Using LC and Hierarchical Cluster Analysis as Tools to Distinguish Timbó Collections into Two Deguelia Species: A Contribution to Chemotaxonomy.

The species Deguelia utilis and Deguelia rufescens var. urucu, popularly known as "timbó," have been used for many years as rotenone sources in insecticide formulations. In this work, a method was developed and validated using a high-performance liquid chromatography-photodiode array (HPLC-PDA) system, and results were analyzed using hierarchical cluster analysis (HCA). By quantifying the major rotenoids of these species, it was possible to establish a linear relation between them. The ratio between the concentrations of rotenone and deguelin for D. utilis is approximately 1:0.8, respectively, while for D. rufescens var. urucu it is 2:1. These results may help to distinguish these species contributing to their taxonomic identification.

Intraspecific and interspecific interaction and fitness cost of stink bugs Euschistus heros, Diceraeus melacanthus, and Piezodorus guildinii in soybean.

BACKGROUND: The most common pentatomid species in soybean crops are Euschistus heros (F.), Piezodorus guildinii (W.), and Diceraeus melacanthus (D.), causing a significant reduction in yield. It is known that these stink bugs inhabit the reproductive structures of soybeans simultaneously; however, there are few studies addressing their intraguild interactions, as well as aspects of possible competition between them in plants. Thus, the interspecific and intraspecific interactions of these stink bugs were evaluated in laboratory and field conditions, throughout the duration of the instars and adulthood, including longevity, mortality, and the number of eggs per female. RESULTS: Euschistus heros had a higher competitive capacity in the interaction with D. melacanthus and P. guildinii, negatively interfering in the abundance or development (duration of instar, fertility, and mortality) of these stink bugs in soybean crops. This interference may act on the natural balance of these insect pests. Mortality of adults in interactions containing E. heros as a competitor or not showed that this species was not affected by the other species under field conditions. In the scenario where D. melacanthus was evaluated, it was observed that the presence of other species caused higher mortality in D. melacanthus. Additionally, higher P. guildiniii mortality was observed in interspecific interactions. CONCLUSION: Our results suggest that E. heros has a greater competitive ability in the soybean crop, followed by D. melacanthus and P. guildinii. Therefore, the results found justified the greater abundance of E. heros and helped to explain the increasing occurrence of D. melacanthus in soybean crops, contributing to new directions for understanding the interaction of the soybean stink bug complex. © 2023 Society of Chemical Industry.

Aspects of Sexuality in Quilombola Communities' Young Adults in Eastern Brazilian Amazon.

Quilombola communities are descended from African slaves who escaped in resistance to imperial rule in Brazil. Today, these communities suffer from inadequate health care and health promotion programs due to socioeconomic, geographic, and political factors. This generates greater vulnerability among these groups because they have limited information about prevention to improve their quality of life. This research aimed to analyze the sexuality of young quilombola adults and the impact on their quality of life through an observational, cross-sectional, quantitative study with descriptive and inferential analyses. Our study is the first to address these issues among quilombolas in the Eastern Amazon region. The participants were 79 individuals of both sexes, aged between 18 to 35 years, belonging to seven communities in the state of Pará. The questionnaires were designed to assess sexual behavior and satisfaction, values and beliefs about sexuality, prejudice regarding sexual and gender diversity, knowledge about sexually transmitted infections (STIs), beliefs about maternity, and quality of life. Women reported greater sexual dissatisfaction and lower quality of life than men. Men reported no dysfunctions; however, they were highly prejudiced towards sexual and gender diversity. Low education negatively impacts the health of quilombola populations, as knowledge about STIs and values and beliefs influence sexual behavior, exposing individuals to diseases. The research also confirms that, both among quilombolas and other groups, factors such as sexual satisfaction, values and beliefs about reproduction, and affectivity directly influence the quality of life.

A Comparison Between Saline and Balanced Solutions in Kidney Transplants: A Randomized Clinical Trial.

Objective This study aimed to investigate the impact of different types of intravenous fluids - normal saline (NS), lactated Ringer's solution (LR), and PlasmaLyte (PL) - on the acid-base balance and electrolyte concentration following kidney transplant, a common procedure for patients with end-stage renal disease (ESRD). Methodology A randomized controlled trial design was employed, wherein the primary parameters analyzed were postoperative pH and serum potassium levels. Postoperative concentrations of serum bicarbonate, sodium, chloride, and creatinine, as well as graft functionality, were assessed as secondary outcomes. These measurements were performed at the start and end of surgery, as well as 24 and 72 hours postoperatively. Results A total of 53 patients were included in the study and randomized into three cohorts: NS, LR, and PL, each of which showed comparability in terms of demographic and transplantation specifics. Notably, patients in the NS group exhibited a more significant decrease in pH (NS group: 7.285 ±0.098, LR group: 7.324 ±0.075, PL group: 7.7338 ±0.059) and bicarbonate levels (17.0 ±4.2, 20.9 ±2.8, 20.0 ±4.5) post 24 hours after the operation and displayed a similar pattern immediately after the surgery. However, there were no discernible differences in potassium (p=0.460), sodium (p=0.681), and chloride (p=0.321) levels across the groups. Furthermore, the study did not observe any significant differences in postoperative graft functionality. Conclusion The use of NS as the intraoperative fluid of choice led to lower pH and bicarbonate levels following kidney transplant, as compared to LR and PL. However, these results did not correlate with improvements in graft functionality.

Renal and cardiovascular repercussions in preeclampsia and their impact on fluid management: a literature review.

Preeclampsia is a multifactorial condition associated with significant morbidity and mortality. Fluid therapy in these patients is challenging since volume expansion may precipitate pulmonary edema, and fluid restriction may worsen renal function. Furthermore, cardiac impairment may introduce an additional component to the hemodynamic management. This article reviews the repercussions of preeclampsia on renal and cardiovascular systems and the development of pulmonary edema, as well as to discuss fluid management, focusing on the mitigation of adverse outcomes and monitoring alternatives. The literature review was carried out using PubMed, Embase, and Google Scholar databases from May 2019 to March 2020. Papers addressing the subjects of interest were included regardless of the publication language. There is a current trend towards restricting the administration of fluids in women with non-complicated preeclampsia. However, patients with preeclampsia may experience hemorrhagic shock, requiring volume resuscitation. In this case, hemodynamic monitoring is recommended to guide fluid therapy while avoiding complications.

Restrictive versus Liberal Fluid Therapy for Post-Cesarean Acute Kidney Injury in Severe Preeclampsia: a Pilot Randomized Clinical Trial.

OBJECTIVES: The aim of this study was to determine whether a restrictive compared to a liberal fluid therapy will increase postoperative acute kidney injury (AKI) in patients with severe preeclampsia. METHODS: A total of 46 patients (mean age, 32 years; standard deviation, 6.8 years) with severe preeclampsia were randomized to liberal (1500 ml of lactated Ringer's, n=23) or restrictive (250 ml of lactated Ringer's, n=23) intravenous fluid regimen during cesarean section. The primary outcome was the development of a postoperative renal dysfunction defined by AKI Network stage ≥1. Serum cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) were evaluated at postoperative days 1 and 2. ClinicalTrials.gov: NCT02214186. RESULTS: The rate of postoperative AKI was 43.5% in the liberal fluid group and 43.5% in the restrictive fluid group (p=1.0). Intraoperative urine output was higher in the liberal (116 ml/h, IQR 69-191) than in the restrictive fluid group (80 ml/h, IQR 37-110, p<0.05). In both groups, serum cystatin C did not change from postoperative day 1 compared to the preoperative period and significantly decreased on postoperative day 2 compared to postoperative day 1 (p<0.05). In the restrictive fluid group, NGAL levels increased on postoperative day 1 compared to the preoperative period (p<0.05) and decreased on postoperative day 2 compared to postoperative day 1 (p<0.05). CONCLUSION: Among patients with severe preeclampsia, a restrictive fluid regimen during cesarean section was not associated with increased postoperative AKI.

Restrictive versus liberal fluid therapy for post-cesarean acute kidney injury in severe preeclampsia: a pilot randomized clinical trial

OBJECTIVES: The aim of this study was to determine whether a restrictive compared to a liberal fluid therapy will increase postoperative acute kidney injury (AKI) in patients with severe preeclampsia. METHODS: A total of 46 patients (mean age, 32 years; standard deviation, 6.8 years) with severe preeclampsia were randomized to liberal (1500 ml of lactated Ringer's, n=23) or restrictive (250 ml of lactated Ringer's, n=23) intravenous fluid regimen during cesarean section. The primary outcome was the development of a postoperative renal dysfunction defined by AKI Network stage ≥1. Serum cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) were evaluated at postoperative days 1 and 2. ClinicalTrials.gov: NCT02214186. RESULTS: The rate of postoperative AKI was 43.5% in the liberal fluid group and 43.5% in the restrictive fluid group (p=1.0). Intraoperative urine output was higher in the liberal (116 ml/h, IQR 69-191) than in the restrictive fluid group (80 ml/h, IQR 37-110, p<0.05). In both groups, serum cystatin C did not change from postoperative day 1 compared to the preoperative period and significantly decreased on postoperative day 2 compared to postoperative day 1 (p<0.05). In the restrictive fluid group, NGAL levels increased on postoperative day 1 compared to the preoperative period (p<0.05) and decreased on postoperative day 2 compared to postoperative day 1 (p<0.05). CONCLUSION: Among patients with severe preeclampsia, a restrictive fluid regimen during cesarean section was not associated with increased postoperative AKI.

Epidemiological profile of acute bacterial meningitis in the state of Rio Grande do Norte, Brazil.

INTRODUCTION: Acute bacterial meningitis (ABM) remains a public health problem in Brazil. To evaluate the epidemiology of ABM cases at Giselda Trigueiro Hospital, Rio Grande do Norte, a descriptive retrospective survey was conducted covering 2005 to 2008. METHODS: Clinical and laboratory data were collected from the epidemiology department of the hospital and analyzed. RESULTS: Out of 168 ABM cases, 24.4%, 10.7%, and 2.4% were, respectively, caused by Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenza b, and 5.4% by other bacteria. The mean age was 22.48 +/- 18.7 years old. CONCLUSIONS: Streptococcus pneumoniae was the main causative pathogen in the young urban population.

Avaliação da aplicabilidade do modelo de Gail como preditor de risco de câncerde mama em mulheres baianas / Evaluation of the applicability of Gail model as a predictor of breast cancer risk in women from Bahia

Objetivo: Avaliar a acurácia do modelo de Gail em mulheres baianas. Métodos: Estudo de casocontrole, com 64 casos e 64 controles. Este estudo foi conduzido em duas clínicas de Salvador, Bahia, que atendem pacientes conveniados aos planos de saúde: o Núcleo de Oncologia da Bahia e o Núcleo da Mama. Foram calculados dois valores do índice de Gail para cada paciente, com etnia referida e com etnia desconhecida. Os valores encontrados foram comparados entre os grupos caso e controle, comanálise de significância pelo teste t de Student. Também foi calculado qual o percentual de pacientes do grupo caso que apresentavam alto (?1,67%) e baixo risco (<1,67%). Resultados: As  médias dos valores do índice de Gail do grupo controle foram superiores às médias dos valores nos casos,independente de qual risco foi avaliado (em cinco anos ou ?life-time?) e da etnia utilizada (autoreferida ou desconhecida). Quando utilizada a etnia auto-referida, apenas 26,7% das pacientes com câncer de mama teriam sido identificadas como alto risco pelo modelo, e, quando utilizada a etniadesconhecida, apenas 34,7%. Conclusão: Na presente amostra com mulheres baianas, o modelo de Gail não foi um bom preditor para o desenvolvimento de câncer de mama.

Purpose: To evaluate the accuracy of Gail model applied to women from Bahia. Methods: It is a casecontrol study, with 64 cases and 64 controls. This study was lead in two clinics in Salvador, Bahia, Brazil, that attend patients with health insurance: Núcleo de Oncologia da Bahia and Núcleo da Mama. Two values of Gail model were calculated for each patient, one using self-reported ethnicity and other using ethnicity as unknown. The values were compared between case and control groups, using significance analysis by Student t test. It was also calculated which percentage of patients in case group were at high-risk (?1.67%) or low risk (<1.67). Results: The mean values of the Gail model was higher in the control group than the mean values in the case group, regardless of which risk was assessed (in five years or life-time) and of ethnicity was used (self-reported or unknown). When used the self-reported ethnicity for calculation, only 26.7% of women with breast cancer would have been identified as high-risk by the Gail model, and when used unknown ethnicity, only 34.7% of these would have been identified. Conclusion: In the present sample, the Gail model was nota good predictor for the development of breast cancer in womens from Bahia.

[Incidence and risk factors of retinopathy of prematurity in University Hospital Onofre Lopes, Natal (RN)-Brazil]. / Incidência e fatores de risco da retinopatia da prematuridade no Hospital Universitário Onofre Lopes, Natal (RN) - Brasil.

PURPOSES: To determine the incidence of retinopathy of prematurity and assess the main risk factors involved in its development. METHODS: Retrospective cohort study carried out from January 2004 to December 2006, at University Hospital Onofre Lopes, Natal (RN)-Brazil. The sample was composed of 663 newborns, with less than or equal to 36 weeks of gestational age and/or birth weight less than or equal to 1,500 g, submitted to the protocol of retinopathy of prematurity in the ophthalmology department of the hospital. The variables were: gender, birth weight, gestational age, duration of oxygen therapy, mechanical ventilation, sepsis and blood transfusion. Data were analyzed through the chi-squared test, Fisher's exact test and logistic regression model. RESULTS: Of the 663 cases, retinopathy of prematurity occurred in 414 (62.4%). Of the total sample, 338 (51.0%) were male and 282 (42.5%) female. Mean and standard deviation of weight, gestational age and duration of oxygen therapy were, respectively, 1,334.9+/-345.6 g, 31.9+/-2.3 weeks and 10.0+/-14.0 days. The incidence of retinopathy in premature newborns in the period was 62.4%, 58.0% of cases in 2004, 67.2% in 2005 and 63.0% in 2006. The multiple logistic regression analysis showed that the weight less than 1,000 g (p<0.001; adjOR=17.18, CI=6.52-45.29) and between 1,000 g and 1,500 g (p=0.002; adjOR -4.20 CI=1.68-10.48), the time of oxygen lounger than 20 days (p=0.022; adjOR=3.40, CI=1.19-9.69) and blood transfusion (p=0.022; adjOR -2.06, CI=1.11-3.83) are independent factors for the disease. CONCLUSIONS: The study showed a high incidence of the disease in the service. A low birth weight, a prolonged oxygen therapy and blood transfusion are factors associated with the development of retinopathy of prematurity. Gestational age is not a reliable parameter for screening of newborns in the service.

Associação entre índice de massa corpórea e câncer de mama em pacientes de Salvador, Bahia / Association between body mass index and breast cancer in patients from Salvador, Bahia

Objetivo: Identificar a associação entre o índice de massa corpórea (IMC) e a ocorrência de câncer de mama em uma população de pacientes de duas clínicas de Salvador (BA). Métodos: Estudo caso-controle no qual foram recrutadas 190 pacientes entre 2012 e 2014, sendo 68 diagnosticadas com carcinoma ductal da mama e 122 controles. Foi realizado cálculo amostralcom n=140 pacientes por meio do programa Winpepi. Dados de peso e altura foram coletados para cálculo do IMC de cada paciente. Com base nos critérios da Organização Mundial de Saúde (OMS), foram classificadas como desnutridas pacientes com IMC <18,5, normais aquelas com IMC ?18,5 e <25,0 kg/m², sobrepeso com ?25 e <30 kg/m², e obesas com ?30 kg/m².Proporções de cada categoria de IMC foram determinadas para casos e controles. Análise estatística incluiu realização de teste do ?2 para avaliação de correlação entre as variáveis categóricas. Resultados: A idade média foi de 56,7±13 anos entre os casos e de 53,1±11,9 anos entre os controles. IMC médio foi de 27,5±4,6 kg/m² entre os casos e de 26,1±4,9 kg/m² entre os controles. A proporção de pacientes normais, sobrepeso e obesas foi de 33,8, 38,2 e 27,9% entre os casos e de 43,4, 43,4 e 13,1% entre os controles, respectivamente. Houve significativamente mais obesas entre os casos do que entre os controles (OR=2,57; IC95% 1,22?5,42; p=0,011),com mulheres na menacme e pós-menopausadas. Conclusão: Os resultados demonstram correlação entre a presença de câncer de mama e o IMC elevado na amostra estudada, o que está condizente com os resultados de outros estudos.

Objective: Identify the association between body mass index (BMI) and breast cancer in a population of patients from two clinics in Salvador (BA). Methods: A case-control study in which 190 patients were recruited between 2012 and 2014, 68 diagnosed with ductal breast carcinoma and 122 controls. Sample calculation was performed with n=140 patients, through Winpepi program. Weight and height data were collected to calculate the body mass index of each patient. Based on the World Health Organization (WHO) criteria were classified as malnourished patients with BMI <18.5, those with normal BMI ?18.5 and <25.0 kg/m², overweight ?25 and <30 kg/m² and obese ?30 kg/m². BMI proportions of each category were determined for cases and controls. Statistical analysis included performing chi-square test to evaluate the correlation between categorical variables. Results: Mean age was 56.7±13 years between cases and 53.1±11.9 years among controls. Mean BMI was 27.5±4.6 kg/m² among cases and 26.1±4.9 kg/m² among controls. The proportion of normal patients, overweight and obese was 33.8, 38.2 and 27.9% in the cases and 43.4, 43.4 and 13.1% among controls, respectively. There were significantly more obese among cases than among controls (OR=2.57, 95%CI 1.22?5.42; p=0.011), with women in premenopausal and post-menopausal. Conclusion: The resultsshow a correlation between the presence of breast cancer and high BMI in this sample, consistent with the results of other studies.

Perfil epidemiológico dos subtipos moleculares de carcinoma ductal da mama em população de pacientes em Salvador, Bahia / Epidemiological profile of molecular subtypes of breast ductal carcinoma in patients population in Salvador, Bahia

Objetivo: Avaliar o perfil dos subtipos moleculares do câncer de mama em uma população de pacientes de duas clínicas privadas de Salvador, Bahia: o Núcleo da Mama e o Núcleo de Oncologia da Bahia. Metodologia: Estudo de corte transversal que incluiu pacientes do sexo feminino com diagnóstico aná- tomo-patológico de carcinoma invasivo sem tipo especial (ductal invasor). Foram excluídas as pacientes com história de câncer prévio, exceto câncer de pele não melanoma; com dados clínicos anteriores ao tratamento sistêmico indisponíveis e sem laudo de imuno-histoquímica. Foi realizada classificação do câncer de mama com base no subtipo molecular em quatro padrões principais: luminal A, luminal B, HER2+ e triplo-negativo. Frequências e proporções foram estabelecidas para cada um dos subtipos moleculares. Outros dados clínicos e laboratoriais também foram colhidos para estabelecer o perfil da população estudada. Resultados: Foram recrutadas 59 pacientes entre dezembro de 2012 e maio de 2014, com idade média de 56,9 anos. O subtipo molecular mais comum na amostra foi o luminal B, com 35 casos (59,3%), seguido do luminal A, (11 casos; 18,6%), triplo-negativo (6 casos, 10,2%) e HER2+ (7 casos; 11,9%). Conclusões: Corroborando outros estudos realizados em população brasileira, o subtipo luminal B é o mais comum encontrado nesta amostra de pacientes de Salvador, Bahia. O achado ajuda a confirmar o padrão atípico do país em relação ao descrito na literatura internacional, com importantes implicações terapêuticas e prognósticas.

Objective: The aim of this study is to evaluate breast cancer molecular subtype distribution in a female population of two private centers in Salvador, Bahia, Brazil: Núcleo da Mama e o Núcleo de Oncologia da Bahia. Methodology: This is a cross-sectional study involving female patients with pathological diagnosis of invasive ductal carcinoma not otherwise specified (NOS). Patients with history of previous cancer except non-melanoma skin câncer; clinical data prior to systemic treatment unavailable and those without immunohistochemical report were excluded from the study. Breast cancer classification was based on four main molecular subtype patterns: luminal A, luminal B, HER2 + and triple negative. Frequencies and proportions were established for each of the molecular subtypes. Other clinical and laboratory data were also collected to determine baseline characteristics of the population studied. Results: We recruited 59 patients between December 2012 and May 2014 with an average age of 56.9 years. The most common molecular subtype of the sample was luminal B subtype, with 35 cases (59.3%), followed by luminal A (11 cases; 18.6%), triple negative (6 cases, 10.2%) and HER2+ (7 cases; 11.9%). Conclusions: Similar to other studies with Brazilian population samples, luminal B subtype is the most common in this sample of patients in Salvador, Bahia. The finding helps confirm the atypical pattern of the country in relation to that described in international literature, with important therapeutic and prognostic implications.

Estudo da autodepuração do rio Jordão, localizado na bacia hidrográfica do rio Dourados / Self-depuration study of Jordão river, located in Dourados river basin

O presente artigo avaliou a capacidade de autodepuração do Rio Jordão, considerando as contribuições reais do córrego Brejo Alegre em período de estiagem e os dois cenários que levam em conta as cargas poluidoras estimadas da estação de tratamento de esgoto e a baixa capacidade de diluição do rio para a vazão crítica Q7,10, por meio do modelo QUAL-UFMG. A simulação na estiagem apresentou aceitável calibração, tendo em vista a otimização dos coeficientes, evidenciando a prevalência da desoxigenação por demanda carbonácea sobre a nitrificação e a importância da reaeração natural no processo de autodepuração. Apenas o parâmetro 'demanda bioquímica de oxigênio' (DBO5) não respeitou os limites preconizados pela Resolução do Ministério do Meio Ambiente 357:2005, tendo ficado em toda a extensão do rio fora da regulamentação devido ao recebimento de cargas poluidoras do córrego Brejo Alegre. Quanto às simulações dos cenários, as cargas poluidoras de uma população de 13.300 habitantes para o Cenário 1 e 20.500 para o 2 garantiriam a capacidade de autodepuração, considerando-se uma vazão crítica 3,2 vezes inferior à menor vazão medida no período de estiagem.

The present article assessed the self-depuration capacity of Jordão River, considering the real contributions of Brejo Alegre stream in a drought period and two scenarios regarding the estimated polluting loads of a waste treatment plant and the low dilution capacity of the river for the Q7,10 critical flow by using the QUAL-UFMG model. The simulation for the drought period presented acceptable calibration by adjusting coefficients, evidencing the deoxygenation by carbon demand over nitrification and the importance of natural re-aeration in the self-depuration process. Only the biochemical oxygen demand (BOD5) parameter did not respect the limits recommended by the CONAMA Resolution 357:2005, in which all the river extension was outside the regulations due to the pollution loads received from Brejo Alegre stream. For the simulated scenarios, polluting loads of a population of 13.300 people for scenario 1 and 20.500 for 2 guaranteed the self-depuration capacity, considering a critical flow 3.2 times lower than the lowest flow measured in the drought period.

Câncer de mama em mulheres jovens: análise de 12.689 casos / Breast Cancer in Young Women: Analysis of 12.689 Cases

Introdução: O câncer de mama em mulheres com idade inferior a 40 anos é incomum. Entretanto, nessa população,a doença cursa, em geral, com pior prognóstico. Objetivos: Descrever o perfil clínico e epidemiológico de mulheres jovens diagnosticadas com câncer de mama no Brasil e comparar as características clínicas entre mulheres com idade inferior a 34 anos e aquelas entre 35 e 39 anos. Método: Estudo transversal dos casos analíticos de câncer de mama em mulheres de 18 a 39 anos, inseridos no Módulo Integrador dos Registros Hospitalares de Câncer e no Registro Hospitalar de Câncer do Estado de São Paulo, entre 2000 a 2009. Foi realizada a análise descritiva das variáveis. Resultados: Foram incluídos 12.689 casos. A idade mediana foi de 36 anos, a maioria das mulheres possuía ensino médio (32,3%)e era proveniente do Sistema Único de Saúde (74,6%). O estadiamento avançado (≥IIB) foi registrado em 62,8% dos casos e, ao final do primeiro tratamento, 44,4% das pacientes encontravam-se sem evidência da doença. Mulheres muito jovens apresentaram mais frequentemente tamanho do tumor >2cm, status dos linfonodos positivo, presença demetástase, estadiamento clínico avançado (≥IIB) e ausência de resposta terapêutica ao primeiro tratamento. Conclusão: No Brasil, mulheres jovens com câncer de mama apresentam estadiamento avançado ao diagnóstico. Aquelas muitojovens (<35 anos) apresentam doença ainda mais avançada e pior resposta terapêutica que aquelas entre 35 e 39 anos

Introduction:Breast cancer in women under 40 years old is unusual. However, in this population the disease usually progresses with worse prognosis.Objectives:to describe the clinical and epidemiological profile of young women diagnosed with breast cancer in Brazil and to compare the clinical characteristics among women aged less than 34 years and those between 35 and 39 years...

Epidemiological profile of acute bacterial meningitis in the state of Rio Grande do Norte, Brazil / Perfil epidemiológico da meningite bacteriana aguda no estado do Rio Grande do Norte, Brasil

INTRODUCTION: Acute bacterial meningitis (ABM) remains a public health problem in Brazil. To evaluate the epidemiology of ABM cases at Giselda Trigueiro Hospital, Rio Grande do Norte, a descriptive retrospective survey was conducted covering 2005 to 2008. METHODS: Clinical and laboratory data were collected from the epidemiology department of the hospital and analyzed. RESULTS: Out of 168 ABM cases, 24.4 percent, 10.7 percent, and 2.4 percent were, respectively, caused by Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenza b, and 5.4 percent by other bacteria. The mean age was 22.48 ± 18.7 years old. CONCLUSIONS: Streptococcus pneumoniae was the main causative pathogen in the young urban population.

INTRODUÇÃO: Meningite bacteriana aguda (MBA) permanece um problema de saúde pública no Brasil. Para avaliar a epidemiologia da MBA atendida no Hospital Giselda Trigueiro, Rio Grande do Norte, um estudo retrospectivo-descritivo foi realizado de 2005 a 2008. MÉTODOS: Dados clínicos e laboratoriais foram coletados do departamento de epidemiologia hospitalar e analisados. RESULTADOS: Dos 168 casos de MBA, 24,4 por cento, 10,7 por cento e 2,4 por cento foram, respectivamente, causados por Streptococcus pneumoniae, Neisseria meningitidis e Haemophilus influenzae b e 5,4 por cento por outras bactérias. A média da idade foi 22,48 ± 18,7 anos. CONCLUSÕES: Streptococcus pneumoniae foi o principal patógeno causador na população urbana jovem.

Auditoria de enfermagem e a qualidade da assistência à saúde: uma revisão da literatura / Nursing audit and the quality of the assistance to the health: a revision of literature / Auditoria de enfermería y de la calidad de la ayuda a la salud: una revisión de la literatura

A fim de garantir a qualidade dos serviços prestados, instituições de saúde têm-se preocupado em utilizar a auditoria. Este estudo teve como objetivo identificar na produção nacional artigos sobre auditoria de enfermagem, publicados no período de2001 a 2008 analisando a contribuição destes na melhoria da qualidade da assistência e no desempenho do papel do enfermeiro nessa área. Trata-se de uma revisão de literatura constituída de artigos científicos nacionais da temática auditoride enfermagem. Os dados encontrados foram agrupados em categorias: “Auditoria de enfermagem e a qualidade da assistência”, “o papel das anotações de enfermagem para a auditoria” e “atribuições do enfermeiro auditor”. A análise dos artigos mostrou que a efetivação da auditoria de enfermagem facilitaria a avaliação da qualidade da assistência prestada ao cliente oferecendo condições para a sua melhoria. Observou-se que as anotações de enfermagem representam um dos objetos de investigação na auditoria e que o enfermeiro é o profissional de enfermagem habilitado para a função de auditor.Sabendo que a enfermagem passa por uma reforma curricular, entendemos que é momento para reflexão sobre a responsabilidade que as instituições de ensino têm em preparar profissionais para desempenhar a função de auditor nos serviços de enfermagem e de saúde.

In order to guarantee the quality of the given services, health institutions have been worried in using the auditorship. Thisstudy it had as objective to identify in the national production articles on nursing auditorship, published in the period of 2001the 2008 analyzing the contribution of these in the improvement of the quality of the assistance and in the performance ofthe paper of the nurse in this area. This is review of literature contends national scientific articles of the thematic auditorshipof nursing. “The data had been grouped in categories: “Auditorship of nursing and the quality of the assistance”, “the paperof the notations of nursing for the auditorship” and “attributions of the nurse auditor”. The analysis of articles showed thatthe nursing auditorship would facilitate to the evaluation of the quality of the assistance offered to the patient/customeroffering conditions for its improvement. It was observed that the nursing register represent one of objects of inquiry in theauditorship and that the nurse is the professional of nursing qualified for the auditor function. In view of that the nursingpasses for a curricular reform, understands that is moment for reflection on the responsibility that the education institutionshave in forming and launching in the work market, professionals to play the function of auditor in the health and nursingservices.

Para garantizar la calidad de los servicios dados, las instituciones de salud han estado preocupadas al usar el auditorship.Este estudio que tenía como objetivo a identificar en los artículos nacionales de la producción sobre el auditorship del oficio de enfermera, publicado en el período de 2001 el 2008 que analiza la contribución de éstos en la mejora de la calidad de la ayuda y en el funcionamiento del papel de la enfermera en esta área. Esto es una investigación bibliográfica afirma losartículos científicos nacionales del auditorship temático del oficio de enfermera. “Los datos habían sido agrupados en trescategorías: “Auditorship del oficio de enfermera y de la calidad de la ayuda”, “el papel de las notaciones del cuidado para elauditorship” y “atribuciones del interventor de la enfermera”. El análisis de artículos demostró que el auditorship del oficio de enfermera facilitaría a la evaluación de la calidad de la ayuda ofrecida a las condiciones de ofrecimiento del paciente/delcliente para su mejora. Fue observado que el registro del oficio de enfermera representa uno de objetos de la investigaciónen el auditorship y que es la enfermera el profesional del oficio de enfermera calificó para la función del interventor. Debido a eso los pasos del oficio de enfermera para una reforma del plan de estudios, entienden que sea momento para la reflexión enla responsabilidad que las instituciones de la educación tienen en la formación y el lanzamiento en el mercado del trabajo,profesionales para jugar la función del interventor en la salud y los servicios de cuidado.

Incidência e fatores de risco da retinopatia da prematuridade no Hospital Universitário Onofre Lopes, Natal (RN) - Brasil / Incidence and risk factors of retinopathy of prematurity in University Hospital Onofre Lopes, Natal (RN) - Brazil

OBJETIVOS: Determinar a incidência de retinopatia da prematuridade e avaliar os principais fatores de risco implicados no seu desenvolvimento. MÉTODOS: Estudo coorte retrospectivo de base hospitalar realizado no período de janeiro de 2004 a dezembro de 2006, no Hospital Universitário Onofre Lopes, Natal (RN) - Brasil. A amostra foi composta por 663 recém-nascidos, com idade gestacional < 36 semanas e/ou peso ao nascimento < 1.500 g e submetidas ao protocolo de retinopatia da prematuridade existente no ambulatório de oftalmologia do hospital. As variáveis estudadas foram: gênero, peso ao nascimento, idade gestacional, tempo de oxigenioterapia, ventilação mecânica, sepse e transfusão sanguínea. Os dados foram analisados por meio dos testes do qui-quadrado, exato de Fisher e da regressão logística múltipla. RESULTADOS: Entre os 663 prontuários, retinopatia da prematuridade ocorreu em 414 casos (62,4 por cento). Do total da amostra, 338 (51,0 por cento) eram do sexo masculino e 282 (42,5 por cento) do feminino. As médias e os desvios-padrão do peso, da idade gestacional e do tempo de oxigenioterapia foram, respectivamente, 1.334,9 ± 345,6 g, 31,9 ± 2,3 semanas e 10,0 ± 14,0 dias. A incidência de retinopatia em prematuros no período foi de 62,4 por cento, com 58,0 por cento dos casos em 2004, 67,2 por cento em 2005 e 63,0 por cento em 2006. A análise de regressão logística múltipla demonstrou que o peso <1.000 g (p<0,001; ORaj=17,18; IC= 6,52-45,29) e entre 1.000 g a 1.500 g (p=0,002; ORaj=4,20; IC= 1,68-10,48), o tempo de oxigenioterapia >20 dias (p=0,022; ORaj=3,40; IC= 1,19-9,69) e a transfusão sanguínea (p=0,022; ORaj=2,06; IC= 1,11-3,83) são fatores independentes de risco para a doença. CONCLUSÕES: O estudo demonstra uma alta incidência da patologia no serviço. O baixo peso ao nascer, um tempo prolongado de oxigenoterapia, bem como a transfusão sanguínea são fatores associados ao desenvolvimento da retinopatia da prematuridade. Idade ...

PURPOSES: To determine the incidence of retinopathy of prematurity and assess the main risk factors involved in its development. METHODS: Retrospective cohort study carried out from January 2004 to December 2006, at University Hospital Onofre Lopes, Natal (RN) - Brazil. The sample was composed of 663 newborns, with less than or equal to 36 weeks of gestational age and/or birth weight less than or equal to 1,500 g, submitted to the protocol of retinopathy of prematurity in the ophthalmology department of the hospital. The variables were: gender, birth weight, gestational age, duration of oxygen therapy, mechanical ventilation, sepsis and blood transfusion. Data were analyzed through the chi-squared test, Fisher's exact test and logistic regression model. RESULTS: Of the 663 cases, retinopathy of prematurity occurred in 414 (62.4 percent). Of the total sample, 338 (51.0 percent) were male and 282 (42.5 percent) female. Mean and standard deviation of weight, gestational age and duration of oxygen therapy were, respectively, 1,334.9 ± 345.6 g, 31.9 ± 2.3 weeks and 10.0 ± 14.0 days. The incidence of retinopathy in premature newborns in the period was 62.4 percent, 58.0 percent of cases in 2004, 67.2 percent in 2005 and 63.0 percent in 2006. The multiple logistic regression analysis showed that the weight less than 1,000 g (p<0.001; adjOR=17.18, CI= 6.52-45.29) and between 1,000 g and 1,500 g (p=0.002; adjOR -4.20 CI= 1.68-10.48), the time of oxygen lounger than 20 days (p=0.022; adjOR=3.40, CI= 1.19-9.69) and blood transfusion (p=0.022; adjOR -2.06, CI= 1.11-3.83) are independent factors for the disease. CONCLUSIONS: The study showed a high incidence of the disease in the service. A low birth weight, a prolonged oxygen therapy and blood transfusion are factors associated with the development of retinopathy of prematurity. Gestational age is not a reliable parameter for screening of newborns in the service.

Vasculite de Churg-Strauss / Churg-Strauss`s vasculitis

Tema livre apresentado no Simpósio Multidisciplinar sobre vasculites, na II Jornada Anual da Sociedade de Reumatologia do Rio de Janeiro, em 22-23 de agosto de 1997, no Colégio Brasileiro de Cirurgiöes, sobre o tema. Universidade do Estado do Rio de Janeiro - Hospital Universitário Pedro Ernesto - Serviço de Dermatologia e Sifilografia