Multiorgan talks in the presence of brain injury.

PURPOSE OF REVIEW: The brain is the command center of the rest of the body organs. The normal multiorgan talks between the brain and the rest of the body organs are essential for the normal body homeostasis. In the presence of brain injury, the disturbed talks between the brain and the rest of body organs will result in several pathological conditions. The aim of this review is to present the most recent findings for the pathological conditions that would result from the impaired multiorgan talks in the presence of brain injury. RECENT FINDINGS: The brain injury such as in acute ischemic stroke, subarachnoid hemorrhage and traumatic brain injury will result in cascade of pathological talks between the brain and the rest of body organs. These pathological talks could result in pathological conditions such as cardiomyopathy, acute lung and kidney injuries, impaired liver functions, and impaired gut barrier permeability as well. SUMMARY: Better understanding of the pathological conditions that could result from the impaired multiorgan talks in the presence of brain injury will open the doors for precise targeted therapies in the future for myriad of pathological conditions.

High-risk twin pregnancy: case report of an adolescent patient with cystic fibrosis and systemic lupus erythematosus.

BACKGROUND: We present the first case to our knowledge of a spontaneous twin pregnancy in a 16-year-old Caucasian patient with cystic fibrosis and systemic lupus erythematosus. Cystic fibrosis is one of the most common autosomal recessive genetic disorders and primarily affects the respiratory and digestive systems. Systemic lupus erythematosus is a chronic inflammatory disease of unknown cause that affects nearly every organ. Patients with cystic fibrosis or systemic lupus erythematosus are progressively having longer life expectancy and better quality of life, which has led a greater number of female patients reporting the desire to become mothers. CASE PRESENTATION: We present a case of a Caucasian 16-year-old pregnant with twins being treated for both cystic fibrosis and systemic lupus erythematosus. She has two CFTR mutations: p.F508del and 1812_1G>A. In the second trimester, she was admitted for possible preterm labor, which was successfully stopped. The patient's nutritional status worsened, and she had a pulmonary exacerbation as well as a flare of systemic lupus erythematosus. At the 28th gestational week, she presented with a massive hemoptysis episode. The cesarean delivery had no complications, and there were no serious immediate postpartum complications. DISCUSSION AND CONCLUSIONS: While adolescent pregnancies in and of themselves are considered high risk for both the young mothers and their children, they are further complicated when the mother has two chronic diseases and a twin pregnancy. We achieved positive results using a multidisciplinary approach; however, the risks involved were so high that major efforts are to be taken by our medical community to prevent unplanned pregnancies in all patients with cystic fibrosis, especially when a serious comorbidity like the one in this case is present.

Ultrasound findings of pubertal development in girls with cystic fibrosis and their association with clinical outcomes and Tanner staging.

OBJECTIVE: Patients with cystic fibrosis (CF) have a high incidence of pubertal and growth delay. In girls with CF, pubertal delay has an important psychological impact. Still, only a few studies have explored the occurrence of pubertal delay in girls with CF. The aims of this study were to compare the pubertal development of girls with CF compared with healthy controls regarding Tanner staging and pelvic ultrasound and, in girls with CF, correlate the findings with those of spirometry, body mass index, Shwachman-Kulczycki score (SKS), and genotyping. METHODS: This was a cross-sectional, case-control study including 35 girls with CF aged 6-17 years and following up at the Pediatric Pulmonology Outpatient Clinic of a tertiary hospital. These patients were compared with 59 healthy controls who had undergone pelvic ultrasound as part of another study conducted by the same group. Girls with CF were consecutively enrolled in the study during their annual routine check-up visit. Data collected in the CF group included spirometry and anthropometric results, SKS values, bone age, occurrence of current cystic fibrosis-related diabetes (CFRD) and Pseudomonas aeruginosa colonization, history of meconium ileus, genotype, ultrasound parameters, and Tanner stage. RESULTS: Pelvic ultrasound findings and Tanner stage reflected less pubertal development in girls with CF compared with healthy controls. Pubertal stage in patients with CF who presented CFRD (3.17 ± 1.16), had chronic colonization by Pseudomonas aeruginosa (3.10 ± 1.10), or were homozygous for the F508del mutation (1.91 ± 1.30) was more delayed than in controls (3.41 ± 1.41). Tanner stage correlated with age at menarche, bone age, and anthropometric and ultrasound data. CONCLUSION: Girls with CF presented a delay in pubertal development evaluated by Tanner stage and ultrasound parameters, which was more evident in the presence of comorbidities.

Cashew apple (Anacardium occidentale L.) extract from a by-product of juice processing: assessment of its toxicity, antiproliferative and antimicrobial activities.

Cashew apple extract (CAE) is a product with intense yellow color obtained from residual fibers of juice processing. Although CAE is known to be rich in carotenoids and anacardic acids, the biological activities of this potential natural food colorant remain unexplored. The present study is the first to investigate the toxicity, antiproliferative and antimicrobial activities of the lyophilized CAE (L-CAE) and its encapsulated products, using maltodextrin (M-CAE) or cashew gum (CG-CAE) as carriers. In addition to their high carotenoid content, the phenolic contents in all materials was determined using UPLC-QTOF-MSE. The acute toxicity was performed using adult zebrafish (Danio rerio); antiproliferative activity was assessed using seven different human tumor cell lines [U-251 (glioblastoma), MCF-7 (breast, adenocarcinoma), NCI-ADR/RES (multidrug-resistant ovarian adenocarcinoma), NCI-H-460 (lung, large cell carcinoma), PC-3 (prostate, adenocarcinoma), OVCAR-3 (ovarian adenocarcinoma), and HT-29 (colon, adenocarcinoma)] and an immortalized human keratinocyte (HaCaT) while the antimicrobioal activity was evaluated on Staphylococcus aureus ATCC 25923, Listeria monocytogenes ATCC 19115, Escherichia coli ATCC 25922 and Salmonella Typhimurium ATCC 51812 microorganisms. Both lyophilized and encapsulated CAE samples did not exert acute toxicity against zebrafish neither antiproliferative effect against human tumor and non-tumor cell lines. Further, L-CAE showed potential antimicrobial activity against Listeria monocytogenes, which was confirmed using electron microscopy. The current findings demonstrated that CAE is a potential source of bioactive compounds to use as an additive in the food industry.

Ultrasound findings of pubertal development in girls with cystic fibrosis and their association with clinical outcomes and Tanner staging

ABSTRACT Objective: Patients with cystic fibrosis (CF) have a high incidence of pubertal and growth delay. In girls with CF, pubertal delay has an important psychological impact. Still, only a few studies have explored the occurrence of pubertal delay in girls with CF. The aims of this study were to compare the pubertal development of girls with CF compared with healthy controls regarding Tanner staging and pelvic ultrasound and, in girls with CF, correlate the findings with those of spirometry, body mass index, Shwachman-Kulczycki score (SKS), and genotyping. Subjects and methods: This was a cross-sectional, case-control study including 35 girls with CF aged 6-17 years and following up at the Pediatric Pulmonology Outpatient Clinic of a tertiary hospital. These patients were compared with 59 healthy controls who had undergone pelvic ultrasound as part of another study conducted by the same group. Girls with CF were consecutively enrolled in the study during their annual routine check-up visit. Data collected in the CF group included spirometry and anthropometric results, SKS values, bone age, occurrence of current cystic fibrosis-related diabetes (CFRD) and Pseudomonas aeruginosa colonization, history of meconium ileus, genotype, ultrasound parameters, and Tanner stage. Results: Pelvic ultrasound findings and Tanner stage reflected less pubertal development in girls with CF compared with healthy controls. Pubertal stage in patients with CF who presented CFRD (3.17 ± 1.16), had chronic colonization by Pseudomonas aeruginosa (3.10 ± 1.10), or were homozygous for the F508del mutation (1.91 ± 1.30) was more delayed than in controls (3.41 ± 1.41). Tanner stage correlated with age at menarche, bone age, and anthropometric and ultrasound data. Conclusions: Girls with CF presented a delay in pubertal development evaluated by Tanner stage and ultrasound parameters, which was more evident in the presence of comorbidities.

The Effects of Altering the Concentric/Eccentric Phase Times on EMG Response, Lactate Accumulation and Work Completed When Training to Failure.

This study compared the electromyographic response, the blood lactate concentration (BLC), and the maximum number of repetitions (MNR) between protocols of different concentric/eccentric duration taken to muscle failure. This comparison may help to understand how different concentric/eccentric duration may influence performance and the central and metabolic responses in trained men. Seventeen strength-trained men performed two protocols in a counterbalanced design. Three sets of the Smith bench press exercise were performed to failure at 60% of the one-repetition maximum (1RM) using each protocol (4-s concentric/2-s eccentric [4 s: 2 s]; and 2-s concentric/4-s eccentric [2 s: 4 s]). The normalized root mean square (EMGRMS) and the mean frequency (EMGMF) of the electromyographic signals for the pectoralis major and the triceps brachii were compared in the first, middle, and last repetitions. The BLC was assessed at rest, during and after the test sessions. To compare the EMG and BLC, a 3-way ANOVA with repeated measures with a post hoc Tukey's test was used. To compare the MNR performed across the sets, an ANOVA-type rank test with the Dunn's post hoc test was used. The ANOVA indicated a greater EMGRMS for Protocol 4 s: 2 s in the pectoralis major and a lower EMGMF for Protocol 4 s: 2 s in the triceps brachii at the middle and last repetitions. Both protocols increased the EMGRMS and decreased the EMGMF across repetitions. Despite the results show different levels of activation and neuromuscular fatigue between protocols, the BLC and the MNR were similar.

Multimodal Analgesic Regimen for Spine Surgery: A Randomized Placebo-controlled Trial.

BACKGROUND: Various multimodal analgesic approaches have been proposed for spine surgery. The authors evaluated the effect of using a combination of four nonopioid analgesics versus placebo on Quality of Recovery, postoperative opioid consumption, and pain scores. METHODS: Adults having multilevel spine surgery who were at high risk for postoperative pain were double-blind randomized to placebos or the combination of single preoperative oral doses of acetaminophen 1,000 mg and gabapentin 600 mg, an infusion of ketamine 5 µg/kg/min throughout surgery, and an infusion of lidocaine 1.5 mg/kg/h intraoperatively and during the initial hour of recovery. Postoperative analgesia included acetaminophen, gabapentin, and opioids. The primary outcome was the Quality of Recovery 15-questionnaire (0 to 150 points, with 15% considered to be a clinically important difference) assessed on the third postoperative day. Secondary outcomes were opioid use in morphine equivalents (with 20% considered to be a clinically important change) and verbal-response pain scores (0 to 10, with a 1-point change considered important) over the initial postoperative 48 h. RESULTS: The trial was stopped early for futility per a priori guidelines. The average duration ± SD of surgery was 5.4 ± 2.1 h. The mean ± SD Quality of Recovery score was 109 ± 25 in the pathway patients (n = 150) versus 109 ± 23 in the placebo group (n = 149); estimated difference in means was 0 (95% CI, -6 to 6, P = 0.920). Pain management within the initial 48 postoperative hours was not superior in analgesic pathway group: 48-h opioid consumption median (Q1, Q3) was 72 (48, 113) mg in the analgesic pathway group and 75 (50, 152) mg in the placebo group, with the difference in medians being -9 (97.5% CI, -23 to 5, P = 0.175) mg. Mean 48-h pain scores were 4.8 ± 1.8 in the analgesic pathway group versus 5.2 ± 1.9 in the placebo group, with the difference in means being -0.4 (97.5% CI; -0.8, 0.1, P = 0.094). CONCLUSIONS: An analgesic pathway based on preoperative acetaminophen and gabapentin, combined with intraoperative infusions of lidocaine and ketamine, did not improve recovery in patients who had multilevel spine surgery.

Height and sexual maturation in girls with juvenile idiopathic arthritis / Estatura e maturação sexual em meninas com artrite idiopática juvenil

Abstract Objective To evaluate height, sexual maturation, and the difference between final and expected height in girls with juvenile idiopathic arthritis and no glucocorticoid treatment for at least six months, as compared to a group of healthy girls. Methods This cross-sectional study involved 44 girls with juvenile idiopathic arthritis, diagnosed according to the International League of Associations for Rheumatology criteria, and 59 healthy controls aged between 8 and 18 (incomplete) years with no comorbid chronic diseases. Demographic data were collected from all participants, and disease and treatment variables were compiled for the patient group. Anthropometric measurements were converted into Z-scores based on World Health Organization standards. Sexual maturation was classified according to Tanner stages. Results Body mass index and height Z-scores were lower in girls with juvenile idiopathic arthritis as compared to control participants. These values differed significantly in Tanner stage II. Three (6.8%) girls with juvenile idiopathic arthritis had height-for-age Z-scores <−2 (short stature). Girls with polyarticular juvenile idiopathic arthritis and higher cumulative glucocorticoid doses were significantly more likely to present with short stature. The percentage of prepubertal girls in the juvenile idiopathic arthritis group was significantly higher than that observed in the control group, (p = 0.012). Age of menarche, adult height, and the difference between actual and expected height did not differ between groups. Conclusion These findings suggest that even six months after the suspension of glucocorticoid treatment, children with polyarticular/systemic juvenile idiopathic arthritis subtypes are still susceptible to low height and delayed puberty.

Resumo Objetivo Avaliar a estatura, maturação sexual e a diferença entre a estatura final e a esperada em meninas com artrite idiopática juvenil (AIJ) sem tratamento com glicocorticoides por pelo menos seis meses, em comparação com um grupo de meninas saudáveis. Métodos Este estudo transversal avaliou 44 meninas com artrite idiopática juvenil, diagnosticadas de acordo com os critérios da International League of Associations for Rheumatology e 59 controles saudáveis, entre oito e 18 anos (incompletos) sem comorbidades por doenças crônicas. Os dados demográficos foram coletados de todos os participantes e as variáveis de doença e tratamento foram compiladas para o grupo de pacientes. As medidas antropométricas foram convertidas em escores-z com base nos padrões da Organização Mundial da Saúde. A maturação sexual foi classificada de acordo com os estágios de Tanner. Resultados Índice de massa corporal e escores-z de estatura foram menores em meninas com artrite idiopática juvenil em comparação com os participantes-controle. Esses valores diferiram significativamente no estágio II de Tanner. Três (6,8%) meninas com artrite idiopática juvenil tinham escores-z de estatura para idade < -2 (baixa estatura). Meninas com artrite idiopática juvenil poliarticular e doses cumulativas de glicocorticoides foram significativamente mais propensas a apresentar baixa estatura. A porcentagem de meninas pré-púberes no grupo artrite idiopática juvenil foi significativamente maior do que a observada no grupo controle (p = 0,012). A idade da menarca, a estatura adulta e a diferença entre a estatura real e a esperada não diferiram entre os grupos. Conclusão Esses achados sugerem que, mesmo após seis meses da suspensão do tratamento com glicocorticoides, as crianças com os subtipos poliarticular/sistêmico de AIJ ainda são suscetíveis a baixa estatura e atraso na puberdade.

Height and sexual maturation in girls with juvenile idiopathic arthritis.

OBJECTIVE: To evaluate height, sexual maturation, and the difference between final and expected height in girls with juvenile idiopathic arthritis and no glucocorticoid treatment for at least six months, as compared to a group of healthy girls. METHODS: This cross-sectional study involved 44 girls with juvenile idiopathic arthritis, diagnosed according to the International League of Associations for Rheumatology criteria, and 59 healthy controls aged between 8 and 18 (incomplete) years with no comorbid chronic diseases. Demographic data were collected from all participants, and disease and treatment variables were compiled for the patient group. Anthropometric measurements were converted into Z-scores based on World Health Organization standards. Sexual maturation was classified according to Tanner stages. RESULTS: Body mass index and height Z-scores were lower in girls with juvenile idiopathic arthritis as compared to control participants. These values differed significantly in Tanner stage II. Three (6.8%) girls with juvenile idiopathic arthritis had height-for-age Z-scores <-2 (short stature). Girls with polyarticular juvenile idiopathic arthritis and higher cumulative glucocorticoid doses were significantly more likely to present with short stature. The percentage of prepubertal girls in the juvenile idiopathic arthritis group was significantly higher than that observed in the control group, (p=0.012). Age of menarche, adult height, and the difference between actual and expected height did not differ between groups. CONCLUSION: These findings suggest that even six months after the suspension of glucocorticoid treatment, children with polyarticular/systemic juvenile idiopathic arthritis subtypes are still susceptible to low height and delayed puberty.

Safety of tocilizumab in the treatment of juvenile idiopathic arthritis.

INTRODUCTION: Tocilizumab (TCZ) is a recombinant humanized monoclonal antibody and IL-6 receptor antagonist, currently approved for the treatment of systemic juvenile idiopathic arthritis (sJIA) and polyarticular juvenile idiopathic arthritis (pJIA) in children aged 2 years or older refractory to conventional treatment. The most common adverse events in patients treated with TCZ were infections, especially in the respiratory tract. The most frequent laboratory abnormalities were altered liver function, neutropenia and elevated cholesterol levels. Areas covered: The safety of TCZ in the treatment of children with JIA was determined based on a review of published clinical trials, including two multicenter studies of patients with sJIA and pJIA (the TENDER and CHERISH trials, respectively). The frequency of adverse events (AEs), serious adverse events (SAEs) and deaths reported in these studies was analyzed and discussed. Expert opinion: TCZ was effective and well tolerated in the treatment of severe forms of sJIA and pJIA, and can be considered a treatment of choice for these conditions. The risk of infections and laboratory abnormalities, such as neutropenia, should be constantly monitored. There is still a need for comparative studies of the risks and benefits of biological agents in patients with refractory JIA.

Anesthesia for Endovascular Approaches to Acute Ischemic Stroke.

Involvement of the Anesthesiologist in the early stages of care for acute ischemic stroke patient undergoing endovascular treatment is essential. Anesthetic management includes the anesthetic technique (general anesthesia vs sedation), a matter of much debate and an area in need of well-designed prospective studies. The large numbers of confounding factors make the design of such studies a difficult process. A universally agreed point in the endovascular management of acute ischemic stroke is the importance of decreasing the time to revascularization. Hemodynamic and ventilatory management and implementation of neuroprotective modalities and treatment of acute procedural complications are important components of the anesthetic plan.

Social cognitions about food choice in children aged five to eight years: Feasibility and predictive validity of an age appropriate measurement.

There are currently no instruments available to measure social cognitions towards food choice in children. This study aimed to test the feasibility and predictive validity of a novel measurement tool to assess food-related social cognitions. Sixty-eight children, five to eight years old, were asked to sort cards with photographs of four fruit and four sweet/savoury snacks as a mean to measure attitudes, subjective norms, perceived behavioural control (PBC), and intention. Subsequently, food choice (dependent variable) was assessed using a laboratory food choice task in which children could gain access to sweet and savoury or fruit items, or a combination. All participants completed the tasks successfully, demonstrating feasibility of the procedure. The order in which the cards were sorted for each construct differed sufficiently and correlations between constructs were in line with previous studies. Measures of PBC, intention, attitude, and subjective norm from the mother, but not from teachers or friends, correlated significantly with subsequent food choice. It is possible to measure food-related social cognitions in children aged five to eight and these measures were predictive of observed behaviour. The new instrument can contribute to our understanding of psychological determinants of food choice in young children.

Evaluation of mediators of oxidative stress and inflammation in patients with acute appendicitis.

CONTEXT: This study aims to explore the potential of new inflammatory markers for improving the challenging diagnosis of acute appendicitis (AA). METHODS: Levels of IL-1, IL-6, IL-8, IL-10, CRP, INF-γ, and TNF-α in serum were measured in 73 patients with AA. Oxidative stress and antioxidant enzymes were analyzed. RESULTS: Serum levels of interleukins, TNF-α, and INF-γ were significantly elevated in patients with appendicitis (p < 0.0001), except for IL-10, which presented decreased levels. There were no significant differences in SOD (p = 0.29), CAT (p = 0.19), or TBARS levels (p = 0.18), whereas protein carbonyls presented significant increase (p < 0.0001). CONCLUSION: Evaluating these biomarkers could aid in diagnosing AA.

Longer repetition duration increases muscle activation and blood lactate response in matched resistance training protocols

This study analyzed the effect of different repetition durations on electromyographic and blood lactate responses of the bench press exercise. Fifteen recreationally trained male volunteers completed two training protocols, matched for intensity (% one-repetition maximum; 1RM), number of sets, number of repetitions, and rest intervals. One of the protocols was performed with a repetition duration of 4 s (2 s concentric: 2 s eccentric; 2:2 protocol), whereas the second protocol had a repetition duration of 6 s (2 s concentric: 4 s eccentric; 2:4 protocol). The results showed higher normalized integrated electromyography (pectoralis major and triceps brachii) for the 2:4 protocol. Blood lactate concentration was also higher in the 2:4 protocol across all sets. These results show that adding 2 s to the eccentric action in matched training protocols increases muscle activation and blood lactate response, which reinforces the notion that increasing repetition duration is an alternative load progression in resistance training.

Repetition duration influences ratings of perceived exertion.

This study investigated the effect of different repetition durations on ratings of perceived exertion (RPE) in active muscles (RPE-AM) and the overall body (RPE-O). 19 male volunteers (M age = 25.4 yr., SD = 3.5) performed strength training protocols with multiple sets matched by the number of sets and repetitions, intensity and rest interval but different repetition durations: 4 sec., 6 sec., or self-paced. Participants were asked to estimate their RPE-AM and RPE-O after each set. Training protocols with a 6-sec. repetition duration produced distinct responses on RPE during and after performance compared to 4-sec. and self-paced durations. However, there were no significant differences between 4-sec. and self-paced durations.

The effect of whole-body cooling on brain metabolism following perinatal hypoxic-ischemic injury.

INTRODUCTION: Magnetic resonance imaging (MRI) and spectroscopy (MRS) have proven valuable in evaluating neonatal hypoxic-ischemic injury (HII). RESULTS: MRI scores in the basal ganglia of HII/HT(+) neonates were significantly lower than HII/HT(-) neonates, indicating less severe injury and were associated with lower discharge encephalopathy severity scores in the HII/HT(+) group (P = 0.01). Lactate (Lac) was detected in the occipital gray matter (OGM) and thalamus (TH) of significantly more HII/HT(-) neonates (31.6 and 35.3%) as compared to the HII/HT(+) group (10.5 and 15.8%). In contrast, the -N-acetylaspartate (NAA)-based ratios in the OGM and TH did not differ between the HII groups. DISCUSSION: Our data show that the HT was associated with a decrease in the number of HII neonates with detectable cortical and subcortical Lac as well as a decrease in the number of MRI-detectable subcortical lesions. METHODS: We retrospectively compared the medical and neuroimaging data of 19 HII neonates who received 72 h of whole-body cooling (HII/HT(+)) with those of 19 noncooled HII neonates (HII/HT(-)) to determine whether hypothermia was associated with improved recovery from the injury as measured by MRI and MRS within the first 14 days of life. MRI scores and metabolite ratios of HII/HT(+) and HII/HT(-) neonates were also compared with nine healthy, nonasphyxiated "control" neonates.

Aleitamento materno exclusivo em bebês com fissura de lábio e/ou palato / Exclusive breastfeeding in infants with cleft lip and/or palate

OBJETIVO: Investigar o aleitamento materno exclusivo em bebês com fissura de lábio e/ou palato e sua associação com o tipo de fissura. MÉTODOS: Foram coletados dados de 137 prontuários, obtidos pela pediatra na primeira consulta. A amostra constituiu-se das fichas de pediatria de bebês de ambos os gêneros, com fissura de lábio e/ou palato, nascidos a termo e sem outras anomalias associadas, que chegaram para a primeira consulta entre zero e 12 meses. Os dados foram analisados estatisticamente. RESULTADOS: Houve predomínio da fissura transforame incisivo em bebês do gênero masculino. Os bebês apresentavam média de idade de 53 dias e mediana de 33 dias na primeira consulta. Quanto ao aleitamento materno exclusivo, este ocorreu em 7,3 por cento do total da amostra, sendo 6,57 por cento no grupo pré-forame incisivo e 0,73 por cento no grupo pós-forame incisivo, mas não ocorreu no grupo transforame incisivo. Houve associação significativa entre o tipo de fissura e o aleitamento. CONCLUSÃO: O aleitamento exclusivo está presente em pequena parte da amostra total de bebês com fissura de lábio e/ou palato, sendo frequente na fissura pré-forame incisivo.

PURPOSE: To investigate exclusive breastfeeding in infants with cleft lip and/or palate and its association with the type of cleft. METHODS: Data recorded by the pediatrician during the first consultation were obtained from 137 clinical charts. The sample consisted of the pediatric records of infants of both genders, with cleft lip and/or palate, born full term and without any other associated anomalies, who arrived for the first consultation between zero and 12 months of age. Data were statistically analyzed. RESULTS: There was predominance of complete cleft lip and palate in male infants. Subjects' mean age was 53 days, with median of 33 days on the date of first consultation. Exclusive breastfeeding occurred in 7.3 percent of the total sample - 6.57 percent in cleft lip group, 0.73 percent in the cleft palate, and none in the complete cleft lip and palate group. There was significant association between type of cleft and breastfeeding. CONCLUSION: Exclusive breastfeeding is present in only a small part of the total sample of infants with cleft lip and/or palate, and is frequent in infants with incomplete cleft lip.

Violencia ejercida a la mujer en la relación de pareja. Policlínica Rolando Monterrey. Enero- Diciembre 2009. Moa / Exercised violence to the woman in the relation of couple. Policlinica Rolando Monterrey. January December 2009. Moa

Se realizó un estudio descriptivo, utilizando un diseño no experimental transversal, sobre la violencia ejercida a la mujer en la relación de pareja, en el Policlínico Rolando Monterrey (Enero- Diciembre 2009) en un universo de 245 mujeres y una muestra de 70. Aplicamos una encuesta con el objetivo de caracterizar sociopsicológicamente a las víctimas; describir la edad, escolaridad, ocupación, tipo y tiempo de la relación de pareja, funcionamiento familiar, las formas de violencia más frecuentes y los factores que la perpetúan, así como valorar las habilidades para la solución de situaciones de conflictos, utilizando para ello estadígrafos descriptivos, y determinar las características personológicas de la muestra. Encontramos que el tipo de violencia más empleada fue la psicológica, la cual fue utilizada en mujeres entre 35-44 años de edad, con un nivel preuniversitario; donde las trabajadoras resultaron las más afectadas, repercutiendo el fenómeno sobre aquellas mujeres con unión consensual, que tenían más de 10 años de duración con su pareja, que convivían en contextos de familias disfuncionales; poseían escasas habilidades para la solución de problemas, y que perduran en la relación por la dependencia económica que mantienen y por su seguridad personal. La caracterización personológica reveló que fueron mujeres dispensarizadas como supuestamente sanas, la mayoría manifestó ansiedad como estado y depresión en niveles altos, sin embargo la ansiedad como rasgo es bajo; poseen una autovaloración inadecuada, y sus necesidades giran en torno a su seguridad, autorrealización y afecto o estima. Recomendamos la participación de todos los grupos sociales, para profundizar y promover líneas de investigación sobre tal problemática(AU)

A descriptive study came true, using a design not experimental side road, on the exercised violence to the woman in the relation of couple, in the Polclinica Rolando Monterrey (January December 2009) in a universe of 245 women and a sample of 70. We applied an opinion poll for the sake of characterizing sociopsicológic to the victims; Describing the age, scholarship, occupation, type and time of the relation of couple, familiar functioning, more frequent the forms of violence and the factors that perpetuate her, as well as appreciating the abilities for the solution of situations of conflicts, using for it descriptive estadigrafs, and determining characteristics personologics of the sample. We found out that the type of more used violence was her psychological one, which was used in women between 35-44 years elderly, with a pre-university level; where workers gave results them more affected, having influence the phenomenon on those women with consensual union, that they had more of 10 years of duration with their couple, that they lived together in contexts of dysfunctional families; They had scarce abilities for the solution of problems, and that they last in the relation for the cost-reducing dependence that they hold and for their personal safety. Characterization personologic revealed that controlled were womanly as supposedly you heal, the majority manifested anxiety like status and depression in tall levels, however anxiety as feature is softly; they have an unsuitable self-appraisal, and your needs revolve around their certainty, self-actualization and affection or esteem. We recommended the participation of all the social groups, in order to deepen and to promote fact-finding trajectories on such problems(AU)

Metabolic syndrome and juvenile idiopathic arthritis.

Juvenile idiopathic arthritis (JIA) is the most prevalent chronic arthropathy in childhood and adolescence. The prevalence of metabolic syndrome, as well as obesity, is increasing rapidly in all age groups, including children. Metabolic syndrome is defined as a cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus, including abdominal obesity, insulin resistance, dyslipidemia and hypertension. Besides those components, inflammation has been increasingly considered as a significant component of metabolic syndrome and obesity, and patients with diseases characterized by the presence of chronic inflammation, such as JIA, could represent special risk groups. Glucocorticoids are used routinely in the management of the inflammation of JIA, in high doses and long-term. Long-term use of the glucocorticoids can cause to insulin resistance, hypertension, and obesity, increasing the risk of metabolic syndrome. The aim of this study is to review the literature on the prevalence of different components of metabolic syndrome in patients with JIA. We observed that the data on metabolic syndrome and its components in those patients are very scarce and more studies needed, in view of the potential increased risk of cardiovascular disease.

[Does the consumption of salt and food rich in sodium influence blood pressure in infants?]. / O consumo de sal e alimentos ricos em sódio pode influenciar na pressão arterial das crianças?

This article verifies the consumption of salt and food rich in sodium and the blood pressure of schoolchildren of a private and a public school in the city of Barra do Ribeiro, Rio Grande do Sul State, Brazil. It is a cross-sectional study with standardized methods of anthropometric and blood pressure measures. Parents and tutors answered a questionnaire about socio-economic conditions, family risk factors regarding hypertension and feeding habits of the student (frequency questionnaire). 81 students were evaluated, from those 42 (51.90%) medium age were 8.3 +/- 3.2 years. 45 (55.60%) studied in the private school and 36 (44.40%) in the public school. Findings show two children with systolic hypertension, both from the public school (p = 0.194), yet this may be found by chance. Similar fact may have occurred with the four cases of diastolic hypertension; being three of them from the private school. But there was not significant difference between the groups (p = 0.625). The medium consumption of salt found in this population was of 7.66 g (3098.81 mg or 133.86 mEq), which is above the recommended in the present literature. Canned food was related to be rich in sodium and to be associated with high levels of systolic blood pressure. In conclusion, as higher the salt consumption, higher the systolic blood pressure.