RESUMEN

OBJECTIVE: To assess the anesthetic efficacy of articaine with the needle-free/Comfort-in™ method compared to the conventional needle method. To assess pain during anesthesia application, onset of anesthesia and patient`s self-reported quality of life-related to oral health after the dental emergency appointment. MATERIALS AND METHODS: This parallel, randomized clinical trial was conducted by a single operator/dentist in the state of Maranhao, northeast of Brazil. Included participants were adult dental patients with one molar (maxillary) or premolar (maxillary or mandibular) tooth diagnosed with symptomatic irreversible pulpitis. The primary outcome was the anesthetic efficacy, measured using a combination of electrical and cold pulp tests (cold + EPT) and the Numerical Rating Scale (NRS). Secondary outcomes were pain during anesthesia application, onset of anesthesia, and patient`s quality-of-life (measured with the OHIP-14). RESULTS: 62 patients were randomized in the anesthesia needle-free group and Comfort-in group (34.26 ± 10.786 × 33.29 ± 8.399 years old, respectively). The group of patients in the Comfort-in group had 71.0% success. Patients from the Comfort-in group reported statistically lower pain during the anesthesia application than patients from the conventional group (2.13 ± 2.172 × 6.03 ± 3.146 NRS scores, respectively) as well as immediately after the anesthetic procedure. Patients self-reported negative impact in quality of life was similar between groups before (p > 0.05) and after (p > 0.05) the dental emergency. CONCLUSIONS: Comfort-in™ had similar efficacy to the conventional needle method. CLINICAL RELEVANCE: This trial showed that it is possible to anesthetize patients with tooth pulpits without using needles to provide comfort mainly to anxious patients.

Asunto(s)

Asunto(s)

RESUMEN

The Zika virus was responsible for an outbreak between 2015 and 2016 in Brazil: an alarming public health problem of international relevance. The Congenital Zika Syndrome (CZS) is often associated with manifestations that are responsible for cognitive and motor development delays and behavioral disorders. Thus, we aimed to characterize the clinical-epidemiological and familial context of those children and to identify factors associated with the risk of behavioral disorders using the Survey of Well-Being of Young Children questionnaire (SWYC). In total, 52 children diagnosed with CZS were evaluated. Logistic regressions were employed to assess predictive variables for behavioral alteration. Eighteen (35%) of the children presented a risk of behavioral alteration. Children born normocephalic were 36-fold more likely to present behavioral alteration (95% CI: 3.82 to 337.92, p = 0.002). Children with hearing and visual impairments showed reduced risks. In total, 35% percent of families reported food insecurity and 21% were at risk for maternal depression. Our findings suggest better social interactions and conditions to externalize reactions for children with CZS born normocephalic. The continuous assessment of these children and families may identify conditions associated with behavioral alteration and psychosocial vulnerabilities that help in decision-making, therefore optimizing patient-family interactions.

Asunto(s)

Asunto(s)

RESUMEN

Amazonian rainforests, once thought to be pristine wilderness, are increasingly known to have been widely inhabited, modified, and managed prior to European arrival, by human populations with diverse cultural backgrounds. Amazonian Dark Earths (ADEs) are fertile soils found throughout the Amazon Basin, created by pre-Columbian societies with sedentary habits. Much is known about the chemistry of these soils, yet their zoology has been neglected. Hence, we characterized soil fertility, macroinvertebrate communities, and their activity at nine archeological sites in three Amazonian regions in ADEs and adjacent reference soils under native forest (young and old) and agricultural systems. We found 673 morphospecies and, despite similar richness in ADEs (385 spp.) and reference soils (399 spp.), we identified a tenacious pre-Columbian footprint, with 49% of morphospecies found exclusively in ADEs. Termite and total macroinvertebrate abundance were higher in reference soils, while soil fertility and macroinvertebrate activity were higher in the ADEs, and associated with larger earthworm quantities and biomass. We show that ADE habitats have a unique pool of species, but that modern land use of ADEs decreases their populations, diversity, and contributions to soil functioning. These findings support the idea that humans created and sustained high-fertility ecosystems that persist today, altering biodiversity patterns in Amazonia.

Asunto(s)

RESUMEN

The aim of this study was to evaluate the antibacterial potential of a calcium silicate-based sealer (Bio-C Sealer, Angelus) against common bacteria in primary and secondary endodontic infections. Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus mutans were exposed to fresh Bio-C Sealer for 24 h by the agar diffusion method (n=5). Additionally, the antibacterial activity was investigated against E. faecalis and S. mutans biofilms (48 h old) grown in discs with 4 mm in diameter and 2 mm in height. (n=3) of set discs of Bio-C Sealer (Angelus), EndoFill (Dentsply-Mallefer), Sealer 26 (Dentsply), AH Plus (Dentsply), Sealapex (Sybron-Endo) and EndoSequence BC Sealer (Brasseler). The antibacterial activity was evaluated by colony forming unity (CFU) counting using ImageJ software. Data were compared by one-way ANOVA followed by Holm-Sidak test (a=5%). Fresh Bio-C Sealer exhibited antimicrobial activity against all bacteria evaluated by agar diffusion method, except for S. mutans. Set discs of all endodontic sealers tested showed similar CFU values for E. faecalis (p>0.05). S. mutans in biofilms showed higher susceptibility to EndoFill compared with the other sealers (p<0.05). In conclusion, the results indicate that fresh Bio-C Sealer does not inhibit S. mutans growth, but exhibits antibacterial activity against E. faecalis, S. aureus, P. aeruginosa and E. coli. After setting, the Bio-C Sealer exhibits an antimicrobial potential comparable to that of the other sealers evaluated in E. faecalis biofilm, but lower than that of EndoFill for S. mutans biofilm.

Asunto(s)

RESUMEN

Abstract The aim of this study was to evaluate the antibacterial potential of a calcium silicate-based sealer (Bio-C Sealer, Angelus) against common bacteria in primary and secondary endodontic infections. Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus mutans were exposed to fresh Bio-C Sealer for 24 h by the agar diffusion method (n=5). Additionally, the antibacterial activity was investigated against E. faecalis and S. mutans biofilms (48 h old) grown in discs with 4 mm in diameter and 2 mm in height. (n=3) of set discs of Bio-C Sealer (Angelus), EndoFill (Dentsply-Mallefer), Sealer 26 (Dentsply), AH Plus (Dentsply), Sealapex (Sybron-Endo) and EndoSequence BC Sealer (Brasseler). The antibacterial activity was evaluated by colony forming unity (CFU) counting using ImageJ software. Data were compared by one-way ANOVA followed by Holm-Sidak test (a=5%). Fresh Bio-C Sealer exhibited antimicrobial activity against all bacteria evaluated by agar diffusion method, except for S. mutans. Set discs of all endodontic sealers tested showed similar CFU values for E. faecalis (p>0.05). S. mutans in biofilms showed higher susceptibility to EndoFill compared with the other sealers (p<0.05). In conclusion, the results indicate that fresh Bio-C Sealer does not inhibit S. mutans growth, but exhibits antibacterial activity against E. faecalis, S. aureus, P. aeruginosa and E. coli. After setting, the Bio-C Sealer exhibits an antimicrobial potential comparable to that of the other sealers evaluated in E. faecalis biofilm, but lower than that of EndoFill for S. mutans biofilm.

Resumo O objetivo deste estudo foi avaliar o potencial antibacteriano do novo cimento biocerâmico (Bio-C Sealer, Angelus) contra bactérias comuns em infecções endodônticas primárias e secundárias. Culturas de Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus e Streptococcus mutans foram expostos a amostras frescas do Bio-C sealer durante 24 h pelo método de difusão em agar (n=5). A atividade antibacteriana de amostras dos cimentos Bio-C Sealer (Angelus), EndoFill (Dentsply-Mallefer), Sealer 26 (Dentsply), AH Plus (Dentsply), Sealapex (Sybron-Endo) e EndoSequence BC Sealer (Brasseler) após a presa também foi investigada em biofilmes de 48 h das bactérias E. faecalis e S. mutans, crescidos em discos com 4 mm de diâmetro e 2 mm de altura. A atividade antibacteriana foi avaliada por contagem das unidades formadoras de colônias (UFC) utilizando o software ImageJ. Os dados foram comparados por ANOVA a um critério seguido pelo pós-teste Holm-Sidak (a=5%). Amostras frescas do Bio-C Sealer exibiram atividade antimicrobiana contra todas as bactérias avaliadas pelo método de difusão em ágar, exceto para S. mutans. A análise da formação de biofilme mostrou que todos os cimentos endodônticos testados apresentaram valores similares de UFC para E. faecalis (p> 0,05), enquanto biofilmes de S. mutans foram mais suscetíveis ao EndoFill em comparação com os demais cimentos (p<0,05). Conclui-se que o cimento Bio-C Sealer fresco exibe atividade antibacteriana para E. faecalis, S. aureus, P. aeruginosa e E. coli, mas não inibe o crescimento de S. mutans. Após a presa, o cimento Bio-C Sealer exibe potencial antimicrobiano similar ao dos demais cimentos avaliados em biofilme de E. faecalis, mas inferior ao do EndoFill para S. mutans.

Asunto(s)

RESUMEN

BACKGROUND: Intrauterine infection with the Zika virus (ZIKV) has been connected to severe brain malformations, microcephaly, and abnormal electrophysiological activity. METHODS: We describe the interictal electroencephalographic (EEG) recordings of 47 children born with ZIKV-derived microcephaly. EEGs were recorded in the first year of life and correlated with brain morphology. In 31 subjects, we tested the association between computed tomography (CT) findings and interictal epileptiform discharges (IED). In eighteen, CTs were used for correlating volumetric measurements of the brainstem, cerebellum, and prosencephalon with the rate of IED. FINDINGS: Twenty-nine out of 47 (62%) subjects were diagnosed as having epilepsy. Those subjects presented epileptiform discharges, including unilateral interictal spikes (26/29, 90%), bilateral synchronous and asynchronous interictal spikes (21/29, 72%), and hypsarrhythmia (12/29, 41%). Interestingly, 58% of subjects with clinical epilepsy were born with rhombencephalon malformations, while none of the subjects without epilepsy showed macroscopic abnormalities in this region. The presence of rhombencephalon malformation was associated with epilepsy (odds ratio of 34; 95% CI: 2 - 654). Also, the presence of IED was associated with smaller brain volumes. Age-corrected total brain volume was inversely correlated with the rate of IED during sleep. Finally, 11 of 44 (25%) subjects presented sleep spindles. We observed an odds ratio of 0·25 (95% CI: 0·06 - 1·04) for having sleep spindles given the IED presence. INTERPRETATION: The findings suggest that certain CT imaging features are associated with an increased likelihood of developing epilepsy, including higher rates of IED and impaired development of sleep spindles, in the first year of life of CZVS subjects. FUNDING: This work was supported by the Brazilian Federal Government through a postdoctoral fellowship for EBS (Talented Youth, Science without Borders), an undergraduate scholarship for AJR (Institutional Program of Science Initiation Scholarships, Federal University of Rio Grande do Norte, Brazil), by International Centre for Genetic Engineering and Biotechnology (CRP/BRA18-05_EC) and by CAPES (Grant number 440893/2016-0), and CNPq (Grant number 88881.130729/2016-01).

RESUMEN

The production chain of Acai (Euterpe oleracea Mart) has a high economic representativeness in the Brazilian Amazon. However, wastes generated from the processing of the fruit has been deliberately discarded in the environment, causing health risks to the population due to environmental contamination or the proliferation of disease agents. Thus, the production of biochar arises as an alternative to the irregular disposal of these residues. The objective of this work was to evaluate the conditions (temperature and residence time) to produce biochar from Acai processing residues and its potential for use as soil conditioner in the Amazon region. Acai seeds were carbonized using the process of muffle pyrolysis at different temperatures and residence times. Biochars were evaluated for their physical and chemical properties and hydrophobicity. The temperature had a greater influence than the residence time for most parameters. Higher values of pH, higher recalcitance and greater potential for water retention were observed for the biochar produced at temperatures of 600 and 700 °C. At lower temperatures (300 and 400 °C), a greater yield was observed, however, in this condition, the material presented an extremely hydrophobic character. By considering the favorable agronomic characteristics of biochar, the temperature of 600 °C and residence time of 60 min are the most suitable conditions for the production of biochar from Acai seeds.

Asunto(s)

RESUMEN

AIMS: To compare root canal treatment of teeth with apical periodontitis (AP) in a single or two visits, using cone beam computed tomography (CBCT). MATERIALS AND METHODS: Twenty-six pairs of teeth (13 patients) were assigned to two groups: Group single-session (GSS): Instrumentation and root canal filling in the same session; and group two-session (GTS): A calcium hydroxide intracanal medication (Calen(®) paste) was used for 14 days between two sessions. Cone beam computed tomography scans were obtained before and 12 months after treatment. The pre- and postoperative volume of the AP lesions was measured in mm(3). The percentages of volume reduction was compared using Student's t-test and the existence of significant difference between the groups for cases with ≤ 50% or > 50% lesion volume reduction was assessed by chi-squared test ratio likelihood test (α = 5%). RESULTS: The volume reduction was greater in GTS (79.25%) than GSS (68.35%), though without significant difference (p > 0.05). After 12 months, complete repair was not observed in any specimen. Lesion volume reduction > 50% was significantly greater with the use of an intracanal medication (p < 0.05). CONCLUSION: Twelve months posttreatment, CBCT did not show complete repair in any of the teeth, suggesting that this follow-up period is not sufficient for complete lesion regression. In both groups, similar AP lesion volume reduction was observed after 12 months, with a more advanced repair (> 50% volume reduction) in the teeth medicated with calcium hydroxide intracanal dressing. CLINICAL SIGNIFICANCE: Calcium hydroxide intracanal dressing provided clinical evidence to indicate its use in teeth with apical periodontitis prior to definitive root canal filling.

Asunto(s)

RESUMEN

The Brazilian Societies of Rheumatology (SBR) and Dermatology (SBD), the Brazilian Federation of Gastroenterology (FBG) and the Brazilian Study Group on Inflammatory Bowel Disease (GEDIIB) gathered a group of their respective specialists on the topic of interest to discuss the most relevant issues regarding the clinical use of biosimilar medicines in Brazil. The main aim of that meeting was to prepare a document with recommendations to guide medical specialists and to help the national regulatory and policy-making agencies as concerns the authorization for marketing biosimilars used in autoimmune diseases, such as rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, Crohn's disease, juvenile idiopathic arthritis and ulcerative colitis. In addition to considerations on the typical differences between innovator medicines and biosimilars, the specialists established a set of seven recommendations on regulatory advances related to clinical studies, indication extrapolation, nomenclature, interchangeability, automatic substitution and pharmacovigilance.

Asunto(s)

RESUMEN

Este estudo teve por objetivo avaliar a participação comunitária (PC) a partir da implementação da segunda etapa de um programa de controle da esquistossomose e de promoção da saúde (PPC-SPJII). Trata-se de uma pesquisa participativa de base comunitária (PPBC) de caráter avaliativo, realizada com moradores do distrito rural de São Pedro do Jequitinhonha, no município de Jequitinhonha – Minas Gerais. Os dados foram coletados por meio de um questionário estruturado, aplicado aos membros comunitários e às pesquisadoras ao final do programa e por meio de oficinas e entrevistas informais. Para a avaliação da extensão da PC ocorrida no programa os dados do questionário foram empregados no modelo spidergram. Para a análise dos fatores contextuais intervenientes sobre a PC, apreendidos por meio das oficinas e entrevistas, utilizou-se a técnica de análise de conteúdo. O estudo indicou que o enfoque de PPBC utilizado possibilitou o desenvolvimento de uma consciência crítica, o aumento da capacidade dos membros comunitários participantes quanto ao uso de métodos investigativos, o estabelecimento de respeito mútuo e o desenvolvimento de confiança entre pesquisadoras e membros comunitários. Ademais, levou ao alcance de alguns resultados tais como a aquisição parcial de verba para a compra de uma ambulância para o distrito; a conclusão do regimento interno e da estruturação do Conselho Local de Saúde; e, o envio de um documento ao poder público, solicitando a implementação de um sistema de esgotamento canalizado no local. Foi possível apreender que a extensão de PC foi satisfatória em relação ao planejamento, às tomadas de decisão, à implementação das atividades do programa e à comunicação estabelecida entre os parceiros. Contudo, esta extensão foi reduzida quanto ao controle dos recursos financeiros, indicando alta dependência de financiamento externo e reduzida quanto ao monitoramento e à avaliação das ações, sugerindo insuficiente apropriação dos dados...

This study aimed to assess the process of community participation (CP) in a second stage of a schistosomiasis control and health promotion program (PPC-SPJII). It was a Community Based Participatory Research (CBPR), with evaluation feature, conduced with residents of São Pedro do Jequitinhonha, a rural district of Jequitinhonha – MG. Data collection was performed through a structured questionnaire, applied both to community members and researchers, and by means of group sessions and informal interviews. In order to evaluate the extent of CP reached, the data from the questionnaire were applied to the spidergram framework. To analyze the data obtained through group sessions and informal interviews, the content analysis technique was utilized. The study indicated that the CBPR approach enabled a critical consciousness development, the capacity building of community members in regard to the use of inquiry methodologies, the mutual respect building and the development of mutual trust among community members and researchers. Furthermore, it leaded to the achievement of specific results such as the partial acquisition of fund to buy an ambulance vehicle for the district, the conclusion of the statute and the organization of the Local Health Council and the dispatch of a document to the political managers soliciting the implementation of a channelized sewage system at the place. It was possible to apprehend that the extent of CP was satisfactory in relation to the planning, decision-making, activities implementation and communication established among partners. And was perceived as narrow in regard to financial resources and monitoring and evaluation, indicating large dependence of external funds and community members insufficient ownership of data obtained. It was encountered variations in scoring in relation to both groups of respondents, so that a definitive conclusion about the extent of PC was elusive. When compared to the program first stage, it was verified...

Asunto(s)

RESUMEN

OBJECTIVE: [corrected] The study sought to determine the prevalence of postnatal growth restriction (PNGR) and the predictors of nutritional outcome in very low birth weight (VLBW) infants. METHODS: Cross-sectional study conducted in a maternity school between July 2005 and August 2006. One-hundred and twelve VLBW infants were assessed during hospitalization, fed unfortified human milk and assisted by Kangaroo Mother Care. The dependent variables included the number of days required to reach minimum weight and regain birth weight, the percentage of weight loss, and the deterioration of nutritional status. These parameters were converted into a factor termed "nutritional outcome" using factor analysis. Multiple linear regressions were used to identify predictors of nutritional outcome. RESULTS: PNGR was observed in 89.3% of the infants at hospital discharge. The predictors of nutritional outcome were: appropriate-for-gestational-age infants, children of mothers aged ≤ 20 years old, need for mechanical ventilation, longer stays in the neonatal intensive care unit, and a greater number of days to achieve full enteral nutrition. CONCLUSION: It is important to know the factors that negatively influence the nutritional outcome of VLBW infants, as these can be modified through the improvement of perinatal care and can reduce PNGR.

Asunto(s)

RESUMEN

OBJETIVO: Analisar os efeitos de uma intervenção pedagógica na aprendizagem de crianças e adolescentes participantes de pesquisa clínica. MÉTODOS: Estudo quantitativo, quasi-experimental e longitudinal, parte de um conjunto de estudos envolvidos no teste de uma vacina contra ancilostomíase. Amostra por conveniência com 133 estudantes de dez a 17 anos, de ambos os sexos, da Escola Municipal de Maranhão, MG, Brasil, 2009. Utilizou-se um questionário estruturado aplicado pré e pós-intervenção. O dispositivo pedagógico foi o Teatro do Oprimido. As variáveis dependentes foram o conhecimento específico e global sobre pesquisa clínica e sobre verminoses; a variável independente foi a participação na intervenção educativa. RESULTADOS: Houve aumento do conhecimento sobre sinais e sintomas, susceptibilidade à reinfecção e modo de contágio da verminose após a intervenção educativa. Aumentaram acertos relativos à duração da pesquisa clínica, aos procedimentos previstos, à possibilidade de desistência da participação e de ocorrência de eventos adversos. Permaneceu a noção de que o propósito primário da pesquisa é terapêutico, embora tenha reduzido o percentual de participantes que associaram a pesquisa ao tratamento médico. O Teatro do Oprimido possibilitou que as discussões acerca da helmintose e da pesquisa clínica fossem contextualizadas e materializadas. Os sujeitos puderam se despojar ou reduzir suas representações prévias. CONCLUSÕES: A participação de crianças e adolescentes em ensaios clínicos deve ser precedida de intervenção educativa, já que indivíduos dessa faixa etária nem sequer reconhecem que têm direito a decidir por si próprios.

OBJECTIVE: To analyze the effects of a pedagogical intervention on the learning of children and teenagers participating in a clinical research. METHODS: Quantitative, quasi-experimental and longitudinal study, part of a group of studies conducted to test a vaccine against ancylostomiasis. Convenience sample with 133 students aged 10-17 years, of both sexes, from the school Escola Municipal de Maranhão (Southeastern Brazil), 2009. A structured questionnaire was used, which was administered before and after the intervention. The pedagogical device was the "Theater of the Oppressed". The dependent variables were specific and global knowledge about clinical research and about parasitic worms; the independent variable was participation in the educational intervention. RESULTS: There was an increase in knowledge about signals and symptoms, susceptibility to reinfection and way of contagion after the educational intervention. We observed an increase in the number of right answers concerning duration of clinical research, procedures, the possibility of quitting participation, and occurrence of adverse events. The notion that the research's primary purpose is therapeutic remained, but the percentage of participants who associated the research with medical treatment decreased. The "Theater of the Oppressed" enabled that the discussions about helminthiasis and clinical research were contextualized and materialized. The subjects could dispose of or reduce their previous representations. CONCLUSIONS: Participation of children and adolescents in clinical trials must be preceded by an educational intervention, since individuals of that age group do not even recognize they have the right to decide for themselves.

OBJETIVO: Analizar los efectos de una intervención pedagógica en el aprendizaje de niños y adolescentes participantes de investigación clínica. MÉTODOS: Estudio cuantitativo, cuasi-experimental y longitudinal, parte de un conjunto de estudios envueltos en la prueba de una vacuna contra anquilostomiasis. La muestra por conveniencia estaba constituida por 13 estudiantes de diez a 17 años, de ambos sexos, de la Escuela Municipal de Maranhao, MG, Brasil, 2009. Se utilizó un cuestionario estructurado aplicado pre y post intervención. El dispositivo pedagógico fue el Teatro del Oprimido. Las variables dependientes fueron el conocimiento específico y global sobre la investigación clínica y sobre helmintiasis; la variable independiente fue la participación en la intervención educativa. RESULTADOS: Hubo aumento del conocimiento sobre señales y síntomas, susceptibilidad a la reinfección y modo de contagio de la helmintiasis posterior a la intervención educativa. Aumentaron los aciertos relativos a la duración de la investigación clínica, a los procedimientos previstos, a la posibilidad de desistencia de la participación y de ocurrencia de eventos adversos. Permaneció la noción de que el propósito primario de la investigación es terapéutico, a pesar de que hubo reducción en el porcentaje de participantes que asociaron la investigación al tratamiento médico. El Teatro del Oprimido posibilitó que las discusiones sobre helmintiasis y de la investigación clínica fueran contextualizadas y materializadas. Los individuos pudieron despojarse o reducir sus representaciones previas. CONCLUSIONES: La participación de niños y adolescentes en ensayos clínicos debe ser precedida por intervención educativa, ya que individuos de ese grupo etario no pudieron siquiera reconocer que tienen derecho a decidir por sí mismos.

Asunto(s)

RESUMEN

OBJECTIVE: To analyze the effects of a pedagogical intervention on the learning of children and teenagers participating in a clinical research. METHODS: Quantitative, quasi-experimental and longitudinal study, part of a group of studies conducted to test a vaccine against ancylostomiasis. Convenience sample with 133 students aged 10-17 years, of both sexes, from the school Escola Municipal de Maranhão (Southeastern Brazil), 2009. A structured questionnaire was used, which was administered before and after the intervention. The pedagogical device was the "Theater of the Oppressed". The dependent variables were specific and global knowledge about clinical research and about parasitic worms; the independent variable was participation in the educational intervention. RESULTS: There was an increase in knowledge about signals and symptoms, susceptibility to reinfection and way of contagion after the educational intervention. We observed an increase in the number of right answers concerning duration of clinical research, procedures, the possibility of quitting participation, and occurrence of adverse events. The notion that the research's primary purpose is therapeutic remained, but the percentage of participants who associated the research with medical treatment decreased. The "Theater of the Oppressed" enabled that the discussions about helminthiasis and clinical research were contextualized and materialized. The subjects could dispose of or reduce their previous representations. CONCLUSIONS: Participation of children and adolescents in clinical trials must be preceded by an educational intervention, since individuals of that age group do not even recognize they have the right to decide for themselves.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

OBJECTIVE: To identify the inpatient maternal and neonatal factors associated to the weaning of very low birth weight (VLBW) infants. METHODS: One hundred nineteen VLBW (<1500 g) infants were monitored from July 2005 through August 2006, from birth to the first ambulatory visit after maternity discharge. This maternity unit uses the Kangaroo Method and the Baby Friendly Hospital Initiative. Out of 119 VLBW infants monitored until discharge, 88 (75%) returned to the facility, 22 (25%) were on exclusive breastfeeding (EB), and 66 (75%) were weaned (partial breastfeeding or formula feeding). RESULTS: Univariate analysis found an association between weaning and lower birth weight, longer stays in the neonatal intensive care unit (NICU), and longer hospitalization times, in addition to more prolonged enteral feeding and birth weight recovery period. Logistic regression showed length of NICU stay as being the main determinant of weaning. CONCLUSION: The negative repercussion on EB of an extended stay in the NICU is a significant challenge for health professionals to provide more adequate nutrition to VLBW infants.

Asunto(s)

RESUMEN

Gnathostomiasis is an endemic disease in Asian countries caused by the ingestion of larval stage of Gnathostoma sp roundworms that may be acquired by eating raw fresh-water fish. It can reach many organs and the skin is one of them, characterized by creeping eruptions and/or migrating erythema. Since 1970 the number of patients affected seems to be increasing in Central and South America countries like Mexico and Peru. This is the first notification and publication of gnathostomiasis in Brazil, and it serves as an alert to the possibility of the emergence of this disease in non-endemic areas. We report a case of a man who traveled to Peru and developed cutaneous features accordant with gnathostomiasis.

Asunto(s)

RESUMEN

A gnatostomíase é parasitose endêmica em alguns países asiáticos, causada pela ingestão da larva do nematódio Gnathostoma sp, que pode ocorrer no consumo de carne crua de peixes de água doce. Atinge vários órgãos, entre eles a pele, manifestando-se frequentemente como lesão subcutânea migratória. Países da América Central e do Sul como México e Peru vêm apresentando número crescente de casos da doença desde 1970. Este trabalho registra o primeiro caso notificado e publicado no Brasil e alerta para o surgimento dessa doença em áreas anteriormente não endêmicas. Relata-se caso de paciente, com história de viagem ao Peru, que evoluiu com quadro cutâneo compatível com gnatostomíase.

Gnathostomiasis is an endemic disease in Asian countries caused by the ingestion of larval stage of Gnathostoma sp roundworms that may be acquired by eating raw fresh-water fish. It can reach many organs and the skin is one of them, characterized by creeping eruptions and/or migrating erythema. Since 1970 the number of patients affected seems to be increasing in Central and South America countries like Mexico and Peru. This is the first notification and publication of gnathostomiasis in Brazil, and it serves as an alert to the possibility of the emergence of this disease in non-endemic areas. We report a case of a man who traveled to Peru and developed cutaneous features accordant with gnathostomiasis.

Asunto(s)