Innovative formulation of nystatin particulate systems in toothpaste for candidiasis treatment.

Oral candidiasis is a mycosis on the mucous membranes of the mouth but not limited to the mouth. Nystatin is one of the most frequently employed antifungal agents to treat infections and may be safely given orally as well as applied topically but its absorption through mucocutaneous membranes such as the gut and the skin is minimal. The purpose of this study is to enhance the effectiveness of nystatin using particulate system such as beads, micro- and nanoparticles of alginate incorporated into toothpaste. Those particulate systems of nystatin were prepared by extrusion/external gelation for beads and emulsification/internal gelation for micro- and nanoparticles and characterized. Small, anionic charged and monodispersed particles were successfully produced. The type of particulate system influenced all previous parameters, being microparticles the most suitable particulate system of nystatin showing the slowest release, the highest inhibitory effect of Candida albicans over a period of one year. Those results allowed the conclusion that alginate exhibits properties that enable the in vitro functionality of encapsulated nystatin and thus may provide the basis for new successful approaches for the treatment of oral antifungal infections such as oral candidiasis.

Development and evaluation of a novel topical treatment for acne with azelaic acid-loaded nanoparticles.

Azelaic acid (AzA) is used in the treatment of acne. However, side effects and low compliance have been associated with several topical treatments with AzA. Nanotechnology presents a strategy that can overcome these problems. Polymeric nanoparticles can control drug release and targeting and reduce local drug toxicity. The aim of this study was to produce and evaluate an innovative topical treatment for acne with AzA-loaded poly-DL-lactide/glycolide copolymer nanoparticles. A soft white powder of nanoparticles was prepared. The mean size of loaded nanoparticles was < 400 nm and zeta potential was negative. Spherical nanoparticles were observed by scanning electron microscopy. Encapsulation efficiency was around 80% and a strong interaction between the polymer and the drug was confirmed by differential scanning calorimetric analysis. In vitro drug release studies suggested a controlled and pulsatile release profile. System efficacy tests suggested similar results between the loaded nanoparticles and the nonencapsulated drug against the most common bacteria associated with acne. Cytotoxicity of AzA-loaded nanoparticles was concentration dependent, although not pronounced. The occluded patch test seemed to indicate that the formulation excipients were safe and thus AzA-loaded nanoparticles appear to be an efficient and safe treatment for acne.

Renal and hepatic changes in the offspring of rats that received biological insecticides during pregnancy and lactation.

Bacillus thuringiensis insecticides have been considered safe, being an alternative to the use of synthetic insecticides. However, studies have shown the effects of Bt Cry toxins on various organs, compromising their functions. The objective of this work was to test whether the administration of biological insecticides based on B. thuringiensis in pregnant rats will cause histopathological changes in the liver and kidneys, as well as in the levels of toxicity biomarkers, of their puppies in adulthood. Twenty rats, 90 days old, were used, divided into four groups: GC - Pregnant rats, GX - Pregnant rats that received XenTari®, GDi - Pregnant rats that received Dipel® and GDe - Pregnant rats that received deltamethrin. Insecticides were administered by gavage at a dosage of 1 mg/100 g/day (GX and GDi), and 2 mg/Kg/day (GDe) during pregnancy and lactation. In the animals of the groups whose matrices received the insecticides, there was a reduction in the levels of the biomarkers of toxicity alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea and creatinine, about the control group. The biological insecticides promoted histopathological changes in the liver, with the presence of portal vein, centrilobular and sinusoidal capillaries congestion, and in the kidney, presence of cortical congestion and reduction of the subcapsular space. Histochemical evaluation in the liver demonstrated a significant reduction in glycogen in the groups that received insecticides when compared to the control group, whereas for collagen fibers in both the liver and the kidneys, no differences were observed between the experimental groups. The morphometry of the liver revealed a significant reduction in the lobular parenchyma and an increase in the non-lobular parenchyma, and in the kidney, there was a reduction in the diameter and volume of the glomerulus and Bowman's capsule of the animals whose matrices received both biological and synthetic insecticides. Thus, it is concluded that the biological insecticides XenTari® and Dipel® in sublethal doses in pregnant rats promote changes in the liver and kidney of the offspring similar to the insecticide deltamethrin, which extend into adulthood.

Effect of melatonin on gonad and thyroid development of offspring of hypothyroid pregnant rats.

We investigated the effects of melatonin on rats with induced hypothyroidism during gestation as well as its effect on the development of the gonads of their offspring. Fifteen pregnant rats were divided into three groups: GC, rats without induced hypothyroidism; GH, rats with induced hypothyroidism; GHM, rats with induced hypothyroidism plus melatonin. Hypothyroidism was induced by oral administration of 6-propyl-2-thiouracil and melatonin was applied subcutaneously. Treatments were performed during gestation and lactation. For the matrices, we evaluated the number of pups, body weight gain, ovarian weight, thyroid weight, organosomatic index, thyroid stimulating hormone (TSH) dose and thyroid morphometry. For the pups, weight gain, TSH, weight, morphometry of the gonads and organosomatic index were analyzed, as well as the cell proliferation index. TSH was elevated only in the matrices of GH animals. Melatonin prevented reduction of ovarian and thyroid weight, number of pups, follicular diameter and thyroid epithelial proportion of the matrices with hypothyroidism. The offspring of rats of the GH group exhibited less body weight gain, gonad and thyroid weight, and gonad cell proliferation index compared to the offspring born of rats of the GC and GHM groups. Melatonin prevented the effects of maternal hypothyroidism on the offspring of rats.

Interaction with human plasminogen system turns on proteolytic activity in Streptococcus agalactiae and enhances its virulence in a mouse model.

Interactions of several microbial pathogens with the plasminogen system increase their invasive potential. In this study, we show that Streptococcus agalactiae binds human plasminogen which can be subsequently activated to plasmin, thus generating a proteolytic bacterium. S. agalactiae binds plasminogen via the direct pathway, using plasminogen receptors, and via the indirect pathway through fibrinogen receptors. The glyceraldehyde-3-phosphate dehydrogenase is one of the S. agalactiae proteins that bind plasminogen. Presence of exogenous activators such as uPA and tPA are required to activate bound plasminogen. Results from competitive inhibition assays indicate that binding is partially mediated through the lysine binding sites of plasminogen. Following plasminogen binding and activation, S. agalactiae is able to degrade in vitro fibronectin, one of the host extracellular matrix proteins. Moreover, incubation of S. agalactiae with either plasminogen alone, or plasminogen plus fibrinogen, in the presence of tPA enhanced its virulence in C57BL/6 mice, suggesting that acquisition of plasmin-like activity by the bacteria increase their invasiveness.

Effect of fortification of drinking water with iron plus ascorbic acid or with ascorbic acid alone on hemoglobin values and anthropometric indicators in preschool children in day-care centers in Southeast Brazil.

BACKGROUND: Iron-deficiency anemia currently is the most frequently occurring nutritional disorder world-wide. Previous Brazilian studies have demonstrated that drinking water fortified with iron and ascorbic acid is an adequate vehicle for improving the iron supply for children frequenting day-care centers. OBJECTIVE: The objective of this study was to clarify the role of ascorbic acid as a vehicle for improving iron intake in children in day-care centers in Brazil. METHODS: A six-month study was conducted on 150 children frequenting six day-care centers divided into two groups of three day-care centers by drawing lots: the iron-C group (3 day-care centers, n = 74), which used water fortified with 10 mg elemental iron and 100 mg ascorbic acid per liter, and the comparison group (3 day-care centers, n = 76), which used water containing only 100 mg ascorbic acid per liter. Anthropometric measurements and determinations of capillary hemoglobin were performed at the beginning of the study and after six months of intervention. The food offered at the day-care centers was also analyzed. RESULTS: The food offered at the day-care center was found to be deficient in ascorbic acid, poor in heme iron, and adequate in non-heme iron. Supplementation with fortified drinking water resulted in a decrease in the prevalence of anemia and an increase in mean hemoglobin levels associated with height gain in both groups. CONCLUSIONS: Fortification of drinking water with iron has previously demonstrated effectiveness in increasing iron supplies. This simple strategy was confirmed in the present study. The present study also demonstrated that for populations receiving an abundant supply of non-heme iron, it is possible to control anemia in a simple, safe, and inexpensive manner by adding ascorbic acid to drinking water.

Histomorphometric and immunohistochemical evaluation of the frontal cerebral cortex in diabetic rats after treatment with melatonin / Avaliação histomorfométrica e imuno-histoquímica do córtex cerebral frontal em ratos diabéticos após o tratamento com melatonina

The central nervous system is vulnerable to complications caused by diabetes. These complications lead to increased oxidative stress in the brain, resulting in damage to the cerebral cortex, among other regions. Insulin and hypoglycemic agents are still the most widely used treatments. However, current research with an experimental model of diabetes suggests the use of antioxidants, such as melatonin. Thus, we tested the hypothesis that exogenous melatonin may decrease or prevent the effects of diabetes in the frontal cortex of the rat brain. Fifty albino rats were allocated into five groups: GC = rats without diabetes induction, GD = diabetic rats induced by streptozotocin, GDM = streptozotocin-induced and melatonin-treated diabetic rats, GDI = diabetic rats induced by streptozotocin and treated with insulin, GDMI = diabetic rats induced by streptozotocin and treated with melatonin and insulin simultaneously. Diabetes was induced by intraperitoneal administration of streptozotocin (60mg/kg). Insulin (5U/day) was administered subcutaneously and melatonin (10mg/kg) by drinking water; both treatments last days after. We analyzed animals' weight, the cytokines IL-6 and TNF-α, apoptosis, glycogen, and did morphometry and histopathology of the frontal cortex were analyzed. The results showed that the cerebral cortex of the diabetic animals presented axonal degeneration, reduced number of neurons in the cortex, reduced glycogen, increased IL-6 and TNF-α expression, high apoptotic index, and reduced animal weight and the brain. Treatment with melatonin associated or not with insulin prevented such effects. Thus, we conclude that melatonin associated with insulin may be an alternative for avoiding the impact of diabetes in the brain's frontal cortex.(AU)

O sistema nervoso central é vulnerável a complicações originadas pelo diabetes estresse oxidativo no cérebro e resultando em lesões no córtex cerebral, dentre outras regiões. A insulina e hipoglicemiantes ainda são os tratamentos mais utilizados, entretanto, pesquisas atuais com modelo experimental do diabetes sugerem a utilização de antioxidantes como, por exemplo, a melatonina. Assim, testamos a hipótese de que a melatonina exógena pode diminuir ou prevenir os efeitos do diabetes no córtex frontal do cérebro de ratos. Foram utilizados 50 ratos albinos, divididos em 5 grupos: GC = ratos sem indução ao diabetes, GD = ratos induzidos ao diabetes pela estreptozotocina, GDM = ratos induzidos ao diabetes pela estreptozotocina e tratados com melatonina, GDI = ratos induzidos ao diabetes pela estreptozotocina e tratados com insulina, GDMI = ratos induzidos ao diabetes pela estreptozotocina e tratados com melatonina e insulina simultaneamente. O diabetes foi induzido pela administração intraperitoneal de estreptozotocina (60mg/kg). A insulina (5U/dia) foi administrada por via subcutânea e a melatonina (10mg/kg) pela água de beber. Ambos tratamentos foram realizados durante 30 dias após a indução. Foram analisados o peso dos animais, do cerebro, as citocinas IL-6 e TNF-α, apoptose, glicogênio, além da morfometria e histopatologia do córtex frontal. Os resultados mostraram que o córtex cerebral dos animais diabéticos apresentou degeneração axonal, redução do número de neurônios no córtex, redução do glicogênio, aumento da expressão do IL-6 e TNF-α, elevação do índice apoptótico, além da redução do peso dos animais e do cérebro. O tratamento com melatonina associada ou não a insulina preveniu tais efeitos. Assim, concluímos que a melatonina associada ou não a insulina pode ser uma alternativa na prevenção dos efeitos do diabetes no córtex frontal do cérebro.(AU)

Follow up of infection of chacma baboons with inoculum containing A and non-A genotypes of hepatitis B virus.

AIM: To determine whether one genotype (A or non-A genotypes of HBV) predominated over the other during the course of HBV infection. METHODS: Four baboons were inoculated with HBV. DNA was extracted from serum obtained at monthly intervals post-inoculation for 52 weeks and HBV DNA was amplified using primers specific for the core region containing an insert characteristic of genotype A (nt 2 354-2 359, numbering from the EcoRI site). The amplicons were cloned into PCR-Script(TM) and a minimum of 15 clones per time point were sequenced in both directions. RESULTS: Both genotypes persisted for the entire follow-up period of 52 weeks. Genotype non-A predominated in two baboons and genotype A in one baboon. Neither genotype predominated in the fourth baboon, as shown at a 5 % level of testing. CONCLUSION: No conclusions concerning the dominance of either genotype or the natural progression or replication rates of HBV could be drawn because the pattern of the genotypes found may have been caused by sampling fluctuations at the time of DNA extraction and cloning as a result of the very low viral loads in the baboon sera.

O poder na relação enfermeiro-paciente: revisão integrativa / The power in the nurse-patient relationship: integrative review / El poder en la relación enfermero-paciente: revisión integradora

Visando descrever e analisar a produção de conhecimento acerca do poder nas relações de cuidado de enfermagem a pacientes internados, realizou-se busca em sete das principais bases de dados eletrônicas em saúde para embasar revisão integrativa de literatura. Conforme os critérios estabelecidos, 10 artigos publicados desde 2000 até setembro de 2015 foram selecionados. A análise mostrou que o conhecimento científico e as normas e rotinas hospitalares são instrumentos de exercício de poder que podem violar a identidade da pessoa ao transformá-la em paciente. Entretanto, alguns estudos revelaram que profissionais de enfermagem nem sempre se dão conta de que exercem poder sobre pacientes, argumentando que agem conforme as necessidades de cuidado diagnosticadas, prescrevendo intervenções que, embora resolutivas, nem sempre são pactuadas com os enfermos. Em suma, esses profissionais precisam refletir sobre seus processos de trabalho, concentrando-se no cuidado e na autonomia do paciente.

Abstract An integrative literature review was performed by searching seven of the main electronic health databases order to describe and analyse the production of knowledge about the power in nursing care relationships to hospitalised patients. According to the established criteria, 10 articles were selected from the year 2000 to September 2015. The analysis of these data evidenced that the scientific knowledge and the hospital routines and norms are instruments of exercise of power that end up violating the identity of the person who is transformed into a patient. However, the studies revealed that nursing professionals do not always perceive themselves as exercising power over patients, arguing that they act according to the needs diagnosed care, prescribing interventions, not always agreed with the patients, but resolutive. In short, nursing professionals need to reflect on their work processes to perceive themselves as care professionals and to guarantee the space for autonomy.

Resumen Con el propósito de describir y analizar la producción del conocimiento acerca del poder en las relaciones de cuidado de enfermería con pacientes internados, se realizó una revisión integrativa de la literatura mediante una búsqueda en siete de las principales bases de datos electrónicos en salud. Conforme a los criterios establecidos se seleccionaron 10 artículos publicados desde el año 2000 hasta septiembre de 2015. El análisis de éstos evidenció que el conocimiento científico y las normas y rutinas hospitalarias son instrumentos de ejercicio de poder que acaban violando la identidad de la persona transformándola en paciente. Sin embargo, los estudios revelaron que los profesionales de enfermería no siempre se perciben ejerciendo poder sobre los pacientes, argumentando que actúan conforme a las necesidades de cuidado diagnosticadas, prescribiendo intervenciones, no siempre pactadas con ellos, sino resolutivas. En suma, los profesionales de enfermería necesitan reflexionar sobre sus procesos de trabajo para percibirse como profesionales de cuidado y garantizar el espacio para la autonomía.

The patient and the relation between power-knowledge and care by nursing professionals / El paciente y las relaciones de poder-saber cuidar de los profissionales de enfermería / O paciente e as relações de poder-saber cuidar dos profissionais de enfermagem

This is a study whose objective was to analyze, in the discourse of hospitalized patients, how the power of knowledge is revealed in Nursing care relations. It was developed in the qualitative perspective, having as theoretical reference the concept of power issued by Michel Foucault. The data were collected between August and December 2015 and the participants were 16 patients hospitalized in the medical and surgical clinics of a university hospital, who had the speech recorded through a semi-structured interview, after approval of the ethics committee under Opinion No. 1189934. In order to analyze the data we used the system of differentiations developed by Foucault. The results showed that the professionals exert power by the highly specialized professional knowledge and that they know what they do, so they send and control the accomplishment of the care, leading the patient to submission. It concludes that the exercise of the power to care must be based on the observance of ethical and bioethical principles.

Estudio cuyo objetivo fue analizar, en el discurso de pacientes internados, como el poder del saber se revela en las relaciones de cuidado de Enfermería. Fue desarrollado desde una perspectiva cualitativa, teniendo como referencial teórico el concepto de poder emitido por Michel Foucault. El muestreo de los datos ocurrió entre agosto y diciembre de 2015 y los participantes fueron 16 pacientes internados en las clínicas médica y quirúrgica de un hospital universitario y sus discursos grabados mediante una entrevista semiestructurada, después del estudio haber sido aprobado por el comité de ética con el Parecer nº 1189934. Para analizar los datos se utilizó el sistema de diferenciaciones desarrollado por Foucault. Los resultados mostraron que los profesionales ejercen poder por el saber profesional altamente especializado y como ellos saben lo que hacen, mandan y controlan la realización de los cuidados, sometiendo al paciente. Se concluye que el ejercicio de poder del cuidar debe ser marcado por la observación de los principios éticos y bioéticos.

Estudo cujo objetivo foi analisar, no discurso de pacientes internados, como o poder do saber se revela nas relações de cuidado de Enfermagem. Foi desenvolvido na perspectiva qualitativa, tendo como referencial teórico o conceito de poder emitido por Michel Foucault. A coleta dos dados se deu entre agosto e dezembro de 2015 e os participantes foram 16 pacientes internados nas clínicas médica e cirúrgica de um hospital universitário, os quais tiveram o discurso gravado mediante entrevista semiestruturada, após aprovação do comitê de ética sob Parecer nº 1189934. Para analisar os dados se utilizou o sistema de diferenciações desenvolvido por Foucault. Os resultados mostraram que os profissionais exercem poder pelo saber profissional altamente especializado e que eles sabem o que fazem, por isso mandam e controlam a realização dos cuidados, conduzindo o paciente à submissão. Conclui que o exercício do poder de cuidar deve ser balizado pela observância dos princípios éticos e bioéticos.

Streptococcus agalactiae GAPDH is a virulence-associated immunomodulatory protein.

Certain extracellular proteins produced by several pathogenic microorganisms interfere with the host immune system facilitating microbial colonization and were thus designated virulence-associated immunomodulatory proteins. In this study, a protein with B lymphocyte stimulatory activity was isolated from culture supernatants of Streptococcus agalactiae strain NEM316. This protein, with an apparent molecular mass of 45 kDa, was identified as GAPDH by N-terminal amino acid sequencing. The gapC gene was cloned and expressed in Escherichia coli for the production of a recombinant histidyl-tagged protein. The recombinant GAPDH (rGAPDH), purified in an enzymatically active form, induced in vitro an up-regulation of CD69 expression on B cells from normal and BCR transgenic mice. In addition, rGAPDH induced an increase in the numbers of total, but not of rGAPDH-specific, splenic Ig-secreting cells in C57BL/6 mice treated i.p. with this protein. These in vitro- and in vivo-elicited B cell responses suggest that the B cell stimulatory effect of rGAPDH is independent of BCR specificity. A S. agalactiae strain overexpressing GAPDH showed increased virulence as compared with the wild-type strain in C57BL/6 mice. This virulence was markedly reduced in IL-10-deficient and anti-rGAPDH antiserum-treated mice. These results suggest that IL-10 production, which was detected at higher concentrations in the serum of rGAPDH-treated mice, is important in determining the successfulness of the host colonization by S. agalactiae and they highlight the direct role of GAPDH in this process. Taken together, our data demonstrate that S. agalactiae GAPDH is a virulence-associated immunomodulatory protein.

The SrtA Sortase of Streptococcus agalactiae is required for cell wall anchoring of proteins containing the LPXTG motif, for adhesion to epithelial cells, and for colonization of the mouse intestine.

Streptococcus agalactiae (group B streptococcus [GBS]) is the leading cause of neonatal pneumonia, sepsis, and meningitis. An in silico genome analysis indicated that GBS strain NEM316 encodes 35 proteins containing an LPXTG motif which are thought to be covalently linked to the peptidoglycan by an enzyme called sortase. The role of these cell wall-anchored proteins in GBS pathogenesis was evaluated on a global level by inactivating the srtA gene. This gene encodes the major sortase SrtA that anchors most of the LPXTG-containing proteins. We chose the C5a peptidase (ScpB) and Alp2, an abundant immunogenic protein, as prototypical LPXTG-containing proteins. As expected, the SrtA knockout mutant was unable to anchor the C5a peptidase (ScpB) and Alp2 to the cell wall. Complementation with plasmid-borne srtA inserted into the chromosome restored the correct surface localization of both ScpB and Alp2. Interestingly, the SrtA mutant was impaired for binding to the major extracellular matrix components fibronectin and fibrinogen and displayed a significant reduction in adherence to human (A549, HeLa, and Caco-2) and murine (L2) epithelial cells compared to the parental wild-type strain. Surprisingly, the inactivation of srtA had no effect on the virulence of the type III strain of GBS in a neonatal rat model (measured by the 50% lethal dose and lung colonization) but strongly impaired the capacity of the strain to colonize the intestines of gnotobiotic mice in a competition assay. These results demonstrate that LPXTG-containing proteins are involved in cell adhesion and GBS persistence in vivo.

Attenuated virulence of Streptococcus agalactiae deficient in D-alanyl-lipoteichoic acid is due to an increased susceptibility to defensins and phagocytic cells.

D-alanylation of lipoteichoic acid (LTA), allows Gram-positive bacteria to modulate their surface charge, regulate ligand binding and control the electromechanical properties of the cell wall. In this study, the role of D-alanyl LTA in the virulence of the extracellular pathogen Streptococcus agalactiae was investigated. We demonstrate that a DltA- isogenic mutant displays an increased susceptibility to host defence peptides such as human defensins and animal-derived cationic peptides. Accordingly, the mutant strain is more susceptible to killing by mice bone marrow-derived macrophages and human neutrophils than the wild-type strain. In addition, the virulence of the DltA- mutant is severely impaired in mouse and neonatal rat models. This mutant was eliminated more rapidly than the wild-type strain from the lung of three-week-old mice inoculated intranasally and, consequently, is unable to induce a pneumonia. Finally, after intravenous injection of three-week-old mice, the survival of the DltA- mutant is markedly reduced in the blood in comparison to that of the wild-type strain. We hypothesize that the decreased virulence of the DltA- mutant is a consequence of its increased susceptibility to cationic antimicrobial peptides and to killing by phagocytes. These results demonstrate that the D-alanylation of LTA contributes to the virulence of S. agalactiae.

Avaliação da utilização de medicamentos em pacientes idosos por meio de conceitos de farmacoepidemiologia e farmacovigilância / Evaluation of using medicines in elderly subjects through the concepts of pharmacovigilance and pharmacoepidemiology

O Conselho Federal de Farmácia tem definido, no Brasil, resoluções que proporcionam um seguimento terapêutico individualizado aos pacientes, avaliando os efeitos adversos, crônicos e agudos, bem como os riscos de um tratamento farmacológico na população em geral, ou em grupos restritos de pacientes. Estudos recentes demonstraram que a prevalência de idosos no Brasil situa-se em torno de 12 por cento. Neste estudo foram avaliados 35 voluntários í 33 mulheres e 2 homens í por meio de entrevistas sobre os medicamentos utilizados e possíveis problemas relacionados aos medicamentos. Entre os principais medicamentos prescritos para uso crônico, destacam-se: anti-hipertensivos, estrógenos e progesteronas, antidepressivos e ansiolíticos. Dos 35 pacientes avaliados, 24 fazem uso de politerapia, nove utilizam monoterapia e um paciente não utiliza medicamento de forma crônica. Este trabalho além de avaliar a utilização de medicamentos nessa população específica, também buscou identificar interações inadequadas e prestar informações sobre o uso adequado de fármacos.

Obesidade infanto-juvenil: uma proposta de classificação clínica / Infant-juvenile obesity: proposal for a clinical classification

Objetivo: propor uma classificação de obesidade infanto-juvenil que sintetize os conhecimentos atuais em relação aos aspectos etiológicos e aos fatores de complicação. Fontes pesquisadas:a proposta de classificação baseou-se nos dados de literatura internacional, constantes das bases MEDLINE, LILACS e SCielo. Os conhecimenos foram organizados de acordo com a experiência de atendimento clínico do Centro de Estudos em Saúde e Nutrição infanto-juvenil...

Monte Alto sem anemia, primeira fase: avaliação nutricional das crianças pré-escolares / The city of Monte Alto: nutritional status in preschool children

Objetivos: Com a finalidade de preparar um programa municipal de intervenção nutricional, foi realizado levantamento das condições nutricionais das crianças intitucionalizadas nas 9 creches da cidade de Monte Alto, SP. Métodos: Em estudo transversal, foram avaliadas 503 crianças com idades entre 12 e 83,9 meses, no período entre 1º e 31 de agosto de 2002. De cada criança foram obtidos dados pessoais, peso, estatura e colhida amostra de sangue para dosagem de hemoglobina capilar. Resultados: A prevalência global de anemia foi de 14,5 por cento e a média de hemoglobina de 11,8 g/dl. As prevalências de déficit (escore z < -2) para os indicadores peso para idade, estatura para idade e peso para estatura foram de respectivamente 2,6 por cento, 1,6 por cento e 4 por cento. A prevalência de obesidade (escore z de peso para estatura > 2) foi de 4,2 por cento. Conclusões: Observaram-se prevalências relativamente baixas entre os distúrbios nutricionais estudados, sendo que a anemia se evidenciou o mais relevante. A obesidade mostrou-se discretamente mais prevalente que a subnutrição, indicando o provável início de um processo de transição nutricional.

Fenomenologia do existir do diabético / Existentialism of the diabetic patient

O presente estudo propôs-se a penetrar e compreender as percepçöes e significados das experiências vividas por diabéticos a partir de seus próprios discursos sobre o significado destas experiências. Para alcançar tal propósito foi utilizada a Fenomenologia Ontológico-Hermenêutica de Marin Heidegger. Foram ouvidos dezenove discursos de pessoas diabéticas proferidos a partir da questäo orientadora: o que significa ser diabético? Esses discursos, uma vez submetidos a análise e hermenêutica, desvelaram que para esses diabéticos, ser diabético significa vivenciar uma profunda transformaçäo em seu mundo, com experiência de possibilidade de perda ou perda definitiva de partes do corpo e dos sentidos, convivência com limitaçöes e situaçöes de controle e disciplina, transformaçäo do mundo de relaçöes, um estreitamento da perspectiva de futuro e convivência com a idéia da morte que começa a fazer parte da vida cotidiana.