Perfil de prescripción de levetiracetam en niños menores de cuatro años atendidos en un hospital de alta complejidad de Chile / Levetiracetam prescription profile in children younger than 4 years treated at a tertiary care hospital in Chile

Introducción. El levetiracetam (LEV) es un antiepiléptico aprobado por el Instituto de Salud Pública de Chile como terapia concomitante en crisis epilépticas en niños mayores de cuatro años. Sin embargo, es ampliamente indicado desde el periodo neonatal, lo que hace necesario evaluar su utilización fuera de ficha técnica. Objetivo. Determinar el perfil de prescripción-indicación de LEV en el tratamiento de las crisis epilépticas en menores de cuatro años en un hospital de alta complejidad del sur de Chile. Población y método. Estudio observacional, descriptivo y retrospectivo. Se revisaron las historias clínicas de quienes iniciaron tratamiento con LEV entre 2014 y 2019, y se recopilaron datos sobre variables sociodemográficas, farmacológicas y clínicas. El análisis se basó en la descripción del perfil de los pacientes, prescripción, seguimiento y seguridad. Resultados. Se incluyeron 68 pacientes: 40 (58,8 %) de sexo masculino, 49 (72,1 %) con edad gestacional ≥ 37 semanas. La etiología principal de la epilepsia fue de tipo estructural (35,3 %); el LEV se utilizó principalmente en niños diagnosticados con malformación del sistema nervioso central (17,6 %) y predominó la monoterapia (55,9 %). En el 50 % se usó LEV para crisis focales. Cinco niños (7,3 %) presentaron trastornos de tipo psiquiátrico clasificados como probables reacciones adversas al medicamento. Conclusión. El LEV se utilizó en niños con diferentes diagnósticos con baja frecuencia de eventos adversos. El perfil de utilización varió en los diferentes grupos etarios. Es necesario identificar en futuros estudios la efectividad especialmente en el recién nacido y en epilepsias refractarias.

Introduction. Levetiracetam (LEV) is an antiepileptic drug approved by the Chilean Institute of Public Health as concomitant therapy for epileptic seizures in children older than 4 years of age. However, it is widely prescribed from the neonatal period, which makes it necessary to evaluate its off-label use. Objective. To determine the prescription-indication profile of LEV in the treatment of epileptic seizures in children younger than 4 years in a tertiary care hospital in southern Chile. Population and method. Observational, descriptive, and retrospective study. The medical records of patients who started treatment with LEV between 2014 and 2019 were reviewed, and data on sociodemographic, pharmacological, and clinical variables were collected. The analysis was based on the description of the profile of patients, prescriptions, follow-up, and safety. Results. A total of 68 patients were included: 40 (58.8%) were males, 49 (72.1%) were born at a gestational age ≥ 37 weeks. The main etiology of epilepsy was structural (35.3%); LEV was mostly used in children diagnosed with central nervous system malformation (17.6%), and monotherapy was the prevailing dosage (55.9%). LEV was used for focal seizures in 50% of cases. Five children (7.3%) had psychiatric disorders, classified as probable adverse drug reactions. Conclusion. LEV was used in children with various diagnoses, with a low rate of adverse events. The profile of drug use varied in the different age groups. Future studies are needed to identify effectiveness, especially in newborn infants and patients with refractory epilepsy.

Levetiracetam prescription profile in children younger than 4 years treated at a tertiary care hospital in Chile. / Perfil de prescripción de levetiracetam en niños menores de cuatro años atendidos en un hospital de alta complejidad de Chile.

Introduction. Levetiracetam (LEV) is an antiepileptic drug approved by the Chilean Institute of Public Health as concomitant therapy for epileptic seizures in children older than 4 years of age. However, it is widely prescribed from the neonatal period, which makes it necessary to evaluate its off-label use. Objective. To determine the prescription-indication profile of LEV in the treatment of epileptic seizures in children younger than 4 years in a tertiary care hospital in southern Chile. Population and method. Observational, descriptive, and retrospective study. The medical records of patients who started treatment with LEV between 2014 and 2019 were reviewed, and data on sociodemographic, pharmacological, and clinical variables were collected. The analysis was based on the description of the profile of patients, prescriptions, follow-up, and safety. Results. A total of 68 patients were included: 40 (58.8%) were males, 49 (72.1%) were born at a gestational age ≥ 37 weeks. The main etiology of epilepsy was structural (35.3%); LEV was mostly used in children diagnosed with central nervous system malformation (17.6%), and monotherapy was the prevailing dosage (55.9%). LEV was used for focal seizures in 50% of cases. Five children (7.3%) had psychiatric disorders, classified as probable adverse drug reactions. Conclusion. LEV was used in children with various diagnoses, with a low rate of adverse events. The profile of drug use varied in the different age groups. Future studies are needed to identify effectiveness, especially in newborn infants and patients with refractory epilepsy.

Introducción. El levetiracetam (LEV) es un antiepiléptico aprobado por el Instituto de Salud Pública de Chile como terapia concomitante en crisis epilépticas en niños mayores de cuatro años. Sin embargo, es ampliamente indicado desde el periodo neonatal, lo que hace necesario evaluar su utilización fuera de ficha técnica. Objetivo. Determinar el perfil de prescripción-indicación de LEV en el tratamiento de las crisis epilépticas en menores de cuatro años en un hospital de alta complejidad del sur de Chile. Población y método. Estudio observacional, descriptivo y retrospectivo. Se revisaron las historias clínicas de quienes iniciaron tratamiento con LEV entre 2014 y 2019, y se recopilaron datos sobre variables sociodemográficas, farmacológicas y clínicas. El análisis se basó en la descripción del perfil de los pacientes, prescripción, seguimiento y seguridad. Resultados. Se incluyeron 68 pacientes: 40 (58,8 %) de sexo masculino, 49 (72,1 %) con edad gestacional ≥ 37 semanas. La etiología principal de la epilepsia fue de tipo estructural (35,3 %); el LEV se utilizó principalmente en niños diagnosticados con malformación del sistema nervioso central (17,6 %) y predominó la monoterapia (55,9 %). En el 50 % se usó LEV para crisis focales. Cinco niños (7,3 %) presentaron trastornos de tipo psiquiátrico clasificados como probables reacciones adversas al medicamento. Conclusión. El LEV se utilizó en niños con diferentes diagnósticos con baja frecuencia de eventos adversos. El perfil de utilización varió en los diferentes grupos etarios. Es necesario identificar en futuros estudios la efectividad especialmente en el recién nacido y en epilepsias refractarias.

Antiulcer activity of Mauritia flexuosa L.f. (Arecaceae) pulp oil: An edible Amazonian species with functional properties.

Mauritia flexuosa, known as buriti in Brazil, is a widespread palm tree in Amazonia. It has many ethnobotanical uses, including food, oil, and medicine. The oil obtained from buriti's fruit pulp has high levels of monounsaturated fatty acids, carotenoids, and tocopherols, and is used in the food, cosmetic, and pharmaceutical industries for its antioxidant properties. Many biological activities have been reported for buriti oil, such as antioxidant, antimicrobial, chemopreventive, and immunomodulatory. Due to its high content of bioactive compounds, buriti oil is considered a functional ingredient with possible benefits in preventing oxidative stress and chronic diseases, particularly in the gastrointestinal tract. Peptic ulcer disease is a multifactorial disorder, involving lesions in the stomach and duodenum mucosa, which has a complex healing process. In this context, some nutrients and bioactive compounds help the maintenance of gastrointestinal mucosal integrity and function, such as carotenoids, tocopherols, and unsaturated fatty acids, which makes buriti oil an interesting candidate to be used in the prevention and management of gastrointestinal diseases. This study aimed to evaluate the gastroprotective and antiulcer effects of buriti oil and its possible mechanisms of action. Buriti oil reduced the ulcerative area and lipid peroxidation induced by ethanol. The gastroprotective activity of buriti oil partially depends on nitric oxide and sulfhydryl compounds. In acetic acid-induced gastric ulcers, buriti oil accelerated healing and stimulated the formation of new gastric glands. These results demonstrated the potential of buriti oil as a functional ingredient to promote health benefits in the gastrointestinal tract.

Preventive effects of resveratrol against early-life impairments in the animal model of autism induced by valproic acid.

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by social interaction deficits and repetitive/stereotyped behaviors. Its prevalence is increasing, affecting one in 36 children in the United States. The valproic acid (VPA) induced animal model of ASD is a reliable method for investigating cellular, molecular, and behavioral aspects related to the disorder. Trans-Resveratrol (RSV), a polyphenol with anti-inflammatory and antioxidant effects studied in various diseases, has recently demonstrated the ability to prevent cellular, molecular, sensory, and social deficits in the VPA model. In this study, we examined the effects of prenatal exposure to VPA and the potential preventive effects of RSV on the offspring. Method: We monitored gestational weight from embryonic day 6.5 until 18.5 and assessed the onset of developmental milestones and morphometric parameters in litters. The generalized estimating equations (GEE) were used to analyze longitudinal data. Results: Exposure to VPA during rat pregnancy resulted in abnormal weight gain fold-changes on embryonic days 13.5 and 18.5, followed by fewer animals per litter. Additionally, we discovered a positive correlation between weight variation during E15.5-E18.5 and the number of rat pups in the VPA group. Conclusion: VPA exposure led to slight length deficiencies and delays in the onset of developmental milestones. Interestingly, the prenatal RSV treatment not only prevented most of these delays but also led to the early onset of certain milestones and improved morphometric characteristics in the offspring. In summary, our findings suggest that RSV may have potential as a therapeutic intervention to protect against the negative effects of prenatal VPA exposure, highlighting its importance in future studies of prenatal neurodevelopmental disorders.

Pertussis antibodies and vaccination coverage among healthcare professionals in Brazil is inadequate: A cross-sectional serological study.

INTRODUCTION: Worldwide, tetanus-diphtheria-acellular pertussis (Tdap) vaccination coverage of healthcare professionals (HCPs) is below 40%, but this data is not available for Brazil. We hypothesize that a high number of HCPs are not immune to pertussis in Brazil. Main objective was to determine the seroprevalence of anti-pertussis toxin (anti-PT IgG) among HCPs. Secondary objectives were to evaluate Tdap vaccination coverage, to assess predictive factors associated with anti-PT IgG, and to estimate the decay of anti-PT IgG and time to Tdap vaccination. METHODS: Observational cross-sectional serological study in 352 HCPs who worked at São Paulo Hospital - Federal University of São Paulo (UNIFESP) in 2020, approved by UNIFESP Ethics Committee. Data collected included sociodemographics, knowledge about Tdap, and vaccination status. Anti-PT IgG were quantified by ELISA: <10 IU/mL seronegative and ≥ 10-1000 IU/mL seropositive. Titers ≥ 10-50 IU/mL were classified low positivity, indicating no recent B. pertussis infection or Tdap vaccination; >50 IU/mL high positivity, indicating recent B. pertussis infection or Tdap vaccination, and > 100 IU/mL as acute B. pertussis infection or Tdap vaccination in the previous year. Comparisons were done by Chi-square test, multivariable logistic regression, and Pearsons correlation, at 5% p-level. RESULTS: 331/352 HCPs were not aware the Brazilian National Immunization Program recommends Tdap for all HCPs and pregnant women. 68/339 HCPs received Tdap (mean 3.1 ± 2.0 years). 55/352 were seronegative for pertussis, all unvaccinated. 56/271 with no history of Tdap vaccination had high positivity. The probability of anti-PT IgG > 50 IU/mL was 11.5 times higher in Tdap vaccinated HCPs than in non-vaccinated (p < 0.001). There was a weak but significant correlation between anti-PT IgG and interval of Tdap vaccination (r = 0.404; p = 0.001). Anti-PT IgG dropped 5 IU/mL/year (p = 0.001). CONCLUSION: Better education of HCPs on needs and benefits of Tdap vaccination is critical. Goals must be to improve HCPs vaccination coverage.

Vaccination strategies for people living with inborn errors of metabolism in Brazil

Abstract Objective: Through a literature review, make recommendations regarding immunizations in people living with Inborn Error of Metabolism (IEM) in Brazil, assess the possible impact on metabolic decompensations after immunization, and if this specific population may have an impaired immune response to vaccines. Source of data: The MeSH Terms vaccination OR vaccine OR immunization associated with the term inborn error of metabolism AND recommendation were used in combination with search databases. Only articles published after 1990, in the languages English, Spanish, French or Portuguese, human-related were included. Synthesis of data: A total of 44 articles were included to make the following recommendations. Individuals with IEMs need to be up to date with their immunizations. Regarding which vaccines should be offered, children and adults should follow the routine immunization schedules locally available, including the COVID-19 vaccines. The only exception is the rotavirus vaccine for hereditary fructose intolerance. The benefit of immunization outweighs the very low risk of metabolic decompensation. Since not all patients will have an adequate immune response, measuring antibody conversion and titers is recommended Conclusions: All patients should receive age-appropriate immunizations in their respective schedules without delays. The only situation when vaccination may be contraindicated is with oral rotavirus vaccine in hereditary fructose intolerance. Monitoring the levels of antibodies should be done to detect any immune dysfunction or the necessity for boosters. A personalized immunization schedule is ideal for patients with IEMs. The reference organizations could improve their recommendations to address all IEMs, not only some of them.

Vaccination strategies for people living with inborn errors of metabolism in Brazil.

OBJECTIVE: Through a literature review, make recommendations regarding immunizations in people living with Inborn Error of Metabolism (IEM) in Brazil, assess the possible impact on metabolic decompensations after immunization, and if this specific population may have an impaired immune response to vaccines. SOURCE OF DATA: The MeSH Terms vaccination OR vaccine OR immunization associated with the term inborn error of metabolism AND recommendation were used in combination with search databases. Only articles published after 1990, in the languages English, Spanish, French or Portuguese, human-related were included. SYNTHESIS OF DATA: A total of 44 articles were included to make the following recommendations. Individuals with IEMs need to be up to date with their immunizations. Regarding which vaccines should be offered, children and adults should follow the routine immunization schedules locally available, including the COVID-19 vaccines. The only exception is the rotavirus vaccine for hereditary fructose intolerance. The benefit of immunization outweighs the very low risk of metabolic decompensation. Since not all patients will have an adequate immune response, measuring antibody conversion and titers is recommended CONCLUSIONS: All patients should receive age-appropriate immunizations in their respective schedules without delays. The only situation when vaccination may be contraindicated is with oral rotavirus vaccine in hereditary fructose intolerance. Monitoring the levels of antibodies should be done to detect any immune dysfunction or the necessity for boosters. A personalized immunization schedule is ideal for patients with IEMs. The reference organizations could improve their recommendations to address all IEMs, not only some of them.

Forage production, morphogenetic and structural components, and nutritional value of tropical grasses in the semiarid condition / Produção de forragem, componentes morfogênicos e estruturais e valor nutricional de gramíneas tropicais em condição semiárida

The objective of this study was to evaluate the forage mass, morphogenetic and structural characteristics, and nutritional value of tropical forage grasses in semiarid conditions. Nine grasses were evaluated, namely, three cultivars of Urochloa brizantha (Marandu, MG4, and Piatã); Urochloa decumbens cv. Basilisk; Urochloa humidicola cv. Llanero; Urochloa ruziziensis cv. Kennedy; and three cultivars of Megathyrsus maximum (Massai, Mombaça, and Tanzania). The experiment was laid out in a randomized complete block design in a split-plot arrangement in which the main factor were the grass cultivars and the secondary factor the seasons, with five replications per treatment. The statistical model included the fixed effect of treatment (grass), whereas the season was included as a random effect within treatments. Urochloa brizantha cvs. Marandu, MG4, and Piatã and Urochloa decumbens cv. Basilisk produced on average 858 kg ha-1 more forage mass than cvs. Kennedy and Basilisk. Megathyrsus maximum cv. Mombaça produced 40% more forage mass than the other cultivars of M. maximum (4205 vs. 3001 kg ha-1). Urochloa ruziziensis cv. Kennedy showed the lowest water use efficiency (36%). Urochloa ruziziensis cv. Kennedy exhibited the lowest leaf weight among the Urochloa cultivars (740 vs. 1319 kg ha-1). There was no treatment effect for leaf weight in the M. maximum cultivars. Urochloa ruziziensis cv. Kennedy showed the highest values of total digestible nutrients and dry matter digestibility (1.84 and 2.34%, respectively) among the other Urochloa cultivars. The M. maximum cultivars showed little differences in nutritional values. Cultivars Marandu, Piatã, and Massai exhibited better productive responses in the edaphoclimatic conditions of this study. However, future studies must be conducted evaluating the adaptation of the forage grass under semiarid conditions. Considering the settings of this study, the grasses Urochloa brizantha cvs. MG4, Marandu, and Piatã, as well as Megathyrsus maximum cvs. Massai and Mombaça, can be used in the semiarid condition.

O objetivo deste estudo foi avaliar a produtividade, características morfogênicas e estruturais e valor nutritivo de gramíneas forrageiras tropicais em condições semiáridas. Nove gramíneas foram avaliadas: Três cultivares de Urochloa brizantha (Marandu, MG4 e Piatã), Urochloa decumbens cv. Basilisk, Urochloa humidicola cv. Llanero, Urochloa ruziziensis cv. Kennedy e três cultivares de Megathyrsus maximum (Massai, capim-Mombaça e Tanzânia). O experimento foi conduzido em blocos completos casualizados em esquema de parcelas subdivididas com o fator principal (cultivar) e o fator secundário (estação) com cinco repetições por tratamento. O modelo estatístico incluiu o efeito fixo de tratamento (cultivar), e a estação do ano foi incluída como efeito aleatório dentro do tratamento. Urochloa brizantha cv. Marandu, MG4 e Piatã e Urochloa decumbens cv Basilisk produziram em média 858 kg ha-1 de massa de forragem a mais que a cv. Kennedy e Llanero. Megathyrsus cv. Mombaça produziu 40% (4205 vs. 3001 kg ha-1) a mais de massa de forragem do que as demais cultivares de Megathyrsus maximum. Urochloa ruziziensis cv. Kennedy apresentou a menor (36%) eficiência no uso da água (EUA). Urochloa ruziziensis cv. Kennedy produziu menor quantidade de folhas (740 vs. 1319 kg ha-1) para as demais cultivares de Urochloa. Não houve efeito do tratamento na produtividade de folhas para as cultivares Megathyrsus maximum. Urochloa ruziziensis cv. Kennedy apresentou os maiores valores de nutrientes digestíveis totais (NDT) e digestibilidade da matéria seca (DMS) (+1,84 e 2,34%, respectivamente) em relação à outra cultivar de Urochloa. As cultivares Megathyrsus maximum tiveram pouco efeito sobre os valores nutritivos. As cultivares Marandu, Piatã e Massai apresentaram melhores respostas produtivas nas condições edafoclimáticas deste estudo. No entanto, estudos futuros devem ser realizados avaliando a adaptação da forrageira em condições semiáridas. Nesta condição de estudo, as gramíneas Urochloa brizantha cv. MG4, Marandu e Piatã, assim como o Megathyrsus maximum cv. Massai e Mombaça podem ser usados em condições semiáridas.

Investigation of factors related to biofilm formation in Providencia stuartii.

Providencia stuartii is one of the Enterobacteriaceae species of medical importance commonly associated with urinary infections, which can also cause other ones, including uncommon ones, such as liver abscess and septic vasculitis. This bacterium stands out in the expression of intrinsic and acquired resistance to antimicrobials. Besides, it uses mechanisms such as biofilm for its persistence in biotic and abiotic environments. This study investigated the cellular hydrophobicity profile of clinical isolates of P. stuartii. It also analyzed genes related to the fimbrial adhesin in this species comparing with other reports described for other bacteria from Enterobacteriaceae family. The investigated isolates to form biofilm and had a practically hydrophilic cell surface profile. However, fimH and mrkD genes were not found in P. stuartii, unlike observed in other species of Enterobacteriaceae. These results show that P. stuartii has specificities regarding its potential for biofilm formation, which makes it difficult to destabilize the infectious process and increases the permanence of this pathogen in hospital units.

Use of biostimulants in elephant grass cv. Napier / Uso de bioestimulantes em capim-elefante cultivar Napier

This study was developed to examine the growth, yield, chemical composition and in situ degradability of elephant grass cv. Napier (Pennisetum purpureum). Five spraying protocols with biostimulants were tested, namely, Control - no application; 1BR - bioregulator at seven days; 2BR - bioregulator at seven days + bioregulator and foliar fertilization at 20 days; 2BR2 - bioregulator at seven days + bioregulator and foliar fertilization at 20 days + ethylene inhibitor at 30 days; and 3BR - bioregulator at seven days + bioregulator and foliar fertilization at 20 days + ethylene inhibitor and bioregulator at 30 days. The grass was cut evenly at a height of 15 cm and harvested at 70 days of regrowth. The experimental area was divided into two blocks according to the slope. Ninety plots were used, totaling an area of 4,608 m2. Each plot was composed of four 4-m rows spaced 80 cm apart. Chemical composition, morphological traits and forage digestibility data were evaluated. The 3BR protocol, with more bioregulator-based applications, resulted in higher canopy (9.78%) and stem (9.58%) compared with control group. The 2BR and 2BR2 treatments provided a 6.5% higher stem than control treatment. The improvement in the nutritional value of Pennisetum purpureum cv. Napier was due to the 17.55% increase in crude protein (CP) content provided by protocol 3BR relative to control group. Treatments 2BR2 and 3BR improved the effective degradability of dry matter (DM). The application of biostimulant protocols increased the potential degradability of neutral detergent fiber (NDF) (+4.1%), with the greatest response seen in treatment 2BR2 in comparison with control treatment. Biostimulant protocols increase the canopy and stem heights and CP content. The application of a bioregulator associated with foliar fertilization and ethylene inhibitor improves the effective degradability of DM and NDF and the potential degradability of NDF in Pennisetum purpureum cv. Napier harvested at 70 days of regrowth.(AU)

Objetivou-se avaliar o crescimento, a produtividade, a composição bromatológica e a degradabilidade in situ do capim-elefante cv. Napier (Pennisetum purpureum). Foram efetuados cinco diferentes protocolos de pulverização com bioestimulantes: Controle - nenhuma aplicação, 1BR - biorregulador aos 7 dias; 2BR - biorregulador aos 7 dias, biorregulador e adubação foliar aos 20 dias; 2BR2 - biorregulador aos 7 dias, biorregulador e adubação foliar aos 20 dias, inibidor de etileno aos 30 dias; 3BR - biorregulador aos 7 dias, biorregulador e adubação foliar aos 20 dias, inibidor de etileno e biorregulador aos 30 dias. Foi realizado o corte de uniformização do capim a 15 centímetros de altura, sendo a colheita efetuada aos 70 dias de rebrota. A área experimental foi dividida em dois blocos de acordo com a declividade. Foram utilizadas 90 parcelas, totalizando 4.608 m2 de área. Cada parcela foi composta por quatro linhas de quatro metros cada, com espaço entrelinhas de 80 centímetros. Os dados foram avaliados quanto à composição química, características morfológicas e digestibilidade da forragem. O protocolo 3BR, com mais aplicações à base de biorreguladores, resultou em dossel maior (9,78%) e maior altura de caule (9,58%) em relação ao grupo controle, bem como os tratamentos 2BR e 2BR2 promoveram aumento da altura de caule em 6,5% se comparado com tratamento controle. A melhoria no valor nutricional do Pennisetum purpureum cv. Napier se deu em função da elevação no teor de proteína bruta (PB) de 17,55% em relação ao grupo controle com o protocolo 3BR. Houve aumento da degradabilidade efetiva da matéria seca (MS) para os tratamentos 2BR2 e 3BR. A aplicação dos protocolos de bioestimulantes aumentou a degradabilidade potencial da fibra em detergente neutro (FDN) (+4,1%), com maior resposta para o tratamento 2BR2 em relação ao tratamento controle. Os protocolos de bioestimulantes elevam a altura do dossel e do caule e incrementam o teor de PB. A aplicação de biorregulador, associado à adubação foliar e inibidor de etileno melhora a degradabilidade efetiva da MS e FDN e a degradabilidade potencial da FDN do Pennisetum purpureum cv. Napier cortado aos 70 dias de rebrota.(AU)

Factors associated with suicide ideation of healthcare university students / Factores relacionados a la ideación suicida de universitarios de la área de salud / Fatores associados à ideação suicida de universitários da área da saúde

ABSTRACT Objectives: to analyze the factors associated with suicidal ideation in students from healthcare graduation courses. Methods: quantitative, cross-sectional study, with 251 students from the courses of radiology, speech-language therapy, medicine, nutrition, health service management, and nursing, from a federal higher education institution in the Southeast of Brazil. Data were collected from August to October 2019, using an electronic questionnaire. Results: the prevalence of suicidal ideation among participants was 26.33%. In the final logistic regression model, only depressive symptoms were associated with suicidal ideation. Having symptoms of depression increased the chances of suicidal ideation 2.6 times. Conclusion: the high prevalence of suicidal ideation and its associated factors constitutes a situational diagnosis that demands the elaboration of public and institutional policies, focused on the promotion and attention to the mental health of the students.

RESUMEN Objetivos: Analizar los factores relacionados a la ideación suicida de estudiantes de cursos de grado de la área de salud. Métodos: Estudio cuantitativo, transversal, con 251 alumnos de los cursos de Radiología, Fonoaudiología, Medicina, Nutrición, Gestión en Servicios de Salud y Enfermería de una institución federal de Educación Superior en el Sudeste brasileño. Los datos fueron recolectados en el período de agosto a octubre de 2019, por medio de encuesta electrónica. Resultados: La prevalencia de ideación suicida entre los participantes fue de 26,33%. En el modelo de regresión logística final, sólo síntomas depresivos fueron relacionados a la ideación suicida. Tener síntomas depresivos aumentó en 2,6 las chances de presentar ideación suicida. Conclusión: La alta prevalencia de la ideación suicida y sus factores relacionados constituyen un diagnóstico situacional que demanda la elaboración de políticas públicas e institucionales, enfocando la promoción y la atención a la salud mental de los estudiantes.

RESUMO Objetivos: analisar os fatores associados à ideação suicida de estudantes de cursos de graduação da área da saúde. Métodos: estudo quantitativo, transversal, com 251 alunos dos cursos de Radiologia, Fonoaudiologia, Medicina, Nutrição, Gestão em Serviços de Saúde e Enfermagem de uma instituição federal de Ensino Superior no Sudeste brasileiro. Os dados foram coletados no período de agosto a outubro de 2019, por meio de questionário eletrônico. Resultados: a prevalência de ideação suicida entre os participantes foi de 26,33%. No modelo de regressão logística final, apenas sintomas depressivos foram associados à ideação suicida. Ter sintomas depressivos aumentou em 2,6 as chances de apresentar ideação suicida. Conclusão: a alta prevalência da ideação suicida e seus fatores associados constituem um diagnóstico situacional que demanda a elaboração de políticas públicas e institucionais, enfocando a promoção e a atenção à saúde mental dos estudantes.

Factors associated with suicide ideation of healthcare university students.

OBJECTIVES: to analyze the factors associated with suicidal ideation in students from healthcare graduation courses. METHODS: quantitative, cross-sectional study, with 251 students from the courses of radiology, speech-language therapy, medicine, nutrition, health service management, and nursing, from a federal higher education institution in the Southeast of Brazil. Data were collected from August to October 2019, using an electronic questionnaire. RESULTS: the prevalence of suicidal ideation among participants was 26.33%. In the final logistic regression model, only depressive symptoms were associated with suicidal ideation. Having symptoms of depression increased the chances of suicidal ideation 2.6 times. CONCLUSION: the high prevalence of suicidal ideation and its associated factors constitutes a situational diagnosis that demands the elaboration of public and institutional policies, focused on the promotion and attention to the mental health of the students.

Evaluation of cytotoxic, immunomodulatory effects, antimicrobial activities and phytochemical constituents from various extracts of Passiflora edulis F. flavicarpa (Passifloraceae).

The leaves of P. edulis were subjected to physicochemical analysis, such as ion content, extractives, and structural molecules. The hexanic, ethanolic and ethyl acetate extracts were submitted to phytochemical analyzes by GC-MS, HPLC-MS, and spectrophotometry. In addition, antioxidant (DPPH, ABTS and TAA methods) potential, antimicrobial (MIC method) action, cytotoxicity and immunostimulant activity (flow cytometry analysis) were performed. The extracts showed a moderate antioxidant capacity and revealed the presence of several metabolites, mainly phenols, such as caffeic acid, p-coumaric acid and luteolin. The ethyl acetate and ethanolic extracts showed antifungal activity. In addition, the extracts did not affect splenocytes viability at 12.5 µg/mL and promoted the production of IL-6, IL-10, IL-17 and TNF-α cytokines. P. edulis extracts showed antifungal and antioxidant activity and were able to induce immunostimulatory action in splenocyte cultures in vitro.

Volumetric and linear evaluation of the sphenoidal sinus of a Brazilian population, in cone beam computed tomography.

The determination of sex from skeletal remains has been widely used in biological profile reconstruction since these are some of the last structures to perish after death. The sphenoid sinus is located deeply in the skull and is enveloped by diverse structures within the sphenoid body. It is, therefore, less predisposed to injuries and/or pathological changes. The aim of this study is to evaluate the possibility of determining sex in a Brazilian population by means of linear and volumetric measurements of the sphenoid sinus, in addition to identifying and quantifying the presence of extensions of this sinus in cone beam computed tomography (CBCT) scans. In total 268 CBCT scans were analysed, from patients aged between 22 and 70 years old, of which 145 were female, and 123 were male. The images, representative of a Brazilian population, were selected by a dental radiologist from a CBCT image bank. The volumetric measurements were made by means of the segmentation software ITK-SNAP 3.0® and the linear inferio-superior, latero-lateral and anteroposterior measurements, as well as the presence of extensions of the sphenoidal sinus, were made using the CS Imaging Software®. The results of this study suggested that when comparing men and women, there were no statistical differences in the linear measurements and extensions of the sphenoidal sinus, although the values were considerable in the extensions for the pterygoid processes and greater wings of the sphenoid bone, particularly in women. However, there was a statistically significant difference when the sphenoidal sinus volume was compared, as it was larger for men (11.364 mm³ ± 4.229 mm³) than for women (10.000 mm³ ± 3.615 mm³). In summary, the sphenoidal sinus volumetric measurements in CBCT exams are useful for determining the sex of unknown individuals.

Redecin Brasil: a construção metodológica de um estudo multicêntrico para avaliação da rede de cuidados à pessoa com deficiência / Redecin Brazil: constructing the methodology of a multicentric study to evaluate the care network for people with disabilities / Redecin Brasil: la construcción metodológica de un estudio multicéntrico para evaluación de la red de cuidados a la persona con discapacidad

Este artigo objetiva apresentar o percurso metodológico do estudo Redecin - Avaliação da Implantação da Rede de Cuidados à Pessoa com Deficiência (RCPCD) no Brasil. Trata-se de estudo multicêntrico, transversal, de delineamento híbrido, envolvendo instrumentos quantitativos por meio de análise documental e questionários estruturados, e qualitativos com entrevistas de atores-chave sobre a implantação da RCPCD. Após discussões com atores do Ministério da Saúde e do grupo de pesquisa, adotou-se a configuração de região/macrorregião de saúde envolvendo todos os componentes da rede descritos na portaria que institui essa rede. O estudo possui representatividade em oito estados nas cinco regiões geográficas brasileiras. O uso de método híbrido, múltiplas fontes de evidências e incorporação do conceito de Rede de Atenção à Saúde foram fundamentais para se estruturar uma avaliação como instrumento que almeja subsidiar processos de tomada de decisão em saúde. (AU)

This article presents the methodological path of the Redecin study - Evaluation of the Implementation of the Care Network for People with Disabilities (RCPCD) in Brazil. We conducted a multicentric cross-sectional study adopting a hybrid design involving quantitative instruments (document analysis and structured questionnaires) and qualitative methods (interviews with key informants about the implementation of the RCPCD). After discussions with informants from the Ministry of Health and research group, a health region/macro region configuration was adopted, involving all the components of the RCPCD described in the Ministerial Order that created the network. The study was shown to be representative in eight states in the country's five geographical regions. The use of a hybrid design and multiple evidence sources, and the incorporation of the concept of health care network were fundamental to structuring the evaluation as an instrument that aims to support health care decision-making processes. (AU)

El objetivo de este artículo es presentar la trayectoria metodológica del estudio Redecin - Evaluación de la implantación de la Red de Cuidados a la Persona con Discapacidad (RCPCD) en Brasil. Se trata de un estudio multicéntrico, transversal, de delineación híbrida, envolviendo instrumentos cuantitativos, por medio de análisis documental y cuestionarios estructurados y cualitativos, con entrevistas de actores-clave sobre la implantación de la RCPCD. Después de discusiones con actores del Ministerio de la Salud y del grupo de investigación, se adoptó la configuración de región/macrorregión de salud, envolviendo a todos los componentes de la red que se describen en el decreto administrativo que constituye esta red. El estudio tiene representatividad en ocho estados en las cinco regiones geográficas brasileñas. El uso del método híbrido, las múltiples fuentes de evidencias y la incorporación del concepto de Red de Atención de la Salud fueron fundamentales para estructurar una evaluación en la condición de instrumento que anhela subsidiar procesos de toma de decisión en salud. (AU)

First report of the aac(6)-Ib-cr gene in Providencia stuartii isolates in Brazil

Abstract INTRODUCTION: The aac(6')-Ib-cr and bla KPC genes are spreading among Enterobacteriaceae species, including Providencia stuartii, in some countries of world. METHODS: These genes were investigated in 28 P. stuartii isolates from a public hospital in Recife, Pernambuco, Brazil, by PCR and sequencing. RESULTS: The aac(6')-Ib-cr gene was detected in 16 resistant isolates, and the bla KPC gene was seen in 14. CONCLUSIONS: The presence of these genes in P. stuartii multi- and extensively drug-resistant isolates indicates that the resistance arsenal of this species is increasing, thus limiting the therapeutic options.

First report of the aac(6')-Ib-cr gene in Providencia stuartii isolates in Brazil.

INTRODUCTION: The aac(6')-Ib-cr and bla KPC genes are spreading among Enterobacteriaceae species, including Providencia stuartii, in some countries of world. METHODS: These genes were investigated in 28 P. stuartii isolates from a public hospital in Recife, Pernambuco, Brazil, by PCR and sequencing. RESULTS: The aac(6')-Ib-cr gene was detected in 16 resistant isolates, and the bla KPC gene was seen in 14. CONCLUSIONS: The presence of these genes in P. stuartii multi- and extensively drug-resistant isolates indicates that the resistance arsenal of this species is increasing, thus limiting the therapeutic options.

Experiências das pessoas com doença renal crônica na capacitação para a diálise peritoneal / Experiences of people with chronic kidney disease when training for peritoneal dialysis

Objetivo: Compreender as experiências das pessoas com doença renal crônica ao realizar a capacitação para a diálise peritoneal ambulatorial contínua no ambiente hospitalar. Metodologia: Estudo com abordagem qualitativa utilizando-se do conceito de experiência de adoecimento de Byron Good. A coleta de dados desenvolvida entre abril de 2013 e junho de 2014, foi mediante entrevistas abertas e semiestruturadas. Participaram do estudo 20 pessoas em diálise peritoneal ambulatorial contínua. Os dados foram gerenciados e organizados pelo Programa Ethnograph V6 e tratados mediante análise de conteúdo convencional. Resultados: Foram construídas três categorias: É bem difícil! Sentimentos e sensações gerados à pessoa durante a capacitação; Olhar e repetir! Processo de aprendizagem durante a capacitação no hospital; e Participação da família na capacitação. Conclusão: As pessoas com doença renal crônica apresentaram diversos sentimentos e sensações relacionados à condição clínica, emocional e social, influenciando de forma negativa o processo de aprendizagem, realizado pelo enfermeiro, para diálise peritoneal.

Objective: To understand the experiences of people with chronic kidney disease when performing training for continuous ambulatory peritoneal dialysis inside the hospital setting. Methodology: Qualitative approach study using concept of illness experience of Byron Good. Data colletion developed between April 2013 and June 2014, through open and semi-structured interviews. Twenty people under continuous ambulatory peritoneal dialysis participated in the study. Data were managed and organized by the Ethnograph V6 Program and processed by conventional content analysis. Results: Data were treated by conventional content analysis from which three categories were constructed: It is pretty hard! Feelings and sensations generated to the person during the training; Look and repeat! Learning process during training at the hospital; and Family participation in training. Conclusion: People with chronic kidney disease presented various feelings and sensations related to the clinical, emotional and social condition, negatively influencing the learning process, performed by the nurse, for peritoneal dialysis.

Bioguided Purification of Active Compounds from Leaves of Anadenanthera colubrina var. cebil (Griseb.) Altschul.

Anadenanthera colubrina var cebil (Griseb.) Altschul is a medicinal plant found throughout the Brazilian semi-arid area. This work performed a bioguided purification of active substances present in ethyl acetate extract from A. colubrina leaves. The anti-Staphylococcus aureus and antioxidant actions were used as markers of bioactivity. The extract was subjected to flash chromatography resulting in five fractions (F1, F2, F3, F4, and F5). The fractions F2 and F4 presented the highest antimicrobial action, with a dose able to inhibit 50% of bacteria growth (IN50) of 19.53 µg/mL for S. aureus UFPEDA 02; whereas F4 showed higher inhibitory action towards DPPH radical (2,2-diphenyl-1-picryl-hydrazyl-hydrate) [dose able to inhibit 50% of the radical (IC50) = 133 ± 9 µg/mL]. F2 and F4 were then subjected to preparative high-performance liquid chromatography (HPLC) and nuclear magnetic resonance (NMR), resulting in the identification of p-hydroxybenzoic acid and hyperoside as the major compounds in F2 and F4, respectively. Hyperoside and p-hydroxybenzoic acid presented IN50 values of 250 µg/mL and 500 µg/mL against S. aureus UFPEDA 02, respectively. However, the hyperoside had an IN50 of 62.5 µg/mL against S. aureus UFPEDA 705, a clinical isolate with multidrug resistant phenotype. Among the purified compounds, the proanthocyanidins obtained from F2 exhibited the higher antioxidant potentials. Taken together, these results highlight the potential of A. colubrina leaves as an alternative source of biomolecules of interest for the pharmaceutical, food, and cosmetic industries.