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INTRODUCTION: The prevalence of hypertension is estimated to be nearly 50% among Brazilian adults. Achieving an adequate control of this CVD risk factor is challenging but truly relevant on a public health perspective, as this is the top ranking cause of all deaths globally. PURPOSE: We aimed to describe crude and simple metrics of blood pressure management (including its control), as based on current guidelinederived recommendations, after one year of the clinical practice registry METHODS: Patients with documented Hypertension were included by using electronic case report form based on the ACC PINNACLE Registry. The registry has been enrolling patients from general practitioners and specialists. The main goal of the PINNACLE program is to improve the quality of care in "real world" clinical practice. Patients data were evaluated after 01 year of follow-up on regular clinical appointments and the differences on clinical practice were evaluated RESULTS: Currently, PINNACLEBrazil has enrolled 7598 patients, with 87% of diagnosed hypertension. Percentage of patients with a diagnosis of hypertension who had a blood pressure measurement <140/90 mmHg was 47.9%(baseline) and 57.3% (followup). Percentage of patients who had a blood pressure < 140/90 mm Hg, or who had a blood pressure >= 140/90 mm Hg and were prescribed >= 2 antihypertensive medications were 67.1% on baseline and 71.2% after 1 year. CONCLUSION: The preliminary data of PINNACLE Registry in Brazil shows that a significant proportion of hypertensive patients (nearly half) have not presented with adequate control of blood pressure levels and, moreover, a large proportion have not been treated with recommended combination of 02 or more antihypertensive medications to reach targeted BP levels the quality of care was improving after 01 year of registry. (AU)

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BACKGROUND: Airway complications after lung transplantation are the major cause of morbidity, affecting up to 33% of all cases. Bronchial stenosis is the most common complication. The use of stents has been established as the most effective therapy; however, their removal is recommended after 3-6 months of use. We have been using self-expandable stents as a definitive treatment and remove them only if necessary. For this report, we evaluated the use of self-expandable stents as a definitive treatment for bronchial stenosis after lung transplantation. METHODS: We performed a retrospective cohort study to evaluate patients with bronchial stenosis from August 2003 to April 2014. Clinical and pulmonary function test data were collected. RESULTS: Two hundred lung transplants were performed, 156 of which were bilateral. Sixteen patients experienced airway complications: 4 had dehiscence, 2 necrosis, and 10 bronchial stenosis. Of these patients, 7 had undergone bilateral procedures, and 2 patients developed stenosis in both sides. Twelve anastomotic stenoses were observed. The follow-up after stenting ranged from 1 to 7 years. All patients had increased lung function, and 4 remained stable with sustained increase in pulmonary function without episodes of infection. Three patients required removal of their prosthesis 6 months to 1 year after implantation because of complications. Two patients died owing to unrelated causes. CONCLUSIONS: Definitive treatment of bronchial stenosis with self-expandable stents is a viable option. The 1st year seems to be the most crucial for determining definitive treatment, because no patients required removal of their stent after 1 year.

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The Younger Dryas stadial, a cold event spanning 12,800 to 11,500 years ago, during the last deglaciation, is thought to coincide with the last major glacial re-advance in the tropical Andes. This interpretation relies mainly on cosmic-ray exposure dating of glacial deposits. Recent studies, however, have established new production rates for cosmogenic (10)Be and (3)He, which make it necessary to update all chronologies in this region and revise our understanding of cryospheric responses to climate variability. Here we present a new (10)Be moraine chronology in Colombia showing that glaciers in the northern tropical Andes expanded to a larger extent during the Antarctic cold reversal (14,500 to 12,900 years ago) than during the Younger Dryas. On the basis of a homogenized chronology of all (10)Be and (3)He moraine ages across the tropical Andes, we show that this behaviour was common to the northern and southern tropical Andes. Transient simulations with a coupled global climate model suggest that the common glacier behaviour was the result of Atlantic meridional overturning circulation variability superimposed on a deglacial increase in the atmospheric carbon dioxide concentration. During the Antarctic cold reversal, glaciers advanced primarily in response to cold sea surface temperatures over much of the Southern Hemisphere. During the Younger Dryas, however, northern tropical Andes glaciers retreated owing to abrupt regional warming in response to reduced precipitation and land-surface feedbacks triggered by a weakened Atlantic meridional overturning circulation. Conversely, glacier retreat during the Younger Dryas in the southern tropical Andes occurred as a result of progressive warming, probably influenced by an increase in atmospheric carbon dioxide. Considered with evidence from mid-latitude Andean glaciers, our results argue for a common glacier response to cold conditions in the Antarctic cold reversal exceeding that of the Younger Dryas.

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One hundred and twenty-six suckled crossbred cows (Bos taurus x Bos indicus), with body condition score >or=3 (1-5 point scale), were employed in the present study to evaluate the effectiveness of intravaginal progestin-releasing sponges (IVS) for shortening anoestrous interval. Fifty-four cows were assigned to control group. Seventy-two cows were treated with IVS impregnated with 250 mg of medroxy-acetate-progesterone (MAP) as follows: day 0, IVS plus 5 mg of 17beta-E and 50 mg of MAP i.m.; day 6, 500 IU of equine chorionic gonadotropin and 25 mg prostaglandin F(2alpha) i.m.; day 8, IVS withdrawal and day 9, 1 mg 17beta-E i.m. Cows were also grouped according to postpartum days (dpp) at treatment: MAP <70 days (n = 25); control <70 days (n = 22); MAP >70 days (n = 47); control >70 days (n = 32). From IVS removal, cows were detected in oestrus and inseminated. Cows not detected in oestrus were timed artificial insemination 72 h after sponge removal. Treatment effect on oestrous rate (ER), conception rate (CR), pregnancy rate (PR) and treatment to conception intervals (TCI) and calving to conception intervals (CCI) were evaluated. The ER, CR and PR were analysed using PROC LOGISTIC, while TCI and CCI with PROC GLM of SAS. The groups MAP <70 days and MAP >70 days showed higher (p < 0.01) ER than control <70 days and control >70 days (84.0% and 76.6% vs 31.8% and 31.3% respectively). The PR was higher (p < 0.01) in MAP <70 days vs control <70 days (64.0% vs 22.7%) and also higher (p < 0.05) in MAP >70 days vs control <70 days (40.4% vs 18.8%). The TCI and CCI were shorter (p < 0.01) in MAP <70 days vs control <70 days (36.0 and 95.8 days; 95.3 and 158.6 days respectively). In conclusion, only cows treated with IVS before 70 dpp had a CCI shorter than 100 days, consequently this treatment shortened postpartum anoestrous interval in crossbred dual purpose cattle.

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OBJECTIVE: To describe the prevalence of health risk behaviors and identify risk and protective factors that are associated with several health risk behaviors (cigarette smoking, drug use, onset of sexual intercourse before age 15, pregnancy, gun-carrying, suicidal ideation, and suicide attempts) among adolescents in Brazil, as well as to explore gender differences. METHODS: We estimated prevalence rates, evaluated bivariate associations, and explored multivariate analyses using logistic regression on data from a 1997 survey of adolescent health among 2059 eighth- and 10(th)-grade students in Santos, Brazil. RESULTS: Youth in Santos, Brazil report high rates of gun-carrying, suicidal thoughts and attempts, sexual intercourse, and pregnancy. Factors associated with diminished involvement for nearly all health risk behaviors, for both boys and girls, included having good family relationships, and feeling liked by friends and teachers. Factors associated with increases in nearly all health risk behaviors were: gun-carrying and gun availability in the home, drug use, and sexual abuse. CONCLUSIONS: Factors that are associated with a wide range of health risk behaviors among adolescents in Brazil appear to parallel those found in industrialized countries: access to guns, substance use, and sexual abuse. Likewise, connectedness to family, school, and peers is consistently the protective factor associated with diminished risky behaviors.

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The results of the black light test for aflatoxin-contaminated maize carried out in a large food factory in the State of São Paulo was evaluated against bi-directional thin layer chromatography (TLC) analysis for 286 samples of maize. All 286 samples were accepted by the black light test (< 7 fluorescent points), however, the results from TLC analysis showed that 96 samples were contaminated and 14 showed aflatoxin B1 contamination levels higher than 20 micrograms/kg. There were 14 false negative results and no false positives and out of the 14 samples, six did not show visible fluorescent points. If the rejection criterion of one or more fluorescent points were applied, the six samples would be accepted by the black light test. But, in this case, 95 samples would be rejected and 87 results would be false positives because they did not have contamination levels over 20 micrograms/kg which is the acceptance limit of the black light test. The results indicate that the black light test, as utilized by this factory, was not able to indicate lots with possible contamination and the black light test, as recommended in the literature, would produce a high number of false positives. It is necessary to make more studies on the use of black light as a screening test for possible aflatoxin B1-contaminated maize.

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The bright greenish yellow fluorescence technique (BGYF) is a screening method for the evaluation of corn occasionally contaminated by aflatoxins, used by an industry of the State of São Paulo on sixty one samples, was compared with laboratory results of the BGYF standard technique, before and after crushing the grains, and also with thin layer chromatographic analysis. The industry showed results with a smaller number of false positives than the BGYF standard technique. However, the industry showed false negative results and the BGYF standard technique did not. It was concluded that the number of fluorescent points adopted, as a rejection criterion, in both techniques, was inadequate and studies should be developed with more samples to determine the adequate number of fluorescent points to be adopted as a rejection criterion and the influence of other factors.

A técnica da fluorescência amarelo-esverdeada brilhante (BGYF) como método de triagem na avaliação de milho eventualmente contaminado com aflatoxina, utilizada por uma indústria alimentícia do Estado de São Paulo em 61 amostras de milho, foi comparada com a técnica BGYF padronizada, aplicada em laboratório antes e após trituração dos grãos e, também, com a técnica da cromatografia em camada delgada (CCD). Os resultados da indústria geraram menor número de resultados falso-positivos do que a técnica BGYF padronizada. Por outro lado, apenas os resultados da indústria apresentaram amostras falso-negativas, ao contrário da BGYF padronizada, que não as apresentou. Conclui-se que existe uma inadequação do número de pontos fluorescentes adotados como critério de rejeição em ambas as técnicas, devendo-se proceder estudos, com maior número de amostras, para determinar o número adequado de pontos fluorescentes a ser adotado como critério além de outros fatores que possam influenciar a metodologia.

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The bright greenish yellow fluorescence technique (BGYF) is a screening method for the evaluation of corn occasionally contaminated by aflatoxins, used by an industry of the State of São Paulo on sixty one samples, was compared with laboratory results of the BGYF standard technique, before and after crushing the grains, and also with thin layer chromatographic analysis. The industry showed results with a smaller number of false positives than the BGYF standard technique. However, the industry showed false negative results and the BGYF standard technique did not. It was concluded that the number of fluorescent points adopted, as a rejection criterion, in both techniques, was inadequate and studies should be developed with more samples to determine the adequate number of fluorescent points to be adopted as a rejection criterion and the influence of other factors.

A técnica da fluorescência amarelo-esverdeada brilhante (BGYF) como método de triagem na avaliação de milho eventualmente contaminado com aflatoxina, utilizada por uma indústria alimentícia do Estado de São Paulo em 61 amostras de milho, foi comparada com a técnica BGYF padronizada, aplicada em laboratório antes e após trituração dos grãos e, também, com a técnica da cromatografia em camada delgada (CCD). Os resultados da indústria geraram menor número de resultados falso-positivos do que a técnica BGYF padronizada. Por outro lado, apenas os resultados da indústria apresentaram amostras falso-negativas, ao contrário da BGYF padronizada, que não as apresentou. Conclui-se que existe uma inadequação do número de pontos fluorescentes adotados como critério de rejeição em ambas as técnicas, devendo-se proceder estudos, com maior número de amostras, para determinar o número adequado de pontos fluorescentes a ser adotado como critério além de outros fatores que possam influenciar a metodologia.

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The prevalence of anti-Leishmania donovani antibodies was investigated in 1,500 Brazilian blood donors and multiply transfused hemodialysis patients. Sera were tested using the fucose-mannose ligand (FML) ELISA, which was shown to have 100% sensitivity and 96% specificity for kala-azar. Among 1,194 volunteer blood donors, seroreactivity was 9%, increasing to 25% in a periurban kala-azar focus. However, higher positivity (37%) was found in multiply transfused hemodialysis patients from Natal, where kala-azar is constantly present in low numbers (endemic), with sporadic outbreaks in localized regions (endemic and epidemic). Risk factors included blood transfusion, which was significantly associated with the presence of anti-Leishmania antibodies (chi2 = 8.567, P < 0.005), but did not include potential exposure to sandfly bites (chi2 = 0.033, P > 0.1). The prevalence significantly decreased to 7% in hemodialysis patients from Rio de Janeiro, where kala-azar is only occasionally seen, and was 0% in patients undergoing continuous ambulatorial peritoneal dialysis. The prospective analysis of 27 FML-seroreactive donors from Natal revealed amastigotes of Leishmania in the bone marrow of one subject while four had clinical complaints, including splenomegaly and hepatosplenomegaly. Our results point to the need for control of blood transfusion as a possible route for transmission of kala-azar in endemic areas.

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In the present work the influence of bag materials on the moisture loss and final aflatoxin content of stored moist in-shell peanuts (MIP) was studied in the rainy season of 1990, in Marília, São Paulo, and in the rainy season of 1991, in Jaboticabal, São Paulo. In each season, MIP were ventilated, as they arrived from the field, to get rid of extraneous materials and then put into 120 bags of jute and into 120 bags of polypropylene, and stored in stacks (12 bags base x 10 bags high). In the rainy season of 1990 (February-April) moisture and aflatoxin were determined at the beginning (average moisture = 14.31%; aflatoxin not detected). Subsequently, moisture was determined twice a week in samples taken from the external part of the stacks for 80 days, when the stacks were dismantled and moisture and aflatoxin were determined in six samples of each stack. In the rainy season of 1991 (February-March), because of operational difficulties, closed mesh jute bags were used (green coffee type) and the experiment lasted only 30 days. Moisture and aflatoxin were determined only at the beginning (average moisture = 15%; aflatoxin not detected). At the end of the storage period three samples were taken from each lot, for moisture and aflatoxin analyses.(ABSTRACT TRUNCATED AT 250 WORDS)

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