New evidence for refinement of anesthetic choice in procedures preceding the forced swimming test and the elevated plus-maze

Previous studies indicated that some general anesthetics induce long-term antidepressant and/or anxiolytic-like effects. This raises the concern about the use of anesthesia in surgeries that precede psychopharmacological tests, since it may be a potential bias on results depending on the experimental design used. Thus, we evaluated whether general anesthetics used in surgeries preceding psychopharmacological tests would affect rats behavior in tests predictive of antidepressant or anxiolytic-like effects. We tested if a single exposure to sub-anesthetic or anesthetic doses of tribromoethanol, chloral hydrate, thiopental or isoflurane would change rats behavior in the forced swimming test (FST) or in the elevated plus-maze (EPM) test, at 2 h or 7 days after their administration. We also evaluated whether prior anesthesia would interfere in the detection of the antidepressant-like effect of imipramine or the anxiolytic-like effect of diazepam. Previous anesthesia with the aforementioned anesthetics did not change rats behaviors in FST per se nor it changed the antidepressant-like effect induced by imipramine treatment. Rats previously anesthetized with tribromoethanol or chloral hydrate exhibited, respectively, anxiogenic-like and anxiolytic-like behaviors in the EPM. Prior anesthesia with thiopental or isoflurane did not produce any per se effect in rats behaviors in the EPM nor disturbed the anxiolytic-like effect of diazepam. Our results suggest that, in our experimental conditions, tribromoethanol and chloral hydrate are improper anesthetics for surgeries that precede behavioral analysis in the EPM. Isoflurane or thiopental may be suitable for anesthesia before evaluation in the EPM or in the FST.

Outbreak of acute gastroenteritis in young children with death due to rotavirus genotype G9 in Rio Branco, Brazilian Amazon region, 2005

BACKGROUND

An epidemic of acute gastroenteritis occurred in Rio Branco City, Acre State, in Brazil's Amazon region in 2005. An investigation was conducted to confirm the etiology and identify possible risk factors for death.

METHODS

Rio Branco municipality surveillance data for the period May to October 2005 were reviewed. In a case-control study, children who died following acute gastroenteritis were compared to age-matched controls with acute gastroenteritis who survived. Rotavirus A (RV-A) was investigated in 799 stool samples and genotyped by reverse transcription polymerase chain reaction (RT-PCR).

RESULTS

The cumulative incidence of diarrhea in children aged <5 years was 21%. A fatal outcome was significantly associated with uncovered household water storage containers. RV-A was identified in 88% of samples and G9 was the prevalent genotype (71%).

CONCLUSIONS

Oral rehydration solution and boiling or chlorinating drinking water likely limited mortality. This epidemic was caused by RV-A genotype G9. After the outbreak, a rotavirus vaccine was introduced into the official childhood immunization schedule in Brazil.

[Women and contraception: knowledge and use of contraceptive methods]

This article analyzes knowledge and use of contraceptive methods in women ages 10 to 49 years residing in the southern region of the city of São Paulo in 1992. A total of 1,157 childbearing-age women were studied, focusing on variables that might define them as to: knowledge in the use of contraceptive methods and reasons for choosing a given method. We observed that 86% of the women referred knowledge of some contraceptive method, while the most common was the pill (95.3%), followed by condoms (92.6%). Meanwhile, 14% of the interviewees denied knowledge of any contraceptive method. Of the sexually active women (66.4%), 34.9% reported never having used contraceptive methods. Of those who had, 35.3% used the pill, while 42.9% had resorted to sterilization. Only 5.2% used condoms. Despite the high level of knowledge concerning contraceptive methods, especially oral contraceptives and condoms, we observed limited use of same as compared to the high sterilization rate around the age of 27, thus leaving contraception limited to the pill and female sterilization.

[Female mortality in the Municipality of São Paulo: quality of medical death certificates]

OBJECTIVE

To evaluate the quality of the medical certification of deaths of 10-49 year-old women, resident in the Southern region of the city of S. Paulo

METHODS

The Puffer methodology was utilized to investigate the causes of death of all 10-49 year-old women, resident in the region, and deceased in the year 1989 (664 deaths in the total). The main causes of death in the original death certificates and the "new" causes of death arisen from the research were compared. The sensitivity and the kappa index were calculated.

RESULTS

In some chapters of the International Classification of Diseases and Causes of Death, 9th Revision (CID-9), a high sensitivity was found: "Diseases of the Circulatory System" (91.9%), "Neoplasms" (89.7%) and "External Causes" (84.1 %). In some others, a very low sensitivity was found. The chapter "Mental Illnesses", with a 34.3 percent sensitivity only, must be mentioned. From 11 deaths originally classified in this chapter, 32 cases were found. In most of these "new" cases, the main cause of death was found to be alcoholism. The chapter "Complications of Pregnancy, Delivery and the Puerperium", also showed a low sensitivity (44.9%). The kappa index was found to be 0.63, which indicated a regular concordance.

DISCUSSION

The quality of the medical certification of causes of death is still unsatisfactory in the studied area. This poor quality may affect negatively the interventions in the area of women's health, masking the severity of important problems

[Prevalence of use of medicines during pregnancy and its relationship to maternal factors]

INTRODUCTION

There is in Brazil a growing use of industrially produced medicines even during the female reprodutive cycle. During pregnancy two organisms are exposed to the effects of medicines but in the foetus this may result in toxicities with possible irreversible lesions. The present study aims at verifying the prevalence of the use of medicines during pregnancy in the studied population and its relationship with maternal characteristics, the pharmacological groups used and the source of prescription.

METHODS

The use of medication was evaluated among 1,620 women that gave birth in five public, private and contracted hospitals in the city of S. Paulo between July and September 1993.

RESULTS AND CONCLUSIONS

The relation between maternal schooling and kind of assistance in hospitals has revealed social inequality in the access to the several kinds of delivery assistance services. The prevalence of use of at least one medicine was 97.6% with an average of 4.2 drugs per woman. The prevalence of use of drugs by medical prescription and self-medication were 94.9% and 33.5%, respectively. The most used medications, excluding vitamins, mineral salts and vaccines, were analgesics, antacids, antispasmodics and antemetics. Users of the largest number of medicines were, characteristically, over 29, married, of university level, salaried workers and had access to private health services. Medical assistance had a facilitating role in access to the use of drugs during the gestational period of the population studied. Women need to be made aware of the potential risks they expose their foetuses to when using so many medicines. Physicians should reflect on their role in contributing to the solution to this problem.

[Perinatal mortality in São Paulo, Brazil]

Foi analisada a mortalidade perinatal em São Paulo num período de dois anos. Partiu o estudo da totalidade dos atestados de nascidos mortos e de uma amostra de óbitos de menores de sete dias, para a qual a metodologia foi a de entrevistas domiciliares e junto aos médicos e hospitais que tenham prestado assistência às crianças falecidas. O coeficiente de mortalidade perinatal encontrado foi igual a 42,04 por mil nascidos vivos. Esse valor apresenta-se bastante elevado quando comparado ao de áreas desenvolvidas. Foi verificado que ele poderia ser diminuído com a simples redução dos coeficientes específicos por algumas causas evitáveis a nível de pré-natal (sífilis congênita, doenças próprias ou associadas à gravidez), do parto (distócias, traumatismos obstétricos e anóxia), ou da atenção ao recém-nascido (causas infecciosas, do aparelho respiratório, hemorragias e certas anóxias). O coeficiente de mortalidade perinatal segundo a idade da mãe mostrou que o risco varia com a idade, apresentando-se maior nas mulheres de 40 a 49 anos.