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INTRODUCTION: The wrapping of the newborn in an orthopedic tubular mesh, simulating a cocoon, can allow the infant to regain the feeling of security and stability experienced in the uterus given that the movement of one of the parts of the body exerts tactile and pressure variation in others. OBJECTIVE: We aimed to evaluate the influence of an orthopedic tubular mesh, simulating a cocoon, in therapeutic positioning, on the variables of the autonomous, motor, and regulatory systems of preterm newborns. METHODS: A controlled and randomized clinical trial was conducted with preterm newborns positioned in dorsal decubitus and divided into two groups: (a) cocoon - newborns covered with an orthopedic tubular mesh, and (b) control - newborns positioned according to the sector's routine and without the use of an orthopedic mesh. During the follow-up, each newborn was placed in the position for 30 min and was recorded for a total of 2 min, once at the beginning and again at the end of the observation period. Variables related to the autonomous system (heart rate, respiratory rate, and peripheral oxygen saturation), motor system (general movements), and regulatory system (Neonatal Infant Pain Scale) were evaluated before and after the intervention. The videos were evaluated by a researcher blind to the purpose of the study, and the resulting data were analyzed using SPSS. RESULTS: Of the 40 preterm newborns evaluated (32.5 ± 1.83 weeks), 21 were female, and 20 were allocated to the cocoon group. The variables related to the autonomous, motor, and regulatory systems remained unchanged following the positioning in the cocoon, as compared to the typical positioning employed in the neonatal unit. CONCLUSION: The simulation of a cocoon, utilizing an orthopedic tubular mesh, when applied to preterm newborns admitted to a neonatal intensive care unit can contribute to maintaining low levels of stress, without altering variables of the autonomous, motor, and regulatory systems.
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Recém-Nascido Prematuro , Humanos , Recém-Nascido , Recém-Nascido Prematuro/fisiologia , Feminino , Masculino , Frequência Cardíaca/fisiologia , Sistema Nervoso Autônomo/fisiologia , Sistema Nervoso Autônomo/fisiopatologia , Posicionamento do Paciente/métodos , Taxa Respiratória/fisiologia , Medição da DorRESUMO
COVID-19-related in-hospital mortality has been reported at 30.7-47.3% in Brazil, however studies assessing exclusively private hospitals are lacking. This is important because of significant differences existing between the Brazilian private and public healthcare systems. We aimed to determine the COVID-19-related in-hospital mortality and associated risk factors in a Brazilian private network from March/2020 to March/2021. Data were extracted from institutional database and analyzed using Cox regression model. Length of hospitalization and death-related factors were modeled based on available independent variables. In total, 38,937 COVID-19 patients were hospitalized of whom 3058 (7.8%) died. Admission to the intensive care unit occurred in 62.5% of cases, and 11.5% and 3.8% required mechanical ventilation (MV) and renal replacement therapy (RRT), respectively. In the adjusted model, age ≥ 61 years-old, comorbidities, and the need for MV and/or RRT were significantly associated with increased mortality (p < 0.05). Obesity and hypertension were associated with the need for MV and RRT (p < 0.05).
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COVID-19 , Brasil/epidemiologia , COVID-19/epidemiologia , Estudos de Coortes , Atenção à Saúde , Mortalidade Hospitalar , Hospitalização , Humanos , Unidades de Terapia Intensiva , Pessoa de Meia-Idade , Respiração Artificial/efeitos adversos , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2RESUMO
Resumen Introducción: el quiste aracnoideo es una colección benigna de fluido similar en composición al líquido cefalorraquídeo dentro de la aracnoides, circunscrita por tejido fibrovascular normal que comprime las leptomeninges que rodean el nervio óptico. Se describe el caso de una paciente con quiste aracnoideo de la vaina del nervio óptico con un defecto campimétrico típico de glaucoma, pero con un disco óptico sin características de glaucoma, con el fin de resaltar la necesidad de estudiar con neuroimágenes estos casos y detectar este tipo de alteraciones. El quiste aracnoideo de la vaina del nervio óptico es una entidad excepcional que generalmente tiene un comportamiento benigno, permaneciendo estable en el tiempo, aunque eventualmente puede producir una neuropatía óptica compresiva, afectando la agudeza o el campo visual por daño de la capa de fibras nerviosas. En el caso descrito, este daño se manifestó con un defecto de campo visual que simulaba neuropatía glaucomatosa.
Abstract Background: Arachnoid cyst is a benign fluid collection similar in composition to cerebrospinal fluid within the arachnoid, circumscribed by normal fibrovascular tissue that compresses the leptomeninges surrounding the optic nerve. Objective: To describe the case of a patient with an optic nerve sheath arachnoid cyst with a typical glaucoma campimetric defect, but with an optic disc without findings of glaucoma, to highlight the need to study these cases with neuroimaging to detect this type of changes. Conclusion: Optic nerve sheath arachnoid cyst is an exceptional entity that generally has a benign behavior remaining stable over time; but could eventually originate compressive optic neuropathy, affecting visual acuity or visual fields due to nerve fiber layer damage. In the patient´s case this damage was manifested with a visual field defect that simulated glaucomatous neuropathy.
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Parkinson's disease (PD) is a neurodegenerative disorder that affects adult people whose treatment is palliative. Thus, we decided to test three dammarane triterpenes 1, 1a, 1b, and we determined that 1 and 1a inhibit ß-aggregation through thioflavine T rather than 1b. Since compound 1 was most active, we determined the interaction between α-synuclein and 1 at 50 µM (Kd) through microscale thermophoresis. Also, we observed differences in height and diameter of aggregates, and α-synuclein remains unfolded in the presence of 1. Also, aggregates treated with 1 do not provoke neurites' retraction in N2a cells previously induced by retinoic acid. Finally, we studied the potential sites of interaction between 1 with α-synuclein fibrils using molecular modelling. Docking experiments suggest that 1 preferably interact with the site 2 of α-synuclein through hydrogen bonds with residues Y39 and T44.
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Simulação de Acoplamento Molecular , Triterpenos/farmacologia , alfa-Sinucleína/antagonistas & inibidores , Animais , Sítios de Ligação/efeitos dos fármacos , Relação Dose-Resposta a Droga , Magnoliopsida/química , Camundongos , Conformação Molecular , Agregados Proteicos/efeitos dos fármacos , Relação Estrutura-Atividade , Triterpenos/química , Triterpenos/isolamento & purificação , Células Tumorais Cultivadas , alfa-Sinucleína/isolamento & purificação , alfa-Sinucleína/metabolismo , DamaranosRESUMO
Abstract Introduction: The immaturity of the integumentary system in premature newborns (PTNB), associated with ventilatory support, contributes to the higher occurrence of nasal trauma. Objective: This article reports on the case of a newborn submitted to Kinesio® Taping as an innovative prophylactic therapy for nasal trauma. Method: We report on Kinesio® Taping, a material frequently used to treat pain in athletes, as an innovative therapeutic tool to prevent nasal septal lesions in a PTNB undergoing noninvasive mechanical ventilation (NIMV), who, after 13 days on NIMV, presented with nasal septal lesions. Results: The Kinesio® Taping, was positioned to protect the nasal septum from friction caused by direct contact of the nasal prong, maintained NIMV pressure, adapted well to the shape of the nose and improved nasal trauma after 3 days of use. Conclusion: Given that breathing in this period of life occurs predominantly through the nose and maintaining the integrity of this mucosa reduces not only respiratory discomfort, but also deformities and the risk of infections. The present study presents KT as an innovative protective tool against nasal injury in premature newborns submitted to positive pressure ventilation using nasal prongs. Despite describing a single case, the results obtained were promising. However, studies with a larger sample and different groups are needed, primarily to compare with existing methods.
Resumo Introdução: A imaturidade do sistema tegumentar em recém-nascidos prematuros (RNPT), associado a necessidade de suporte ventilatório contribuem para uma maior ocorrência de traumas nasais. Objetivo: Este artigo relata o caso de um recém-nascido submetido ao Kinesio® Taping, como terapia profilática inovadora para trauma nasal. Método: Relatamos o uso do Kinesio® Taping, material frequentemente usado para tratamento de dor em atletas, como uma ferramenta de inovação terapêutica para prevenção de lesões do septo nasal em um RNPT em ventilação mecânica não invasiva (VMNI) que após 13 dias em VMNI apresentou lesão nasal e septal. Resultados: O Kinesio® Taping, foi posicionado de forma a proteger a columela e o septo nasal do atrito provocado pelo contato direto da pronga nasal, manteve a pressão da VMNI, boa adaptação ao formato do nariz e melhorou o trauma nasal após 3 dias de uso. Conclusão: Considerando que a respiração nesse período da vida acontece predominantemente pelo nariz, manter a integridade dessa mucosa reduz não só o desconforto respiratório, mas também as deformidades e o riscos de infecções. O presente estudo apresenta o KT como uma ferramenta inovadora de proteção contra lesões nasais em recém-nascidos prematuros submetidos à ventilação com pressão positiva com ponta nasal. Apesar de descrever um único caso, os resultados obtidos foram promissores. No entanto, são necessários estudos com uma amostra maior e grupos diferentes, principalmente para comparar com os métodos existentes.
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Congenital heart disease is considered the most common malformation found in neonatology. The aim of this study was to characterize the congenital heart diseases of premature newborns in the Neonatal Intensive Care Unit (NICU) of a high-risk maternity unit. This was an observational retrospective, descriptive character study carried out in a maternity school, reference in high-risk gestation in the state of Rio Grande do Norte. The study was carried out with premature infants admitted to NICU, who presented some cardiological findings when performing the echocardiogram examination. Data collection was performed through the records of infants hospitalized from December 2016 to December 2017. A total of 371 records were evaluated. Fifty-eight infants were diagnosed with congenital heart disease, and 38 of them had Persistence of the ductus arteriosus. The main diagnosed cardiopathies caused low pulmonary flow. About half of the pregnant women with cardiac infants presented some complications during pregnancy, and the most frequent was Urinary Tract Infection; 55 infants needed some ventilatory support, 14 had at least one extubation failure during the hospitalization period, and 8 presented atelectasis. Persistence of the ductus arteriosus was the most common cardiologic finding, and the most frequent congenital heart diseases were those that decreased pulmonary flow, diagnosed mostly in premature infants who needed some ventilation support, but who were discharged from hospital. (AU)
Cardiopatias congênitas (CC) são consideradas as malformações mais comuns encontradas na neonatologia. O objetivo deste estudo foi caracterizar as CC de recém-nascidos prematuros em Unidade de Terapia Intensiva Neonatal (UTIN) de uma maternidade de alto risco. Tratase de um estudo observacional retrospectivo, de caráter descritivo, realizado em uma maternidade escola, referência em gestação de alto risco do estado do Rio Grande do Norte. O estudo foi realizado com os bebês prematuros admitidos na UTIN, que apresentaram algum achado cardiológico ao realizar o exame de ecocardiograma. A coleta de dados foi realizada através dos prontuários dos bebês internados no período de dezembro de 2016 a dezembro de 2017. Foram avaliados 371 prontuários, sendo elencados para o estudo 58 bebês, 38 apresentaram persistência do canal arterial (PCA) e foram alocados no grupo PCA e 20 apresentaram outro tipo de CC e foram alocados no grupo CC. 55 bebês necessitaram do uso de algum suporte ventilatório, 14 apresentaram pelo menos uma falha de extubação durante o período de internação e 8 apresentaram atelectasia. Cerca de metade das gestantes com bebês cardiopatas apresentaram alguma intercorrência durante a gestação. A mais frequente foi à infecção do trato urinário. A PCA foi o achado cardiológico mais comum da amostra (65%) e dentre os 20 RN com diferentes CC, as que causam o baixo fluxo pulmonar foram as mais frequentes (70%), sendo encontradas em sua maioria em prematuros que necessitaram de algum suporte ventilatório, mas que receberam alta hospitalar. (AU)
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BACKGROUND: The central repetitive region (CRR) of the Plasmodium vivax circumsporozoite surface protein (CSP) is composed of a repetitive sequence that is characterised by three variants: VK210, VK247 and P. vivax-like. The most important challenge in the treatment of P. vivax infection is the possibility of differential response based on the parasite genotype. OBJECTIVES: To characterise the CSP variants in P. vivax isolates from individuals residing in a malaria-endemic region in Brazil and to profile these variants based on sensitivity to chloroquine and mefloquine. METHODS: The CSP variants were determined by sequencing and the sensitivity of the P. vivax isolates to chloroquine and mefloquine was determined by Deli-test. FINDINGS: Although five different allele sizes were amplified, the sequencing results showed that all of the isolates belonged to the VK210 variant. However, we observed substantial genetic diversity in the CRR, resulting in the identification of 10 different VK210 subtypes. The frequency of isolates that were resistant to chloroquine and mefloquine was 11.8 and 23.8%, respectively. However, we did not observe any difference in the frequency of the resistant isolates belonging to the VK210 subtypes. MAIN CONCLUSION: The VK210 variant is the most frequently observed in the studied region and there is significant genetic variability in the CRR of the P. vivax CSP. Moreover, the antimalarial drug sensitivity profiles of the isolates does not seem to be related to the VK210 subtypes.
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Antimaláricos/farmacologia , Cloroquina/farmacologia , Malária Vivax/parasitologia , Mefloquina/farmacologia , Plasmodium vivax/efeitos dos fármacos , Proteínas de Protozoários/genética , Genótipo , Humanos , Testes de Sensibilidade Parasitária , Plasmodium vivax/genética , Plasmodium vivax/isolamento & purificação , Reação em Cadeia da PolimeraseRESUMO
RESUMEN Introducción: el tamizaje visual en niños es una evaluación que debería ser realizada por el médico de cuidado primario para detectar disminución de la agudeza visual o factores de riesgo que puedan interferir en el desarrollo adecuado del ojo y el sistema visual. En este se debe valorar la agudeza visual, el alineamiento ocular y la presencia de anomalías oculares estructurales. Métodos: se revisó en la literatura las estrategias para realizar un adecuado examen visual pediátrico por médicos generales y pediatras, para identificar de forma temprana los problemas visuales de los niños. Resultados: las alteraciones visuales son una de las causas más importantes de discapacidad en los niños, cuyos factores principales de riesgo son los trastornos refractivos no corregidos, estrabismo y cataratas congénitas, identificables mediante el tamizaje visual; no detectarlas a tiempo puede dejar secuelas irreversibles. Conclusiones: siempre que se detecte en el examen una agudeza visual por debajo de la esperada para la edad del paciente, pobre fijación y/o seguimiento después de los 3 meses, alteración del balance muscular, alteración del reflejo rojo, etc., se debe remitir el niño a un profesional de la salud visual para prevenir pérdida visual permanente.
SUMMARY Introduction: Visual screening in children is an assessment that should be performed by the primary care physician to detect diminished visual acuity or risk factors that may interfere with an appropriate development of the eye and visual system. In the visual screening, visual acuity, ocular alignment and the presence of structural ocular anomalies should be assessed. Methods: A literature review about strategies to perform an adequate pediatric visual examination by general physicians and pediatricians for early detection of visual problems in children was carried out. Results: Visual disorders are one of the main causes of disability in children, being the main risk factors uncorrected refractive errors, strabismus and congenital cataracts, that can leave irreversible sequels if they are not detected on time, being those disorders identified through visual screening. Conclusions: Whenever the visual acuity is detected below the expected for the patient's age, poor fixation and/or follow after 3 months, muscle imbalance, alteration of the red reflex, etc., the child should be referred to a visual health professional to prevent permanent visual loss.
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Humanos , Criança , Acuidade Visual , CriançaRESUMO
BACKGROUND The central repetitive region (CRR) of the Plasmodium vivax circumsporozoite surface protein (CSP) is composed of a repetitive sequence that is characterised by three variants: VK210, VK247 and P. vivax-like. The most important challenge in the treatment of P. vivax infection is the possibility of differential response based on the parasite genotype. OBJECTIVES To characterise the CSP variants in P. vivax isolates from individuals residing in a malaria-endemic region in Brazil and to profile these variants based on sensitivity to chloroquine and mefloquine. METHODS The CSP variants were determined by sequencing and the sensitivity of the P. vivax isolates to chloroquine and mefloquine was determined by Deli-test. FINDINGS Although five different allele sizes were amplified, the sequencing results showed that all of the isolates belonged to the VK210 variant. However, we observed substantial genetic diversity in the CRR, resulting in the identification of 10 different VK210 subtypes. The frequency of isolates that were resistant to chloroquine and mefloquine was 11.8 and 23.8%, respectively. However, we did not observe any difference in the frequency of the resistant isolates belonging to the VK210 subtypes. MAIN CONCLUSION The VK210 variant is the most frequently observed in the studied region and there is significant genetic variability in the CRR of the P. vivax CSP. Moreover, the antimalarial drug sensitivity profiles of the isolates does not seem to be related to the VK210 subtypes.
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Plasmodium vivax/efeitos dos fármacos , Mefloquina/uso terapêutico , Cloroquina/uso terapêutico , Resistência a Múltiplos Medicamentos/imunologia , BrasilRESUMO
A terapia de nutrição enteral é uma opção para pacientes que possuem limitações principalmente no sistemagastrointestinal e sistema neurológico. Para que ocorra a ingestão adequada de substâncias nutricionais, utiliza-se a sonda denutrição enteral. Uma vez que a maioria dos fármacos não está disponível em soluções, elixires, suspensões, é adotada a práticade macerar esses fármacos e os diluir em água. Objetivo: observar a técnica utilizada para triturar, diluir e administrar formulaçõessólidas via sonda. Método: estudo observacional com abordagem qualitativa e quantitativa, utilizando o Diagrama de Ishikawa,o checklist qualitativo e a fórmula quantitativa. Resultado: foi observado um percentual de 21,42% de obstrução das sondas denutrição enteral. Conclusão: a prática de trituração e diluição de fármacos sólidos influencia na obstrução das sondas de nutriçãoenteral, logo, é oportuna a sugestão da integração da equipe de saúde para maior conhecimento sobre formulações sólidas a serem trituradas.
Enteral nutrition therapy is an option for patients who have limitations primarily in the gastrointestinal system andneurological system. For the proper intake of nutritional substances, the enteral nutrition probe is used. Since most drugs are notavailable in solutions, elixirs, suspensions, the practice is to macerate these drugs and dilute them in water. Objective: to observethe technique used to crush, dilute and administer solid formulations via probe. Method: observational study with qualitative andquantitative approach, using the Ishikawa Diagram, the qualitative checklist and the quantitative formula. Result: a percentageof 21.42% of obstruction of the enteral nutrition probes was observed. Conclusion: the practice of grinding and dilution of soliddrugs influences the obstruction of the enteral nutrition probes, so it is timely to suggest the integration of the health team fora better knowledge about solid formulations to be crushed.
La terapia de nutrición enteral es una opción para pacientes que tienen limitaciones principalmente en el sistemagastrointestinal y el sistema neurológico. Para que ocurra la ingestión adecuada de sustancias nutricionales, se utiliza la sonda denutrición enteral. Una vez que la mayoría de los fármacos no están disponibles en soluciones, elixires, suspensiones, se adoptala práctica de macerar estos fármacos y diluirlos en agua. Objetivo: observar la técnica utilizada para triturar, diluir y administrarformulaciones sólidas vía sonda. Método: estudio observacional con enfoque cualitativo y cuantitativo, utilizando el Diagramade Ishikawa, el checklist cualitativo y la fórmula cuantitativa. Resultado: se observó un porcentaje de 21,42% de obstrucción delas sondas de nutrición enteral. Conclusión: la práctica de trituración y dilución de fármacos sólidos influye en la obstrucción delas sondas de nutrición enteral, luego es oportuno la sugerencia de la integración del equipo de salud para mayor conocimientosobre formulaciones sólidas a ser trituradas.
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Humanos , Nutrição Enteral , Obstrução do Cateter , Preparações Farmacêuticas/administração & dosagem , Stents , Unidades de Terapia IntensivaRESUMO
RESUMO Este estudo observacional, quantitativo e transversal teve por objetivo avaliar a função sexual e comparar a qualidade de vida e independência funcional entre indivíduos acometidos por acidente vascular encefálico (AVE) sexualmente ativos e inativos. Estes foram previamente contatados por telefone e tiveram suas avaliações agendadas de acordo com sua conveniência. Realizou-se a aplicação de uma ficha de avaliação contendo dados sociodemográficos, hábitos de vida, saúde referida e função sexual, além do questionário abreviado de avaliação de qualidade de vida WHOQOL e da escala de medida de independência funcional. Ao avaliar 29 indivíduos, observou-se que 48,3% eram sexualmente ativos. Destes, 64,3% eram do sexo masculino e 35,7% do sexo feminino. A maioria da amostra relatou diminuição da atividade sexual após a doença (64,3%); 60% das mulheres apresentou disfunção sexual pelo quociente sexual - versão feminina -, e 77,7% dos homens apresentou disfunção erétil, avaliada pelo Índice Internacional de Função Erétil. Observou-se que os indivíduos ativos sexualmente apresentavam melhor qualidade de vida relativa ao domínio físico (p=0,035) e maior independência funcional motora (p=0,005) e cognitiva (p=0,006) quando comparados aos indivíduos que não praticavam atividade sexual. Concluiu-se que uma parcela significativa dos pacientes continua ativa sexualmente e que a prática de atividade sexual esteve associada à independência cognitiva e motora.
RESUMEN Este estudio de tipo observacional, cuantitativo, transversal tiene el objetivo de analizar la función sexual y comparar la calidad de vida y la independencia funcional entre los sujetos sexualmente activos e inactivos, acometidos por accidente cerebrovascular. Se contactaron a los sujetos por teléfono y se agendó una cita con ellos según la disponibilidad. Se les aplicó a los participantes una encuesta de evaluación para conocer sus datos sociodemográficos, hábitos de vida, salud y función sexual, además del cuestionario abreviado de la evaluación de la calidad de vida Whoqol-Bref y la escala de la medida de independencia funcional. De los 29 sujetos evaluados un 48,3% eran sexualmente activos. De estos, un 64,3% son hombres y un 35,7% mujeres. La mayoría de los participantes informaron que hubo una disminución de la actividad sexual tras la enfermedad (64,3%), un 60% de las mujeres presentaron disfunción sexual por el coeficiente sexual -versión femenina, y un 77,7% de los hombres presentaron disfunción eréctil, evaluada por el Índice internacional de función eréctil. Los sujetos sexualmente activos presentaron una mejor calidad de vida referente al dominio físico (p=0,035), una mayor independencia funcional motora (p=0,005) y cognitiva (p=0,006) en comparación a los que no tenían actividad sexual. Se concluye que gran parte de estos sujetos mantienen una vida sexual activa y que hay asociación entre la práctica de la actividad sexual a la independencia cognitiva y motora.
ABSTRACT This observational, quantitative and cross-sectional study aimed to assess the sexual function and compare the quality of life and functional independence among individuals, affected by cerebrovascular accident (CVA), sexually active and inactive. Individuals were previously contacted by telephone and scheduled at their convenience. We applied an assessment form containing demographic data, life habits, self-reported health and sexual function, in addition to the WHOQOL questionnaire for the evaluation of quality of life and scale of measure of functional independence. When assessing 29 individuals, we found that 48.3% were sexually active. Among them, 64.3 individuals were male and 35.7 were female. Most of the sample reported decreased sexual activity after the stroke (64.3%), 60% of women have sexual dysfunction through female sexual quotient, and 77.7% of men have erectile dysfunction, evaluated by the International Index of Erectile Function. We observed that sexually active individuals had better quality of life on the physical domain (p=0.035), greater functional (p=0.005) and cognitive (p=0.006) motor independence when compared with individuals who were not sexually active. We concluded that a significant portion of patients remain sexually active and that sexual activity was associated with cognitive and motor independence.
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[Purpose] The aim of the present study was to assess the influence of parity, type of delivery, and physical activity level on pelvic floor muscles in postmenopausal women. [Subjects and Methods] This was an observational analytic cross-sectional study with a sample of 100 postmenopausal women, aged between 45 and 65â years, divided into three groups according to menopausal stage: hysterectomized and early and late postmenopause. Patients were assessed for sociodemographic and gyneco-obstetric factors and subjected to a muscle strength test and perineometry. Descriptive statistics, ANOVA, Kruskal-Wallis and multiple regression were applied. [Results] The results showed homogeneity in sociodemographic and anthropometric characteristics. There was no difference in pelvic floor muscle function among the three groups. Type of delivery, parity and physical activity level showed no influence on muscle function. [Conclusion] The findings demonstrate that parity, type of delivery, and physical activity level had no influence on pelvic floor muscle pressure in postmenopausal women. One hypothesis to explain these results is the fact that the decline in muscle function in postmenopausal women is related to the female aging process.
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Intimate partner violence (IPV) is one of the most common forms of violence against women worldwide. Among Mexican women, it is estimated that 15 to 71% have experienced physical or sexual abuse by an intimate male partner in their lifetime. This study examined the prevalence of four leading risk factors associated with IPV (alcohol consumption, education, socioeconomic status (SES), and gender roles) in adult women (n = 68) in a migrant farmworker community in México. Alcohol consumption among women was higher than the national average, and partner consumption was lower. Education level and SES were low, and women identified with a feminist ideology more than a traditional gender role. Results also revealed that 86.4% (n = 57) of participants identified violence against women as a common problem in the community, and the majority (94.0%, n = 62) of participants believe that IPV specifically is a problem within the community.
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Consumo de Bebidas Alcoólicas/etnologia , Escolaridade , Fazendeiros , Identidade de Gênero , Maus-Tratos Conjugais/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , México/epidemiologia , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Maus-Tratos Conjugais/etnologia , Violência/etnologia , Violência/psicologiaRESUMO
OBJECTIVE: to evaluate the influence of the hammock on neuromotor development in full-term infants. METHOD: the study included 26 infants born at normal gestational age, of single-births and birth weight > 2500g, 19 of them constituting the group of hammock-users and seven the group of non-hammock-users. All the 26 infants had their neuromotor development assessed using the Alberta Infant Neuromotor Scale, at six months of age. The assessments, undertaken in the infants' homes at times convenient to both mothers and children, were recorded on video and two other observers evaluated the infants' performance. RESULTS: the neuromotor development of the hammock-using infants obtained a lower score than did that of the non-hammock-using infants (p 0.03). Among the four postures evaluated by AIMS, the upright position was the only one that showed a statistically significant difference between the two groups (p 0; 01). In the correlation analysis, maternal age showed a negative relationship ((r = -0.42; p 0.03;) and the value of the Apgar score at 1 minute a positive relationship with neuromotor development (r = 0.49; p 0.05;). CONCLUSION: hammock-using infants present slower neuromotor development than the non-hammock-users of the same age...
OBJETIVO: Avaliar a influência do uso da rede de descanso sobre o desenvolvimento neuromotor de lactentes nascido a termo aos seis meses de idade. MÉTODO: Foram incluídos 26 lactentes, nascidos a termo, de parto único e com peso > 2500g, 19 foram inseridos no grupo que faziam uso da rede de descanso e sete foram incluídos no grupo que não faziam uso da rede de descanso. Os 26 lactentes estavam com seis meses de idade quando tiveram seu desenvolvimento neuromotor avaliado por meio da Alberta Infant Neuromotor Scale. Todas as avaliações foram registradas em vídeo-gravações e as performances neuromotoras foram reavaliadas e pontuadas por dois avaliadores capacitados e cegos ao estudo. RESULTADOS: O desenvolvimento neuromotor dos lactentes que fazem uso da rede apresentou pior escore quando comparado ao desenvolvimento neuromotor dos lactentes que não fazem uso da rede (p 0,03). Dentre as quatro posturas avaliadas na AIMS a postura em pé foi à única que apresentou diferença estatisticamente significativa entre os dois grupos (p 0,01). Na análise de correlação, a idade da mãe apresentou relação negativa (r = -0,42; p 0,03;) e o valor de Apgar no 1º minuto relação positiva com o desenvolvimento neuromotor (r = 0,49; p 0,05;). CONCLUSÃO: Os lactentes que fazem uso da rede de descanso apresentam um desenvolvimento neuromotor mais lento quando comparado ao desenvolvimento de lactentes de mesma idade que não fizeram uso da rede de descanso...
Assuntos
Humanos , Masculino , Feminino , Lactente , Desenvolvimento Infantil , Meio Ambiente , Lactente , Cuidado do Lactente , Relações Mãe-Filho , Destreza Motora , Posicionamento do Paciente , Estudos Transversais , Fatores de RiscoRESUMO
OBJECTIVE: to evaluate the influence of the hammock on neuromotor development in full-term infants. METHOD: the study included 26 infants born at normal gestational age, of single-births and birth weight > 2500g, 19 of them constituting the group of hammock-users and seven the group of non-hammock-users. All the 26 infants had their neuromotor development assessed using the Alberta Infant Neuromotor Scale, at six months of age. The assessments, undertaken in the infants' homes at times convenient to both mothers and children, were recorded on video and two other observers evaluated the infants' performance. RESULTS: the neuromotor development of the hammock-using infants obtained a lower score than did that of the non-hammock-using infants (p 0.03). Among the four postures evaluated by AIMS, the upright position was the only one that showed a statistically significant difference between the two groups (p 0; 01). In the correlation analysis, maternal age showed a negative relationship ((r = -0.42; p 0.03;) and the value of the Apgar score at 1 minute a positive relationship with neuromotor development (r = 0.49; p 0.05;). CONCLUSION: hammock-using infants present slower neuromotor development than the non-hammock-users of the same age...(AU)
OBJETIVO: Avaliar a influência do uso da rede de descanso sobre o desenvolvimento neuromotor de lactentes nascido a termo aos seis meses de idade. MÉTODO: Foram incluídos 26 lactentes, nascidos a termo, de parto único e com peso > 2500g, 19 foram inseridos no grupo que faziam uso da rede de descanso e sete foram incluídos no grupo que não faziam uso da rede de descanso. Os 26 lactentes estavam com seis meses de idade quando tiveram seu desenvolvimento neuromotor avaliado por meio da Alberta Infant Neuromotor Scale. Todas as avaliações foram registradas em vídeo-gravações e as performances neuromotoras foram reavaliadas e pontuadas por dois avaliadores capacitados e cegos ao estudo. RESULTADOS: O desenvolvimento neuromotor dos lactentes que fazem uso da rede apresentou pior escore quando comparado ao desenvolvimento neuromotor dos lactentes que não fazem uso da rede (p 0,03). Dentre as quatro posturas avaliadas na AIMS a postura em pé foi à única que apresentou diferença estatisticamente significativa entre os dois grupos (p 0,01). Na análise de correlação, a idade da mãe apresentou relação negativa (r = -0,42; p 0,03;) e o valor de Apgar no 1º minuto relação positiva com o desenvolvimento neuromotor (r = 0,49; p 0,05;). CONCLUSÃO: Os lactentes que fazem uso da rede de descanso apresentam um desenvolvimento neuromotor mais lento quando comparado ao desenvolvimento de lactentes de mesma idade que não fizeram uso da rede de descanso...(AU)
Assuntos
Humanos , Masculino , Feminino , Lactente , Lactente , Cuidado do Lactente , Destreza Motora , Desenvolvimento Infantil , Posicionamento do Paciente , Meio Ambiente , Relações Mãe-Filho , Estudos Transversais , Fatores de RiscoRESUMO
OBJECTIVE: There are extremely limited data on minority populations, especially Hispanics, describing the clinical epidemiology of acute coronary disease. The aim of this study is to examine the incidence rate of acute myocardial infarction (AMI), in-hospital case-fatality rate (CFR), and management practices among residents of greater San Juan (Puerto Rico) who were hospitalized with an initial AMI. METHODS: Our trained study staff reviewed and independently validated the medical records of patients who had been hospitalized with possible AMI at any of the twelve hospitals located in greater San Juan during calendar year 2007. RESULTS: The incidence rate (# per 100,000 population) of 1,415 patients hospitalized with AMI increased with advancing age and were significantly higher for older patients for men (198) than they were for women (134). The average age of the study population was 64 years, and women comprised 45% of the study sample. Evidence-based cardiac therapies, e.g., aspirin, beta blockers, ACE inhibitors/angiotensin receptor blockers, and statins, were used with 60% of the hospitalized patients, and women were less likely than men to have received these therapies (59% vs. 65%) or to have undergone interventional cardiac procedures (47% vs. 59%) (p<0.05). The in-hospital CFR increased with advancing age and were higher for women (8.6%) than they were for men (6.0%) (p<0.05). CONCLUSION: Efforts are needed to reduce the magnitude of AMI, enhance the use of evidence-based cardiac therapies, reduce possible gender disparities, and improve the short-term prognoses of Puerto Rican patients hospitalized with an initial AMI.
Assuntos
Infarto do Miocárdio/epidemiologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Cateterismo Cardíaco/estatística & dados numéricos , Fármacos Cardiovasculares/uso terapêutico , Comorbidade , Gerenciamento Clínico , Uso de Medicamentos , Feminino , Mortalidade Hospitalar , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/prevenção & controle , Infarto do Miocárdio/terapia , Revascularização Miocárdica/estatística & dados numéricos , Fatores de Risco , Distribuição por Sexo , Sexismo , Fatores Socioeconômicos , População Urbana/estatística & dados numéricosRESUMO
OBJETIVO: Determinar la actividad antiinflamatoria de la Metformina, así como la dosis óptima, en un evento agudo de inflamación, en roedores. MATERIAL Y MÉTODOS: Se emplearon 42 ratas albinas hembras (Wistar), de peso promedio 250 gr. distribuidas aleatoriamente en seis grupos (n = 7), se empleó la prueba de formalina. Los animales recibieron Metformina (100, 200 o 300 mg/kg), Diclofenaco, agua destilada y formalina. Se aplicó la prueba de ANOVA de una vía, se utilizó el programa IBM SPSS Statistics v.20. RESULTADOS: No se presentó efecto de la Metformina sobre el dolor neurogénico. En la fase II de dolor inflamatorio, la Metformina a dosis de 100 y 300 mg/Kg, presentó tiempos de latencia de 22,40 y 47,10 seg., frente a 2,21 seg. con formalina (p<0.05). La Metformina a dosis de 300 y 100 mg/kg, presentó un tiempo de lamidas de 130,47 y 148,71 seg., frente a 283,36 seg. con formalina (p<0.05). La dosis de Metformina 300 mg/kg fue la que mayor efecto antiinflamatorio presentó, seguido de la dosis de 100mg/Kg.CONCLUSIONES: Se confirmó la acción antiinflamatoria aguda de la Metformina a dosis de 100 y 300 mg/kg, en roedor, mediante el test de formalina. La mayor eficacia anti-inflamatoria fue obtenida con dosis de 300 mg/kg.
OBJETIVE: To determine the antiinflammatory activity of metformin and the optimal dose in an acute event of inflammation in rodents. MATERIALS AND METHODS: We used 42 female albino rats (Wistar), average weight 250 gr. randomized into six groups (n = 7), and applied the formalin test. The animals received Metformin (100, 200 or 300 mg/kg), diclofenac, distilled water and formalin. Statistical analysis with one-way ANOVA, we used the IBM SPSS Statistics v.20 program. RESULTS: No effect of Metformin over neurogenic pain occurred. In phase II Metformin at doses of 100 and 300 mg/kg, had latencies of 22,40 and 47,10 sec. compared to 1.48 sec. with formalin (p<0.05). Metformin in doses of 300 and 100 mg/kg, had a time of 130,47 and 148,71 sec of licking compared to 283,36 sec. with formalin (p<0.05). The 300 mg/kg Metformin dose showed the greatest antiinflammatory effect, followed by the 100mg/kg dose. CONCLUSIONS: We confirmed the acute anti-inflammatory action of Metformin at doses of 100 and 300 mg / kg in mice through the formalin test. Most anti-inflammatory efficacy was obtained with the 300 mg/kg Metformin dose.
Assuntos
Animais , Analgesia , Dor , InflamaçãoRESUMO
OBJECTIVE: to describe the ocular findings in children with mucopolysaccharidosis at the Ophtalmology department. METHODS: clinical, descriptive, retrospective, transversal, and observational study was done. The cohort included patients under 16 years old, treated at the Hospital General, Centro Médico Nacional La Raza, with diagnosis of mucopolysaccharidosis. The variables were age, gender, damaged eye, visual acuity, ocular findings, type of mucopolysaccharidosis. RESULTS: there were 11 patients with mucopolysaccharidosis, 10 of them (90.9 %) full filled the inclusion criteria; nine were men. Mean age was 5.5 ± 2.8 years. There were ocular findings in both eyes in 60 % of the patients, 10 % of them in just one eye. The most frequent finding was corneal opacity (70 %), bilateral in 85.7 %, and in a single eye in 14.3 %. The ocular findings (40 %) were common in mucopolysaccharidosis type I. CONCLUSIONS: there is visual sequels secondary to mucopolysaccharidosis. It is important to study the ocular disorders in order to treat it timely and give to patients the immediate rehabilitation to improve the quality of life.
Assuntos
Oftalmopatias/etiologia , Mucopolissacaridoses/complicações , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Estudos RetrospectivosRESUMO
OBJECTIVES: Aristotelia chilensis leaves (Elaeocarpaceae) are used in Chilean folk medicine to treat pain and inflammation. A bioguided study was carried out on serial extracts (hexane, dichloromethane, methanol, aqueous extract (INFU) and a crude mixture of alkaloids (ALK-MIX). All extracts were evaluated for (1) topical administration against both arachidonic acid and 12-deoxyphorbol-13-decanoate (TPA)-induced inflammation in mice and (2) per-os administration against inflammation by λ-carrageenan-induced paw oedema in guinea-pigs and (3) topical analgesia in tail flick and formalin models and per-os writhing test in mice. METHODS: Greater anti-inflammatory effects were obtained against TPA with dichloromethane extract and methanol extract (63.9 and 66.0%, respectively). INFU showed the most potent effect (56.2%) against arachidonic acid. Greater effects were obtained in the writhing test with hexane and dichloromethane extracts (89.2% both). In the topical analgesia models, all the extracts and ALK-MIX were active with exception of the hexane extract in the formalin assay. In tail flick test, ALK-MIX and the methanol extract were the most active (58.2 and 55.2%, respectively). In relation to the tail formalin assay, the methanol extract (74.1%) was the most active. Concerning antioxidant activity, both INFU and the methanol extract were the most active either in the inhibition of xanthine oxidase (52.9 and 62.7%, respectively) or in the DPPH free radical scavenging activity (EC50 (concentration that produced 50% of activity) = 12.1 and 9.7 µg/ml, respectively). KEY FINDINGS: Aristoteline, aristone, serratoline and hobartinol were isolated from ALK-MIX. Ursolic acid, friedelin and quercetin 5,3'-dimethyl ether were present in the dichloromethane extract while quercetin 3-O-ß-D-glucoside and kaempferol were present in the methanol extract. From INFU were isolated protopine, aristoteline and caffeic and ferulic acids. CONCLUSIONS: The effects of A. chilensis are herein demonstrated, validating its use in traditional medicine. Protopine is reported for the first time in Elaeocarpaceae.
Assuntos
Alcaloides/uso terapêutico , Analgésicos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Antioxidantes/farmacologia , Elaeocarpaceae/química , Fitoterapia , Extratos Vegetais/uso terapêutico , Administração Tópica , Alcaloides/farmacologia , Analgesia/métodos , Analgésicos/farmacologia , Animais , Anti-Inflamatórios/farmacologia , Ácido Araquidônico/antagonistas & inibidores , Comportamento Animal/efeitos dos fármacos , Compostos de Bifenilo/metabolismo , Carragenina , Chile , Edema/tratamento farmacológico , Feminino , Formaldeído , Cobaias , Inflamação/induzido quimicamente , Inflamação/tratamento farmacológico , Masculino , Medicina Tradicional , Camundongos , Camundongos Endogâmicos , Dor/tratamento farmacológico , Ésteres de Forbol , Picratos/metabolismo , Extratos Vegetais/farmacologia , Folhas de Planta/química , Xantina Oxidase/antagonistas & inibidoresRESUMO
Antecedentes: El cáncer de piel no melanoma ocupa el primer lugar en incidencia, con mortalidad baja, pero con morbilidad significativa. Uno de los pilares en el cáncer de piel es la prevención primaria y el principal factor de riesgo es la exposición a la radiación ultravioleta. Se han adelantado campañas de prevención sobre este tema, pero no hay información sobre los conocimientos en la población. Metodología: Se llevó a cabo una jornada de salud en octubre de 2009 en un municipio de Santander, para atender pacientes en diferentes especialidades, entre ellas, dermatología. Se realizó, además de la consulta, una encuesta para evaluar los conocimientos sobre el cáncer de piel. Resultados: Se atendieron 64 pacientes, 70% mujeres (n=45) y 30% hombres (n=19), con predominio de la población adulta en ambos sexos. Las dermatomicosis y las queratosis actínicas fueron el diagnóstico más frecuente, seguidas de nevos, acné y carcinoma basocelular en la cara. La encuesta sobre conocimientos de cáncer de piel la respondieron 115 personas; 96% (n=110) lo conocía. De éstos, 55% consideraron que el cáncer de piel es muy frecuente, 25%, frecuente, 16%, poco frecuente, y 4% no sabía que existía el cáncer de piel. El 80% mencionó que se presenta en ambos sexos; el 11% lo considera más frecuente en mujeres y el 5 %, en hombres; el 4 % no sabe. El 59,2% piensa que se presenta a cualquier edad y 24,4 % considera que sólo afecta a los adultos. El 86,1% considera el sol como factor de riesgo más frecuente. El 45,2% piensa que la complicación más frecuente de padecer cáncer de piel es la muerte; 19,1% no sabe de complicaciones y los restantes consideran el deterioro de la piel, la pigmentación y la deformidad, como secuelas del cáncer. El 62,7% considera la protección solar como la forma más importante de prevenirlo; el 17,4% asume que asistiendo al médico se previene su presentación y el 9% no sabe cómo debe prevenirse el cáncer de piel.