Oropharyngeal colostrum administration in neonates with gastroschisis: a randomized clinical trial.

OBJECTIVE: To evaluate the effect of colostrum therapy on days to start a suckling diet in newborns diagnosed with simple gastroschisis. METHODS: Randomized clinical trial with newborns diagnosed with simple gastroschisis at a federal hospital in Rio de Janeiro who were randomized to receive oropharyngeal administration of 0.2mL of colostrum or a "sham procedure" during the first 3 days of life. The analysis included clinical outcomes such as days without food, days with parenteral feeding, days until the start of enteral feeding, days to reach complete enteral feeding, sepsis and length of hospital stay. RESULTS: The onset of oral feeding (suction) in patients with simple gastroschisis in both groups occurred at a median of 15 days. CONCLUSION: The present study showed that there were no significant differences in the use of colostrum therapy and the number of days to the start of enteral feeding and suction diet between groups of newborns with simple gastroschisis.

Oropharyngeal colostrum administration in neonates with gastroschisis: a randomized clinical trial / Administração orofaríngea de colostro em recém-nascidos com gastrosquise: ensaio clínico randomizado

ABSTRACT Objective: To evaluate the effect of colostrum therapy on days to start a suckling diet in newborns diagnosed with simple gastroschisis. Methods: Randomized clinical trial with newborns diagnosed with simple gastroschisis at a federal hospital in Rio de Janeiro who were randomized to receive oropharyngeal administration of 0.2mL of colostrum or a "sham procedure" during the first 3 days of life. The analysis included clinical outcomes such as days without food, days with parenteral feeding, days until the start of enteral feeding, days to reach complete enteral feeding, sepsis and length of hospital stay. Results: The onset of oral feeding (suction) in patients with simple gastroschisis in both groups occurred at a median of 15 days. Conclusion: The present study showed that there were no significant differences in the use of colostrum therapy and the number of days to the start of enteral feeding and suction diet between groups of newborns with simple gastroschisis.

RESUMO Objetivo: Avaliar o efeito da colostroterapia em dias para iniciar a dieta por sucção em recém-nascidos com diagnóstico de gastrosquise simples. Métodos: Ensaio clínico randomizado com recém-nascidos diagnosticados com gastrosquise simples em um hospital federal no Rio de Janeiro que foram randomizados para receber administração orofaríngea de 0,2mL de colostro ou "procedimento simulado", nos primeiros 3 dias de vida. A análise incluiu desfechos clínicos, como dias sem alimentação, dias com alimentação parenteral, dias para iniciar a alimentação enteral, dias para atingir a alimentação completa, sepse e tempo de internação. Resultados: O início da alimentação por via oral (sucção) na gastrosquise simples, em ambos os grupos, ocorreu com mediana de 15 dias. Conclusão: O presente estudo mostrou que não há diferenças significativas no uso de colostroterapia em dias para início de alimentação enteral e dieta por sucção entre grupos de recém-nascidos com gastrosquise simples.

Breast MRI: Simplifying Protocol and BI-RADS Categories.

BACKGROUND: Breast magnetic resonance imaging (MRI) is a useful imaging method, and studies have proven abbreviated protocols may reduce its time and costs with comparable accuracy. To assess the agreement of the abbreviated and full MRI protocols for breast cancer. PATIENTS AND METHODS: This retrospective cross-sectional study included consecutive women who underwent breast MRI from June 2019 to May 2020. Breast MRIs were performed in 2 hospitals, and 3 board-certified radiologists conducted its evaluations. The abbreviated breast MRI was assessed in the following order: MIP; subtraction; and T1W pre- and post-contrast. Findings were categorized according Breast Imaging - Reporting and Data System (BI-RADS 5th edition). The groups were named simplified BI-RADS and were adapted from BI-RADS 5-point scoring system. RESULTS: Four hundred and nineteen women (838 BI-RADS), with mean age of 49.5 ± 12.3 years were evaluated. A very good agreement was found between the protocols for total population (weighted kappa: 0.95; P <.001) and for MRI indication subgroups (weighted kappa: 0.86-1.00; P <.001). A high accuracy was also observed comparing abbreviated breast MRI compared to a full diagnostic MRI (97.6%). CONCLUSION: Abbreviated breast MRI has demonstrated performance comparable to full diagnostic MRI protocols for breast cancer screening and diagnostic. In addition, the present study proposes the use of the simplified BI-RADS as a new classification, in order to assist physicians in clinical management.

Genotype-Phenotype Correlations in Central Precocious Puberty Caused by MKRN3 Mutations.

CONTEXT: Loss-of-function mutations of makorin RING finger protein 3 (MKRN3) are the most common monogenic cause of familial central precocious puberty (CPP). OBJECTIVE: To describe the clinical and hormonal features of a large cohort of patients with CPP due to MKRN3 mutations and compare the characteristics of different types of genetic defects. METHODS: Multiethnic cohort of 716 patients with familial or idiopathic CPP screened for MKRN3 mutations using Sanger sequencing. A group of 156 Brazilian girls with idiopathic CPP (ICPP) was used as control group. RESULTS: Seventy-one patients (45 girls and 26 boys from 36 families) had 18 different loss-of-function MKRN3 mutations. Eight mutations were classified as severe (70% of patients). Among the 71 patients, first pubertal signs occurred at 6.2 ±â€…1.2 years in girls and 7.1 ±â€…1.5 years in boys. Girls with MKRN3 mutations had a shorter delay between puberty onset and first evaluation and higher follicle-stimulating hormone levels than ICPP. Patients with severe MKRN3 mutations had a greater bone age advancement than patients with missense mutations (2.3 ±â€…1.6 vs 1.6 ±â€…1.4 years, P = .048), and had higher basal luteinizing hormone levels (2.2 ±â€…1.8 vs 1.1 ±â€…1.1 UI/L, P = .018) at the time of presentation. Computational protein modeling revealed that 60% of the missense mutations were predicted to cause protein destabilization. CONCLUSION: Inherited premature activation of the reproductive axis caused by loss-of-function mutations of MKRN3 is clinically indistinct from ICPP. However, the type of genetic defect may affect bone age maturation and gonadotropin levels.

Mortality due to congenital heart disease in Pernambuco from 1996 to 2016.

BACKGROUND To determine the magnitude and temporal trends of deaths due to congenital heart disease (CHD) in Pernambuco between 1996 and 2016. METHODS This was an ecological, time-series study, involving all cases of deaths from congenital cardiovascular malformations in the state of Pernambuco, from 1996 to 2016, using data from DATASUS, SINASC and SIM. RESULTS There were 3,584 deaths from congenital cardiovascular malformations amongst individuals aged 0 to 14 years, of which 81.94% were concentrated in children aged under one year. The infant mortality rate (IMR) presented a linear growth trend of 0.4645 per year (p <0.01). The cause-of-death code Q24 (other congenital malformations of the heart) was present in 72.54% of the death records and 48.17% of the deaths occurred in infants aged between 28 and 364 days of life. The highest occurrence of deaths was identified in children with low birth weight (500 and 1,499g), male, premature, children of mothers without schooling, in deliveries at home (p <0.05). CONCLUSIONS Congenital heart disease still represents a public health problem as a cause of death, particularly in the first year of life, with IMR in a linear growth trend. Deaths from CHD were more prevalent in male children, born prematurely, with low birth weight, born to mothers with low schooling and deliveries without medical care.

Improving water use efficiency by changing hydraulic and stomatal characteristics in soybean exposed to drought: the involvement of nitric oxide.

A variety of cellular responses is needed to ensure the plants survival during drought, but little is known about the signaling mechanisms involved in this process. Soybean cultivars (EMBRAPA 48 and BR 16, tolerant and sensitive to drought, respectively) were exposed to the following treatments: control conditions (plants in field capacity), drought (20% of available water in the soil), sodium nitroprusside (SNP) treatment (plants irrigated and treated with 100-µM SNP [SNP-nitric oxide (NO) donor molecule], and Drought + SNP (plants subjected to drought and SNP treatment). Plants remained in these conditions until the reproductive stage and were evaluated for physiological (photosynthetic pigments, chlorophyll a fluorescence and gas exchange rates), hydraulic (water potential, osmotic potential and leaf hydraulic conductivity) and morpho-anatomical traits (biomass, venation density and stomatal characterization). Exposure to water deficit considerably reduced water potential in both cultivars and resulted in decrease in photosynthesis and biomass accumulation. The addition of the NO donor attenuated these damaging effects of water deficit and increased the tolerance index of both cultivars. The results showed that NO was able to reduce plant's water loss, while maintaining their biomass production through alteration in stomatal characteristics, hydraulic conductivity and the biomass distribution pattern. These hydraulic and morpho-anatomical alterations allowed the plants to obtain, transport and lose less water to the atmosphere, even in water deficit conditions.

Concordância e completude dos dados sobre nascidos vivos e óbitos infantis / Concordancia y completitud de los datos sobre nacidos vivos y defunciones infantiles / Agreement and completeness of data on live births and infantdeaths

Resumo Objetivo Avaliar a qualidade dos dados (concordância e completude) dos óbitos infantis no Sistema de Informações de Mortalidade (SIM) e no Sistema de Informações sobre Nascidos Vivos (Sinasc), Recife, Pernambuco, Brasil. Métodos Estudo transversal com dados de óbitos infantis capturados no Sinasc e no SIM. Para os óbitos, foi utilizado o período 2013-2016 e para os nascidos vivos, o de 2012-2016. Foi utilizado o linkage determinístico. Calculou-se a porcentagem de incompletude de 10 variáveis comuns a ambas as bases, antes e após a vinculação das bases de dados. A concordância foi avaliada pelo índice Kappa para variáveis qualitativas, e pelo coeficiente de correlação intraclasse (ICC do inglês intraclass correlation coefficient) para variáveis quantitativas. Resultados Foi possível relacionar 96,64% dos óbitos às respectivas declarações de nascidos vivos. Todas as variáveis analisadas foram classificadas como excelentes (menos de 5% de incompletude), antes e após a vinculação das bases de dados. No Sinasc, a maior incompletude ocorreu na variável duração da gestação (1,55%), e no SIM, no número de natimortos (2,89%). A concordância foi classificada como quase perfeita para todas as variáveis qualitativas (Kappa entre 0,8 e 1). Todas as variáveis quantitativas foram classificadas como excelentes (ICC maior que 0,75). Conclusão Apesar dos avanços na qualidade do SIM e do Sinasc, ainda houve problemas de completude das variáveis, principalmente no SIM. A vinculação das bases de dados contribuiu para aprimorar as informações para a análise de óbitos infantis pelos serviços de saúde e para pesquisa. O linkage uma técnica de fácil acesso e baixo custo operacional, que pode ser incluída na rotina de vigilância da mortalidade infantil para a melhoria contínua das informações.

Resumen Objetivo Evaluar la calidad de los datos (concordancia y completitud) de defunciones infantiles en el Sistema de Información de Mortalidad (SIM) y en el Sistema de Información sobre Nacidos Vivos (Sinasc), Recife, estado de Pernambuco, Brasil. Métodos Estudio transversal con datos de defunciones infantiles registrados en el Sinasc y en el SIM. Para las defunciones, se utilizó el período 2013-2016 y para los nacidos vivos, 2012-2016. Fue utilizada la vinculación determinística. Se calculó el porcentaje de incompletitud de 10 variables comunes de ambas bases, antes y después de su vinculación. La concordancia fue evaluada por el índice Kappa en las variables cualitativas y por el coeficiente de correlación intraclase (ICC, por sus siglas en inglés intraclass correlation coefficient) en las variables cuantitativas. Resultados Fue posible relacionar 96,64% de las defunciones con las respectivas declaraciones de nacidos vivos. Todas las variables analizadas fueron clasificadas como excelentes (menos de 5% de incompletitud), antes y después de la vinculación de las bases de datos. En el Sinasc, la mayor incompletitud ocurrió en la variable duración de la gestación (1,55%) y, en el SIM, en el número de mortinatos (2,89%). La concordancia fue clasificada como casi perfecta en todas las variables cualitativas (Kappa entre 0,8 y 1). Todas las variables cuantitativas fueron clasificadas como excelentes (ICC mayor a 0,75). Conclusión A pesar de los avances en la calidad del SIM y del Sinasc, aún hay problemas de completitud de las variables, principalmente en el SIM. La vinculación de las bases de datos contribuyó en la mejora de la información para el análisis de defunciones infantiles por parte de los servicios de salud y para estudios. La vinculación es una técnica de fácil acceso y bajo costo operativo, que puede incluirse en la rutina de la vigilancia de la mortalidad infantil para la mejora continua de la información.

Abstract Objective To assess the quality of data (agreement and completeness) on infant deaths in the Mortality Information System (SIM) and in the Information System on Live Births (Sinasc), Recife, Pernambuco, Brazil. Methods Cross-sectional study with data on infant deaths captured in Sinasc and SIM. For the deaths, the period 2013-2016 and the live births of 2012-2016 were used. The deterministic linkage was used. The percentage of incompleteness of 10 variables common to both bases pre- and post-linkage was calculated. The agreement was assessed by the Kappa index for qualitative variables and by the intraclass correlation coefficient (ICC) for the quantitative variables. Results It was possible to relate 96.64% of the deaths to their respective declaration of live birth. All analyzed variables were classified as excellent (less than 5% incompleteness), pre- and post-linkage. In Sinasc, the greatest incompleteness was in the variable length of pregnancy (1.55%) and in the SIM, the number of stillbirths (2.89%). The agreement was classified as almost perfect for all qualitative variables (Kappa between 0.8 and 1). All quantitative variables were excellent (ICC greater than 0.75). Conclusion Despite advances in the quality of SIM and Sinasc, there were still problems of completeness of variables, especially in SIM. The linkage contributed to the improvement of information for the analysis of infant deaths by health services and for research. It is a technique that is easy to access and low operational cost, which can be included in the routine of infant mortality surveillance for the continuous improvement of information.

Mortality due to congenital heart disease in Pernambuco from 1996 to 2016

SUMMARY BACKGROUND To determine the magnitude and temporal trends of deaths due to congenital heart disease (CHD) in Pernambuco between 1996 and 2016. METHODS This was an ecological, time-series study, involving all cases of deaths from congenital cardiovascular malformations in the state of Pernambuco, from 1996 to 2016, using data from DATASUS, SINASC and SIM. RESULTS There were 3,584 deaths from congenital cardiovascular malformations amongst individuals aged 0 to 14 years, of which 81.94% were concentrated in children aged under one year. The infant mortality rate (IMR) presented a linear growth trend of 0.4645 per year (p <0.01). The cause-of-death code Q24 (other congenital malformations of the heart) was present in 72.54% of the death records and 48.17% of the deaths occurred in infants aged between 28 and 364 days of life. The highest occurrence of deaths was identified in children with low birth weight (500 and 1,499g), male, premature, children of mothers without schooling, in deliveries at home (p <0.05). CONCLUSIONS Congenital heart disease still represents a public health problem as a cause of death, particularly in the first year of life, with IMR in a linear growth trend. Deaths from CHD were more prevalent in male children, born prematurely, with low birth weight, born to mothers with low schooling and deliveries without medical care.

RESUMO OBJETIVO Determinar a magnitude e tendência temporal dos óbitos por doenças cardiovasculares congênitas (DCC) em Pernambuco entre 1996 e 2016. MÉTODOS Trata-se de um estudo ecológico, de série temporal, com todos os casos de óbitos por doenças cardiovasculares congênitas no estado de Pernambuco, entre 1996 e 2016, por meio dos dados do Datasus, Sinasc e SIM. RESULTADOS Ocorreram 3.584 óbitos por DCC entre indivíduos de 0 a 14 anos de idade, dos quais 81,94% foram concentrados em crianças menores de 1 ano de idade. A taxa de mortalidade infantil apresentou tendência linear de crescimento de 0,4645 por ano (p<0,01). A causa Q24 (outras malformações congênitas do coração) esteve presente em 72,54% dos registros de óbitos e 48,17% dos óbitos ocorreram na faixa etária de 28 a 364 dias de vida. Maior ocorrência de óbitos foi identificada entre os nascidos com peso entre 500 e 1.499 g, do sexo masculino, pré-termos, filhos de mães sem escolaridade e em partos domiciliares (p<0,05). CONCLUSÕES As cardiopatias congênitas ainda representam um problema de saúde pública como causa de mortalidade, especialmente no primeiro ano de vida. A taxa de mortalidade por DCC apresentou tendência linear de crescimento. As características gerais demonstraram significância estatística para óbitos entre crianças prematuras, com baixo peso, do sexo masculino, nascidas de mães sem escolaridade e em partos domiciliares.

Agronomic performance of lettuce cultivars submitted to different irrigation depths.

The use of cultivars adapted to the climate and soil conditions associated with adequate irrigation supply maximizes lettuce agronomic performance. The aim of this work was to evaluate the agronomic performance of four lettuce cultivars submitted to five different drip irrigation depths under a protected environment in Viçosa-MG, Brazil. A randomized block design was applied in a split plot scheme with four replications, and several agronomic characteristics were evaluated by analysis of variance, Tukey range tests, regression and principal component analysis. A higher chlorophyll concentration in the Raider Plus cultivar promoted the production of more leaves, leading to a higher phytomass. The Luara cultivar presented a higher number of commercial leaves per plant than the other cultivars, regardless of the irrigation depth, reflected in a larger diameter and volume of the aerial part of the plants. The Raider Plus and Luara cultivars presented better root development than that of the other cultivars, reducing the effect of plant water stress even under lower irrigation depth conditions. Although higher water productivity (WP) was observed for the lowest irrigation depth (50% of ETc), important variables reached the maximum values at depths higher than 100% water replenishment. Therefore, Raider Plus and Luara cultivars with an irrigation depth of 110% of crop evapotranspiration provided better commercial lettuce quality and are recommended for lettuce cultivation in the research region and under conditions similar to those of the present study.

Relationship of databases of live births and infant deaths for analysis of congenital malformations / Análise das malformações congênitas a partir do relacionamento das bases de dados de nascidos vivos e óbitos infantis

Abstract Objectives: to describe the prevalence of congenital malformations in live births in Recife, based on the relationship of birth and infant death data. Methods: a cross-sectional study with data from the Live Birth Information System (Sinasc) and Mortality (MIS) of residents in Recife-PE between 2013 and 2015. The deterministic linkage of deaths and live births (LB) with malformation and the prevalence rate were calculated. Results: 545 (95.1%) deaths and live births were matched. According to the Sinasc, the prevalence of congenital malformations was 10.4 per 1,000 LB. After the linkage, the rate was 12.4. Malformations of the musculoskeletal system (42.1%) among live births were high-lighted, as well as malformations of the circulatory system (35.3%) found in infant deaths. Conclusions: linkage increased the prevalence of congenital malformations in the studied cohort. This demonstrates the potential of this strategy for the monitoring of congenital malformations, which can be used to monitor infant death.

Resumo Objetivos: descrever a prevalência das malformações congênitas em nascidos vivos no Recife, com base no relacionamento de dados de nascimentos e óbitos infantis . Métodos: estudo transversal com dados do Sistema de Informações sobre Nascidos Vivos (Sinasc) e Mortalidade (SIM) de residentes no Recife-PE, entre 2013 e 2015. Realizou-se linkage determinístico dos óbitos e nascidos vivos (NV) com malformação e calculou-se a prevalência. Resultados: obteve-se o pareamento de 545 (95,1%) declarações de óbito e de nascidos vivos. Segundo o Sinasc a prevalência de malformações congênitas foi de 10,4 por 1.000 NV; após o linkage a taxa foi de 12,4. Destacaram-se as malformações do aparelho osteomuscular (42,1%) entre os nascidos vivos, e nos óbitos as do aparelho circulatório (35,3%). Conclusões: o linkage aumentou a prevalência de malformações congênitas nas crianças estudadas. Isso indica a potencialidade dessa estratégia para o monitoramento das malformações congênitas, podendo ser empregada na vigilância do óbito infantil.

Antibacterial Activity of Terpenes and Terpenoids Present in Essential Oils.

Background: The antimicrobial activity of essential oils has been reported in hundreds of studies, however, the great majority of these studies attribute the activity to the most prevalent compounds without analyzing them independently. Therefore, the aim was to investigate the antibacterial activity of 33 free terpenes commonly found in essential oils and evaluate the cellular ultrastructure to verify possible damage to the cellular membrane. Methods: Screening was performed to select substances with possible antimicrobial activity, then the minimal inhibitory concentrations, bactericidal activity and 24-h time-kill curve studies were evaluated by standard protocols. In addition, the ultrastructure of control and death bacteria were evaluated by scanning electron microscopy. Results: Only 16 of the 33 compounds had antimicrobial activity at the initial screening. Eugenol exhibited rapid bactericidal action against Salmonella enterica serovar Typhimurium (2 h). Terpineol showed excellent bactericidal activity against S. aureus strains. Carveol, citronellol and geraniol presented a rapid bactericidal effect against E. coli. Conclusions: The higher antimicrobial activity was related to the presence of hydroxyl groups (phenolic and alcohol compounds), whereas hydrocarbons resulted in less activity. The first group, such as carvacrol, l-carveol, eugenol, trans-geraniol, and thymol, showed higher activity when compared to sulfanilamide. Images obtained by scanning electron microscopy indicate that the mechanism causing the cell death of the evaluated bacteria is based on the loss of cellular membrane integrity of function. The present study brings detailed knowledge about the antimicrobial activity of the individual compounds present in essential oils, that can provide a greater understanding for the future researches.

Evaluation of the adequacy of information from research on infant mortality in Recife, Pernambuco, Brazil. / Adequação da investigação dos óbitos infantis no Recife, Pernambuco, Brasil.

This study is an evaluation of infant death research in Recife, Pernambuco (PE). It is a cross-sectional study with 120 variables grouped into six dimensions (prenatal, birth, child care, family characteristics, occurrence of death, and conclusion and recommendations), weighted by consensus technique. The research was classifiedas adequate, partially adequate or inadequate according to a composite indicator assessment (ICA). There was dissension on 11 variables (9 in prenatal dimension, one in labor and birth, and 1 in the conclusions and recommendations). Of the 568 deaths studied, 56.2% have adequate research. The occurrence of death was the best-evaluated dimension and prenatal the poorest. The preparation of the ICA enables professionals and managers of child health policies to identify bottlenecks in the investigation of infant deaths for better targeting of actions, and contributing to the discussion about surveillance in other cities and states.

Avaliou-se a adequação da investigação do óbito infantil no Recife-PE, Brasil. Estudo transversal com 120 variáveis da ficha de investigação, agrupadas em seis dimensões (pré-natal; parto e nascimento; puericultura; características da família; ocorrência do óbito; e conclusão e recomendações), ponderadas pela técnica de consenso e analisadas quanto ao preenchimento. A investigação foi classificada (adequada, parcialmente adequada e inadequada) segundo um indicador composto de avaliação (ICA). Houve dissenso em 11 variáveis (9, na dimensão pré-natal; 1, no parto e nascimento; 1, na conclusões e recomendações). Dos 568 óbitos estudados, 56,2% apresentam investigação adequada. A ocorrência do óbito foi a dimensão melhor avaliada, e pré-natal, a mais deficiente. A elaboração do ICA possibilita aos profissionais e gestores das políticas de saúde da criança, identificar os pontos de estrangulamento da investigação dos óbitos infantis para um melhor direcionamento das ações e contribui com a reflexão sobre esta vigilância em outros municípios e estados.

Adequação da investigação dos óbitos infantis no Recife, Pernambuco, Brasil / Evaluation of the adequacy of information from research on infant mortality in Recife, Pernambuco, Brazil

Resumo Avaliou-se a adequação da investigação do óbito infantil no Recife-PE, Brasil. Estudo transversal com 120 variáveis da ficha de investigação, agrupadas em seis dimensões (pré-natal; parto e nascimento; puericultura; características da família; ocorrência do óbito; e conclusão e recomendações), ponderadas pela técnica de consenso e analisadas quanto ao preenchimento. A investigação foi classificada (adequada, parcialmente adequada e inadequada) segundo um indicador composto de avaliação (ICA). Houve dissenso em 11 variáveis (9, na dimensão pré-natal; 1, no parto e nascimento; 1, na conclusões e recomendações). Dos 568 óbitos estudados, 56,2% apresentam investigação adequada. A ocorrência do óbito foi a dimensão melhor avaliada, e pré-natal, a mais deficiente. A elaboração do ICA possibilita aos profissionais e gestores das políticas de saúde da criança, identificar os pontos de estrangulamento da investigação dos óbitos infantis para um melhor direcionamento das ações e contribui com a reflexão sobre esta vigilância em outros municípios e estados.

Abstract This study is an evaluation of infant death research in Recife, Pernambuco (PE). It is a cross-sectional study with 120 variables grouped into six dimensions (prenatal, birth, child care, family characteristics, occurrence of death, and conclusion and recommendations), weighted by consensus technique. The research was classifiedas adequate, partially adequate or inadequate according to a composite indicator assessment (ICA). There was dissension on 11 variables (9 in prenatal dimension, one in labor and birth, and 1 in the conclusions and recommendations). Of the 568 deaths studied, 56.2% have adequate research. The occurrence of death was the best-evaluated dimension and prenatal the poorest. The preparation of the ICA enables professionals and managers of child health policies to identify bottlenecks in the investigation of infant deaths for better targeting of actions, and contributing to the discussion about surveillance in other cities and states.

Atuação do enfermeiro da atenção básica diante das dificuldades para a implementação da política de saúde do homem / Basic care nurse's activities in connection with difficulties for the implementation of men's health policy

Objetivo: identificar os desafios e a atuação do enfermeiro da atenção básica frente à Política Nacional deAtenção Integral à Saúde do Homem. Método: revisão integrativa em que se buscaram artigos nas bases dedados BDENF, LILACS e na biblioteca virtual SciELO, no período entre 2011 e 2016. Resultados: foramidentificados 11.923 artigos. Desses, foram selecionados dez artigos. Os artigos foram sistematizados em duascategorias empíricas: > e >. Conclusão: os desafios enfrentados pelos enfermeiros, para a implementaçãoda PNAISH, podem ser divididos em duas classes: a primeira está relacionada ao gênero masculino e aosserviços de saúde e a segunda é pertinente ao profissional de Enfermagem e relacionada à sua formação,repercutindo nas suas ações dentro das unidades básicas de saúde.

Avaliação do preenchimento das variáveis da ficha de investigação da vigilância do óbito infantil no Recife / Evaluation of the completion of the surveillance of infant death's investigation record variables in Recife / Evaluación del relleno de las variables de la ficha de investigación de vigilancia del óbito infantil en Recife

As fichas de investigação da vigilância do óbito infantil possuem informações necessárias para identificar mortes evitáveis e para a proposição de medidas de intervenção para reorganização da assistência à saúde materno-infantil. O objetivo foi avaliar a completitude da ficha de investigação do óbito infantil. Estudo descritivo, baseado na análise das fichas da vigilância do óbito infantil entre 2011 e 2014, de residentes no Recife, Pernambuco. Para cada variável, calculou-se o grau de preenchimento, que foi classificado como: excelente (menos de 5% de preenchimento incompleto); bom (5 a 9,9%); regular (10 a 19,9%); ruim (20 a 50%); e muito ruim (mais de 50%). Foram registrados 1.123 óbitos infantis, 832 (74,1%) eram elegíveis para investigação, 807 (71,9%) foram discutidos e 752 (67,0%) tiveram as fichas localizadas e disponibilizadas. Os resultados mostraram que houve redução na proporção de óbitos investigados (-0,9%) e discutidos (-6,4%) e aumento na proporção de fichas localizadas (3,9%). O bloco de identificação teve a melhor proporção de preenchimento médio (98,6%; DP=2,5%) e o de características da família registrou a menor proporção (٦٥,٢٪; DP=Ù¢,Ù¡%). Dez variáveis foram consideradas excelentes em todos os anos analisados. As variáveis Recomendações e medidas de prevenção e evidências de evitabilidade tiveram acréscimo de 71,0% e 43,5%, respectivamente. Concluiu-se que a incompletude verificada no preenchimento dos blocos e suas variáveis pode prejudicar, quando for necessário utilizar essas informações para o monitoramento da saúde materna e infantil.

The investigation records of infant death surveillance have necessary information to identify preventable deaths and to propose intervention measures to reorganize maternal and child health care. The objective of this study was to evaluate the completion of the infant death's investigation records. Descriptive study, based on the analysis of the records of infant death surveillance between 2011 and 2014, less than one year old (excluding congenital malformations), living in Recife, Pernambuco. For each variable, the degree of filling was calculated, which was classified as: excellent (less than 5% of incomplete filling); good (5 to 9.9%); regular (10 to 19.9%); bad (20 to 50%); and very bad (over 50%). There were 1,123 infant deaths registered, from which 832 (74.1%) were eligible for research, 807 (71.9%) were discussed and 752 (67.0%) had the records located and made available. Results show there was a reduction in the proportion of deaths investigated (-0.9%) and discussed (-6.4%) and an increase in the proportion of located records (3.9%). The identification section had the best average filling rate (98.6%, DP = 2.5%) and the one of family characteristics had the lowest proportion (65.2%, DP = 2.1%). Ten variables were considered excellent in the years analyzed. The variables Recommendations and preventive measures and evidences of avoidability increased by 71.0% and 43.5%, respectively. It was possible to conclude that the incompleteness verified in the filling of the sections and their variables may cause prejudice when it is necessary to use these informations for the monitoring of maternal and child health.

Las fichas de investigación de la vigilancia del óbito infantil reúnen informaciones necesarias para identificar muertes evitables y para el planeamiento de medidas de intervención para reorganizar la atención a la salud materno-infantil. El objetivo fue evaluar el relleno de la ficha de investigación del óbito infantil. Estudio descriptivo, basado en el análisis de las fichas de vigilancia del óbito infantil entre 2011 y 2014, con menos de un año (excluyendo las malformaciones congénitas), residentes en Recife, Pernambuco. Para cada variable, fue calculado el grado de relleno, que se clasificó como: excelente (menos del 5% del relleno incompleto); bueno (5 al 9,9%); regular (10 al 19,9%); malo (20 al 50%); y muy malo (más del 50%). Fueron registrados 1.123 óbitos infantiles, 832 (74,1%) eran elegibles para investigación, 807 (71,9%) fueron discutidos y 752 (67,0%) tuvieron sus fichas localizadas y puestas a disposición. Los resultados mostraron que hubo reducción en la proporción de óbitos investigados (-0,9%) y discutidos (-6,4%) e incremento en la proporción de fichas localizadas (3,9%). El bloque de identificación tuvo la mejor proporción de relleno medio (98,6%; DP = 2,5%) y el de características de familia registró la menor proporción (65,2%; DP=2,1%). Diez variables fueron consideradas excelentes en todos los años analizados. Las variables Recomendaciones y medidas de prevención y evidencias de evitabilidad tuvieron un incremento del 71,0% y 43,5% respectivamente. Concluyóse que la incompletitud verificada en el relleno de los bloques y sus variables puede perjudicar cuando sea necesario utilizar esas informaciones para el seguimiento de la salud materna e infantil.

Are There Changes in the Fatty Acid Profile of Breast Milk with Supplementation of Omega-3 Sources? A Systematic Review.

Purpose To evaluate the effect of supplementation with omega-3 sources on the fatty acid composition of human milk. Methods The review consisted of the search for articles published in PubMed, Biblioteca Virtual de Saúde (Virtual Health Library[VHL]) and Web of Science databases using the following keywords: fatty acids, omega-3, human milk and supplementation; for this purpose, we have used the program of research to integrate the services for the maintenance of autonomy (PRISMA) checklist. The following selection criteria were used: articles in English, Portuguese, Spanish or Italian, published between 2000 and 2015, and about studies performed in humans. We found 710 articles that met the established criteria; however, only 22 of them were selected to be part of this study. Results All studies found a positive relationship between the consumption of omega-3 sources and their concentration in human milk. The differences in the findings are due to the distinct methods used, such as the specific time of the omega-3 supplementation, the type of omega-3 source offered, as well as the sample size. Conclusion Although the studies were different in several methodological aspects, it was possible to observe the importance of omega-3 supplementation during gestation and/or the puerperium.

Are There Changes in the Fatty Acid Profile of Breast Milk with Supplementation of Omega-3 Sources? A Systematic Review / Existem mudanças no perfil de ácidos graxos no leite materno com a suplementação de fontes de ômega 3? Uma revisão sistemática

Abstract Purpose To evaluate the effect of supplementation with omega-3 sources on the fatty acid composition of human milk. Methods The review consisted of the search for articles published in PubMed, Biblioteca Virtual de Saúde (Virtual Health Library[VHL]) andWeb of Science databases using the following keywords: fatty acids, omega-3, human milk and supplementation; for this purpose, we have used the program of research to integrate the services for the maintenance of autonomy (PRISMA) checklist. The following selection criteria were used: articles in English, Portuguese, Spanish or Italian, published between 2000 and 2015, and about studies performed in humans. We found 710 articles that met the established criteria; however, only 22 of them were selected to be part of this study. Results All studies found a positive relationship between the consumption of omega- 3 sources and their concentration in humanmilk. The differences in the findings are due to the distinct methods used, such as the specific time of the omega-3 supplementation, the type of omega-3 source offered, as well as the sample size. Conclusion Although the studies were different in several methodological aspects, it was possible to observe the importance of omega-3 supplementation during gestation and/or the puerperium.

Resumo Objetivo Avaliar o efeito da suplementação com fontes de ômega 3 sobre a composição de ácidos graxos do leite humano. Métodos A revisão consistiu na busca de artigos publicados nas bases de dados PubMed, Biblioteca Virtual de Saúde e Web of Science utilizando-se as palavras-chave: ácidos graxos, ômega-3, leitematerno e suplementação; para isso, foi utilizado o checklist PRISMA. Foram utilizados os seguintes critérios para a seleção: artigos publicados em inglês, português, espanhol ou italiano, entre os anos de 2000 a 2015, sobre estudos realizados em humanos. A busca bibliográfica, segundo a estratégia estabelecida, resultou em 710 artigos. Entretanto, apenas 22 destes foram selecionados para compor a presente revisão. Resultados Todos os estudos encontraram relação positiva entre o consumo de fontes de ômega 3 e sua concentração no leite humano. As diferenças nos achados se devem aos métodos empregados como, por exemplo, o momento da suplementação do ômega 3, o tipo de fonte de ômega 3 ofertado, e o tamanho amostral. Conclusão Apesar de os estudos serem díspares em inúmeros aspectos metodológicos, observou-se a importância da suplementação do ômega 3 na gestação e/ou no puerpério.

Effects of ß-caryophyllene and Murraya paniculata essential oil in the murine hepatoma cells and in the bacteria and fungi 24-h time-kill curve studies.

CONTEXT: Orange Jessamine [Murraya paniculata L. (Rutaceae)] has been used worldwide in folk medicine as an anti-inflammatory, antibiotic and analgesic. OBJECTIVE: The objective of this study is to investigate the in vitro antioxidant, cytotoxic, antibacterial and antifungal activity and the time-kill curve studies of orange jessamine essential oil and ß-caryophyllene, as well as the chemical composition of the essential oil. MATERIAL AND METHODS: The cytotoxic activity of M. paniculata and ß-caryophyllene (7.8-500 µg/mL) was evaluated using the MTT assay on normal fibroblasts and hepatoma cells. The minimal inhibitory concentration and time-kill curves (24 h) were evaluated against those of Staphylococcus aureus, Escherichia coli, Salmonella typhimurium, Enterococcus faecallis, Aspergillus (niger, fumigates and parasiticum) and F. solani by the broth microdilution method. The antioxidant activity was measured by the DPPH and ABTS assays. Chemical composition was evaluated by GC/MS analyses. RESULTS: GC/MS analyses identified 13 compounds, with ß-caryophyllene as the major compound. The oil exhibited moderate antibacterial activity (MIC <1.0 mg/mL) and strong antifungal activity. Time-kill curve studies showed that either the essential oil or ß-caryophyllene presented rapid bacterial killing (4 h for S. aureus) and fungicidal effect (2-4 h for F. solani); however, both displayed weak free radical scavenger capacity. The cytotoxic activity exhibited a prominent selective effect against hepatoma cancer cells (IC50 value =63.7 µg/mL) compared with normal fibroblasts (IC50 value =195.0 µg/mL), whereas the ß-caryophyllene showed low cytotoxicity. DISCUSSION AND CONCLUSION: The experimental data suggest that the activities of M. paniculata essential oil are due to the synergistic action among its components.

The Amazing World of Peptide Engineering: the Example of Antimicrobial Peptides from Frogs and Their Analogues.

This review discusses the importance and properties of antimicrobial peptides from frogs and their synthetic analogues as potential therapeutic alternatives in fighting not only bacterial infections, but also protozoans involved with the major neglected diseases, which afflict human populations (e.g., Chagas disease, African sleeping sickness, Leishmaniasis and malaria). Here, we emphasize their multifunctional properties such as promising broad-spectrum drugs that target protozoan parasites too.

A formação do self e a dependência afetiva: uma revisão bibliográfica da abordagem centrada na pessoa / The Self Formation and the Affective Dependence: a Person Centered Approach literature review / La Formación del Selfy la Dependencia Afectiva: una revisión bibliográfica del enfoque centrado en la persona

O presente artigo tem como objetivo discutir a compreensão da Abordagem Centrada na Pessoa sobre a Dependência Afetiva, especificando os sintomas da dependência afetiva, conceitos de formação do self, e a relação entre os conceitos da abordagem e as características presentes no transtorno. Para isso, foi realizada uma pesquisa bibliográfica, dentro do período de 2005 a 2015 (com exceção de obras clássicas que estão presentes em edições mais antigas). Os resultados encontrados comprovam que por não perceber a aceitação através do meio o sujeito de personalidade dependente está sempre se adequando ao outro, ou seja, distorce seu verdadeiro self. Para tanto, discutiu-se que o processo de formação de self somado ao ambiente disponível para o desenvolvimento da personalidade, quando não se demonstra favorável, ocorre uma distorção da noção de si,provocando a formação do transtorno de personalidade dependente.(AU)

This article aims to discuss the Person Centered Approach understanding about the affective dependence, specifying the symptoms of the affective dependence, the self concept formation, and the relationship between the concepts of the approach and the characteristics present in the disorder. For this, a literature review will be held within the period from 2005 to 2015 (except for work basis that are stated in earlier editions). The results were that by the lack of acceptance found in the enviroment that surounds the human being affected by this disorder, the person with the dependent personality will be always adapting to the others, causing the distortion of the true self. To do so, it was discussed that the self -forming process plus the environment available for the personality development, when it is not favorable, it occurs a distortion of the self, causing the dependent personality disorder formation.(AU)

Este Este articulo tiene como objetivo discutir lacomprensióndel Enfoque Centrado enla Persona sobre la Dependencia Afectiva, especificando los sintomas de ladependenciaefectiva, conceptos de formación del self, y larelación entre los conceptos del enfoque y las características presentes enel transtorno. Para esto, fuehecha una busqueda bibliográfica, desde elaño 2005 hasta elaño 2015 (conexepción de losclásicos que están presentes enlasediciones más antiguas). Los resultados obtenidoscomprueban que por no percibirlaaceptación a través del médio, elsujeto de personalidaddependiente está siempreadecuandose al otro, es decir, distorsionasuverdaderoself. Para esto, se discutió que elproceso de formación de self, sumado al ambiente disponible para eldesarrollo de lapersonalidad, cuando no se demuestrafavorable, se produce una distorción de lanoción de símismo, provocando laformacióndel transtorno de lapersonalidaddependiente.(AU)