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INTRODUCTION AND AIMS: The primary aim was to explore the epidemiologic trend of pediatric inflammatory bowel disease in Latin America, and the secondary aims were to obtain an overview of the diagnostic/therapeutic focus of the members of the LASPGHAN and examine the relation of case frequency to year, during the study period. MATERIALS AND METHODS: Latin American pediatric gastroenterologists participated in an online survey, conducted through the SurveyMonkey platform, that investigated the yearly frequency of new inflammatory bowel disease patients within the time frame of 2005-2016, their disease variety, the gastrointestinal segments affected, and the diagnostic and treatment methods utilized. The correlation of new case frequency with each study year was evaluated. RESULTS: A total of 607 patients were studied. The diagnoses were ulcerative colitis in 475 (78.3%) cases, Crohn's disease in 104 (17.1%), and inflammatory bowel disease D unclassified in 28 (4.6%). The trend in ulcerative colitis was a lineal increase in the frequency of new cases related to each study year, with a significant correlation coefficient. Pancolitis was found in 67.6% of the patients. The diagnostic methods included clinical data, endoscopy, and biopsies in more than 99% of the cases, and imaging studies were indicated selectively. Drug regimens were limited to 5-aminosalicylic acid derivatives, azathioprine, 6-mercaptopurine, infliximab, and adalimumab. CONCLUSIONS: Pediatric inflammatory bowel disease in Latin America appears to have increased during the years included in the study period, with a predominance of moderate or severe ulcerative colitis. That lineal trend suggests the predictive likelihood of a gradual increase in the coming years, with possible epidemiologic and clinical implications.

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INTRODUCTION AND OBJECTIVES: The primary aim was to explore the epidemiologic trend of pediatric inflammatory bowel disease in Latin America, and the secondary aims were to obtain an overview of the diagnostic/therapeutic focus of the members of the LASPGHAN and examine the relation of case frequency to year, during the study period. MATERIALS AND METHODS: Latin American pediatric gastroenterologists participated in an online survey, conducted through the SurveyMonkey platform, that investigated the yearly frequency of new inflammatory bowel disease patients within the time frame of 2005 to 2016, their disease variety, the gastrointestinal segments affected, and the diagnostic and treatment methods utilized. The correlation of new case frequency with each study year was evaluated. RESULTS: A total of 607 patients were studied. The diagnoses were ulcerative colitis in 475 (78.3%) cases, Crohn's disease in 104 (17.1%), and inflammatory bowel disease D unclassified in 28 (4.6%). The trend in ulcerative colitis was a lineal increase in the frequency of new cases related to each study year, with a significant correlation coefficient. Pancolitis was found in 67.6% of the patients. The diagnostic methods included clinical data, endoscopy, and biopsies in more than 99% of the cases, and imaging studies were indicated selectively. Drug regimens were limited to 5-aminosalicylic acid derivatives, azathioprine, 6-mercaptopurine, infliximab, and adalimumab. CONCLUSIONS: Pediatric inflammatory bowel disease in Latin America appears to have increased during the years included in the study period, with a predominance of moderate or severe ulcerative colitis. That lineal trend suggests the predictive likelihood of a gradual increase in the coming years, with possible epidemiologic and clinical implications.

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BACKGROUND: Although aging is considered a risk factor for pelvic floor muscle dysfunction (PFMD), the effect of aging on the function of the pelvic floor muscles (PFM) remains unclear. OBJECTIVE: To compare PFM function and activity in nulliparous women in different age groups. METHODS: This was a cross-sectional study in which 70 women with ages between 18 and 69 years were divided into five age groups for evaluation. Initially, medical histories were taken, and then the PFM function was assessed using digital palpation (Modified Oxford Scale), manometry and surface electromyography (sEMG). The Kruskal-Wallis test was applied to check the differences between the groups. The Spearman correlation coefficient was used to verify the correlations between age and PFM function, manometry values and sEMG. A significance level of 5% was adopted. RESULTS: No significant differences were observed between the different age groups in PFM digital palpation, manometry values and sEMG. There was a low negative correlation between age root mean square and peak of sEMG signals. CONCLUSION: This study found no difference in PFM function and activity between nulliparous women in the five different age groups. Future long-term large prospective studies are required to confirm these findings.

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BACKGROUND: Gastric residuals are a common finding in enterally fed preterm neonates and traditionally thought to reflect immaturity-related delayed gastric emptying. Adult human data suggest that the meal volume regulate the gastric emptying rate, but early in life, this has not been adequately evaluated. The goal of this study was to study the rat postnatal changes in gastric emptying rate and the strain-induced effect on muscle contraction. We hypothesized that the stomach content volume and not developmental factors determines the newborn gastric emptying rate, via the Rho-kinase 2 (ROCK-2) pathway. METHODS: Gastric volume and emptying rate measurements were obtained by ultrasound at different postprandial times and the wall strain-dependent changes in muscle contraction were evaluated ex vivo. KEY RESULTS: The newborn rat gastric emptying rate was unrelated to postnatal age, maximal 30 min postprandial, and directly proportional to content volume. In vitro measurements showed that the agonist-induced gastric muscle contraction was directly proportional to the stomach wall strain. These changes were mediated via upregulation of ROCK-2 activity. CONCLUSIONS & INFERENCES: The newborn rat gastric emptying rate is not developmentally regulated, but dependent on the content volume via wall strain-induced ROCK-2 activation. Further clinical studies addressing the content volume effect on the rate of gastric emptying are warranted, to enhance feeding tolerance in preterm neonates.

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O objetivo foi avaliar o crescimento e a viabilidade econômica de alevinos de tilápia do Nilo (Oreochromis niloticus), alimentados com diferentes níveis de farinha da folha de mandioca desidratada na ração (FFMD). Foram utilizados 80 alevinos distribuídos em 20 recipientes de 18L, constando de sistema de recirculação de água, durante um período de 51 dias. Cem exemplares, alimentados três vezes ao dia até a saciedade, foram distribuídos aleatoriamente em um delineamento experimental inteiramente casualizado, constituindo-se de 4 tratamentos (0, 5, 10 e 15% de adição da FFMD na ração) e 5 repetições cada. Os peixes alimentados com 10% de FFMD apresentaram melhor homogeneidade no crescimento. Entretanto, os indivíduos alimentados com inclusão de 5% de FFMD apresentaram homogeneidade de crescimento similar aos alimentados com 10%. Além disso, os peixes alimentados com 5% de FFMD obtiveram melhor desempenho zootécnico e viabilidade econômica da ração. Dessa maneira, recomenda-se a utilização de 5% da farinha de folha de mandioca desidratada em rações para tilápia do Nilo.

The aim was to evaluate the growth and the economic viability of the Nile tilapia (Oreochromis niloticus) fed with different levels of dehydrated cassava leaf flour in the diet (FFMD). 80 fingerlings were distributed into 20 18L containers, consisting of a water recirculation system over a period of 51 days. 100 copies fed three times a day to satiation were randomly assigned in a completely randomized design, constituting 4 treatments (0%, 5%, 10% and 15% addition of FFMD in diet) with 5 repetitions each. The fishes fed with 10% FFMD had better homogeneity in growth. However, individuals fed with inclusion of 5% FFMD homogeneity grew similarly to those fed with 10% FFMD. In addition, the fish from the 5% had better growth performance and economic viability of the feed. Thus, it is recommended to use 5% of dehydrated cassava leaf meal in diets for Nile tilapia.

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O objetivo foi avaliar o crescimento e a viabilidade econômica de alevinos de tilápia do Nilo (Oreochromis niloticus), alimentados com diferentes níveis de farinha da folha de mandioca desidratada na ração (FFMD). Foram utilizados 80 alevinos distribuídos em 20 recipientes de 18L, constando de sistema de recirculação de água, durante um período de 51 dias. Cem exemplares, alimentados três vezes ao dia até a saciedade, foram distribuídos aleatoriamente em um delineamento experimental inteiramente casualizado, constituindo-se de 4 tratamentos (0, 5, 10 e 15% de adição da FFMD na ração) e 5 repetições cada. Os peixes alimentados com 10% de FFMD apresentaram melhor homogeneidade no crescimento. Entretanto, os indivíduos alimentados com inclusão de 5% de FFMD apresentaram homogeneidade de crescimento similar aos alimentados com 10%. Além disso, os peixes alimentados com 5% de FFMD obtiveram melhor desempenho zootécnico e viabilidade econômica da ração. Dessa maneira, recomenda-se a utilização de 5% da farinha de folha de mandioca desidratada em rações para tilápia do Nilo.(AU)

The aim was to evaluate the growth and the economic viability of the Nile tilapia (Oreochromis niloticus) fed with different levels of dehydrated cassava leaf flour in the diet (FFMD). 80 fingerlings were distributed into 20 18L containers, consisting of a water recirculation system over a period of 51 days. 100 copies fed three times a day to satiation were randomly assigned in a completely randomized design, constituting 4 treatments (0%, 5%, 10% and 15% addition of FFMD in diet) with 5 repetitions each. The fishes fed with 10% FFMD had better homogeneity in growth. However, individuals fed with inclusion of 5% FFMD homogeneity grew similarly to those fed with 10% FFMD. In addition, the fish from the 5% had better growth performance and economic viability of the feed. Thus, it is recommended to use 5% of dehydrated cassava leaf meal in diets for Nile tilapia.(AU)

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Low back pain is a problem that is faced by 50% of pregnant women and causes important social trouble. In spite of this, the problem is considered to be normal and is expected during pregnancy, which has contributed to the lack of prophylactic and relief measures. This work aims at under standing the historical and conceptual bases that have given rise to such naturalization as outlined by midwifery and by using world literature indexed on the topic from 1987 to 1997 as a theoretical framework. We have apprehended that a deterministic view related to this issue is supported by the biomedical model. Therefore, the adoption of effective solutions requires the incorporation of a new paradigm.

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