Primeiro registro da saracura-carijó Pardirallus maculatus(Aves: Rallidae) para o município de Bertioga, São Paulo / First record of the Spotted Rail Pardirallus maculatus(Aves: Rallidae) for the municipality of Bertioga, São Paulo

A saracura-carijó Pardirallus maculatus possui uma distribuição ampla e disjunta na América Central e na América do Sul, ocorrendo em todas as regiões do Brasil. No estado de São Paulo, Sudeste do País, os registros são escassos, e estão espalhados entre interior e litoral. Com isso, apresentamos aqui o primeiro registro documentado desta espécie para o município de Bertioga, litoral de São Paulo. Uma ave adulta foi encontrada no dia 9 de outubro de 2020, em uma área urbana, sendo resgatada e solta no mesmo dia em uma área natural no Serviço Social do Comércio (Sesc) em Bertioga. Essa ave apareceu após uma forte tempestade, e sua ocorrência pode ter relação com isso, ou poderia estar fazendo algum deslocamento regional, comportamento já observado em outros ralídeos. Devido ao baixo número de registros desta espécie para o litoral paulista, este relato pode ajudar a entender melhor sua ocorrência nesta região do estado de São Paulo, contribuindo com sua conservação.

The Spotted Rail Pardirallus maculatus has a wide and disjunct distribution in Central and South America, occurring in all regions of Brazil. In the state of São Paulo, southeast of the country, records are scarce, and are scattered between the interior and the coast. Thus, we present here the first documented record of this species for the municipality of Bertioga, on the coast of São Paulo. An adult bird was found on October 9, 2020, in an urban area, being rescued and released on the same day in a natural area at Serviço Social do Comércio (Sesc) in Bertioga. This bird appeared after a strong storm, and its occurrence may be related to this, or it could be making some regional movement, a behavior already observed in other rails. Due to the low number of records of this species for the São Paulo coast, this report can help to better understand its occurrence in this region of the state of São Paulo, contributing to its conservation.

Children's Perceived Barriers to a Healthy Diet: The Influence of Child and Community-Related Factors.

A healthy diet influences the promotion and maintenance of health throughout an individual's life. Many individuals struggle to have a healthy diet, despite it being mainly under their control. The current study aims to explore children's perceived barriers to a healthy diet. A qualitative study with the open-ended question, "Please identify the top 5 barriers to a healthy diet", was undertaken between January-June 2019 in which 274 students from the 5-6th grades wrote down their answers to the open-ended question. Content analysis was used to analyze responses with a codebook based on the Six C's Model. Five categories were identified: Child, Clan, Community, Country, and Culture-related barriers. Findings showed that the barriers most highlighted were in the Child sphere (e.g., dietary intake) and the Community sphere (e.g., peer food choices). Children seldom referred to barriers from the Clan sphere, i.e., related to family (e.g., food available at home). Additionally, it seems that girls emphasize more barriers from the Child sphere, while boys emphasize more barriers from the Community sphere. Due to the qualitative nature of this study, interpretation of the data should take into account the specific characteristics and context of the sample. Nevertheless, the current data are helpful in identifying implications for practice, for example, the need to empower children with tools (e.g., self-regulation-based interventions) likely to help them overcome perceived barriers. Finally, advocacy groups may help set environmental and structural changes in the community likely to facilitate children's healthy choices.

Yoga como prática integrativa e recurso terapêutico no apoio ao aleitamento materno / Yoga as an integrative practice and therapeutic resource in support of breastfeeding

Objetivo: descrever a utilização da Yoga no apoio ao aleitamento materno, a partir do olhar das nutrizes. Método: trata-se de um estudo exploratório, descritivo com abordagem qualitativa, com dez mulheres lactantes, do município de Niterói - RJ, no período entre maio e setembro de 2018, utilizando-se como ferramenta de produção dos dados a entrevista estruturada, oficina de Yoga e diário de campo. Os dados foram submetidos à análise de discurso na modalidade temática. Resultados: Foram identificadas três categorias: A Yoga como apoio emocional e físico para as mães; A assistência da equipe de saúde, e os significados da vivência durante o processo de parturição e amamentação; e A relação mãe-bebê como base para o bem-estar e segurança materna e continuidade da amamentação. Conclusão: identifica-se a convergência entre Yoga e aleitamento materno, uma vez que os processos fisiológicos e psíquicos se manifestam na saúde do corpo físico, interligados holisticamente. Os sentidos e emoções negativos, relatados no processo de aleitamento, foram minimizados com a utilização da Yoga como recurso terapêutico. (AU)

Objective: Describe the use of Yoga in breastfeeding support, from the perspective of nursing mothers. Methods: This is an exploratory, descriptive study with a qualitative approach, with ten lactating women, from the municipality of Niterói - RJ, in the period between May and September 2018, using the structured interview, workshop as data production tool Yoga and field diary. The data were submitted to discourse analysis in the thematic modality. Results: Three categories were identified: Yoga as emotional and physical support for mothers; The assistance of the health team, and the meanings of the experience during the parturition and breastfeeding process; and The mother-baby relationship as a basis for maternal well-being and continuity of breastfeeding. Conclusion: The convergence between Yoga and breastfeeding is identified, since the physiological and psychic processes are manifested in the health of the physical body, holistically interconnected. The senses and negative emotions, reported in the breastfeeding process were minimized with the use of yoga as a therapeutic resource. (AU)

Objetivo: Describir el uso del Yoga en apoyo de la lactancia materna, desde la perspectiva de las madres lactantes. Métodos: Se trata de un estudio exploratorio descriptivo con enfoque cualitativo, con diez mujeres lactantes, del municipio de Niterói - RJ, en el período comprendido entre mayo y septiembre de 2018, utilizando la entrevista estructurada, el taller como herramienta de producción de datos. Yoga y diario de campo. Los datos fueron sometidos a análisis del discurso en la modalidad temática. Resultados: Se identificaron tres categorías: Yoga como apoyo emocional y físico para las madres; La asistencia del equipo de salud y los significados de la experiencia durante el parto y el proceso de lactancia materna; y La relación madre-bebé como base para el bienestar materno y la seguridad y continuidad de la lactancia materna. Conclusión: Se identifica la convergencia entre el yoga y la lactancia, ya que los procesos fisiológicos y psíquicos se manifiestan en la salud del cuerpo físico, interconectados holísticamente. Los sentidos y las emociones negativas, informados en el proceso de lactancia, se redujeron al mínimo con el uso del yoga como recurso terapéutico. (AU)

Course of serological tests in treated subjects with chronic Trypanosoma cruzi infection: A systematic review and meta-analysis of individual participant data.

OBJECTIVE: To determine the course of serological tests in subjects with chronic Trypanosoma cruzi infection treated with anti-trypanosomal drugs. METHODS: A systematic review and meta-analysis was conducted using individual participant data. Survival analysis and the Cox proportional hazards regression model with random effects to adjust for covariates were applied. The protocol was registered in the PROSPERO database (http://www.crd.york.ac.uk/PROSPERO; CRD42012002162). RESULTS: A total of 27 studies (1296 subjects) conducted in eight countries were included. The risk of bias was low for all domains in 17 studies (63.0%). Nine hundred and thirteen subjects were assessed (149 seroreversion events, 83.7% censored data) for enzyme-linked immunosorbent assay (ELISA), 670 subjects (134 events, 80.0% censored) for indirect immunofluorescence assay (IIF), and 548 subjects (99 events, 82.0% censored) for indirect hemagglutination assay (IHA). A higher probability of seroreversion was observed within a shorter time span in subjects aged 1-19 years compared to adults. The chance of seroreversion also varied according to the country where the infection might have been acquired. For instance, the pooled adjusted hazard ratio between children/adolescents and adults for the IIF test was 1.54 (95% confidence interval 0.64-3.71) for certain countries of South America (Argentina, Bolivia, Chile, and Paraguay) and 9.37 (95% confidence interval 3.44-25.50) for Brazil. CONCLUSIONS: The disappearance of anti-T. cruzi antibodies was demonstrated along the course of follow-up. An interaction between age at treatment and country setting was found.

The detection of Trypanosoma cruzi by nested-PCR in elderly patients: relationship to the clinical and epidemiological profile.

Chagas disease, which is caused by Trypanosoma cruzi, is transmitted primarily by triatomine bugs, although the incidence of new cases has decreased as a result of vector control. In Brazil, most of those affected have the chronic form of the disease and are generally elderly individuals who require appropriate clinical follow-up. In this work, we undertook a descriptive study in which 85 patients were interviewed and blood samples were collected for molecular analyses based on the amplification of parasite satellite DNA. The cardiac form of the disease was the most prevalent among the patients and hypertension was the most frequent comorbidity; polypharmacy was detected in 34% of the cases. Serological tests were positive in 95% of cases while 36% were positive in nested-polymerase chain reaction. These findings indicate an increased use of medications and a larger number of age-related diseases in elderly patients with Chagas disease, even in patients with low parasitemia. We conclude that elderly patients with Chagas disease require special attention and that further studies should be done with elderly individuals who carry this disease.

Carotid body tumor: retrospective analysis on 22 patients.

CONTEXT AND OBJECTIVE: Carotid body tumors, or chemodectomas, are the most common head and neck paragangliomas, accounting for 80% of the cases. They may present minor symptoms; however, they deserve special attention in order to achieve accurate diagnosis and adequate treatment. The objectives of this study were to show the approach towards chemodectomas and evaluate the complications of the patients treated surgically without previous embolization. DESIGN AND SETTING: Retrospective study on chemodectomas followed up at the Head and Neck Surgery Service, Department of Surgery, Unicamp. METHODS: Twenty-two patients were evaluated between 1983 and 2009. The diagnosis was based on clinical findings and imaging methods. The epidemiological characteristics, lesion characteristics, diagnostic methods, treatment and complications were analyzed. RESULTS: The paragangliomas were classified as Shamblin I (9%), II (68.1%) and III (22.7%). Angiography, magnetic resonance imaging and computed tomography confirmed the diagnosis in 20 patients (90.9%). Five (22.7%) had significant bleeding during the surgery, while four (18.1%) had minor bleeding. Four patients (18.1%) developed neurological sequelae. Seven (31.8%) needed ligatures of the external carotid artery. Three patients (13.6%) underwent carotid bulb resection. The postoperative follow-up ranged from 3 months to 14 years without recurrences or mortality. CONCLUSIONS: In our experience and in accordance with the literature, significant bleeding and neurological sequelae may occur in chemodectoma cases, particularly in Shamblin III patients. The complications from treatment without previous embolization were similar to data in the literature data, from cases in which this procedure was applied prior to surgery.

Carotid body tumor: retrospective analysis on 22 patients / Tumor de corpo carotídeo: análise retrospectiva de 22 pacientes

CONTEXT AND OBJECTIVE: Carotid body tumors, or chemodectomas, are the most common head and neck paragangliomas, accounting for 80% of the cases. They may present minor symptoms; however, they deserve special attention in order to achieve accurate diagnosis and adequate treatment. The objectives of this study were to show the approach towards chemodectomas and evaluate the complications of the patients treated surgically without previous embolization. DESIGN AND SETTING: Retrospective study on chemodectomas followed up at the Head and Neck Surgery Service, Department of Surgery, Unicamp. METHODS: Twenty-two patients were evaluated between 1983 and 2009. The diagnosis was based on clinical findings and imaging methods. The epidemiological characteristics, lesion characteristics, diagnostic methods, treatment and complications were analyzed. RESULTS: The paragangliomas were classified as Shamblin I (9%), II (68.1%) and III (22.7%). Angiography, magnetic resonance imaging and computed tomography confirmed the diagnosis in 20 patients (90.9%). Five (22.7%) had significant bleeding during the surgery, while four (18.1%) had minor bleeding. Four patients (18.1%) developed neurological sequelae. Seven (31.8%) needed ligatures of the external carotid artery. Three patients (13.6%) underwent carotid bulb resection. The postoperative follow-up ranged from 3 months to 14 years without recurrences or mortality. CONCLUSIONS: In our experience and in accordance with the literature, significant bleeding and neurological sequelae may occur in chemodectoma cases, particularly in Shamblin III patients. The complications from treatment without previous embolization were similar to data in the literature data, from cases in which this procedure was applied prior to surgery. .

CONTEXTO E OBJETIVO: O tumor de corpo carotídeo, ou quimiodectoma, é o paraganglioma mais comum em cabeça e pescoço, com aproximadamente 80% dos casos. Pode apresentar poucos sintomas; no entanto, necessita atenção especial para o diagnóstico e tratamento adequado. Os objetivos deste estudo são mostrar a abordagem do quimiodectoma e avaliar as complicações nos pacientes tratados cirurgicamente sem embolização prévia. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo de quimiodectomas acompanhados pelo Serviço de Cirurgia de Cabeça e Pescoço, Departamento de Cirurgia, Unicamp. MÉTODOS: Vinte e dois pacientes foram avaliados entre 1983 e 2009. O diagnóstico foi baseado em achados clínicos e métodos de imagens. Foram analisados aspectos epidemiológicos, características das lesões, métodos diagnósticos, tratamento e complicações. RESULTADOS: Os paragangliomas foram classificados em Shamblin I (9%), II (68,1%) e III (22,7%). Angiografia, ressonância nuclear magnética e tomografia computadorizada confirmaram o diagnóstico em 20 pacientes (90,9%). Cinco (22,7%) tiveram sangramento significativo durante a cirurgia, enquanto quatro (18,1%) tiveram sangramento mínimo. Quatro pacientes (18,1%) tiveram sequelas neurológicas. Sete (31,8%) necessitaram de ligadura da artéria carótida externa. Três (13,6%) foram submetidos a ressecção do bulbo carotídeo. O acompanhamento variou de 3 meses a 14 anos, sem recorrências ou óbitos. CONCLUSÕES: Em nossa experiência e de acordo com a literatura, sangramentos significativos e sequelas neurológicas podem ocorrer nos quimiodectomas principalmente em pacientes Shamblin III. As complicações do tratamento sem embolização prévia foram similares aos relatos observados ...

Retalhos miocutâneos para reconstrução em cirurgia de cabeça e pescoço: Experiência da UNICAMP / Myocutaneous flaps for reconstruction in head and neck surgery: UNICAMP experience

Introdução: Retalhos miocutâneos pediculados sãoreconhecidos como importante método para reconstrução emcirurgia de cabeça e pescoço. São amplamente utilizados apósressecções oncológicas extensas que resultam em grandesdefeitos cirúrgicos. Apesar de atualmente os retalhos livresrealizados com técnicas microvasculares serem largamenteutilizados e considerados a melhor opção em grandes centros, ouso de retalhos pediculados é técnica frequentemente empregadaem muitos serviços. Objetivo: Avaliar a taxa de sucesso e ascomplicações encontradas com o uso de retalhos miocutâneospediculados em pacientes submetidos a ablações cirúrgicasoncológicas extensas no serviço de Cirurgia de Cabeça e Pescoçoda UNICAMP. Método: Entre fevereiro de 1990 e janeiro de 2010,foram avaliados retrospectivamente os dados de 138 pacientessubmetidos à ressecção oncológica em cabeça e pescoço, o tipode retalho utilizado para reconstrução, a taxa de sucesso e ascomplicações observadas. Resultados: A taxa global de sucessofoi de 92,7%. Para o retalho de músculo peitoral maior a taxa desucesso foi de 93,6%; para o retalho infra-hioideo, 85,9%; parao retalho de grande dorsal, 100%. Conclusão: Os resultadosencontrados fundamentam o uso dos retalhos miocutâneospediculados na cirurgia de reconstrução em cabeça e pescoço,pois apresentam altas taxas de sucesso e podem ser realizadosem centros que não disponham de equipe especializada emcirurgia microvascular.

Serological profiles and evaluation of parasitaemia by PCR and blood culture in individuals chronically infected by Trypanosoma cruzi treated with benzonidazole.

OBJECTIVE: To evaluate the serological and parasitological status of patients with chronic Chagas disease (CD) after chemotherapy with benzonidazole. METHODS: Retrospective study of patients treated with benzonidazole (5 mg/kg/day for 60 days) between 1980 and 2010. Twenty-nine patients who had CD confirmed by two reagent immunological tests and/or one positive xenodiagnosis before treatment were included. Conventional serology (ELISA and IIF) and parasitological tests (haemoculture and N-PCR) were performed. RESULTS: At the time of treatment, the mean age of patients was 36 ± 7.24 years (20-39 years) and the time post-treatment varied from 1 to 29 years. After chemotherapy, all individuals had reagent ELISA and 93.1% had positive results for the IIF test. T. cruzi DNA was detected by N-PCR in 48.3%. Negative results were observed in 41.4% and inconclusive ones in 10.3%. Haemoculture was negative for all individuals. CONCLUSIONS: Our results suggest that N-PCR may be useful in the early identification of therapeutic failure of CD. Although it is difficult to determine parasitological cure in negative N-PCR cases, we can infer that this condition represents a declination of parasitaemia as a favourable consequence of aetiological treatment.

Evidence of Chagas disease in seronegative Brazilian patients with megaesophagus.

BACKGROUND: After 100 years of research, Chagas disease (CD) remains an important public health problem in Latin America. The symptomatic chronic phase is usually characterized by cardiac or digestive involvement and diagnosis currently relies on the measurement of Trypanosoma cruzi-specific antibodies produced in response to the infection. However, the detection of parasite DNA in seronegative persons has been reported. METHODS: The prevalence of CD in a population with esophageal disorders was assessed by conventional serology. We also detected T. cruzi DNA in blood samples of seronegative and inconclusive patients by nested polymerase chain reaction (N-PCR). RESULTS: The seroprevalence of CD determined by conventional serologic tests (indirect immunofluorescence (IIF) and enzyme-linked immunosorbent assay (ELISA)) was 79% in 513 patients with esophageal disorders. Out of 41 blood samples, N-PCR was positive in 31 (76%) cases for which serology was negative or inconclusive. CONCLUSIONS: As all patients presented with clinical signs suggestive of the digestive form of CD and most of them were born in endemic areas, we highlight the importance of improving diagnosis of the disease and the implications for blood bank screening. Our data suggest that N-PCR is effective in the detection of T. cruzi DNA in patients with inconclusive or negative serology, and it may eventually be useful in the determination of the etiology of megaesophagus.