Obstetric causes are classified as direct (complications of pregnancy, childbirth or the puerperium) or indirect (caused by pregnancy but not directly caused by it). This study aimed to analyze ...maternal mortality from obstetric causes in Brazil from 2011 to 2021.
This was an ecological study on mortality and live births. The outcomes were the specific risk of mortality from direct and indirect cause adjustment and death during pregnancy and the puerperium. Binary and multiple linear logistic regressions were used to assess the influence of sociodemographic factors and maternal and child health indicators on maternal mortality and time of death (pregnancy and puerperium).
Regarding mortality during pregnancy and during the puerperium, increased (p = 0.003) and decreased (p = 0.004) mortality over the years, respectively; residing in the northern region was associated with lower (p < 0.05) and greater (p = 0.035) odds; and the Maternal Mortality Committee was the primary and least active source of investigation, respectively (p < 0.0001). The number of deaths from indirect causes increased with age (p < 0.001) and in the northern region (p = 0.011) and decreased in the white (< 0.05) and stable union (0.002) regions. Specifically, for mortality risk, the age group women aged 15-19 years presented an increase in cesarean section (p < 0.001) was greater than that of women who had < 4 antenatal visits (p < 0.001), education women who completed high school (8 to 11 years) was greater when they had < 4 prenatal visits (p = 0.018), and marital status unmarried women had more than 4 antenatal visits (p < 0.001); cesarean birth (p = 0.010) and < 4 antenatal visits (p = 0.009) were predictors of marriage; and women in a stable union who had < 4 prenatal visits and live births to teenage mothers (p < 0.001) were predictors. Women who had no education (p = 0.003), were divorced (p = 0.036), had cesarean deliveries (p < 0.012), or lived in the north or northeast (p < 0.008) had higher indirect specific mortality risk.
Sociodemographic factors and maternal and child health indicators were related to different patterns of obstetric mortality. Obstetric mortality varied by region, marital status, race, delivery, prenatal care, and cause of death.
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IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UL, UM, UPUK, VSZLJ
This study aims to assess the acceptability, adherence, and retention of a feasibility trial on milk fortification with calcium and vitamin D (Ca+VitD) and periodontal therapy (PT) among low income ...Brazilian pregnant women with periodontitis (IMPROVE trial). This 2 × 2 factorial feasibility trial used a mixed-methods evaluation. In total, 69 pregnant women were randomly allocated to four groups: 1. fortified sachet with Ca+VitD and milk plus early PT (throughout gestation); 2. placebo and milk plus early PT; 3. fortified sachet with Ca+VitD and milk plus late PT after childbirth; 4. placebo and milk plus late PT. Data were collected via questionnaires, field notes, participant flow logs, treatment diary, and focal group discussions. Quantitative and qualitative data were analysed using appropriate descriptive statistics and content analysis, respectively. Eligibility rate (12%) was below the target of 15%, but participation (76.1%) and recruitment rate (2 women/week) exceeded the targets. Retention rate (78.6%) was slightly below the target (80%). Adherence to the PT was significantly higher in the early treatment groups (98.8%) compared to the late treatment groups (29%). All women accepted the random allocation, and baseline groups were balanced. There was no report of adverse events. This multi-component intervention is acceptable, well-tolerated, and feasible among low-risk pregnant women in Brazil.
Sambaqui Arapuan Dias Salles, Adilson; Cunha, Luiz Octavio; Rodrigues-Carvalho, Claudia
Revista de arqueologia (Rio de Janeiro, Brazil),
05/2021, Volume:
34, Issue:
2
Journal Article
Peer reviewed
Este estudo foi iniciado a partir da análise do material arqueológico coletado no sítio sambaqui Arapuan, localizado no município de Guapimirim, litoral do Rio de Janeiro, e que estava sob a guarda ...do Museu Nacional/UFRJ. O sítio Arapuan é um espaço funerário com uma elevada quantidade de sepultamentos, em relação aos demais sítios da região. Ao confrontar as informações dos relatórios de campo, que registraram as variadas ações a partir da década de 1970; os registros dos sepultamentos, com dados do material esquelético humano e do material lítico; adornos e fragmentos de cerâmica; e as informações das coleções das reservas técnicas do Setor de Antropologia Biológica e do Setor de Arqueologia do Museu Nacional, observamos a ausência de grande parte do material coletado (ossos e elementos da cultura material), um elevado grau de fragmentação dos ossos e falta de identificação no material, impedindo a sua localização nos relatórios. Assim, este estudo tem como objetivo criar subsídios para propor uma série de novas ações no sítio, face ao seu expressivo potencial informativo a respeito da cultura sambaquieira no litoral do Rio de Janeiro, completando uma série de estudos mais consistentes em outros sítios dessa região.
Tuberculosis (TB) has been described in Native American populations prior to the arrival of European explorers, and in Brazilian populations dating from the Colonial Period. There are no studies ...demonstrating TB infection in native Brazilians, and the history and epidemiological scenario of TB in Brazil is still unknown. The aim of this study was to verify the presence of TB infection among the native Tenetehara-Guajajara population from Maranhão State, Brazil, 210 ± 40 years ago. A Tenetehara-Guajajara skeleton collection was submitted to paleopathological analysis, and rib bone samples (n = 17) were used for paleogenetic analysis based on Mycobacterium tuberculosis complex (MTC) targets. Porotic hyperostosis and cribra orbitalia were found in 10 and 13 individuals, respectively. Maternal ancestry analysis revealed Native American mtDNA haplogroups A and C1 in three individuals. Three samples showed osteological evidence suggestive of TB. katG and mtp40 sequences were detected in three individuals, indicating probable TB infection by two MTC lineages. Tuberculosis infection in the Tenetehara-Guajajara population since the 18th century points to a panorama of the disease resulting, most probably, from European contact. However, the important contribution of African slaves in the population of Maranhão State, could be also considered as a source of the disease. This study provides new data on TB during the Brazilian Colonial Period. This is the first report integrating paleopathological and paleogenetic data for the study of TB in Brazil.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Non-alcoholic fatty liver disease (NAFLD) is common in patients with growth hormone deficiency (GHD). Some noninvasive techniques have been used to quantify liver fat, such as the controlled ...attenuation parameter (CAP).
To evaluate CAP as a tool to identify liver steatosis and its relationship with different clinical and biochemical metabolic parameters in a group of patients with severe adult growth hormone deficiency (AGHD), and to compare the evolution of metabolic profiles after 6 months of human growth hormone (rhGH) replacement therapy in a subgroup of patients.
Cross-sectional observational study at baseline of naive rhGH multiple pituitary hormonal deficiency (MPHD) hypopituitarism patients. A 6-month intervention clinical trial in a selected group of a non-randomized, non-controlled cohort was also applied.
Liver stiffness measurement (LSM) was normal in severe AGHD patients. CAP evaluation showed steatosis in 36.3% of baseline patients (8/22), associated with higher BMI, waist circumference, insulin, and alanine aminotransferase (ALT) levels. According to steatosis degree by CAP, child-onset growth hormone deficiency (CO-GHD) was graded as 68.75% (11/16) S0, 12.5% (2/16) S1, and 18.75% (3/16) S3, whereas AO-GHD was graded as 50% (3/6) S0, 16.66% (1/6) S2, and 33.33% S3. After 6 months of hrGH replacement, CAP measurements did not change significantly, neither on group without hepatic steatosis at baseline (194.4 ± 24.3 vs. 215.4 ± 51.3;
= 0.267) nor on the group with hepatic steatosis (297.2 ± 32.3 vs. 276.4 ± 27.8;
= 0.082). A significant improvement of body composition was observed only in the first group.
We have demonstrated the importance of CAP as a non-invasive tool in the liver steatosis identification on hypopituitary patients. This method may be an important indicator of the severity of metabolic disorders in MPHD patients. In our study, no liver health modification in LSM at baseline or after 6 months of rhGH replacement was found. Longer studies can help to establish the potential repercussions of growth hormone replacement therapy on liver steatosis.
Inspirado pelas pesquisas em Lagoa Santa conduzidas pelo paleontólogo Peter Lund (século XIX), J. H. A. Padberg-Drenkpol realizou campanhas na região em 1926 e 1929. O principal sítio arqueológico ...trabalhado por ele foi a Lapa Mortuária de Confins (Confins, MG). Todo o acervo e informações do sítio ficaram sob a guarda do Museu Nacional – UFRJ. O incêndio de 2 de setembro de 2018 impactou profundamente pesquisas em curso, dentre as quais o projeto de caracterização da Lapa Mortuária de Confins. O objetivo deste artigo é resgatar a memória sobre o acervo documental deste sítio. Dessa forma, observou-se como o sítio pode ser caracterizado e contextualizado a partir dos dados das cartas e relatórios produzidos por Padberg-Drenkpol em suas expedições.
Vesicular trichomes play a key role in excluding toxic ions from some halophyte species, preventing the essential processes and functions of plants from being altered. Thus, the present study aimed ...to evaluate the influence of these structures on Atriplex nummularia irrigated using waters with three levels of osmotic potential (−0.1, −1.4 and −2.7 MPa), formulated with NaCl in plants with vesicular trichomes and plants with partial removal of trichomes. The experiment was conducted in a protected environment and plants were evaluated for physiological parameters (water, osmotic and pressure potentials, relative water content, osmotic adjustment, pressure-volume curve, gas exchange), electrolyte leakage, lipid peroxidation and enzymatic activity (superoxide dismutase, ascorbate peroxidase, catalase). The results obtained made it possible to identify the strong contribution of vesicular trichomes to physiological and biochemical parameters, with indication of cell wall stiffening and maintenance of turgor. Furthermore, the evaluation of the osmotic potentials obtained in the study suggests that the contribution of vesicular trichomes to the salinity tolerance of the species is greater than that of osmotic adjustment. Furthermore, gas exchange results suggest that the presence of trichomes was able to regulate stomatal processes so that the plant maintains its photosynthetic performance. Evaluation of electrolyte leakage, together with the increase in malondialdehyde content, showed that the maintenance of trichomes reduces the probability of oxidative stress. The activity of antioxidant enzymes was efficient in eliminating reactive oxygen species, especially the activity of ascorbate peroxidase, which stood out in terms of hydrogen peroxide detoxification.
•Vesicular trichomes play a key role in excluding toxic ions.•Irrigation with saline water contributes to cell wall rigidity.•Maintenance of trichomes helps maintain photosynthetic efficiency.•Presence of trichomes reduces the occurrence of oxidative stress.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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