RESUMO

Abstract We report the first known occurrence of Panstrongylus megistus (Burmeister, 1835) (Hemiptera, Reduviidae, Triatominae) in the Metropolitan Region of São Paulo, Brazil. In 2018, adult specimens were sent by residents to the competent authorities and, in the inspection of the property, a large focus associated with a marsupial nest was found. This finding reinforces the importance of the species in the state of São Paulo, serves as an alert for epidemiological surveillance and extends the species colonization area in the state of São Paulo.

Resumo Relatamos a primeira ocorrência de Panstrongylus megistus (Burmeister, 1835) (Hemiptera, Reduviidae, Triatominae) na Região Metropolitana de São Paulo, Brasil. Em 2018, espécimes adultos foram enviados por residentes e a pesquisa na propriedade constatou a presença de um grande foco associado a um ninho marsupial. Este achado reforça a importância da espécie no estado de São Paulo, serve de alerta para a vigilância epidemiológica e amplia a área de colonização da espécie no estado de São Paulo.

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We report the first known occurrence of Panstrongylus megistus (Burmeister, 1835) (Hemiptera, Reduviidae, Triatominae) in the Metropolitan Region of São Paulo, Brazil. In 2018, adult specimens were sent by residents to the competent authorities and, in the inspection of the property, a large focus associated with a marsupial nest was found. This finding reinforces the importance of the species in the state of São Paulo, serves as an alert for epidemiological surveillance and extends the species colonization area in the state of São Paulo.(AU)

Relatamos a primeira ocorrência de Panstrongylus megistus (Burmeister, 1835) (Hemiptera, Reduviidae, Triatominae) na Região Metropolitana de São Paulo, Brasil. Em 2018, espécimes adultos foram enviados por residentes e a pesquisa na propriedade constatou a presença de um grande foco associado a um ninho marsupial. Este achado reforça a importância da espécie no estado de São Paulo, serve de alerta para a vigilância epidemiológica e amplia a área de colonização da espécie no estado de São Paulo.(AU)

Assuntos

RESUMO

We report the first known occurrence of Panstrongylus megistus (Burmeister, 1835) (Hemiptera, Reduviidae, Triatominae) in the Metropolitan Region of São Paulo, Brazil. In 2018, adult specimens were sent by residents to the competent authorities and, in the inspection of the property, a large focus associated with a marsupial nest was found. This finding reinforces the importance of the species in the state of São Paulo, serves as an alert for epidemiological surveillance and extends the species colonization area in the state of São Paulo.

Assuntos

RESUMO

We report the first known occurrence of Panstrongylus megistus (Burmeister, 1835) (Hemiptera, Reduviidae, Triatominae) in the Metropolitan Region of São Paulo, Brazil. In 2018, adult specimens were sent by residents to the competent authorities and, in the inspection of the property, a large focus associated with a marsupial nest was found. This finding reinforces the importance of the species in the state of São Paulo, serves as an alert for epidemiological surveillance and extends the species colonization area in the state of São Paulo

Relatamos a primeira ocorrência de Panstrongylus megistus (Burmeister, 1835) (Hemiptera, Reduviidae, Triatominae) na Região Metropolitana de São Paulo, Brasil. Em 2018, espécimes adultos foram enviados por residentes e a pesquisa na propriedade constatou a presença de um grande foco associado a um ninho marsupial. Este achado reforça a importância da espécie no estado de São Paulo, serve de alerta para a vigilância epidemiológica e amplia a área de colonização da espécie no estado de São Paulo.

RESUMO

Abstract We report the first known occurrence of Panstrongylus megistus (Burmeister, 1835) (Hemiptera, Reduviidae, Triatominae) in the Metropolitan Region of São Paulo, Brazil. In 2018, adult specimens were sent by residents to the competent authorities and, in the inspection of the property, a large focus associated with a marsupial nest was found. This finding reinforces the importance of the species in the state of São Paulo, serves as an alert for epidemiological surveillance and extends the species colonization area in the state of São Paulo.

Resumo Relatamos a primeira ocorrência de Panstrongylus megistus (Burmeister, 1835) (Hemiptera, Reduviidae, Triatominae) na Região Metropolitana de São Paulo, Brasil. Em 2018, espécimes adultos foram enviados por residentes e a pesquisa na propriedade constatou a presença de um grande foco associado a um ninho marsupial. Este achado reforça a importância da espécie no estado de São Paulo, serve de alerta para a vigilância epidemiológica e amplia a área de colonização da espécie no estado de São Paulo.

RESUMO

BACKGROUND: The intrinsic ageing and photoaged skin present biomechanical and morphological differences, which are reflected in the appearance of roughness, superficial and deep wrinkles, atrophy, reduced elasticity, hypo- and hyperpigmentation and actinic keratosis. OBJECTIVE: To evaluate and compare the characteristics of the flexor (with a predominance of intrinsic ageing) and extensor (chronically exposed to sunlight and other environmental factors, with a predominance of photoageing) skin surfaces of the forearms. METHODS: Interventional, prospective, diagnostic study, including 23 females, aged over 60 years. The extensor and flexor faces of forearms were compared in relation to clinical parameters and non-invasive instrumental measurements, such as skin surface, elasticity, hydration as well as dermal thickness and echogenicity. RESULTS: Regarding the water content of the stratum corneum, the flexor face presented an average value higher than the extensor face. The average of measures obtained through images of high-frequency ultrasound demonstrated greater echogenicity of flexor face compared to the extensor face. The measurements of the skin surface showed significant differences between the faces. The roughness and scaliness were lower in the flexor face. Regarding the depth of wrinkles, there was no significant difference between the faces. The average of the measurements was slightly higher in the flexor face, which demonstrated that wrinkles are present in the intrinsic ageing and photoageing. The presence of elastosis and the reduction in elasticity in the clinical aspect of the photoaged face of forearms were according to the results of the non-invasive measurements. CONCLUSION: Meaningful differences in the biophysical characteristics of the extensor and flexor faces of the forearms were detected. Because the non-invasive instrumental measurements correlated with clinical findings, they may represent useful tools to assess efficacy and safety of skin ageing treatments in clinical research.

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Abstract We report the first known occurrence of Panstrongylus megistus (Burmeister, 1835) (Hemiptera, Reduviidae, Triatominae) in the Metropolitan Region of São Paulo, Brazil. In 2018, adult specimens were sent by residents to the competent authorities and, in the inspection of the property, a large focus associated with a marsupial nest was found. This finding reinforces the importance of the species in the state of São Paulo, serves as an alert for epidemiological surveillance and extends the species colonization area in the state of São Paulo.

Resumo Relatamos a primeira ocorrência de Panstrongylus megistus (Burmeister, 1835) (Hemiptera, Reduviidae, Triatominae) na Região Metropolitana de São Paulo, Brasil. Em 2018, espécimes adultos foram enviados por residentes e a pesquisa na propriedade constatou a presença de um grande foco associado a um ninho marsupial. Este achado reforça a importância da espécie no estado de São Paulo, serve de alerta para a vigilância epidemiológica e amplia a área de colonização da espécie no estado de São Paulo.

RESUMO

OBJECTIVE: To evaluate the incidence of subglottic stenosis in children undergoing endotracheal intubation. METHODS: Children in the paediatric intensive care unit of a tertiary care hospital were considered eligible for inclusion if they received endotracheal intubation for more than 24 hours. After extubation, children underwent flexible fibre-optic nasolaryngoscopy. Based on this first evaluation, they were divided into two groups: 'acute normal', with mild laryngeal alterations or normal findings; and 'acute alterations', with moderate to severe laryngeal alterations. Further laryngoscopic follow up (7-10 days later) was undertaken for those children in the acute normal group who developed symptoms during follow up (after discharge from the intensive care unit), and for all children in the acute alterations group. Children were then classified into two final groups: 'normal final examination', with no chronic changes; and 'subglottic stenosis'. RESULTS: We included 123 children. The incidence of subglottic stenosis was 11.38 per cent (95 per cent confidence interval, 6.63-17.94 per cent). All the children who developed subglottic stenosis had had moderate to severe alterations immediately after extubation. CONCLUSION: This incidence of subglottic stenosis is quite high and needs further investigation to identify risk factors.

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AIMS: This study evaluated the agreement of growth charts proposed by the National Center for Health Statistics (NCHS/1977), Centers for Disease Control and Prevention (CDC/2000) and World Health Organization (WHO/2006). METHODS: Were assessed children between 0 and 5 years old, hospitalized in the pediatric wards of a Brazilian school hospital. Z-score indexes: stature/age (S/A), weight/age (W/A) and weight/stature (W/S) was evaluated, in each of the three references (NCHS, CDC and WHO). ANOVA and test Bland & Altman and Lin plots were used in the comparison of the 3 charts. The agreement of the nutritional state categories was also evaluated, through kappa coefficient. The study was approved by the Institution's Research Ethics Committee. RESULTS: The study analyzed 337 children, whose median age was 0.52 (IQR: 0.21-1.65) years, 65.3% of them were below 1 year old, 60.2% were male and 50% hospitalized due to acute respiratory disease. Lower Z-scores of W/A and S/A were obtained with the WHO charts and lower W/S with the CDC chart. High correlation and agreement were observed among the criteria, but more patients were classified as presenting shortness through the WHO criteria. CDC and WHO criteria were more rigorous than the NCHS criteria for the diagnosis of underweight (W/A) and malnutrition (W/S). CONCLUSION: Despite the strong agreement of the 3 charts, the adoption of the WHO charts seems to be more helpful for the children's nutritional screening for admission, as it enables to detect a higher number of malnourished children or at nutritional risk, who will benefit from an early intervention.

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ABSTRACT This experiment was conducted using 288 32-week-old Hisex White laying hens for a period of 10 weeks, with the objective of studying the fatty acid enrichment of the egg yolk of hens fed diets supplemented with fish oil (OP) or marine algae (AM) to provide five levels of DHA (120, 180, 240, 300 and 360 mg/100 g diet) for each source. A 2 x 5 completely randomized factorial design with three replicates of 8 birds per treatment was applied in order to have the following groups: OP120, OP180, OP240, OP300, OP360, AM120, AM180, AM240, AM300 and AM360. A control group submitted to a corn/soy basal diet (CON) and another one supplemented with AM at the level of 420 mg of DHA/100 g diet (AM420) were also used. The amounts of DHA in the egg yolk in birds fed OP diets were significantly increased from 22.64 mg/egg yolk (CON) to 187.91 mg/ egg yolk (OP360). The egg-yolk n-3 PUFAs of the control group (62.16 mg) increased significantly as compared to the OP360 group (218.62 mg/yolk). For the AM source the DHA means were also linear (Y = 0.23X + 1.27, R2 = 0.86), ranging from 22.64 mg/yolk (CON) to 149.75 mg/yolk (AM420), while the n-3 PUFAs ranged from 104.18 mg/yolk (AM120) to 175.32 mg/yolk (AM420). The percentage of DHA incorporation into the egg yolk decreased linearly as the DHA levels increased in the diet. Thus, for the OP and AM sources, mean values of 85.11% (OP120) and 65.28% (AM120) decreased to 49.45% (OP360) and 34.06% (AM420). Significant improvement (P 0.05) was found in the ratio n-6/n-3, ranging from17.50 (CON) to 3.72 (OP320) and 6.36 (AM420).

RESUMO A presente pesquisa foi conduzida utilizando-se 288 galinhas poedeiras da linhagem Hisex White com 32 semanas de idade, pelo período de 10 semanas, com o objetivo de estudar o enriquecimento da gema do ovo em ácidos graxos, a partir de rações suplementadas com óleo de peixe (OP) ou alga marinha (AM) em cinco níveis de DHA (120, 180, 240, 300 e 360 mg/100 g dieta). Foi aplicado o modelo fatorial 2 x 5, inteiramente casualizado, com três repetições de oito aves por tratamento, de modo a constituir os grupos: OP120, OP180, OP240, OP300, OP360, AM120, AM180, AM240, AM300 e AM360. Um grupo controle submetido à ração basal de milho e soja (CON) e outro contendo 420 mg de DHA/ 100 g dieta (AM420) acrescido de AM, foram também utilizados. Quanto aos teores de DHA na gema do ovo de aves suplementadas com OP, foi observado aumento significativo de 22,64 mg/gema (CON), para 187,91 mg/gema no grupo OP360. Os PUFAs n-3 apresentaram acréscimo significativo no contraste entre CON (62,16 mg/gema) e OP360 (218,62 mg/gema). Para a fonte AM, as médias de DHA também mostraram linearidade (Y = 0,23X + 1,27, R2 = 0,86), oscilando entre 22,64 mg/gema (CON) e 149,75 mg/gema (AM420), enquanto que o total de PUFAs n-3 oscilou de 104,18 mg/gema (AM120) a 175,32 mg/gema (AM420). O percentual de incorporação de DHA na gema decresceu linearmente com o aumento dos níveis de DHA na ração suplementada com OP e AM, de 85,11% (OP120) e 65,28% (AM120) para 49,45% (OP360) e 34,06% (AM420). Melhora significativa (P 0,05) foi consignada na relação n-6/n-3, que variou de 17,50 no grupo CON para 3,72 e 6,36 nos tratamentos OP360 e AM420, respectivamente.

RESUMO

ABSTRACT This experiment was conducted using 288 Hisex White laying hens, 32 weeks old, for a period of 10 weeks, with the objective of studying the fatty-acid enrichment of the egg yolk of hens fed diets supplemented with fish oil (OP) or marine algae (AM) to provide five levels of docosahexaenoic acid (DHA) of 120, 180, 240, 300 and 360 mg/100 g diet for each source. A 2x5 completely randomized factorial design with three replicates of eight birds per treatment was applied in order to have the following groups: OP120, OP180, OP240, OP300, OP360, AM120, AM180, AM240, AM300 and AM360. A control group submitted to a corn/soy basal diet (CON) and another one supplemented with marine algae at the level of 420 mg of DHA/100 g diet (AM420) were also used. The arachidonic acid (AA), linoleic (AL) and n-6 PUFAs showed significant decreases (P 0.05) with the increase of fish oil in the diet, ranging, respectively, from 98.71 mg, 987.70 mg and 1108.92 mg/yolk in the CON diet to 38.87 mg, 734.22 and 802.79 mg/yolk, for the group OP360. For the fish-oil source, the average amount of arachidonic acid also showed linearity (X + Y = 0.16 89.40, R2 = 0.86), decreasing from 98.71 mg/yolk (CON) to 38.87 mg/yolk (OP360) and 77.79 mg/yolk (AM420), while the total of n-6 PUFAs ranged from 1108.92 mg/yolk (CON) to 802.79 mg/yolk (OP360) and 1178.19 mg/yolk (AM120). The percentage of incorporation of arachidonic acid in the yolk of eggs decreased linearly with increasing levels of DHA in feed supplemented with fish oil and marine algae, from 4.81% (CON) to 2.57% (OP360) and 3.51% (AM420). The averages of 1572.11 mg/yolk (fish oil) and 2118.16 mg/yolk (marine algae) of the total consumption of n-6 PUFAs, and 3.12% (fish oil) and 4.30% (marine algae) of the incorporation of AA into yolk differed (P 0.05) between sources. A significant decrease (P 0.05) was noted in the n-6/n-3 ratio, varying from 17.50 (CON) to 3.72 (OP360) and 6.36 (AM420).

RESUMO A presente pesquisa foi conduzida utilizando-se 288 galinhas poedeiras da linhagem Hisex White com 32 semanas de idade, pelo período de 10 semanas, com o objetivo de estudar o enriquecimento da gema do ovo em ácidos graxos a partir de rações suplementadas com óleo de peixe (OP) ou alga marinha (AM) em cinco níveis de ácido docosahexaenóico (DHA) de 120, 180, 240, 300 e 360 mg/100 g dieta. Foi aplicado o modelo fatorial 2 x 5, em delineamento inteiramente casualizado, com três repetições de oito aves por tratamento, de modo a constituir os grupos: OP120, OP180, OP240, OP300, OP360, AM120, AM180, AM240, AM300 e AM360. Um grupo controle submetido à ração basal de milho e soja (CON) e outro, acrescido de AM, contendo 420 mg de DHA/ 100 g dieta (AM420) foram também utilizados. Os ácidos araquidônico (AA), linoléico e PUFAs n-6 mostraram decréscimos significativos (P 0,05) com o aumento de OP na dieta, variando, respectivamente, de 98,71 mg, 987,70 mg e 1.108,92 mg/gema na dieta CON a 38,87 mg, 734,22 mg e 802,79 mg/gema, para o grupo OP360. Para a fonte OP, as médias de AA também mostraram linearidade (Y = -0,16X + 89,40, R2 = 0,86), decrescendo de 98,71 mg/gema (CON) para 38,87 mg/ gema (OP360) e 77,79 mg/gema (AM420), enquanto que o total de PUFAs n-6 oscilou de 1.108,92 mg/gema (CON) a 802,79 mg/gema (OP360) e 1.178,19 mg/gema (AM120). O percentual de incorporação de AA na gema dos ovos decresceu linearmente com o aumento dos níveis de DHA na ração suplementada com OP e AM, de 4,81% (CON) para 2,57% (OP360) e 3,51% (AM420). As médias de 1.572,11 mg/gema (OP) e 2.118,16 mg/gema (AM) de consumo do total de PUFAs n6 e de 3,12% (OP) e 4,30% (AM) de incorporação de AA na gema diferiram (P 0,05) entre fontes. Um decréscimo significativo (P 0,05) foi consignado na relação n-6/n-3, variando de 17,50 (CON) para 3,72 (OP360) e 6,36 (AM420).

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UNLABELLED: JUSTIFICATION AND OBJECTIVE: Identify changes in the nutritional status of hospitalized children is fundamental for the early establishment of interventions. This study aims at describing the prevalence of undernutrition at admission and over the weeks of in-hospital stay in pediatric patients and evaluate the association between nutritional status and length of in-hospital stay. MATERIALS AND METHODS: A cohort study was carried out. It followed all the in-patients admitted to the general pediatric unit, composed of 72 beds, in the Hospital de Clínicas de Porto Alegre (HCPA), in the south of Brazil, from 20 march to 20 october in 2004. Patients who were between 1 month and 12 years of age and who had been admitted for clinical or/and surgical reasons were included. Those with Down Syndrome or without clinical condition and/or stature for weight measurement were excluded. Anthropometric data were collected up to 48 hours after admission and, weekly, up to hospital discharge (at admission, on 7th, 14th, and 21st day after admission). In children below 5 years of age, the standard defined by the World Heath Organization (WHO/2006) for the classification of the z-score for the stature/age (S/A), weight/age (W/A) and weight/stature (W/S) scores was used. In children from 5 to 10 years of age, the standards of the National Center for Health Statistics (NCHS, 1977) were used to classify the same rates as reference values. In children above 10 years of age, the classification of the Body Mass Index (BMI) was used (OMS/1995). In order to compare the z-scores over the four evaluation moments, analysis of variance (ANOVA) was used for repeated measurements, with Bonferroni's Post-Hoc test, and, for the evaluation of the in-hospital stay length, according to the nutritional status, Kaplan-Meier's survival curve, in the SPSS program, version 12.0, was used. RESULTS: 426 patients were included in the study. 57% of them were male and 50.7% were below one year of age. At admission, the prevalence of malnutrition was 10%, 18%, 21% and 14.7%, according to the W/S, W/A, S/A, and BMI criteria, respectively. Improvement of the nutritional status over the in-hospital stay was observed (at admission to 21st day) in children below 5 years (Z-score W/A: from -1.49 +/- 2.47 to -0.85 +/- 2.36, p = 0.001, and S/A: from -1.69 +/- 2.05 to -1.21 +/- 1.99, p = 0.007) and also in 5 to 10 years of age (S/A: from -0.43 +/- 1.31 to -0.30 +/- 1.37, p = 0.024). Undernourished patients, compared to nourished patients (according to the W/S rate for children below 10 years of age and BMI for above 10 years of age), showed a higher probability of remaining hospitalized (HR = 1.41; IC95%: 1.02-1.92). CONCLUSIONS: The prevalence of malnutrition by the W/S score was about half the prevalence found by the W/A and W/A indices, possibly reflecting a chronic impairment of the nutritional status. Undernutrition was confirmed as a health problem, once undernourished patients remained hospitalized for longer periods, which is a treatable problem as it was observed an improvement in the nutritional status rates over in-hospital stay.

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Estudou-se o efeito de diferentes fontes de ácidos graxos insaturados (óleo de canola e semente de linhaça), acrescidas de diferentes teores de a-tocoferol nas dietas de poedeiras, sobre a composição de ácidos graxos da gema do ovo foi estudado. Foram utilizadas 288 galinhas da linhagem Babcock que receberam dietas com 6% de óleo de canola, 20% de semente de linhaça moída ou 3% de óleo de canola e 10% de linhaça moída com teores de 0, 100 e 200UI/kg de a-tocoferol. As dietas com 20% de semente de linhaça proporcionaram teores mais elevados de ácidos graxos poliinsaturados no ovo com aumento, em particular, dos teores de ácido a-linolênico e EPA (ácido eicosapentaenóico) e diminuição de ácido araquidônico na gema. Os teores de vitamina E contidos nas rações experimentais não determinaram alteração significativa na deposição dos diferentes ácidos graxos na gema dos ovos, exceto com relação aos ácidos graxos saturados.(AU)

The effect of dietary sources of polyunsaturated fatty acids - canola oil and flaxseed with different vitamin E supplementation on the fatty acid deposition into the eggs of 288 Babcock laying hens was investigated. Birds were fed diets containing 6% of canola oil, 20% of flaxseed or a combination of 3% of canola oil and 10% of flaxseed, enriched with 0, 100 or 200Ul of dl-a-tocopheril acetate. The inclusion of flaxseed in the diets increased the yolk polyunsaturated fatty acids, mainly a-linolenic acid and EPA (eicosapentaenoic acid). The concentration of a-tocopherol in the diet did not change the egg yolk, fatty acids deposition but changed the saturated fatty acids deposition.(AU)

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Estudou-se o efeito de diferentes fontes de ácidos graxos insaturados (óleo de canola e semente de linhaça), acrescidas de diferentes teores de alfa-tocoferol nas dietas de poedeiras, sobre a composição de ácidos graxos da gema do ovo foi estudado. Foram utilizadas 288 galinhas da linhagem Babcock que receberam dietas com 6 por cento de óleo de canola, 20 por cento de semente de linhaça moída ou 3 por cento de óleo de canola e 10 por cento de linhaça moída com teores de 0, 100 e 200UI/kg de alfa-tocoferol. As dietas com 20 por cento de semente de linhaça proporcionaram teores mais elevados de ácidos graxos poliinsaturados no ovo com aumento, em particular, dos teores de ácido alfa-linolênico e EPA (ácido eicosapentaenóico) e diminuição de ácido araquidônico na gema. Os teores de vitamina E contidos nas rações experimentais não determinaram alteração significativa na deposição dos diferentes ácidos graxos na gema dos ovos, exceto com relação aos ácidos graxos saturados.

The effect of dietary sources of polyunsaturated fatty acids - canola oil and flaxseed - with different vitamin E supplementation on the fatty acid deposition into the eggs of 288 Babcock laying hens was investigated. Birds were fed diets containing 6 percent of canola oil, 20 percent of flaxseed or a combination of 3 percent of canola oil and 10 percent of flaxseed, enriched with 0, 100 or 200Ul of dl-alpha-tocopheril acetate. The inclusion of flaxseed in the diets increased the yolk polyunsaturated fatty acids, mainly alpha-linolenic acid and EPA (eicosapentaenoic acid). The concentration of alpha-tocopherol in the diet did not change the egg yolk, fatty acids deposition but changed the saturated fatty acids deposition.

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OBJETIVO: Determinar a prevalência dos diferentes modos de morrer e identificar limites terapêuticos em pacientes de uma Unidade de Tratamento Intensivo Pediátrica (UTIP) de hospital universitário. MÉTODOS: Estudo retrospectivo, baseado na revisäo de prontuários dos pacientes que morreram na UTIP do Hospital de Clínicas de Porto Alegre, no período de 1º julho de 1996 a 30 junho de 1997. Para modo de morrer, adotou-se critérios de: näo resposta às medidas de ressuscitaçäo cardiorrespiratória (NRRST), morte cerebral (MC), retirada/näo-adoçäo de medidas de suporte de vida (R/NASV) e decisäo de näo reanimar (DNR). Para causa de morte, adotou-se critério de falências de órgäos. RESULTADOS: Dos 61 óbitos ocorridos no período, entraram no estudo 44 pacientes, cuja mediana de idade foi 28 meses. Todos tiveram como causa de morte a falência de múltiplos órgäos. Vinte e seis pacientes (59 por cento) eram do grupo I (NRRST e MC), enquanto 18 (41 por cento) do grupo II (R/NASV e DNR). No grupo II, 83 por cento dos pacientes tinham doença crônica e/ou debilitante (p = 0,017; chi²). Os motivos de admissäo mais prevalentes foram necessidade de terapias de suporte (55 por cento), ventilatória e cardiocirculatória, sem diferença estatística entre os grupos. A mediana do tempo de permanência na UTI foi de 5 dias, e no hospital, de 11 dias, sem significância estatística entre os dois grupos. CONCLUSÖES: Observou-se alta prevalência de modos de morrer R/NASV e DNR nos pacientes de UTIP avaliados, sugerindo condutas de limitaçäo terapêutica para eles. Näo se conseguiu avaliar o nível de participaçäo da equipe e da família nesse processo de tomada de decisöes

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BACKGROUND: To determine the prevalence of different modes of death and to identify therapeutic limitations in patients admitted to the Pediatric Intensive Care Unit (PICU) at a teaching hospital. METHODS: A retrospective study was carried out. Information was collected from the medical records of patients who died at the PICU of Hospital de Clínicas de Porto Alegre between July 1st, 1996 and June 30th, 1997. Four modes of death were considered: patient not responding to cardiopulmonary resuscitation methods (NRCPR), brain death (BD), withdrawal / withhold life-support measures (W/WLS) and decision not to resuscitate (DNR). For cause of death we employed the criterion of organ failure. RESULTS: Out of 61 deaths occurred during the period under analysis, 44 patients were included in the study. Patient age median was 28 months. The cause of death for all patients was multiple organ failure. Twenty-six patients (59%) were classified in group I (NRCPR and BD) and 18 (41%) in group II (W/WLS and DNR). Among patients of group II, 83% had a chronic and/or debilitating disease (p = 0.017; chi(2)). The prevalent reason for patient admission was the need for organ support (55%), both respiratory and cardiovascular. The median for duration of patient stay at the PICU was 5 days and at the hospital was 11 days. There was no statistically significant difference between the two groups in terms of reason for patient admission or duration of PICU/hospital stay. CONCLUSIONS: There was a high prevalence of W/WLS and DNR deaths among ICU patients, thus suggesting therapeutic limitation for them. We were unable to evaluate the level of participation by the medical team and by the family in this decision making process.

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Maytenus aquifolium (Celastraceae) and Salacia campestris (Hippocrateaceae) species accumulate friedelane and quinonemethide triterpenoids in their leaves and root bark, respectively. Enzymatic extracts obtained from leaves displayed cyclase activity with conversion of the substrate oxidosqualene to the triterpenes, 3beta-friedelanol and friedelin. In addition, administration of (+/-)5-(3)H mevalonolactone in leaves of M. aquifolium seedlings produced radio labelled friedelin in the leaves, twigs and stems, while the root bark accumulated labelled maytenin and pristimerin. These experiments indicated that the triterpenes once biosynthesized in the leaves are translocated to the root bark and further transformed to the antitumoral quinonemethide triterpenoids.

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RESUMO

OBJECTIVE: To discuss ethical and legal aspects of physicians attitudes in emergency departments under the light of Brazils codes and laws.METHODS: The authors raise questions based upon case reports and comment using the medical ethical code, laws that protect children and adolescents, hospitalized children and adolescents rights statement and medical federal council decisions.RESULTS: The authors discuss child patients' rights and the parents disclosure right; the problem of domestic violence and abuse and the physician duty to denunciate this kind of practice for the child security and protection; the medical responsability even under workplace adverse conditions, as well as the concerns related to transportation of patients to another hospital; the dilemma between withholding and withdrawing life support measures at the emergency department and the prohibition to certificate death in violent death situations; the autonomy and decision-making capa-city of adolescent patients and their limitations, including violation of confidentiality.CONCLUSIONS: The commentaries presented in the article try to explain to the pediatrician how to identify ethical and legal conflicts in the emergency department and to prepare him (her) to assume attitudes based on codes and legal statements, as well as to respect the patient's rights.

RESUMO

Colorants derived from the seeds of annatto (Bixa orellana, L.) are extensively used in the food industry. Their pecular characteristics, as that which permits obtaining water-soluble and lipid-soluble colorants through small alterations of the production process, was one of the factors responsible for the success of this pigment. It can be observed that only recently, a little over five years, efforts have been dedicated to the study of the physico-chemical characteristics of the different carotenoid structures that compose the so-called annatto colorant. The very industry that produces the colorant has only recently perceived the possibility of obtaining colorants of different hues from annatto seeds and has dedicated studies to this respect. On the other hand, complementary toxicological studies of these pigments are being demanded, putting their utilization in question, and only with the conclusion of these work can their future be evaluated.

Assuntos