Psychological Intervention with Parents Improves Treatment Results and Reduces Punishment in Children with Enuresis: A Randomized Clinical Trial.

PURPOSE: This study aims to evaluate the impact of psychological intervention with parents of children with enuresis on treatment outcome. MATERIALS AND METHODS: A total of 66 children with enuresis were randomized into 2 groups. All children received urotherapy orientation and psychological counseling. Psychological intervention was performed with parents in the experimental group and not in the control group. All parents answered a questionnaire to evaluate violence against their children (Parent-Child Conflict Tactics Scale) and the Tolerance Scale. The Child Behavior Checklist was applied to evaluate behavior problems. Children responded to the Impact Scale and the Children and Youth Self-Concept Scale. Treatment results were assessed with a 14-day wet night diary. RESULTS: Mean age and gender were similar in both groups. Parent-Child Conflict Tactics Scale showed less violence after the treatment in the experimental group (p=0.007). The Tolerance Scale indicated that parents of children with enuresis were intolerant and that, after treatment, intolerance had a greater decrease in the experimental group (p <0.001). The Impact Scale showed that children suffer some impact from enuresis, and that in those in the experimental group this impact was smaller after treatment (p=0.008). No differences were seen in the Child Behavior Checklist or Children and Youth Self-Concept Scale after intervention. After treatment the percentage of dry nights had a greater improvement in the experimental group (52%, range 30% to 91%) than in the control group (10%, range 3% to 22.5%; p <0.001). Children in the experimental group had a 6.75 times greater chance of having a complete response to treatment. CONCLUSIONS: Psychological intervention with parents of children with enuresis during their treatment improved the percentage of dry nights and the impact of enuresis, while their parents started coping better with the problem and became more tolerant, reducing punishment toward their children.

Correlation between circadian rhythm related genes, type 2 diabetes, and cancer: Insights from metanalysis of transcriptomics data.

Clock genes work as an auto-regulated transcription-translational loop of circadian genes that drives the circadian rhythms in each cell and they are essential to physiological requests. Since metabolism is a dynamic process, it involves several physiological variables that circadian cycling. The clock genes alterations can affect multiple systems concomitantly, because they constitute the promoter factors for relevant metabolic pathways. Considering the intertwined structure of signaling, regulatory, and metabolic processes within a cell, we employed a genome-scale biomolecular network. Accordingly, a meta-analysis of diabetic-associated transcriptomic datasets was performed, and the core information on differentially expressed genes (DEGs) was obtained by statistical analyses. In the current study, meta-analysis was performed on type 2 diabetes, circadian rhythm-related genes, and breast, bladder, liver, pancreas, colon and rectum cancer-associated transcriptome data using the integration of gene expression profiles with genome-scale biomolecular networks in diabetes samples. First, we detected downregulated and upregulated DEGs in mouse cortex and hypothalamus samples of mice with sleep deprivation. In summary, upregulated genes active genes associated with oxidative phosphorylation, cancer and diabetes, mainly in hypothalamus specimens. In cortex, we observed mainly downregulation of immune system. DEGs were combined with 214 circadian rhythm related genes to type 2 DM and cancer samples. We observed that several common genes deregulated in both diseases. Klf10, Ntkr3, Igf1, Usp2, Ezh2 were both downregulated in type 2 DM and cancer samples, while Arntl2 and Agrp were upregulated. It seems that the changes in mRNA are contributing to the phenotypic changes in type 2 DM, resulting in phenotypic changes associated with the malignant transformation. Taking those genes to perform a survival analysis, we found only Igf1, Usp2 and Arntl2 genes associated with patient outcomes. While Igf1 and Usp2 downregulation had a negative impact, Arntl2 upregulation was associated with poor survival both in BLCA and BRCA cancer samples. Our data stimulate efforts in news studies to achieve the experimental and clinical validation about these biomolecules.

Influence of Deforestation on the Community Structure of Sand Flies (Diptera: Psychodidae) in Eastern Amazonia.

Variation in the structure of phlebotomine (sand fly) communities in forest fragments with different degrees of preservation and human occupation (peridomicile) in eastern Amazonia was studied. We identified 43 species of sand flies in our study, of which 38 occurred in both preserved forest areas and in the peridomiciles of short-term settlements, while another 28 species occurred in altered forest fragments and long-term settlements. The composition of the community at each site changed with the type of environment (forest or peridomicile), with the species Lutzomyia evandroi, L. whitmani, L. choti, L. serrana, L. triacantha, L. migonei, L. hirsuta, L. shannoni, and L. brachyphylla accounting for more than 54% of the differences among environments. The quality of the environment exerted a significant influence on the structure of phlebotomine communities, and affected their species composition, richness, and abundance.

Mortalidade por Câncer de Mama Feminino em Alagoas no Período de 2001 a 2016: Análise de Tendência e Distribuição Espacial / Female Breast Cancer Mortality in Alagoas from 2001 to 2016: Trend Analysis and Spatial Distribution / Mortalidad por Cáncer de Mama en Mujeres en Alagoas nel Periodo de 2001 a 2016: Análisis de Tendencias y Distribución Espacial

Introdução: O câncer de mama é a neoplasia que mais causa mortes na população feminina mundial e brasileira. Objetivo: Analisar o perfil epidemiológico, a tendência e a distribuição espacial da mortalidade por câncer de mama feminino em Alagoas no período de 2001 a 2016. Método: Trata-se de um estudo ecológico misto, incluindo os óbitos femininos por câncer de mama registrados em Alagoas durante esse período. Foram utilizadas as variáveis sociodemográficas (faixa etária, cor/raça, estado civil, escolaridade e local de ocorrência) e a taxa de mortalidade por faixa etária e por município do Estado. Os dados foram obtidos do Sistema de Informações sobre Mortalidade e os dados populacionais, do Instituto Brasileiro de Geografia e Estatística (IBGE). A análise de tendência utilizou o modelo de regressão por pontos de inflexão (joinpoint regression model) e a espacial, a estatística de Moran. Resultados: Houve 1.816 óbitos no período, 25,3% entre 50-59 anos, 46,3% de cor parda, 36,1% casadas, 35,5% com menos de oito anos de estudos e 67,2% de óbitos no ambiente hospitalar. As faixas etárias de 40 anos ou mais apresentaram tendências de crescimento, destacando-se 80 anos ou mais (percentual médio de variação anual: 9,2; p<0,001) com o maior crescimento. A distribuição espacial foi aleatória. Conclusão: A taxa de mortalidade por câncer de mama feminino cresceu no período de 2001 a 2016 nas faixas etárias de 40 anos ou mais no Estado e sem padrão espacial definido.

Introduction: Breast cancer is the neoplasm that causes more deaths in the female population worldwide and in Brazil. Objective: To analyze the epidemiological profile, trend and spatial distribution of female breast cancer mortality in Alagoas from 2001 to 2016. Method: Mixed ecological study, including female deaths from breast cancer recorded in Alagoas in the period. Sociodemographic variables (age, color/race, marital status, education and place of occurrence) and the specific mortality rate by age group and municipality were used. Data were obtained from the Mortality Information System and population data from the Brazilian Institute of Geography and Statistics (IBGE). The trend analysis used the Joinpoint regression model and Moran statistics for the spatial distribution. Results: 1,816 deaths in the period, 25.3% between 50-59 years, 46.3%, brown race, 36.1%, married, 35.5%, with less than 8 years of education and 67.2% of deaths within the hospital environment. The age groups of 40 years or older showed a growing trend and the highest growth, for 80 years old or more (average annual percent variation: 9.2; p<0.001). The spatial distribution was random. Conclusion: The mortality rate for female breast cancer increased in the period from 2001 to 2016 in the age group of 40 years and older in the state and without defined spatial pattern.

Introducción: El cáncer de mama es el cáncer que causa más muertes en la población femenina en todo el mundo y en Brasil. Objetivo: Analizar el perfil epidemiológico, la tendencia y la distribución espacial de la mortalidad por cáncer de mama femenino en Alagoas durante el período 2001 a 2016. Método: Este es un estudio ecológico mixto, que incluye muertes femeninas por cáncer de seno registradas en Alagoas durante el período. Se utilizaron variables sociodemográficas (grupo de edad, color/raza, estado civil, educación y lugar de ocurrencia) y tasa de mortalidad por grupo de edad y municipio del estado. Los datos se obtuvieron del Sistema de Información de Mortalidad y los datos de población del Instituto Brasileño de Geografía y Estadística (IBGE). El análisis de tendencias utilizó el modelo de regresión de punto de unión y el espacial con las estadísticas de Moran. Resultados: Hubo 1.816 muertes en el período, 25,3% entre 50-59 años, 46,3% marrón, 36,1% casados, 35,5% con menos de 8 años de educación y 67,2% de muertes en el período. Ambiente hospitalario. Los grupos de edad de 40 años y mayores mostraron una tendencia creciente, con un punto culminante de 80 años y mayores (cambio porcentual anual promedio: 9,2; p<0,001) con el mayor crecimiento. La distribución espacial fue aleatoria. Conclusión: La tasa de mortalidad por cáncer de mama femenino aumentó en el período 2001 a 2016 en el grupo de edad de 40 años y más en el estado y sin un patrón espacial definido.

Development of a Mobile Application for Acquiring Clinical and Laboratorial Skills and Abilities in Pediatric Dentistry and Orthodontics

Abstract Objective: To develop an educational mobile application as a dynamic platform provided free of charge, including several clinical and laboratory protocols for a wider range of skills and greater knowledge on the strategic axes of child dental care: Pediatric Dentistry and Orthodontics. Material and Methods: The prototype tool was structured as follows: development of clinical and laboratory contents to be addressed, software selection, layout format, inclusion of features, applicability and acceptability tests of the operational system, and indexation on the Play Store® application store (free of charge). Results: The mobile application has shown to be a tool capable of storing and providing data through various audiovisual media formats on clinical and laboratory contents of child dental care. Media resources were developed for the following themes: restorative dentistry in pediatric dentistry, radiographic techniques with pediatric patients, pulp therapy in deciduous teeth, traumatic injuries in the primary dentition, and preventive and interceptive orthodontics. The short-duration multimedia content, with different audiovisual formats, proved to be coherent with the peculiarities of each procedure, enabling to better visualize and understand the techniques. Moreover, the rewind, fast forward, and pause features were included in the mobile application, as well as the possibility of saving print screens, as well as highlighting and searching for contents of interest. Conclusion: The OdontoPed-Helpbox® demonstrated to be able to reach new strategies for the dynamic teaching-learning process, through operational efficiency. It proved to be a useful and instant tool for providing information to support clinical decision making in Dentistry.

Blue rubber-bleb nevus syndrome: report of a familial case with a dural arteriovenous fistula.

We report a case of a 45-year-old woman known to have a familial form of blue rubber-bleb nevus syndrome (BRBNS). The patient developed severe occipital headaches and bilateral retroauricular bruits. Cerebral angiography showed a large dural arteriovenous fistula in the torcular region. Central nervous system involvement in BRBNS is not often reported, and most cases of BRBNS are sporadic.

Uso Popular de Plantas Medicinais na Promoção da Saúde Animal em Assentamentos Rurais de Seropédica RJ

O emprego da fitoterapia esteve presente ao longo da história, sendo utilizada no tratamento das enfermidades que acometem o ser humano. Tal afirmativa também é válida para a saúde animal, principalmente em comunidades rurais. Este projeto objetivou resgatar o conhecimento popular sobre o uso de plantas medicinais em animais nas comunidades do Assentamento Rural Sol da Manhã e do Mutirão Eldorado, situadas no município de Seropédica. Foram realizadas visitas aos assentamentos, aplicando-se questionários sobre indicações terapêuticas e formas de utilização das espécies no tratamento de animais domésticos. Exemplares das espécies utilizadas foram identificados pelo Departamento de Botânica da Universidade Federal Rural do Rio de Janeiro (UFRRJ). No total foram entrevistadas 52 famílias, das quais 63,5% afirmaram utilizar plantas medicinais no tratamento de saúde dos seus animais. Dentre as 30 espécies medicinais citadas foram evidenciadas 12 indicações gerais, das quais três destacaram-se: anti-helmíntica (36,58%), anti-inflamatória (17,07%), e repelente (12,19%), caracterizando a importância do emprego das plantas no tratamento de doenças parasitárias, sendo a principal espécie indicada para esse uso o Chenopodium ambrosioides L. (erva-de-santa-maria) com 25% das citações. A correlação entre o conhecimento popular e as pesquisas científicas pode gerar novas intervenções terapêut

Bloqueio de leito psiquiátrico: conseqüências adversas na rede de prestaçäo de serviços / Blockade of psychiatric bed: adverse consequences in the net of installment of services

Primeiro é feito um breve histórico do movimento que se convencionou chamar de Desinstitucionalizaçao, a fim de situar contextualmente o problema em torno dos pacientes bloqueadores de leito. Depois disto é traçado um perfil clínico e social destes pacientes, fazendo-se uma comparaçao com outro grupo de pacientes psiquiátricos, com sintomatologia em atividade, estando ambos os grupos internados em um hospital psiquiátrico para pacientes agudos. Foram utilizados dois instrumentos de avaliaçao: as escalas Positive and Negative Symtoms Scale (PANSS) para avaliaçao dos sintomas psíquicos, agudos e crônicos; e a Social Beheaveour Scale (SBS), para análise do comportamento social destes pacientes. Também foi quantificado o uso de medicamentos pelos dois grupos de pacientes e convertidos para padrao de uso, com reduçao do total de medicamentos à apenas três. Isso permite constatar que no momento da chegada ao hospital ambos os grupos tinham uso semelhante da medicaçao e portanto eram pacientes agudos. Já na saída, os "bed-blockers" tem uso várias vezes menor de medicaçao, comprovando que sao pacientes sem sintomas ativos. Além disto, o nível de utilizaçao do staff e outros recursos que o hospital oferece também foi analisado. Conclui que os pacientes chamados de "bed-blockers" tem sintomatologia compatível com a Síndrome Negativa, de Crow, ingerem pouca quantidade de medicaçao, participam muito pouco das atividades hospitalares e sofrem raras intervençoes pelo staff do hospital. Com esses dados, o autor traça o perfil de uma unidade que estaria adequada a receber esses pacientes, discute algumas conseqüências da permanência destes pacientes em uma unidade de agudos, critica o conceito atual embutido no termo "bed-blocker" e propoe uma nova conceituaçao para esse termo, concluindo que os mecanismos que levam à que um paciente se torne um bloqueador de leito estao intrinsecamente ligados às características da doença e do sistema de saúde.