activity was significant only when interacting with local factors and altitudinal gradient. Environmental filtering associated with altitude played a more important role in shaping the diversity and composition of epiphyllous bryophytes, at both regional and local scales. Each 'Brejo' acts as an ecological refuge, harbouring part of the whole environmental gradient, and presents a unique floristic composition. Moreover, partitioning beta diversity highlighted the interplay of local and regional forces shaping diversity patterns.

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The current definition of is inadequate for early recognition of this important cause of maternal death that is responsible for >80,000 deaths worldwide in 2015. A stronger definition of postpartum hemorrhage should include both blood loss and clinical signs of cardiovascular changes after delivery, which would help providers to identify postpartum hemorrhage more promptly and accurately. Along with the amount of blood loss, clinical signs, and specifically the shock index (heart rate divided by systolic blood pressure) appear to aid in more accurate diagnosis of postpartum hemorrhage.

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Wastes of electrical and electronic equipment (WEEE) represent an important environmental problem, since its composition includes heavy metals and organic compounds used as flame-retardants. Thermal treatments have been considered efficient processes on removal of these compounds, producing carbonaceous structures, which, together with the ceramic components of the WEEE (i.e. silica and alumina), works as support material for the metals. This mixture, associated with the metals present in WEEE, represents promising systems with potential for catalytic application. In this work, WEEE was thermally modified to generate materials that were extensively characterized. Raman spectrum for WEEE after thermal treatment showed two carbon associated bands. SEM images showed a metal nanoparticles distribution over a polymeric and ceramic support. After characterization, WEEE materials were applied in ethanol steam reforming reaction. The system obtained at higher temperature (800°C) exhibited the best activity, since it leads to high conversions (85%), hydrogen yield (30%) and H2/CO ratio (3,6) at 750°C.

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BACKGROUND: The aim of this study was to assess the burden of respiratory disease, considering the influenza A pandemic season (H1N1pdm09), within the Brazilian Network for Surveillance of Severe Maternal Morbidity, and factors associated with worse maternal outcome. METHODS: A multicenter cross-sectional study, involving 27 referral maternity hospitals in five Brazilian regions. Cases were identified in a prospective surveillance by using the WHO standardized criteria for potentially life-threatening conditions (PLTC) and maternal near miss (MNM). Women with severe complications from respiratory disease identified as suspected or confirmed cases of H1N1 influenza or respiratory failure were compared to those with other causes of severe morbidity. A review of suspected H1N1 influenza cases classified women as non-tested, tested positive and tested negative, comparing their outcomes. Factors associated with severe maternal outcome (SMO = MNM + MD) were assessed in both groups, in comparison to PLTC, using PR and 95 % CI adjusted for design effect of cluster sampling. RESULTS: Among 9555 cases of severe maternal morbidity, 485 (5 %) had respiratory disease. Respiratory disease occurred in one-quarter of MNM cases and two-thirds of MD. H1N1 virus was suspected in 206 cases with respiratory illness. Around 60 % of these women were tested, yielding 49 confirmed cases. Confirmed H1N1 influenza cases had worse adverse outcomes (MNM:MD ratio < 1 (0.9:1), compared to 12:1 in cases due to other causes), and a mortality index > 50 %, in comparison to 7.4 % in other causes of severe maternal morbidity. Delay in medical care was associated with SMO in all cases considered, with a two-fold increased risk among respiratory disease patients. Perinatal outcome was worse in cases complicated by respiratory disease, with increased prematurity, stillbirth, low birth weight and Apgar score < 7. CONCLUSIONS: Respiratory disease, especially considering the influenza season, is a very severe cause of maternal near miss and death. Increased awareness about this condition, preventive vaccination during pregnancy, early diagnosis and treatment are required to improve maternal health.

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OBJECTIVE: To identify the burden of severe infection within the Brazilian Network for Surveillance of Severe Maternal Morbidity and factors associated with worse maternal outcomes. METHODS: This was a multicentre cross-sectional study involving 27 referral maternity hospitals in Brazil. WHO's standardised criteria for potentially life-threatening conditions and maternal near miss were used to identify cases through prospective surveillance and the main cause of morbidity was identified as infection or other causes (hypertension, haemorrhage or clinical/surgical). Complications due to infection were compared to complications due to the remaining causes of morbidity. Factors associated with a severe maternal outcome were assessed for the cases of infection. RESULTS: A total of 502 (5.3%) cases of maternal morbidity were associated with severe infection vs. 9053 cases (94.7%) with other causes. Considering increased severity of cases, infection was responsible for one-fourth of all maternal near miss (23.6%) and nearly half (46.4%) of maternal deaths, with a maternal near miss to maternal death ratio three times (2.8:1) that of cases without infection (7.8:1) and a high mortality index (26.3%). Within cases of infection, substandard care was present in over one half of the severe maternal outcome cases. Factors independently associated with worse maternal outcomes were HIV/AIDS, hysterectomy, prolonged hospitalisation, intensive care admission and delays in medical care. CONCLUSIONS: Infection is an alarming cause of maternal morbidity and mortality and timely diagnosis and adequate management are key to improving outcomes during pregnancy. Delays should be addressed, risk factors identified, and specific protocols of surveillance and care developed for use during pregnancy.

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OBJECTIVE: To generate a global reference for caesarean section (CS) rates at health facilities. DESIGN: Cross-sectional study. SETTING: Health facilities from 43 countries. POPULATION/SAMPLE: Thirty eight thousand three hundred and twenty-four women giving birth from 22 countries for model building and 10,045,875 women giving birth from 43 countries for model testing. METHODS: We hypothesised that mathematical models could determine the relationship between clinical-obstetric characteristics and CS. These models generated probabilities of CS that could be compared with the observed CS rates. We devised a three-step approach to generate the global benchmark of CS rates at health facilities: creation of a multi-country reference population, building mathematical models, and testing these models. MAIN OUTCOME MEASURES: Area under the ROC curves, diagnostic odds ratio, expected CS rate, observed CS rate. RESULTS: According to the different versions of the model, areas under the ROC curves suggested a good discriminatory capacity of C-Model, with summary estimates ranging from 0.832 to 0.844. The C-Model was able to generate expected CS rates adjusted for the case-mix of the obstetric population. We have also prepared an e-calculator to facilitate use of C-Model (www.who.int/reproductivehealth/publications/maternal_perinatal_health/c-model/en/). CONCLUSIONS: This article describes the development of a global reference for CS rates. Based on maternal characteristics, this tool was able to generate an individualised expected CS rate for health facilities or groups of health facilities. With C-Model, obstetric teams, health system managers, health facilities, health insurance companies, and governments can produce a customised reference CS rate for assessing use (and overuse) of CS. TWEETABLE ABSTRACT: The C-Model provides a customized benchmark for caesarean section rates in health facilities and systems.

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OBJECTIVE: To identify cases of severe maternal morbidity (SMM) during pregnancy and childbirth, their characteristics, and to test the feasibility of scaling up World Health Organization criteria for identifying women at risk of a worse outcome. DESIGN: Multicentre cross-sectional study. SETTING: Twenty-seven referral maternity hospitals from all regions of Brazil. POPULATION: Cases of SMM identified among 82 388 delivering women over a 1-year period. METHODS: Prospective surveillance using the World Health Organization's criteria for potentially life-threatening conditions (PLTC) and maternal near-miss (MNM) identified and assessed cases with severe morbidity or death. MAIN OUTCOME MEASURES: Indicators of maternal morbidity and mortality; sociodemographic, clinical and obstetric characteristics; gestational and perinatal outcomes; main causes of morbidity and delays in care. RESULTS: Among 9555 cases of SMM, there were 140 deaths and 770 cases of MNM. The main determining cause of maternal complication was hypertensive disease. Criteria for MNM conditions were more frequent as the severity of the outcome increased, all combined in over 75% of maternal deaths. CONCLUSIONS: This study identified around 9.5% of MNM or death among all cases developing any severe maternal complication. Multicentre studies on surveillance of SMM, with organised collaboration and adequate study protocols can be successfully implemented, even in low-income and middle-income settings, generating important information on maternal health and care to be used to implement appropriate health policies and interventions. TWEETABLE ABSTRACT: Surveillance of severe maternal morbidity was proved to be possible in a hospital network in Brazil.

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OBJECTIVE: To assess the incidence of hypertensive disorders of pregnancy and related severe complications, identify other associated factors and compare maternal and perinatal outcomes in women with and without these conditions. DESIGN: Secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health (WHOMCS) database. SETTING: Cross-sectional study implemented at 357 health facilities conducting 1000 or more deliveries annually in 29 countries from Africa, Asia, Latin America and the Middle East. POPULATION: All women suffering from any hypertensive disorder during pregnancy, the intrapartum or early postpartum period in the participating hospitals during the study period. METHODS: We calculated the proportion of the pre-specified outcomes in the study population and their distribution according to hypertensive disorders' severity. We estimated the association between them and maternal deaths, near-miss cases, and severe maternal complications using a multilevel logit model. MAIN OUTCOME MEASURES: Hypertensive disorders of pregnancy. Potentially life-threatening conditions among maternal near-miss cases, maternal deaths and cases without severe maternal outcomes. RESULTS: Overall, 8542 (2.73%) women suffered from hypertensive disorders. Incidences of pre-eclampsia, eclampsia and chronic hypertension were 2.16%, 0.28% and 0.29%, respectively. Maternal near-miss cases were eight times more frequent in women with pre-eclampsia, and increased to up to 60 times more frequent in women with eclampsia, when compared with women without these conditions. CONCLUSIONS: The analysis of this large database provides estimates of the global distribution of the incidence of hypertensive disorders of pregnancy. The information on the most frequent complications related to pre-eclampsia and eclampsia could be of interest to inform policies for health systems organisation.

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OBJECTIVE: To develop and test markers of neonatal severe morbidity for the identification of neonatal near-miss cases. DESIGN: This is a database analysis of two World Health Organization cross-sectional studies: the Global Survey on Maternal and Perinatal Health (WHOGS) and the Multicountry Survey on Maternal and Newborn Health (WHOMCS). SETTING: The WHOGS was performed in 373 health facilities in 24 countries (2004-2008). The WHOMCS was conducted in 359 health facilities in 29 countries (2010-2011). POPULATION: Data were collected from hospital records of all women admitted for delivery and their respective neonates. METHODS: Pragmatic markers (birthweight <1750 g, Apgar score at 5 minutes <7, and gestational age <33 weeks) were developed with WHOGS data and validated with WHOMCS data. The diagnostic accuracy of neonatal characteristics and management markers of severity was determined in the WHOMCS. RESULTS: This analysis included 290 610 liveborn neonates from WHOGS and 310 436 liveborn neonates from WHOMCS. The diagnostic accuracy of pragmatic and management markers of severity for identifying early neonatal deaths was very high: sensitivity, 92.8% (95% CI 91.8-93.7%); specificity, 92.7% (95% CI 92.6-92.8%); positive likelihood ratio, 12.7 (95% CI 12.5-12.9); negative likelihood ratio, 0.08 (95% CI 0.07-0.09); diagnostic odds ratio, 163.4 (95% CI 141.6-188.4). A positive association was found between the frequency of neonatal near-miss cases and Human Development Index. CONCLUSION: Newborn infants presenting selected markers of severity and surviving the first neonatal week could be considered as neonatal near-miss cases. This definition and criteria may be seen as a basis for future applications of the near-miss concept in neonatal health. These tools can be used to inform policy makers on how best to apply scarce resources for improving the quality of care and reducing neonatal mortality.

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A Ilex paraguariensis é espécie nativa da América do Sul. O consumo de erva mate tem sido associado ao aumento nas taxas de câncer oral, de orofaringe, esôfago e laringe. O objetivo deste estudo foi investigar o potencial genotóxico da exposição a dose única de Ilex paraguariensis através do teste do micronúcleo. Para este estudo, foram utilizados 32 ratos Wistar albinos machos e adultos, divididos em 4 grupos: A - Composto por 8 ratos que receberam infusão de chá preparado na concentração de 5% de erva mate (concentração usualmente encontrada no chá de consumo humano); B - Composto por 8 ratos que receberam chá preparado por imersão em água fria na concentração de 5% de erva mate; C - Composto por 8 ratos, os quais receberam ciclofosfamida em dose única subcutânea (50mg/kg) no primeiro dia do experimento (grupo controle positivo); D - Composto por 8 ratos, os quais receberam somente água (grupo controle negativo). Todos os animais receberam ração ad libitum. Os animais dos grupos A, B e D foram submetidos à eutanásia 48 horas após o início do experimento e os do grupo C, 24 horas após. Foi coletado material da medula óssea de cada rato após a eutanásia para realização do teste do micronúcleo em eritrócito policromático, para avaliação do grau de genotoxicidade. A mediana de micronúcleos para o grupo A (chá mate preparado com infusão) foi de 0,00, do grupo B (chá mate em imersão em água fria) foi de 0,00, do grupo C (ciclofosfamida - controle positivo) foi de 9,00, e no grupo D (controle negativo) foi de 0,00. Não se observou genotoxicidade da Ilex paraguariensis, em ambas as formas de preparo do chá, através do teste de micronúcleo, ao nível de significância de 5%.

The Ilex paraguariensis is a native species of South America. Yerba mate consumption has been associated with increased rates of oral, oropharynx, esophagus and larynx cancer. The aim of this study was to investigate the genotoxic potential of the exposure to a single dose of Ilex paraguariensis by the micronucleus test. For this study, 32 male, adult Wistar rats were used, divided into 4 groups: A - Consisting of 8 rats, which received an infusion of tea prepared at a concentration of 5% of mate (concentration usually found in human consumption of tea); B - Consisting of 8 rats, which received tea prepared immersed in cold water at a concentration of 5% of mate; C - Consisting of 8 rats, which received a single subcutaneous dose of cyclophosphamide (50mg/kg) on the first day of the experiment (positive control group); D - Consisting of 8 rats, which received only water (negative control group). All animals received food ad libitum. The animals in groups A, B and D were sacrificed 48 hours after the beginning of the experiment and group C, 24 hours after. Material from the bone marrow of each rat was collected after euthanasia to perform the micronucleus test in polychromatic erythrocyte to assess the degree of genotoxicity. The median of micronuclei for group A (mate tea prepared with infusion) was 0.00, for group B (mate tea immersed in cold water) was 0.00, for group C (cyclophosphamide - positive control) was 9.00 and for group D (negative control) was 0.00. No genotoxicity of Ilex paraguariensis was observed in both tea preparation methods by the micronucleus test at a significance level of 5%.

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Baccharis rufescens Spreng. var. tenuifolia (DC.) Baker pertence à família Asteraceae e é usada na medicina tradicional como estomáquico e hepatoprotetor. Um estudo fitoquímico mostrou a presença de flavonoides e triterpenos, sendo que os extratos clorofórmico e metanólico de folhas apresentaram-se ativos no bioensaio de toxicidade sobre Artemia salina Leach. Além disso, extratos clorofórmicos evidenciaram a presença de peróxidos, sugerindo sua aplicação no tratamento da malária (Schenkel at al., 2002; Montanher et al., 2002; Moreira et al., 2003). Considerando a importância farmacológica de B. rufescens var. tenuifolia, o presente trabalho objetivou o estudo morfoanatômico e histoquímico do caule e da folha dessa espécie, a fim de fornecer subsídios farmacognósticos para o controle de qualidade. O material botânico foi submetido às técnicas usuais empregadas na microscopia de luz e microscopia eletrônica de varredura. Folha anfiestomática, presença de estômatos anomocíticos, tricomas glandulares capitados bisseriados, tricomas tectores flageliformes simples unisseriados, dutos secretores associados ao floema, calota de fibras perivasculares e cristais de oxalato de cálcio do tipo estiloide e prismático na região medular do caule foram as principais características observadas que auxiliam na identificação do táxon.

Baccharis rufescens Spreng. var. tenuifolia (DC.) Baker belongs to the Asteraceae family. It is used for liver and stomach problems in traditional medicine. Previous phytochemical data reported flavonoid and triterpene contents. Chloroform and methanol extracts of the leaves showed activity in the bioassay of brine shrimp. Chloroform extracts showed the presence of peroxides that can be used to treat malaria (Schenkel et al., 2002; Montanher et al., 2002; Moreira et al., 2003). Considering the pharmacological importance of B. rufescens var. tenuifolia, the purpose of this paper was to perform the anatomical analysis of aerial vegetative parts of Baccharis rufescens var. tenuifolia in order to provide pharmacognostic data for quality control. The plant material was studied by the usual methods of light and scanning electron microscopy. Amphistomatic leaves, anomocytic stomata, biseriate capitate glandular trichomes, uniseriate simple flagelliform non-glandular trichomes, secretory ducts associated to the phloem, perivascular fiber cap, calcium oxalate as prismatic and styloid crystals in the pith of the stem were reported as the mainly anatomical data for B. rufescens var. tenuifolia.Ouvir Ler foneticamente.

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The objective of this work was to estimate the quantity of mercury residue present in dental amalgam that is generated and discarded in the city of Manaus (Amazon-Brazil). For this purpose, the locations of amalgam usage (10 public and 31 private dental clinics), the method by which the residue is discarded (14 clinics improper disposal), and the analysis of total mercury in the sediment of the controlled landfill (2.68-3 µgHg/g), were described. It was concluded that: there are dental clinics in the city that discard mercury residue into the common waste disposal system, which contravenes health safety standards.

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

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OBJECTIVE: To describe the prevalence of labour induction, together with its risk factors and outcomes in Latin America. DESIGN: Analysis of the 2005 WHO global survey database. SETTING: Eight selected Latin American countries. POPULATION: All women who gave birth during the study period in 120 participating institutions. METHODS: Bivariate and multivariate analyses. MAIN OUTCOME MEASURES: Indications for labour induction per country, success rate per method, risk factors for induction, and maternal and perinatal outcomes. RESULTS: Of the 97,095 deliveries included in the survey, 11,077 (11.4%) were induced, with 74.2% occurring in public institutions, 20.9% in social security hospitals and 4.9% in private institutions. Induction rates ranged from 5.1% in Peru to 20.1% in Cuba. The main indications were premature rupture of membranes (25.3%) and elective induction (28.9%). The success rate of vaginal delivery was very similar for oxytocin (69.9%) and misoprostol (74.8%), with an overall success rate of 70.4%. Induced labour was more common in women over 35 years of age. Maternal complications included higher rates of perineal laceration, need for uterotonic agents, hysterectomy, ICU admission, hospital stay>7 days and increased need for anaesthetic/analgesic procedures. Some adverse perinatal outcomes were also higher: low 5-minute Apgar score, very low birthweight, admission to neonatal ICU and delayed initiation of breastfeeding. CONCLUSIONS: In Latin America, labour was induced in slightly more than 10% of deliveries; success rates were high irrespective of the method used. Induced labour is, however, associated with poorer maternal and perinatal outcomes than spontaneous labour.

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