Prediction of the small aperture intraocular lens on visual acuity in patients with keratoconus.

PURPOSE: To investigate the impact of corneal higher-order aberrations (HOAs) on predicted corrected distance visual acuity (CDVA) in patients with keratoconus at varying simulated pupil apertures. SETTING: Ophthalmology clinics, Medical University of South Carolina, USA. DESIGN: Retrospective chart review study. METHODS: 56 eyes with keratoconus were examined using Scheimpflug tomography during routine examinations prior to medical intervention. The severity of keratoconus was graded using the Amsler-Krumeich classification. Zernike analysis was used to obtain corneal aberrations using simulated pupil diameters of 6-, 4-, and 2 mm. These data were extrapolated to obtain the total RMS HOAs for a 1.6 mm simulated pupil to evaluate the potential effect of a small aperture intraocular lens. Correlation analysis was used to study the impact and relative contributions of HOAs on CDVA. Convolution of HOAs from OPD-Scan III (NIDEK) provided a clinical method to predict CDVA with different simulated pupil sizes in corneas with irregular astigmatism. RESULTS: There were statistically significant positive correlations between photopic CDVA and the magnitude of total and individual (coma, spherical aberration and trefoil) HOAs in this cohort of keratoconus subjects. A keratoconus case with the small aperture IOL confirms the improvement in vision due to the pinhole effect. CONCLUSIONS: The small aperture IOL is expected to markedly reduce aberrations in keratoconus patients up to Amsler-Krumeich class 4 severity to levels consistent with the levels seen in healthy patients. Convolution of corneal HO aberrations with the ETDRS chart provides a useful simulation of the impact of pinhole optics in aberrated eyes.

Which sit-to-stand test best differentiates functional capacity in older people?

ABSTRACT: The Sit-to-Stand (STS) test provides insight into age-related functional capacity; however, there are various variants of STS, and we do not know which of these better discriminates against age-related functional capacity. Our study aimed to compare the age-related functional capacity in older people by evaluating STS power variants, using young individuals as a reference. A cross-sectional study was conducted in 102 adults (57 women) aged 60-80 and 105 adults (54 women) aged 20-30. Participants performed five times STS (5-STS), 30-seconds STS (30s-STS), and 1-minute STS (1min-STS). Z-scores were obtained for each STS variant using power (W), relative (W/kg), and allometric (W/m2) normalization methods. A mixed repeated-measures ANOVA assessed the interactions among the STS variants, normalization methods, sex, physical activity, and tobacco history. A significant interaction between STS variants, normalization methods, and sex (p=0.002) was found. The mean effect of STS variants revealed that the 1-minSTS had the lowest Z-score (p<0.05). Significant variations were observed between STS variants in all normalization methods for women (p<0.001). However, in men, only the difference between 5-STS and 1min-STS remained consistent across normalization methods (p<0.05). Our findings highlight the efficacy of 1min-STS in distinguishing age-related functional capacity over the other STS tests, especially in women.

Interfacing manganese-based carbonaceous nanocomposites with plasma components: insights on protein interaction, structure and opsonization.

Metal encapsulation delivers a straightforward strategy to improve miscellaneous nanoparticle properties and qualifies the resulting nanocomposite for exceptional application, including bioimaging, drug release, and theranostic development. Besides crucial applications, investigations associated with the nanocomposite impact on the biological media are highly relevant from a pharmacological viewpoint. Such studies can be conducted by exploring nanocomposite attributes and all aspects of their interaction with proteins existing in biofluids. Based on these aspects, the present work examines manganese-encapsulated carbonaceous nanocomposite (MnCQD) and their interaction with plasma proteins. On one side, the obtained nanocomposite has almost spherical shapes (≈12 nm in size), an appropriate composition and interesting optical properties for bioimaging applications. On another side, MnCQD quenches the fluorescence of two plasma proteins (BSA and HTF) following a static mechanism, confirming the formation of the MnCQD-BSA and MnCQD-HTF complexes. Although hydrophobic forces guide the stability of both formed complexes, MnCQD binds preferentially to BSA compared to HTF, with affinity constants differing by almost an order of magnitude. Furthermore, HTF and BSA underwent modifications in their secondary structure provoked due to contact with the nanocomposite, which also presented neglectable opsonization levels when exposed to appropriate biological media. These results highlight the MnCQD outstanding potential to be employed in diverse bioapplications.Communicated by Ramaswamy H. Sarma.

Efficient tyrosinase nano-inhibitor based on carbon dots behaving as a gathering of hydrophobic cores and key chemical group.

Small organic molecules have been extensively applied to achieve enzymatic inhibition. Although numerous efforts have been made to deliver efficient inhibitors, small inhibitors applications are hindered by many drawbacks. Moreover, reporters comprising nanoparticle inhibitory activity against enzymes are very scarce in the literature. In this scenario, carbon nanodots (CDs) emerge as promising candidates for efficient enzyme inhibition due to their unique properties. Here, CDs specific molecular characteristics (core composition and chemical surface groups) have been investigated to produce a more potent enzyme inhibition. Mushroom tyrosinase (mTyr) has been adopted as an enzymatic prototype. The CDs revealed a high affinity to mTyr (Ka ≈ 106 M-1), mainly through hydrophobic forces and followed by slight mTyr structural alteration. CDs competitively inhibit mTyr, with low inhibition constant (KI = 517.7 ±â€¯17.0 nM), which is up 70 fold smaller then the commercial inhibitor (kojic acid) and the starch nanoparticles previously reported. The results expose that the CDs act as a hydrophobic agglomerate with carboxyl groups on its surface, mimicking characteristics found on small molecule inhibitors (but with superior performance). All these results highlight the CD excellent potential as an efficient low toxic Tyr inhibitor, opening the prospect of using these nanoparticles in the cosmetic and food industries.

An Update on the Synthesis and Applications of Bis(Naphthoquinones): An Important Class of Molecules against Infectious Diseases and other Conditions.

Naphthoquinones are important molecules belonging to the general class of quinones, and many of these compounds have become drugs that are in the pharmaceutical market for the treatment of several diseases. A special subclass of compounds is that of the bis(naphthoquinones), which have two linked naphthoquinone units. In the last few years, several synthetic approaches toward such valuable compounds have been described, as well as their evaluation against numerous important biological targets. In this review, we provide a thorough discussion on the various synthetic methods reported for the synthesis of bis(naphthoquinone) analogues, also highlighting the biological activities of these substances.

Impact on cholinesterase-inhibition and in silico investigations of sesquiterpenoids from Amazonian Siparuna guianensis Aubl.

The plant popularly known as "negramina" (Siparuna guianensis Aubl.), member of the family Siparunaceae produces an essential oil that presents several biological activities reported in literature. Here, the essential oil was obtained by hydrodistillation from fresh leaves collected in the state of Roraima, far north of the Amazon. Chemical composition of the essential oil was characterized by gas chromatography coupled to mass spectrometry (GC-MS) and flame ionization detector (GC-FID). The sesquiterpenoid shyobunone and its derivatives were identified as major compounds in the oil (>40%). The effect of S. guianensis essential oil on the acetylcholinesterase (AChE) activity from Crassostrea rhizophorae, Litopenaeus vannamei and Electrophorus electricus was tested by spectrophotometric assays. The essential oil has been identified as an AChE inhibitor. The mechanism of inhibition was investigated as well as spectrofluorimetric interactions between the essential oil and the enzyme. 1H NMR titration and molecular docking were also investigated. The spectrophotometric results revealed that shyobunone and its derivatives strongly interact with AChE with a kind of non-competitive inhibition. Interaction studies support the results of enzyme inhibition. Molecular coupling predicted that iso-shyobunone is the strongest ligand, corroborated by fluorescence suppression and 1H NMR titration results. In conclusion, Siparuna guianensis essential oil can be a new source of shyobunone and derivatives capable to reversibly inhibit AChE showing potential neuroprotective properties to be applied in the treatment of Alzheimer's disease.

The use of biofeedback intervention in the improvement of depression levels: a randomised trial.

OBJECTIVE: To evaluate the use of biofeedback intervention in the levels of depression. The main hypothesis tested if the use of biofeedback improves depression levels compared to the control group. METHODS: A randomised clinical trial. The final sample was composed of 36 participants (18 in the experimental group, receiving 6 training, once a week, with biofeedback; and 18 in the control group, who received conventional treatment in the service).Outcome measures were assessed in two stages: pre-test and post-test. The research used the following instruments: demographic survey data, Mini International Neuropsychiatric Interview 5.0.0 and Beck Depression Inventory (BDI). The factors and variables were presented in terms of descriptive and inferential statistics. Fisher's exact test (p < 0.05) was used to verify the existence of an association between the counting variables. The multinomial logistic regression model was adopted, and the Logit link function was used, as the software RStudio version 3.6.2. RESULTS: The factors that remained in the final model were group, sex, partner, atypical antidepressant, benzodiazepines, mood stabiliser, antiepileptic and antihistamine, according to the levels of depression based on the BDI. The group that did not receive biofeedback intervention had 16 times more chances of increasing the depression levels compared to participants in the experimental group. CONCLUSION: The use of biofeedback reduces depression, thus, representing a complementary alternative for the treatment of moderate and severe depression, and dysthymia.

A new lectin from the floral capitula of Egletes viscosa (EgviL): Biochemical and biophysical characterization and cytotoxicity to human cancer cells.

Egletes viscosa is a plant with therapeutic value due to its antibacterial, antinociceptive and gastroprotective properties. This study aimed to purify, characterize, and evaluate the cytotoxicity of a lectin (EgviL) from the floral capitula of E. viscosa. The lectin was isolated from saline extract through precipitation with ammonium sulfate followed by Sephadex G-75 chromatography. The molecular mass and isoelectric point (pI) of EgviL were determined as well as its temperature and pH stability. Physical-chemical parameters of interaction between EgviL and carbohydrates were investigated by fluorescence quenching and 1H nuclear magnetic resonance (NMR). Cytotoxicity was investigated against human peripheral blood mononuclear cells (PBMCs) and neoplastic cells. EgviL (28.8 kDa, pI 5.4) showed hemagglutinating activity stable towards heating until 60 °C and at the pH range 5.0-7.0. This lectin is able to interact through hydrophobic and electrostatic bonds with galactose and glucose, respectively. EgviL reduced the viability of PBMCs only at the highest concentration tested (100 µg/mL) while was toxic to Jurkat E6-1 cells with IC50 of 24.1 µg/mL,inducing apoptosis. In summary, EgviL is a galactose/glucose-binding protein with acidic character, stable to heating and with cytotoxic effect on leukemic cells.

Pain as the fifth vital sign: nurse's practices and challenges in a neonatal intensive unit care / A dor como quinto sinal vital: práticas e desafios do enfermeiro em uma unidade de terapia

ABSTRACT BACKGROUND AND OBJECTIVES: The importance of recognizing how the nurse acts in the identification, assessment, treatment, and relief of pain since the newborn is not able to express it orally. The objective of this study was to identify the practices and challenges of the nurse in the assessment and treatment of pain in newborns of a neonatal intensive care unit of a reference hospital in the western region of the Brazilian Amazon. METHODS: A descriptive, field-based, qualitative approach was chosen. Eleven nurses participated in the study, starting with an interview, following a semi-structured script. The content analysis method was used for data analysis. RESULTS: The participants do not recognize the term "fifth vital sign" in the evaluation of pain, but they believe in the ability of the newborn to feel pain, identifying it mainly by the cry and facial expression. Among the procedures considered most painful are punctures and aspiration. Nurturing and non-nutritive sucking are among the actions most indicated to prevent and relieve pain. CONCLUSION: We suggest the implementation of protocols, standards, and routines for the assessment and quantification of pain since when not assessed, it can prolong the hospitalization time. The perception of the nurse in the identification of pain signs in a systematized manner, promotes quality and humanized care, and reduces injuries.

RESUMO JUSTIFICATIVA E OBJETIVOS: A importância de se reconhecer como o enfermeiro atua na identificação, avaliação, tratamento e alívio da dor, uma vez que o recém-nascido não é capaz de expressá-la verbalizando. O objetivo deste estudo foi identificar as práticas e desafios do enfermeiro na avaliação e tratamento da dor em recém-nascidos de uma unidade de terapia intensiva neonatal de um hospital de referência na região ocidental da Amazônia brasileira. MÉTODOS: Optou-se por uma pesquisa descritiva, de campo, com abordagem qualitativa. Participaram do estudo 11 enfermeiros, a partir de entrevista, seguindo roteiro semiestruturado. Para análise de dados utilizou-se o método análise de conteúdo. RESULTADOS: Os participantes não reconhecem o termo "quinto sinal vital" na avaliação da dor, contudo acreditam na capacidade do recém-nascido sentir dor, identificando-a, principalmente pelo choro e expressão facial. Dentre os procedimentos considerados mais dolorosos destacam-se as punções e a aspiração. Dentre as ações mais apontadas para prevenção e alívio da dor inclui-se o aninhamento e a sucção não nutritiva. CONCLUSÃO: Sugere-se a implantação de protocolos, normas e rotinas para avaliação e quantificação da dor, visto que quando não avaliada, pode prolongar o tempo de internação. A percepção do enfermeiro na identificação dos sinais álgicos de maneira sistematizada, promove um atendimento de qualidade, humanizado e redução de lesões.

Furan inhibitory activity against tyrosinase and impact on B16F10 cell toxicity.

Many skin disorders and diseases are related to tyrosinase activity, in particular, due to the vital role played by this enzyme in the melanogenic process. Although numerous natural and synthetic tyrosinase inhibitors have been published, substantial efforts have been made to understand the influence of tyrosinase inhibition on the viability of melanoma cells. Here, we assess the impact of two keto-derivatives: 2-acetyl-furan (F1), furfural-acetone (F2), and two carboxyl-derivatives: 2-furan-acrylic acid (F3), 5-methyl-2-furan-acrylic acid (F4), on the mushroom tyrosinase (mTYR) activity, by applying spectroscopic, kinetic and theoretical techniques. From an exploratory and theoretical point of view, results indicated that albeit all furans bind tightly to and inhibit mTYR very efficient, carboxyl-furan derivatives presented best inhibitory activities than keto- derivatives and performed the inhibition competitively and reversible. Moreover, we examined the influence of carboxyl derivative on the viability of melanoma cells. Results expose differential toxicity of these furan derivatives, which indicates a piece of evidence that furan inhibition activity may be related to its toxicity against B16F10 cells.

Doença de Kawasaki: a importância do seu diagnóstico em diferentes faixas etárias / Kawasaki disease: the importance of its diagnosis in different age groups

A doença de Kawasaki é uma vasculite febril aguda autolimitada, de etiologia desconhecida, com incidência predominante em crianças abaixo de 5 anos, asiáticos e no sexo masculino. É atualmente a principal causa de cardiopatia adquirida em países desenvolvidos. A ausência de complicações cardiovasculares depende do diagnóstico precoce, porém esse é essencialmente clínico, não havendo exames laboratoriais específicos. Esse trabalho visa relatar um caso da Doença de Kawasaki fora da faixa etária de maior prevalência e ressaltar a importância da anamnese e do exame físico detalhados no seu diagnóstico. (AU)

Kawasaki disease is a self-limited, acute febrile vasculitis of unknown etiology, more commonly found in Asian and male children under 5 years of age. It is currently the leading cause of acquired heart disease in developed countries. The absence of cardiovascular complications depends on the early diagnosis, but this is essentially clinical, and there is not yet a specific laboratory test for the diagnosis of this pathology. This paper portrays and analyses a case of Kawasaki disease outside the most prevalent age group and emphasizes the importance of detailed anamnesis and physical examination through which the disease may be correctly diagnosed. (AU)

Unidade de Terapia Intensiva Pediátrica: expectativas e Sentimentos dos Pais da Criança Gravemente Enferma / Pediatric Intensive Care Unit: Expectations and Feelings of parents of seriously ill children

Objetivo: Compreender as expectativas e os sentimentos dos pais durante a internação do filho gravemente enfermo na Unidade de Terapia Intensiva Pediátrica. Materiais e métodos: O estudo consiste de uma pesquisa de abordagem qualitativa com enfoque fenomenológico. As informações foram coletadas por meio de entrevista semiestruturada no período de março a abril de 2014 e foram analisadas pelo método análise de conteúdo. Participaram desse estudo 10 genitores de um hospital público no Município de Porto Velho- RO. Resultados: Os resultados apontam que os membros familiares são a base para o enfrentamento da doença para os pais que estão com seu filho internado. Os fatores religiosidade e espiritualidade também se compõem como suporte, a fé e a esperança ajudam a aliviar a dor e o sofrimento além de ser motivo de expectativas em relação à cura. Conclusão: Os sentimentos descritos pelos pais são de desespero, de impotência, de dor, medo, angústia, de muitas dúvidas quanto ao diagnóstico e prognóstico, incapacitando-os no desenvolvimento de suas atividades diárias. Ao mesmo tempo em que os genitores associam a UTI com a doença grave e a morte, suas expectativas se alicerçam na consciência de que esta unidade também é o local de recuperação e reencontro com a vida, com demonstração de confiança em quem cuida do seu filho. (AU)

Objective: To understand the expectations and feelings of parents during hospitalization of seriously ill child in the Pediatric Intensive Care Unit. Material and Methods: This was a qualitative study with phenomenological approach. The information was collected through semi-structured interviews from March to April 2014 and analyzed by the content analysis method. A total of 10 parents participated in this study in a public hospital in the city of Porto Velho-RO. Results: The results show that family members are the basis for coping with the disease for parents who are with their hospitalized children. Factors such as religiousness and spirituality were associated with support, whereas faith and hope help to relieve pain and suffering as well as drive expectations for healing. Conclusion: The feelings described by the parents were related with despair, helplessness, pain, fear, anguish, many doubts about the diagnosis and prognosis, incapacitating them to develop their daily activities. While the parents associate the ICU with serious illness and death, their expectations are rooted in the awareness that this unit is also the site of recovery and reunion with life, with demonstration of confidence in the one who takes care of their child. (AU)

Úlcera de estresse no paciente queimado / Stress ulcer in burned patients

A úlcera de estresse pode ocorrer, dentre outras situações, nas queimaduras graves (de Curling), em que a mortalidade é bastante elevada. Contribuem para a formação dessa úlcera a isquemia de mucosa, a presença do ácido e a difusão de ureia no estômago, bem como a acidose grave e a deficiência de energia diferencial na célula mucosa. Este é um relato de caso de um paciente queimado grave, etilista crônico, sem comorbidades, que desenvolveu uma úlcera duodenal perfurada no terceiro dia de internação hospitalar. Pacientes queimados apresentam redução da perfusão esplâncnica, que torna a mucosa intestinal isquêmica, seguido de lesão e hemorragia. Tal cadeia de eventos normalmente ocorre em 72 horas. Alguns estudos demonstraram que o uso profilático de bloqueadores H2 reduziu a incidência da referida úlcera para 0,9%. Outros evidenciam que os inibidores de bomba de prótons são ainda mais eficazes em aumentar e manter o pH. Preconiza-se que esses doentes devem receber 40 mg de omeprazol intervaladas de 6 horas no primeiro dia, seguidas de 20 mg por dia nos dias seguintes. Novos métodos de profilaxia contra a úlcera de Curling devem ser estudados a fim de reduzir a morbimortalidade desta doença.

Besides other medical situations, stress ulcer may occur in patients with severeburns (Curling’s ulcer) whose mortality rate is expressively high. Factors such as mucosal ischemia, the presence of acid and urea diffusion in the stomach contribute to ulceration, as well as severe acidosis and differential energy deficiency in mucosal cell. This is a case report of a severe burned patient with chronic alcoholism and no comorbidities who developed a perforated duodenal ulcer on the third day of hospitalization. Splanchnic hypoperfusion presented by burned patients leads to ischemia of the bowel mucosa resulting in injury and hemorrhage. Such chain of events usually develops in 72 hours. In some studies, the prophylactic use of H2 blockers was able to reduce the incidence of that ulcer to around 0.9%. In others, the proton-pump inhibitors are more effective in increasing and maintaining the pH level. It´s recommended that these patients should receive 40 mg of omeprazole every 6 hours during the first day and 20 mg per day from the second day on. New prophylactic methods against the Curling ulcer should be studied in order to decrease morbidity and mortality rates of this disease.

Malformações do sistema nervoso central e malformações associadas diagnosticadas pela ultrassonografia obstétrica / Central nervous system malformations and associated defects diagnosed by obstetric ultrasonography

OBJETIVO: Identificar a prevalência de malformações congênitas do sistema nervoso central (SNC) e malformações associadas diagnosticadas pela ultrassonografia obstétrica. MATERIAIS E MÉTODOS: Estudo observacional, transversal, descritivo, em instituição de referência para gestações de alto risco. RESULTADOS: Malformações congênitas do SNC estiveram presentes sem outras malformações associadas em 65,78%, com a distribuição: hidrocefalia (37,5%), mielomeningocele (15%), encefalocele (12,5%), agenesia de corpo caloso (12,5%), anencefalia (12,5%), holoprosencefalia (7,5%), Dandy-Walker (7,5%), Arnold-Chiari (5,0%), hidranencefalia (5,0%), meningocele (5,0%), cisto aracnoideo (2,5%). Malformações congênitas de outros sistemas estiveram associadas às do SNC: craniofacial (73,9%), ortopédica (65,2%), cardiovascular (34,8%), geniturinária (30,4%), gastrintestinal (30,4%), respiratória (8,7%), sindrômica (8,7), oftalmológica (4,3%). A sensibilidade ultrassonográfica no estudo de malformações fetais do SNC foi 79,4%. A taxa de falso-negativos foi 20,5%. Dentre as limitações quantificáveis destaca-se o oligodrâmnio, presente em 25% dos falso-negativos. CONCLUSÃO: A ultrassonografia obstétrica possui boa sensibilidade no rastreio de malformações fetais do SNC, em especial com o aperfeiçoamento constante e domínio na utilização de métodos especializados, como o Doppler e a ultrassonografia volumétrica (3D/4D), contribuindo para firmar-se como modalidade de escolha nesta rotina. Complementar ao método, a ressonância magnética pode vir a fornecer subsídios para uma ainda melhor assistência perinatal.

OBJECTIVE: To identify and evaluate the prevalence of congenital central nervous system (CNS) malformations and associated defects diagnosed by obstetric ultrasonography. MATERIALS AND METHODS: Observational, descriptive, cross-sectional study developed in an institution of reference for high-risk pregnancies. RESULTS: Congenital CNS malformations without other associated defects were present in 65.78% of cases, as follows: hydrocephalus (37.5%), myelomeningocele (15%), encephalocele (12.5%), corpus callosum agenesis (12.5%), anencephaly (12.5%), holoprosencephaly (7.5%), Dandy-Walker (7.5%), Arnold-Chiari (5.0%), hydranencephaly (5.0%), meningocele (5.0%), arachnoid cyst (2.5%). Congenital malformations of other systems were associated with such malformations, as follows: craniofacial (73.9%), orthopedic (65.2%), cardiovascular (34.8%), genitourinary (30.4%), gastrointestinal (30.4%), respiratory (8.7%), syndromic (8.7%), ophthalmologic (4.3%). The sonographic sensitivity in the study of CNS malformations was 79.4%. The rate of false-negative results was 20.5%. Oligohydramnios, present in 25% of false-negative studies, stands out among the quantifiable limitations. CONCLUSION: Obstetric ultrasonography presents good sensitivity in the screening for fetal CNS malformations, specially with the constant improvement and control of specialized methods such as Doppler and volumetric ultrasonography (3D/4D), contributing to consolidate its role as a modality of choice in this routine. Magnetic resonance imaging may play a supplementary role, providing information for an even better perinatal care.

Perfil antropométrico das crianças atendidas no Programa Crescimento e Desenvolvimento no Centro de Saúde nº 1 da Regional de São Sebastião / Anthropometric Profile of Children Assisted by the Growth and Development Program of Centro de Saude 1 of the Sao Sebastiao Region

Foram estudadas 271 crianças no Centro de Saúde nº 01 da Regional de Saúde de São Sebastião atendidas no Programa Crescimento e Desenvolvimento, no período de outubro de 2003 a fevereiro de 2004, com idades entre 1 e 60 meses, para avaliar seu perfil antropométrico. Essa região foi escolhida em virtude de ser considerada um área de baixo poder aquisitivo de relativa fragilidade social. A análise foi realizada por meio das medidas de peso e estatura, correlacionando-as com idade, sexo e fatores socioecônomicos como aleitamento materno, renda per capita, densidade demográfica residencial e escolaridade materna. Foram utilizadas as seguintes avaliações do estado nutricional: critério de Gomez em crianças menores de 2 anos e os escores Z (Peso/Idade, Peso/Estatura e Estatura/Idade) para todas as idades. Para a comparação estatística entre o estado nutricional e os diferentes fatores de risco foi utilizado o teste qui-quadrado. Observou-se um elevado risco populacional para desnutrição, sendo que a proporção de crianças com défict estatural grave foi maior nas crianças com idade mais elevada. Esse fato reflete o grau de cronicidade da desnutrição encontrada na população do estudo. Dentre os fatores de risco avaliados, somente o sexo masculino mostrou-se estatisticamente significativo para desnutrição. Na análise do estudo, constatou-se que o risco de desnutrição aumentou com o crescer da idade e que, apesar da prevalência de desnutridos graves ser baixa, ela foi maior que a esperada.