Domestic violence in pregnancy: prevalence and characteristics of the pregnant woman.

AIMS AND OBJECTIVES: To determine the prevalence of domestic violence (physical, psychological or sexual) during pregnancy and to characterise these women. BACKGROUND: Pregnant women are not immune to domestic violence and therefore may be subject to any form of physical, psychological or sexual violence by partners. Health professionals' knowledge and awareness are important in the identification and intervention of pregnant women who experience domestic violence. METHODS: Quantitative, descriptive, correlational study, using a nonprobabilistic convenience sample consisting of a total of 852 postpartum women, of whom 370 were experiencing domestic violence according to the criteria adopted through the modified scale of prevalence, applied between February-June 2012 in two Portuguese public health institutions. Authorisation was given by the Ethics Committees/Administration Councils of both institutions involved and the National Committee of Data Protection. RESULTS: The prevalence of DV during pregnancy was 43·4% (physical violence - 21·9%; psychological violence - 43·2%; and sexual violence - 19·6%). These women had the following profile: immigrant (OR = 5·70; IC95% 3·32-9·78), non-Caucasian (OR = 6·27; IC95% 3·76-10·46), single/divorced/widowed (OR = 2·28; IC95% 1·70-3·05), academic qualifications up to year 9 (OR = 4·94; IC95% 3·31-7·37); between 10-12 years of schooling (OR = 2·36; IC95% 1·70-3·29); unemployed (OR = 2·01; IC95% 1·50-2·69); and with a monthly income <1000 euros (OR = 1·90; IC95% 1·44-2·50). Through logistic regression, the following protective factors have been identified: nationality (Portuguese), race (Caucasian) and place of residence (city). CONCLUSIONS: Almost half of the sample had experienced some form of domestic violence. This is associated with certain sociodemographic factors identified in the study. Psychological violence was the most prevalent during pregnancy. RELEVANCE TO CLINICAL PRACTICE: Knowledge of the prevalence and characteristics of pregnant women who experience domestic violence is of paramount importance in planning appropriate strategies for their needs during pregnancy. Results indicate the need for nurses to intervene when warning signs of domestic violence against pregnant women are detected.

From juvenile parkinsonism to encephalitis lethargica, a new phenotype of post-streptococcal disorders: case report.

We report the case of a 16-year-old boy presented with a mild akinetic-rigid parkinsonism shortly after a post-streptococcal infection. After stopping corticoids, he had a rapid neurological deterioration to a fatal encephalitis lethargica-like syndrome. Serum analysis demonstrated consistently elevated anti-streptolysin-O. This case illustrates a new severe phenotype in the spectrum of the post-streptococcal disorders. This etiology should be considered in the differential diagnosis of a movement disorder with a rapid detrimental evolution.

IgE-mediated hypersensitivity after ibuprofen administration.

Although many immunoglobulin-related drug sensitivities have been described, there is a paucity of reports regarding IgE-related drug sensitivities. Here we describe a case of a patient who demonstrated IgE-mediated sensitivity to ibuprofen.

CFTR, PRSS1 and SPINK1 mutations in the development of pancreatitis in Brazilian patients.

CONTEXT: Mutations in cystic fibrosis transmembrane conductance regulator (CFTR), in cationic trypsinogen (PRSS1) and in serine protease inhibitor Kazal type 1 (SPINK1) genes have been associated with chronic pancreatitis (alcohol related, idiopathic and hereditary). However, the inheritance pattern is still not clear. PATIENTS: Eighty-two unrelated Brazilian patients with chronic pancreatitis (alcohol-related disease in 64, idiopathic disease in 16, and hereditary disease in 2). Two hundred unrelated individuals with an ethnic distribution comparable to the patients were studied as controls. MAIN OUTCOME MEASURE: Detection of mutations in CFTR, PRSS1, and SPINK1 genes. RESULTS: Mutations in the CFTR gene were found in 8 patients (9.8%) with chronic pancreatitis, 5 of them with idiopathic disease. Interestingly, the only clinical symptom in a male patient in the alcoholic group, who was a compound heterozygote (DeltaF508/R170C) for two CFTR mutations, was pancreatitis without infertility or pulmonary involvement. In the PRSS1 gene, the E79K change in exon 3 was found in one patient (1.2%) with alcohol-related chronic pancreatitis. Four different alterations were identified in the SPINK1 gene. CONCLUSIONS: Mutations in the CFTR gene represent the major cause of idiopathic chronic pancreatitis in Brazilian patients. No mutation was found in the PRSS1 gene among our patients suggesting further genetic heterogeneity for hereditary and idiopathic chronic pancreatitis. Interestingly, the most frequent SPINK1 N34S mutation was not present in patients or controls. Moreover, the -253C allele for the SPINK1 gene was significantly more frequent in patients than controls (P=0.004), suggesting that it might represent a risk factor for the development of pancreatitis in our population.

Unspliced precursors of NMD-sensitive ß-globin transcripts exhibit decreased steady-state levels in erythroid cells.

Nonsense-mediated mRNA decay (NMD) is a quality control mechanism that detects and rapidly degrades mRNAs carrying premature translation-termination codons (PTCs). Mammalian NMD depends on both splicing and translation, and requires recognition of the premature stop codon by the cytoplasmic ribosomes. Surprisingly, some published data have suggested that nonsense codons may also affect the nuclear metabolism of the nonsense-mutated transcripts. To determine if nonsense codons could influence nuclear events, we have directly assessed the steady-state levels of the unspliced transcripts of wild-type and PTC-containing human ß-globin genes stably transfected in mouse erythroleukemia (MEL) cells, after erythroid differentiation induction, or in HeLa cells. Our analyses by ribonuclease protection assays and reverse transcription-coupled quantitative PCR show that ß-globin pre-mRNAs carrying NMD-competent PTCs, but not those containing a NMD-resistant PTC, exhibit a significant decrease in their steady-state levels relatively to the wild-type or to a missense-mutated ß-globin pre-mRNA. On the contrary, in HeLa cells, human ß-globin pre-mRNAs carrying NMD-competent PTCs accumulate at normal levels. Functional analyses of these pre-mRNAs in MEL cells demonstrate that their low steady-state levels do not reflect significantly lower pre-mRNA stabilities when compared to the normal control. Furthermore, our results also provide evidence that the relative splicing efficiencies of intron 1 and 2 are unaffected. This set of data highlights potential nuclear pathways that might be promoter- and/or cell line-specific, which recognize the NMD-sensitive transcripts as abnormal. These specialized nuclear pathway(s) may be superimposed on the general NMD mechanism.

Global and cardiovascular mortality and risk factors in patients under hemodialysis treatment.

BACKGROUND: There is a high global and cardiovascular mortality rate among patients who need hemodialysis. OBJECTIVE: To assess global and cardiovascular mortality and to identify the risk factors in patients who undergo hemodialysis. METHODS: Observational, prospective study. A total of 334 patients were studied within three years. PRIMARY OUTCOMES: global and cardiovascular mortality. Survival was assessed through Kaplan-Meier method, and the risk variables were identified by means of bivariate and multivariate Cox regression. RESULTS: A total of 189 men (56.6%), aging 48.8 +/- 14.2, majority non-white (295, 88.3%) and who did finished the elementary school (211, 63.2%). Global mortality rate was 21.6%, with a 50% rate of 146-month survival; cardiovascular mortality rate was 41.7% (30/72), with a 75% rate of 141-month survival. In the bivariate analysis, the relative risk (RR) for non-cardiovascular and cardiovascular death increased when age > or =60 years old was Hb < or =9.0 g/dl and fast glycemia > or =126 mg/dl. Only non-cardiovascular death with low school grade and widow, Hb<11.0 g/dl, Ht<33.0%, fast glycemia > or =100 mg/dl, Ca product x P<42 and creatinine > or =9.2 mg/dl decreased with blood pressure (BP) > or =140/90 mmHg (before hemodialysis session) and Ht>36%; Obit due only to cardiovascular factors increased with creatinine > or =9.4 mg/dl. In the multivariate analysis, non-cardiovascular and cardiovascular RR increased with age > or =60 years old and Hb<9 g/dl; cardiovascular death RR increased with glycemia > or =126 mg/dl, and non-cardiovascular death RR increased with urea removal rate in hemodialysis (Kt/V) <1,2. CONCLUSION: Global and cardiovascular mortality of patients who need hemodialysis is high. Independent risk factors for non cardiovascular and cardiovascular causes of death were age >60 years old and Hb<9 g/dl, for cardiovascular cause of death only, was fasting blood glucose > or =126 mg/dL, and for non-cardiovascular cause of death, Kt/V<1,2.

Probable acute disseminated encephalomyelitis due to Haemophilus influenzae meningitis.

We report the case of a 17-year-old male on long-term steroid therapy for minimal lesion glomerulopathy who, after an upper respiratory infection, presented with Haemophilus influenzae type b meningitis. Twenty-four hours later he developed depression of consciousness which progressed to coma and left hemiparesis. Brain magnetic resonance imaging (MRI) revealed multiple lesions (hyperintense on T2 and slightly hypointense on Tl) involving mainly white matter suggestive of inflammation. MRI features were compatible with acute disseminated encephalomyelitis (ADEM), although a differential diagnosis included cerebritis or vasculitis, secondary to bacterial meningitis. The patient was treated with high-dose steroids which resulted in a gradual improvement followed by complete clinical recovery. We propose a diagnosis of ADEM was the best diagnosis because of the radiological features and response to steroids. The occurrence of ADEM associated with acute meningitis, however rare, represents an important diagnostic challenge for the clinician.

[Reverse crossed cerebellar diaschisis]. / Diaschisis cerebelosa cruzada reversa.

Cerebral Magnetic Resonance imaging in acute postictal period is performed to exclude structural processes that can be responsible for the epileptic activity. Sometimes, the findings are the result of the epileptic activity, and not the cause reflecting the pathophysiologic changes during epileptic activity. In this paper we describe a patient with status epilepticus who has developed hemicerebellar involvement contralateral to a frontal epileptogenic focus. This phenomenon of Reverse Crossed Cerebellar Diaschisis is rare and has been describe only in Single Photon Emission Computed Tomography (SPECT).

[Wallerian degeneration after stroke: a new prognostic factor?]. / Degenerescência Walleriana pós-enfarte: um novo factor prognóstico?

Wallerian degeneration (WD) after ischemic stroke has been associated to persistent motor impairment, but signal intensity changes on conventional magnetic resonance imaging (MRI) are generally not detected until four weeks after the event. We report a 54 year old male patient, referred to our hospital for sudden-onset left hemiparesis. Cerebral CT showed right fronto-parietal infarct (middle cerebral artery stroke). We performed two CT control, which revealed no haemorrhagic transformation. MRI, obtained 13 days after the onset, demonstrated the infarct, mainly subcortical, extending throughout fronto-temporo-parietal areas and restricted diffusion in the ipsilateral corticospinal tract. In conclusion, WD is apparent on diffusion-weighted imaging within two weeks of stroke, allowing a better prognostic evaluation of recovery. The abnormal signal should not be misinterpreted as new ischaemic lesions.

Mortalidade global e cardiovascular e fatores de risco de pacientes em hemodiálise / Mortalidad global y cardiovascular y factores de riesgo de pacientes en hemodiálisis / Global and cardiovascular mortality and risk factors in patients under hemodialysis treatment

FUNDAMENTO: Mortalidade global e cardiovascular (CV) elevada de pacientes em hemodiálise. OBJETIVO: Avaliação da mortalidade global e CV e identificação do risco de pacientes em hemodiálise. MÉTODOS: Estudo observacional, prospectivo. Estudados 334 pacientes em três anos. Desfechos primários: mortalidade global e CV. Sobrevida avaliada pelo método de Kaplan-Meier. Identificação de variáveis de risco pela Regressão de Cox, bi e multivariada. RESULTADOS: Foram estudados 189 (56,6 por cento) homens, idade 48,8 ± 14,2 anos, maioria de não brancos (295[88,3 por cento]) e com escolaridade de 0 a menor que 8 anos (211[63,2 por cento]). Mortalidade total de 21,6 por cento (72/334), 50 por cento sobrevivendo 146 meses, e mortalidade CV de 41,7 por cento(30/72), 75 por cento sobrevivendo 141 meses. Na análise bivariada, o RR de óbito não cardiovascular (ONCV) e CV aumentou com Idade >60 anos, Hb < 9,0 g/dl e glicemia de jejum >126 mg/dl; de ONCV apenas, com baixa escolaridade, viuvez, Hb<11,0 g/dl, Ht<33,0 por cento, glicemia de jejum >100 mg/dl, produto Ca x P <42 e creatinina >9,2 mg/dl; diminuiu com PA>140/90 mmHg (antes da sessão de HD) e Ht>36 por cento; de óbito CV apenas, aumentou com creatinina >9,4 mg/dl. Na análise multivariada, o RR de ONCV e CV aumentou com idade >60 anos e Hb<9 g/dl; o RR de óbito CV aumentou com glicemia>126 mg/dl e o de ONCV com taxa de remoção de ureia na hemodiálise (Kt/V) <1,2. CONCLUSÃO: A mortalidade global e CV de pacientes em hemodiálise é elevada. Os fatores de risco independentes para ONCV e CV foram idade >60 anos e Hb<9 g/dl, para óbito CV apenas glicemia >126 mg/dl e ONCV Kt/V<1,2. Vale assinalar a importância do monitoramento na correção e prevenção desses três últimos fatores.

BACKGROUND: There is a high global and cardiovascular mortality rate among patients who need hemodialysis. OBJECTIVE: To assess global and cardiovascular mortality and to identify the risk factors in patients who undergo hemodialysis. METHODS: Observational, prospective study. A total of 334 patients were studied within three years. Primary outcomes: global and cardiovascular mortality. Survival was assessed through Kaplan-Meier method, and the risk variables were identified by means of bivariate and multivariate Cox regression. RESULTS: A total of 189 men (56.6 percent), aging 48.8 ± 14.2, majority non-white (295, 88.3 percent) and who did finished the elementary school (211, 63.2 percent). Global mortality rate was 21.6 percent, with a 50 percent rate of 146-month survival; cardiovascular mortality rate was 41.7 percent (30/72), with a 75 percent rate of 141-month survival. In the bivariate analysis, the relative risk (RR) for non-cardiovascular and cardiovascular death increased when age >60 years old was Hb<9.0 g/dl and fast glycemia >126 mg/dl. Only non-cardiovascular death with low school grade and widow, Hb<11.0 g/dl, Ht<33.0 percent, fast glycemia>100 mg/dl, Ca product x P<42 and creatinine >9.2 mg/dl decreased with blood pressure (BP) >140/90 mmHg (before hemodialysis session) and Ht>36 percent; Obit due only to cardiovascular factors increased with creatinine >9.4 mg/dl. In the multivariate analysis, non-cardiovascular and cardiovascular RR increased with age >60 years old and Hb<9 g/dl; cardiovascular death RR increased with glycemia >126 mg/dl, and non-cardiovascular death RR increased with urea removal rate in hemodialysis (Kt/V) <1,2. CONCLUSION: Global and cardiovascular mortality of patients who need hemodialysis is high. Independent risk factors for non cardiovascular and cardiovascular causes of death were age >60 years old and Hb<9 g/dl, for cardiovascular cause of death only, was fasting blood glucose >126 mg/dL, and ...

FUNDAMENTO: Mortalidad global y cardiovascular (CV) elevada de pacientes en hemodiálisis OBJETIVO: Evaluación de la mortalidad global y CV e identificación del riesgo de paciente en hemodiálisis. MÉTODOS: Estudio observacional, prospectivo. Estudiados 334 pacientes en tres años. Desenlaces primarios: mortalidad global y CV. Sobrevida evaluada por el método de Kaplan-Meier. Identificación de variables de riesgo por la Regresión de Cox, bi y multivariada. RESULTADOS: Se estudiaron 189 (56,6 por ciento) hombres, edad 48,8 ± 14,2 años, mayoría no blancos (295[88,3 por ciento]) y con escolaridad de 0 a menor que 8 años (211[63,2 por ciento]). Mortalidad total de 21,6 por ciento (72/334), 50 por ciento sobreviviendo 146 meses, y mortalidad CV de 41,7 por ciento (30/72), 75 por ciento sobreviviendo 141 meses. En el análisis bivariado, el RR de óbito no cardiovascular (ONCV) y CV aumentó con edad > 60 años, Hb < 9,0 g/dl y glucemia en ayunas > 126 mg/dl; sólo de ONCV, con baja escolaridad, viudez, Hb < 11,0 g/dl, Ht < 33,0 por ciento, glucemia en ayunas > 100 mg/dl, producto Ca x P < 42 y creatinina > 9,2 mg/dl; disminuyó con PA > 140/90 mmHg (antes de la sesión de HD) y Ht > 36 por ciento; de óbito CV solamente, aumentó con creatinina > 9,4 mg/dl. En el análisis multivariado, el RR de ONCV y CV aumento con edad > 60 años y Hb < 9 g/dl; el RR de óbito CV aumentó con glucemia > 126 mg/dl y el de ONCV con tasa de remoción de urea en la hemodiálisis (Kt/V) < 1,2. CONCLUSIÓN: La mortalidad global y CV de pacientes en hemodiálisis es elevada. Los factores de riesgo independientes para ONCV y CV fueron edad > 60 años y Hb < 9 g/dl, para óbito CV sólo glicemia > 126 mg/dl y ONCV Kt/V < 1,2. Cabe señalar la importancia del monitoreo en la corrección y prevención de estos tres últimos factores.

Nonsense mutations in close proximity to the initiation codon fail to trigger full nonsense-mediated mRNA decay.

Nonsense-mediated mRNA decay (NMD) is a surveillance mechanism that degrades mRNAs containing premature translation termination codons. In mammalian cells, a termination codon is ordinarily recognized as "premature" if it is located greater than 50-54 nucleotides 5' to the final exon-exon junction. We have described a set of naturally occurring human beta-globin gene mutations that apparently contradict this rule. The corresponding beta-thalassemia genes contain nonsense mutations within exon 1, and yet their encoded mRNAs accumulate to levels approaching wild-type beta-globin (beta(WT)) mRNA. In the present report we demonstrate that the stabilities of these mRNAs with nonsense mutations in exon 1 are intermediate between beta(WT) mRNA and beta-globin mRNA carrying a prototype NMD-sensitive mutation in exon 2 (codon 39 nonsense; beta 39). Functional analyses of these mRNAs with 5'-proximal nonsense mutations demonstrate that their relative resistance to NMD does not reflect abnormal RNA splicing or translation re-initiation and is independent of promoter identity and erythroid specificity. Instead, the proximity of the nonsense codon to the translation initiation AUG constitutes a major determinant of NMD. Positioning a termination mutation at the 5' terminus of the coding region blunts mRNA destabilization, and this effect is dominant to the "50-54 nt boundary rule." These observations impact on current models of NMD.

Manual de procedimentos para entrada de dados em formato MARC no Sistema Aleph: monografias. 2. ed. rev. e atual.

Padronizar os procedimentos de entrada de dados para Monografias na versão 23 do Aleph 500, estabelecendo maior consistência no acervo da Rede de Bibliotecas da Fiocruz. Deve ser utilizado em conjunto com o AACR2, com o manual do MARC21 e com os manuais do Aleph fornecidos pela Ex-Libris, como complementação.

Atualizações dos estudos e práticas na catalogação de materiais bibliográficos raros e especiais: experiência da Seção de Obras Raras da Biblioteca de Manguinhos da Fiocruz

O objetivo principal deste trabalho é compartilhar os estudos, procedimentos e atualizações na identificação, registro e padronização das marcas de proveniência presentes no acervo da Seção de Obras Raras da Biblioteca de Manguinhos Desde 2014, à medida em que o trabalho de identificação das marcas de proveniência e as pesquisas sobre o tema foram sendo desenvolvidos, a equipe técnica começou a observar a necessidade de conceituação e padronização de alguns termos utilizados para descrever as marcas e sua posterior disponibilização no campo 59X da catalogação. Para orientar e registrar as decisões acerca das nomenclaturas adotadas, padronizá-las e justificá-las, foi dado início à construção de materiais de apoio técnico, com a implementação de um glossário e a criação de sentenças para inserção das informações dentro dos campos de catalogação, que pudessem padronizar essas informações dentro dos campos. O trabalho, que é contínuo tem trazido uma série de benefícios, tais como: a agilidade na recuperação de informações, a aquisição de uma visão clara e quantitativa dessas ocorrências, aporte na mensuração do acervo, delineamento de características do acervo, o planejamento de atividades técnicas e ações futuras. Enfim, de maneira mais abrangente, observou-se também que a padronização das notas e sua inserção na catalogação ampliaram a disponibilização de informações para pesquisa das áreas afins e desenvolvimento de pesquisas na própria área de biblioteconomia.

Acervos em diálogo: memória e patrimônio em construção

A proposta desta apresentação é abordar a relação entre memória e patrimônio em sua composição diante de um processo vivo de construção permanente, a partir da coleção de obras raras e especiais da Biblioteca de Manguinhos, Fiocruz. Pretende-se ainda demonstrar a convergência entre diferentes tipologias de acervos, em uma experiência singular, mediante o emprego cultural e social do acervo científico da Fiocruz.

AIDS, homossexualidade e estigma social nos anos 1980: as vozes da mídia nos jornais brasileiros da Coleção ABIA

Apresenta a relevância e a importância histórico-patrimonial da Coleção ABIA. Expõe o acervo de clippings da coleção como uma significativa fonte de informação histórico-científica em AIDS no Brasil. Analisa as notícias de jornais brasileiros publicadas no início da década 1980. Identifica discursos discriminatórios por parte da mídia impressa nacional em relação à população homossexual. Através das notícias, expõe como a falta de conhecimento sobre a doença contribuiu para a disseminação do preconceito contra a população homossexual.

O periódico Brasil-Médico como exemplo para integração e formação de coleções interinstitucionais: estudo de caso

Este trabalho visa apresentar experiência obtida a partir do tratamento de itens bibliográficos em ambiente virtual para a produção de novos objetos em formato digital. Aborda a formação e implementação de laboratório de digitalização, etapas que foram estabelecidas na preparação e seleção de itens a serem digitalizados, padronização de metadados e formação de coleções digitais. A busca pela preservação e acesso são características precursoras no desenvolvimento deste trabalho. A importância na adesão de parcerias interinstitucionais em prol de uma resposta à demanda de pesquisa institucional e da comunidade científica também é de grande relevância na implementação deste projeto de digitalização e acesso. Sendo este um projeto em constante aprimoramento e expansão buscando lançar seu direcionamento ao processo estrutural da produção de conhecimento.

Da esfera privada à administração pública: a análise da institucionalização de uma biblioteca particular

Apresenta-se metodologia desenvolvida a partir do processo de incorporação de coleções bibliográficas particulares pela administração pública federal. Ressalta-se as principais etapas para o processo de institucionalização como: interesse e viabilidade institucional para receber o acervo, tratativas com os doadores, trâmites contratuais, processamento técnico e publicação da doação no Diário Oficial da União. Destaca-se a importância desta metodologia para a política de formação e desenvolvimento de coleções assim como para experiências futuras. Considerando-se a incorporação de coleções particulares como uma das formas de crescimento de acervos públicos.

Tratamento da crise hipertensiva com captopril. / Treatment of hypertensive crisis with captopril

Avaliou-se a eficiencia do captopril, um inibidor da enzima conversora, no tratamento de 28 pacientes em crise hipertensiva de variadas etiologias: 12 com hipertensao arterial maligna, 6 com hipertensao acelerada, 4 com hipertensao renovascular e 6 com hipertensao renovascular arterial refrataria. A resposta imediata ao captopril foi mais intensa nos pacientes portadores de hipertensao arterial acelerada e maligna e hipertensao renovascular. Assim, em 14 dos 18 pacientes com hipertensao acelerada e maligna, doses entre 150 e 300 mg de captopril foram suficientes para reduzir a pressao arterial a niveis proximos da normalidade. Nos outros 4 pacientes deste grupo, necessitou-se de um diuretico para controlar a pressao arterial. Os 4 pacientes com hipertensao renovascular apresentaram reducoes similares na pressao arterial, porem com doses menores de captopril. Os 6 pacientes portadores de hipertensao arterial refrataria apresentaram menores reducoes pressoricas com doses de captopril entre 50 e 150 mg.Concluiu-se que captopril foi eficaz para o tratamento inicial de crises hipertensivas de diversas etiologias