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Objective: To examine the association between molar-incisor hypomineralization (MIH) and the prevalence of thinness among Mexican schoolchildren in communities with different fluoride levels in the drinking water. Methods: A cross-sectional study on Mexican children (n = 488) selected from two communities presenting different concentrations of fluoride in the drinking water (1.0-1.40 ppm/F). The World Health Organization (WHO) growth standards were used to calculate BMI-for-age z-scores, with BMI z-score cutoff points of <-2.0, >+1.0, >+2.0 recommended for defining thinness, being overweight, and obesity. The presence and severity of MIH were evaluated using the European Academy of Paediatric Dentistry (EAPD) criteria. Multiple logistic regression analyses were used to assess the association, adjusting for confounders. Results: The proportion of children presenting thinness, being overweight, and obesity was 8.2%, 23.6%, and 28.7%, respectively, while 21.5% of the schoolchildren had MIH, classified, by severity, as 9.6% mild, 6.4% moderate, and 5.5% severe. Of those schoolchildren presenting thinness, 16.2% had MIH, and only 6.0% did not (p < 0.001). Finally, schoolchildren presenting thinness were more likely to present MIH (OR = 2.76 (CI 95% 1.33-5.73); p=0.006) than children with a normal BMI. Conclusion: The present study found a relationship between thinness and the presence of MIH in schoolchildren, indicating the need for strategies and interventions aimed at preventing and controlling micronutrient deficiencies in the child population.
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Dengvaxia is the first dengue vaccine recommended in the United States (U.S.). It is recommended for children aged 9-16 y with laboratory-confirmed previous dengue infection and living in areas where dengue is endemic. We conducted focus groups with parents and in-depth interviews with key informants (i.e. practicing pediatricians, physicians from immunization clinics, university researchers, and school officials) in Puerto Rico (P.R.) to examine acceptability, barriers, and motivators to vaccinate with Dengvaxia. We also carried out informal meetings and semi-structured interviews to evaluate key messages and educational materials with pediatricians and parents. Barriers to vaccination included lack of information, distrust toward new vaccines, vaccine side effects and risks, and high cost of/lack of insurance coverage for laboratory tests and vaccines. Motivators included clear information about the vaccine, a desire to prevent future dengue infections, the experience of a previous dengue infection or awareness of dengue fatality, vaccine and laboratory tests covered by health insurance, availability of rapid test results and vaccine appointments. School officials and parents agreed parents would pay a deductible of $5-20 for Dengvaxia. For vaccine information dissemination, parents preferred an educational campaign through traditional media and social media, and one-on-one counseling of parents by healthcare providers. Education about this vaccine to healthcare providers will help them answer parents' questions. Dengvaxia acceptability in P.R. will increase by addressing motivators and barriers to vaccination and by disseminating vaccine information in plain language through spokespersons from health institutions in P.R.
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Vacunas contra el Dengue , Dengue , Vacunas , Niño , Humanos , Dengue/prevención & control , Vacunas contra el Dengue/efectos adversos , Padres , Puerto Rico/epidemiología , Estados Unidos , Vacunación/métodos , AdolescenteRESUMEN
OBJECTIVE: this study was undertaken to evaluate the efficacy of multilayer polyurethane foam with silicone (MPF) compared to transparent polyurethane film (TPF) dressings in the control of heel skin microclimate (temperature and moisture) of hospitalized patients undergoing elective surgeries. METHOD: the study took of a secondary analysis of a randomized self-controlled trial, involving patients undergoing elective surgical procedure of cardiac and gastrointestinal specialties in a university hospital in southern Brazil, from March 2019 to February 2020. Patients served as their own control, with their heels randomly allocated to either TPF (control) or MPF (intervention). Skin temperature was measured using a digital infrared thermometer; and moisture determined through capacitance, at the beginning and end of surgery. The study was registered in the Brazilian Registry of Clinical Trials: RBR-5GKNG5. RESULTS: significant difference in the microclimate variables were observed when the groups (intervention and control) and the timepoint of measurement (beginning and end of surgery) were compared. When assessing temperature, an increase (+3.3 °C) was observed with TPF and a decrease (-7.4 °C) was recorded with MPF. Regarding skin moisture, an increase in moisture (+14.6 AU) was recorded with TPF and a slight decrease (-0.3 AU) with MPF. CONCLUSIONS: The findings of this study suggest that MPF is more effective than TPF in controlling skin microclimate (temperature and moisture) in heels skin of hospitalized patients undergoing elective surgeries. However, this control should be better investigated in other studies.
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Talón , Microclima , Humanos , Femenino , Masculino , Persona de Mediana Edad , Brasil , Anciano , Temperatura Cutánea/fisiología , Vendajes/normas , Vendajes/estadística & datos numéricos , Poliuretanos , AdultoRESUMEN
Aedes aegypti control has been fraught with challenges in Puerto Rico. The government has implemented commonly used vector control methods, but arboviral epidemics still occur. It is necessary to explore new Ae. aegypti control methods. This study aimed to understand the perceptions of community members in Ponce, Puerto Rico about emergent and traditional Ae. aegypti vector control methods and determine their acceptability and support for these methods. We identified the type of information needed to increase support for emergent vector control methods, and the preferred strategies to disseminate this information. Four group discussions were conducted with a total of 32 participants representing eight of the 14 clusters participating in the Communities Organized for the Prevention of Arboviruses (COPA), a project designed to mobilize communities in Ponce, Puerto Rico to prevent diseases transmitted by mosquitoes. Group discussions began with an overview of different methods used for controlling Ae. aegypti mosquitoes. These overviews facilitated participant understanding of the mosquito control methods presented. Use of source reduction, autocidal gravid ovitraps (AGO), and manual application of larvicide for arboviral mosquito control received support from almost all participants. Vector control methods that use more familiar techniques in Puerto Rico such as truck-mounted larvicide spraying (TMLS) and insecticide residual spraying received support from most participants. More than half of participants supported the use of emergent mosquito control methods including Wolbachia suppression, Wolbachia replacement, or genetically modified mosquitoes (GMM). Participants preferred to receive vector control information through house-to-house visits with the distribution of written materials, followed by dissemination of information through traditional (i.e., radio, television) and social media. The detailed information resulting from this study was used to develop messages for a communications campaign to garner future community support. Community acceptance and support are critical for the success of vector control programs using emergent mosquito control methods.
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Monitoring of clinical trials is critical to the protection of human subjects and the conduct of high-quality research. Even though the adoption of risk-based monitoring (RBM) has been suggested for many years, the RBM approach has been less widespread than expected. Centralized monitoring is one of the RMB pillars, together with remote-site monitoring visits, reduced Source Data Verification (SDV) and Source Document Reviews (SDR). The COVID-19 pandemic promoted disruptions in the conduction of clinical trials, as on-site monitoring visits were adjourned. In this context, the transition to RBM by all actors involved in clinical trials has been encouraged. In order to ensure the highest quality of data within a COVID-19 clinical trial, a centralized monitoring tool alongside Case Report Forms (CRFs) and synchronous automated routines were developed at the clinical research platform, Fiocruz, Brazilian Ministry of Health. This paper describes how these tools were developed, their features, advantages, and limitations. The software codes, and the CRFs are available at the Fiocruz Data Repository for Research-Arca Dados, reaffirming Fiocruz's commitment to Open Science practices.
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Exactitud de los Datos , Pandemias , Humanos , Pandemias/prevención & control , Programas Informáticos , BrasilRESUMEN
Previous research has shown that woman-headed households, more than man-headed ones, experience food insecurity. The purpose of this article is to contribute on the determinants that are linked to this gender disparity. Using a nationally representative dataset from Chile, we found that food security household head gender disparity is associated with marital status (having or not a partner) and household composition (having children or seniors). In contrast, gender disparity is not strongly associated with household income and household head educational differences. In this way, we expect to bring evidence to inform new alternatives that help mitigate food security gender disparity.
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Composición Familiar , Abastecimiento de Alimentos , Masculino , Niño , Femenino , Humanos , Factores Socioeconómicos , Encuestas y Cuestionarios , Inseguridad AlimentariaRESUMEN
Introdução: O número de adeptos ao vegetarianismo tem crescido consideravelmente. Observa-se que, entre as vantagens de se adotar uma dieta vegetariana, está o menor risco de desenvolver sobrepeso e obesidade, o que pode estar relacionado com o alto consumo de vegetais e práticas importantes de estilo de vida. Objetivos: Avaliar o estado nutricional e a frequência do consumo alimentar de vegetarianos não estritos e estritos. Métodos: Estudo transversal descritivo, realizado com participantes do grupo "Vegans SLZ", de ambos os sexos e com idade a partir de 18 anos. A coleta de dados ocorreu de janeiro a março de 2020. Foi realizada aplicação de questionários sobre dados de frequência do consumo alimentar, socioeconômico e de estilo de vida e a aferição de medidas de peso corporal, estatura e de percentuais de gordura corporal e massa muscular. Os dados foram tabulados no Excel 2010® e analisados no programa estatístico R Studio versão 3.6.1. Resultados: Dos 43 vegetarianos avaliados, a maioria seguia a dieta vegetariana estrita (55,81%) e era eutrófica (62,79%), 32,56% apresentaram alto percentual de gordura corporal e 53,49% percentual de massa magra corporal normal. Foi frequente o consumo de pães, cereais, tubérculos, leguminosas, oleaginosas, frutas e verduras, e 41% consumiam alimentos industrializados de 4 a 7 vezes por semana. Conclusões: A maioria da amostra tinha estado nutricional eutrófico e consumo regular de todos os grupos alimentares, porém com importante consumo de alimentos industrializados.
Introduction: The number of adherents to vegetarianism has grown considerably. It is observed that, among the advantages of adopting a vegetarian diet, there is a lower risk of developing overweight and obesity, which may be related to the high consumption of vegetables and important lifestyle practices. Objectives: To assess the nutritional status and frequency of food consumption of non-strict and strict vegetarians. Methods: Descriptive cross-sectional study carried out with participants of the "Vegans SLZ" group, of both sexes and aged 18 years and over. Data collection took place from January to March 2020. Questionnaires were applied to data on frequency of food, socioeconomic and lifestyle consumption and measurements of body weight, height and percentages of body fat and muscle mass were measured. Data were tabulated in Excel 2010® and analyzed in the statistical program R Studio version 3.6.1. Results: Of the 43 vegetarians evaluated, the majority followed the strict vegetarian diet (55.81%) and were eutrophic (62.79%), 32.56% had a high percentage of body fat and 53.49% percentage of lean body mass normal. The consumption of breads, cereals, tubers, legumes, oilseeds, fruits and vegetables was frequent, and 41% consumed processed foods 4 to 7 times a week. Conclusions: Most of the sample had a eutrophic nutritional status and regular consumption of all food groups, but with a significant consumption of industrialized foods.
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Humanos , Masculino , Femenino , Dieta Vegetariana , Estado Nutricional , Ingestión de Alimentos , VegetarianosRESUMEN
Objetivo: Identificar os fatores associados ao desenvolvimento de lesão por pressão (LP) no período perioperatório em indivíduos submetidos a cirurgia eletiva. Método: Revisão integrativa da literatura realizada, em 2021, com o auxílio da Biblioteca Virtual em Saúde (BVS). Resultados: Identificaram-se 135 artigos na base de dados, dos quais 19 foram selecionados para extração dos resultados. Os critérios de inclusão dos artigos foram: serem originais, responderem à pergunta de pesquisa, publicados em português, inglês ou espanhol, apresentarem como população: pacientes cirúrgicos; como exposição: fatores de risco no pré-operatório, intraoperatório ou pós-operatório; e como resultado: desenvolvimento de LP. Dos artigos incluídos, 15,8% foram realizados no Brasil, com predominância do nível de evidência NE=2 (n = 15; 68,2%). Conclusão: Associaram-se ao desenvolvimento de lesão fatores intrínsecos e extrínsecos relacionados com cirurgia, medicamentos em uso, comorbidades, estado clínico pré-cirúrgico, sexo, idade, ser admitido de um outro local que não sua residência, cirurgias abertas, tipo de cirurgia, tipo de anestesia, episódios hipotensivos, transfusão, tempo cirúrgico, uso de coxim, condições da pele, aumento da pressão no intraoperatório, temperatura da pele, hipotermia
Objective: To identify factors associated with the development of pressure injuries (PI) in the perioperative period in individuals undergoing elective surgery. Method: Integrative literature review carried out in 2021 with the help of Biblioteca Virtual em Saúde (BVS). Results: 135 articles were identified in the database, of which 19 were selected for extraction of results. The inclusion criteria of the articles were: being original, answering the research question, published in Portuguese, English or Spanish, presenting as a population: surgical patients; as exposure: preoperative, intraoperative or postoperative risk factors; and as a result: LP development. Of the articles included, 15.8% were carried out in Brazil, with a predominance of the level of evidence LE=2 (n = 15; 68.2%). Conclusion: Intrinsic and extrinsic factors related to surgery, medications in use, comorbidities, pre-surgical clinical status, sex, age, being admitted from a place other than their residence, open surgeries, type of surgery were associated with the development of injury. , type of anesthesia, hypotensive episodes, transfusion, surgical time, use of cushion, skin conditions, increased intraoperative pressure, skin temperature, hypothermia.
Objetivo: Identificar factores asociados al desarrollo de lesiones por presión (LP) en el perioperatorio en sujetos sometidos a cirugía electiva. Método: Revisión integrativa de la literatura realizada en la Biblioteca Virtual en Salud (BVS) en 2021. Resultados: 135 artículos fueron identificados en la base de datos y 19 fueron seleccionados para la extracción de resultados. Los criterios de inclusión de los artículos fueron: ser originales, responder a la pregunta de investigación, publicados en portugués, inglés o español, con la siguiente población: pacientes quirúrgicos; como exposición: factores de riesgo preoperatorios, intraoperatorios o postoperatorios; y como resultado: desarrollo de LP. De los artículos incluidos, 15,8% fueron realizados en Brasil con predominio del nivel de evidencia NE=2 (n = 15; 68,2%). Conclusión: Asociados con el desarrollo de lesiones, están: Factores intrínsecos y extrínsecos relacionados con la cirugía, medicamentos en uso, comorbilidades, estado clínico prequirúrgico, sexo, edad, ser ingresado de lugar diferente al de residencia, cirugías abiertas, tipo de cirugía, tipo de anestesia, episodios de hipotensión, transfusión, tiempo quirúrgico, uso de almohadillas, afecciones de la piel, aumento de la presión intraoperatoria, temperatura de la piel, hipotermia.
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Humanos , Procedimientos Quirúrgicos Electivos , Úlcera por Presión , Periodo Perioperatorio , Cirugía General , Factores de Riesgo , EnfermeríaRESUMEN
The objective was to evaluate the efficacy of multi-layered silicone foam (intervention) compared with transparent polyurethane film (control) in preventing heel pressure injuries caused by surgical positioning of individuals undergoing elective surgery. It was designed an intra-patient, open, parallel, randomised controlled trial was conducted in a university hospital in southern Brazil, from March 2019 to February 2020, with patients undergoing elective surgeries of cardiac and gastrointestinal specialties. The patients who met the selection criteria constituted, simultaneously, a single group receiving the intervention and active control, through paired analysis of the cutaneous sites (right heel and left heel). The outcome was the occurrence of PI, within the follow-up period was 72 hours. Brazilian Registry of Clinical Trials: RBR-5GKNG5. There was analysis of 135 patients/270 heels, with an overall incidence of 36.7%. The pressure injury incidence was significantly lower in the intervention group (26.7%), compared with the control group (P = .001); relative risk of 0.57. In the intervention group, the estimated pressure injury-free time (survival) was 57.5 hours and in the control group, 43.9 hours. It was concluded that Multi-layered silicone foam (intervention) is more efficacious than transparent polyurethane film (control) in the prevention of pressure injuries caused by surgical positioning of individuals undergoing elective surgery.
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Talón , Úlcera por Presión , Vendajes , Brasil , Femenino , Humanos , Masculino , Quirófanos , Úlcera por Presión/prevención & controlRESUMEN
INTRODUCTION: Children with chronic illnesses and medical complexity (CIMC) require frequent health-care use, thereby increasing medical care costs. We evaluated parent-child perceptions of self-management, self-efficacy, and health-related quality of life (HRQOL) in children with CIMC. METHOD: Parent-children pairs (nâ¯=â¯32) completed three measures before discharge from the hospital (Patient Activation Measure, Self-Efficacy Scale, and Acute Care-Pediatric Quality of Life for Children 8-12 and 13-17 years). RESULTS: Parents (56.3%) and children (40.6%) reported moderate levels of self-management. HRQOL was correlated with both self-management (râ¯=â¯.441, pâ¯=â¯.12) and self-efficacy (râ¯=â¯.464, pâ¯=â¯.008). At least 25% to 50% reported low PedsQL subscale scores (< 70), which indicate problems with physical, emotional, social, and mental domains. DISCUSSION: Our findings support the assessment of not only physical but also mental, emotional, and social needs in children with CIMC. We recommend development and testing strategies promoting self-management and self-efficacy to maximize HRQOL and improve health outcomes in children with CIMC.
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Enfermedad Crónica , Calidad de Vida , Autoeficacia , Automanejo , Adolescente , Niño , Femenino , Humanos , Masculino , PadresRESUMEN
Repetitive sequences are ubiquitous and fast-evolving elements responsible for size variation and large-scale organization of plant genomes. Within tribe Phaseoleae (Fabaceae), some genera, such as Phaseolus, Vigna, and Cajanus, show small genome and mostly stable chromosome number. Here, we applied a combined computational and cytological approach to study the organization and diversification of repetitive elements in some species of these genera. Sequences were classified in terms of type and repetitiveness and the most abundant were mapped to chromosomes. We identified long terminal repeat (LTR) retrotransposons, especially Ogre and Chromovirus elements, making up most of genomes, other than P. acutifolius and Vigna species. Satellite DNAs (SatDNAs) were less representative, but highly diverse among species, showing a clear phylogenetic relationship. In situ localization revealed preferential location at pericentromeres and centromeres for both types of sequences, suggesting a heterogeneous composition, especially for centromeres. Few elements showed subterminal accumulation. Copy number variation among chromosomes within and among species was observed for all nine identified SatDNAs. Altogether, our data pointed two main elements (Ty3/Gypsy retrotransponsons and SatDNAs) to the diversification on the repetitive landscape in Phaseoleae, with a typical set of repeats in each species. The high turnover of these sequences, however, did not affect total genome size.
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Variación Genética , Genoma de Planta , Genómica , Phaseolus/genética , Secuencias Repetitivas de Ácidos Nucleicos , Cromosomas de las Plantas , Biología Computacional/métodos , ADN de Plantas , Minería de Datos , Heterogeneidad Genética , Genómica/métodos , Hibridación Fluorescente in Situ , Phaseolus/clasificación , Filogenia , Retroelementos , Secuencias Repetidas en TándemRESUMEN
INTRODUCTION: Central Venous Catheters (CVCs) are placed in pediatric patients that require frequent and/or long-term access for intravenous treatments and increase the risk for Central line-associated bloodstream infections (CLABSIs). The specific aims of the study were to evaluate adherence to the intervention components and rates of Central Line Associated Bloodstream Infections (CLABSIs) over five years. METHODS: Implementation occurred on the acute care and hematology-oncology pediatric units of a quaternary health care setting in Southern California. Adherence rates were quantified using a CVC audit sheet and CLABSI rates were obtained quarterly before, and at year 1, 2, 3, 4, 5 of implementation. RESULTS: CLABSI rates for both pediatric units decreased over the five-year period. Adherence rates were 90% to 100% on the different features of the intervention; the lowest was adherence to Patient Protective Equipment (PPE). A total of 41 incidents of hospital-acquired CLABSIs were reported the year prior to the Bug Buster Committee, which decreased steadily to 9 incidents after implementation. The quarterly CLABSI rates in the Pediatric Acute Care ranged from 2.8 to 6.6/1,000 catheter days and in Pediatric Hematology-Oncology from 2.1 to 4.3/1,000 catheter days the year prior to implementation. CONCLUSIONS: While adherence for staff remains high, parent/family adherence was low. We recommend including in the multi-level intervention, procedures targeting parent adherence such as patient education handouts, reviewing content on admission, placing signs on doors indicating PPE requirements, and promptly providing PPE to non-adherent family members.
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Infecciones Relacionadas con Catéteres/prevención & control , Cateterismo Venoso Central/normas , Hospitales Pediátricos/normas , Servicio de Oncología en Hospital/normas , Atención Ambulatoria/estadística & datos numéricos , Bacteriemia/prevención & control , California , Catéteres Venosos Centrales/normas , Niño , Infección Hospitalaria/prevención & control , Femenino , Humanos , Masculino , Neoplasias/terapia , Mejoramiento de la CalidadRESUMEN
RESUMEN La sarcopenia se caracteriza por la tríada de reducción de masa muscular en asociación con reducción de la fuerza muscular y/o desempeño físico. Entre las enfermedades crónicas, el cáncer se configura como una condición relacionada al desarrollo de la sarcopenia, debido a la condición inflamatoria, al catabolismo proteico y a la inapetencia alimentaria atribuida a los diversos efectos colaterales del tratamiento de quimioterapia. Objetivo: Describir la prevalencia de sarcopenia en pacientes oncológicos en tratamiento quimioterapéutico. Método: Estudio transversal realizado con pacientes de ambos sexos, en un hospital universitario del nordeste brasileño. Se determinó la sarcopenia a través de la circunferencia muscular del brazo (percentil <10); fuerza de prensión palmar: <20 kg/f y < 30 kg/f para mujeres y hombres ancianos respectivamente, menor tercil: <28,7kg/f y <15,6 kg/f para hombres y mujeres adultas respectivamente y velocidad de marcha (<0.8 m/s). Se evaluaron las variables de asociación, como datos sociodemográficos, estilo de vida, clínico y antropométrico. Resultados: La muestra fue compuesta por 117 pacientes, con edad promedio 60,5 ±13,2 años con prevalencia del sexo femenino (el 59,8%). Se verificó una prevalencia de sarcopenia del 27,4%, y se observó que el 53,1% tenían sarcopenia severa. Los ancianos fueron los más sarcopénicos (p= 0,003). Se encontró también una asociación positiva con el estado nutricional (p<0,001). Conclusión: La prevalencia de la sarcopenia fue significativa y semejante a otros estados, siendo más prevalentes en los pacientes desnutridos y ancianos.
ABSTRACT Sarcopenia is characterized by the triad of reduced muscle mass in association with reduced muscle strength and / or physical performance. Among chronic diseases, cancer is a condition related to the development of sarcopenia because of, among other factors, inflammation, protein catabolism and loss of appetite attributed to the side effects of chemotherapy treatment. Objective: To describe the prevalence of sarcopenia in cancer patients undergoing chemotherapy. Method: A cross-sectional study was carried out with patients of both sexes, in a university hospital in Northeastern Brazil. Sarcopenia was determined by arm circumference (percentile <10); hand grip strength (<20 kg/f and <30 kg/f for women and men, respectively; lowest tertile: <28.7 kg/f and <15.6 kg/f for men and women, respectively) and gait velocity (<0.8 m/s). Sociodemographic, lifestyle, clinical and anthropometric variables were also evaluated. Results: The sample consisted of 117 patients (59.8% female), with a mean age of 60.5 ± 13.2 years. There was a prevalence of sarcopenia of 27.4% and 53.1% had severe sarcopenia. Sarcopenia was more common in older participants (p= 0.003). There was also a positive association with nutritional status (p<0.001). Conclusion: The prevalence of sarcopenia was significant and similar to other studies, being more prevalent in undernourished and elderly participants.
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Humanos , Pacientes , Brasil , Quimioterapia , Fuerza Muscular , Sarcopenia , NeoplasiasRESUMEN
RESUMEN Los ancianos están más expuestos al desarrollo del cáncer, pues el envejecimiento deja las células más susceptibles a la transformación maligna. Identificar la fragilidad puede contribuir a mejorar resultados en el tratamiento antineoplásico. El objetivo de este estudio fue identificar la prevalencia y grado de fragilidad en ancianos oncológicos en tratamiento con quimioterapia e investigar factores asociados al síndrome. Se incluyeron pacientes ≥60 años en nivel ambulatorio. La fragilidad se evaluó a partir del fenotipo desarrollado en la Universidad Johns Hopkins. El nivel de significancia adoptado para todas las pruebas fue menor que p<0,05. De la muestra de 60 individuos, el 55,0% era hombres, con promedio de edad 69,8±7,6. Entre los pacientes evaluados, el 66,7% presentaron fragilidad y el 33,3% pre-fragilidad. Las mujeres fueron más frágiles (81,5% vs 54,5%; p= 0,028) y la fragilidad tendió a ser mayor entre los caquécticos (81,8% vs 57,9%; p= 0,051). Concluimos que hubo un porcentaje elevado de pacientes frágiles y pre-frágiles. El sexo femenino y el sedentarismo se presentaron como factores asociados.
ABSTRACT The elderly are more at risk for developing cancer, as aging leaves cells more susceptible to malignant transformations. Identifying frailty can contribute to improved outcomes in antineoplastic treatment. The purpose of this study was to identify the prevalence and degree of frailty in elderly cancer patients undergoing chemotherapy treatment and investigate factors associated with this syndrome. Ambulatory patients> 60 years were included. Frailty was assessed from the phenotype developed by Johns Hopkins University. The significance level adopted for all tests was p<0.05. From the sample of 60 individuals, 55.0% were men, with mean age 69.8 ± 7.6. Among the patients evaluated, 66.7% presented frailty, and 33.3% pre-frailty. Women were more frail (81.5% vs 54.5%; p= 0.028) and frailty tended to be higher among cachectic patients (81.8% vs 57.9%; p= 0.051). We concluded that there was an elevated percentage of frail and pre-frail patients. Female sex and sedentarism were associated factors.
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Humanos , Brasil , Anciano , Pérdida de Peso , Estado de Salud , Anciano Frágil , Quimioterapia , Fuerza Muscular , Fatiga , Velocidad al Caminar , Neoplasias/tratamiento farmacológicoRESUMEN
O estudo objetivou analisar a experiência de mulheres no pós-parto, sobre o planejamento familiar. Neste período, a mulher tende a receber menor atenção dos profissionais de saúde, uma vez que os olhares estão mais voltados ao recém-nascido, e as questões relacionadas à sexualidade não recebem atenção. Pesquisa qualitativa, descritivo-exploratória, realizada com 17 mulheres no período de até um ano pós-parto. Foi utilizada a técnica da entrevista semiestruturada para a coleta de dados e a análise temática de Bardin para a sua organização. Após a análise do material verbal coletado, três categorias emergiram: Gravidez não planejada pela 'falha' do método; Consulta puerperal; e Planejamento familiar após o parto. O planejamento familiar preconizado pelo Ministério da Saúde não é compatível com as ações realizadas pela Estratégia de Saúde da Família (ESF). Isso porque as mulheres entrevistadas experienciaram, em sua maioria, gravidez indesejada e continuam vulneráveis a adquirir outras futuras gestações.
Current research analyzed the experience of post-partum females on family planning. During this period, females tend to receive less attention by health professionals since the newly born baby comes foremost and sexual issues are not focused. Current qualitative, descriptive and exploratory research was undertaken with 17 females during a period of up to one year after birth. The half-structured interview was prepared for data collection and Bardin´s thematic analysis for organization. After analyzing the verbal material, three categories emerged: non planned pregnancy due to the method´s failure; puerperal attendance, family planning after child birth. Family planning as conceived by the Ministry of Health is not compatible with activities by the Family Health Strategy due to the fact that most interviewed females had undesired pregnancy and remained vulnerable to other future ones.
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Femenino , Embarazo no Deseado , Periodo Posparto , Planificación FamiliarRESUMEN
Fucus spiralis L. is a broadly distributed monoecious intertidal seaweed. The specific status of F. spiralis however is debatable. Here, we contribute to the bioinformatics and systematics of F. spiralis by analysing the complete mitochondrial and plastid genomes of a specimen from California, U.S.A. The F. spiralis mitogenome is 36,396 base pairs (bp) in length and contains 67 genes, and the plastid genome is 125,066 bp in length and contains 171 genes. The F. spiralis genomes are 99.7% and 99.8% similar in nucleotide sequence to F. vesiculosus, and support the revised classification of F. spiralis to Fucus vesiculosus var. spiralis.
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KEY MESSAGE: The plastome of Linum usitatissimum was completely sequenced allowing analyses of evolution of genome structure, RNA editing sites, molecular markers, and indicating the position of Linaceae within Malpighiales. Flax (Linum usitatissimum L.) is an economically important crop used as food, feed, and industrial feedstock. It belongs to the Linaceae family, which is noted by high morphological and ecological diversity. Here, we reported the complete sequence of flax plastome, the first species within Linaceae family to have the plastome sequenced, assembled and characterized in detail. The plastome of flax is a circular DNA molecule of 156,721 bp with a typical quadripartite structure including two IRs of 31,990 bp separating the LSC of 81,767 bp and the SSC of 10,974 bp. It shows two expansion events from IRB to LSC and from IRB to SSC, and a contraction event in the IRA-LSC junction, which changed significantly the size and the gene content of LSC, SSC and IRs. We identified 109 unique genes and 2 pseudogenes (rpl23 and ndhF). The plastome lost the conserved introns of clpP gene and the complete sequence of rps16 gene. The clpP, ycf1, and ycf2 genes show high nucleotide and aminoacid divergence, but they still possibly retain the functionality. Moreover, we also identified 176 SSRs, 20 tandem repeats, and 39 dispersed repeats. We predicted in 18 genes a total of 53 RNA editing sites of which 32 were not found before in other species. The phylogenetic inference based on 63 plastid protein-coding genes of 38 taxa supports three major clades within Malpighiales order. One of these clades has flax (Linaceae) sister to Chrysobalanaceae family, differing from earlier studies that included Linaceae into the euphorbioid clade.
Asunto(s)
Lino/genética , Genoma de Plastidios/genética , Linaceae/genética , Plastidios/genética , Edición de ARN , Sitios de Unión/genética , Proteínas de Cloroplastos/genética , ADN de Cloroplastos/química , ADN de Cloroplastos/genética , Evolución Molecular , Genes del Cloroplasto/genética , Linaceae/clasificación , Filogenia , Análisis de Secuencia de ADNRESUMEN
RESUMO A ocupação urbana intensa e não planejada acarreta problemas diretos à população. Um desses problemas é a diminuição do índice de permeabilidade do solo gerada pela pavimentação crescente que sempre acompanha o desenvolvimento urbano de uma região. Em consequência, o sistema de drenagem pode sofrer sobrecargas uma vez que a capacidade de infiltração do solo é alterada e a pavimentação aumenta a velocidade de escoamento e as vazões de pico. Este trabalho apresenta uma análise integrada da dinâmica do uso do solo ao longo de 32 anos e do comportamento do sistema de microdrenagem urbana para o cenário atual de ocupação dos bairros Catolé e Sandra Cavalcante, em Campina Grande (PB). Verifica-se a deficiência do sistema de microdrenagem em não acompanhar o acelerado crescimento da região, acarretando em pontos de alagamento que geram prejuízos e desconfortos à população em períodos de chuva mais concentrada.
ABSTRACT The intense and unplanned urban occupation entails direct problems to the population. One of these problems is the decrease in the permeability index of soil generated by increasing paving that always accompanies the urban development of a region. As a result, the drainage system may experience overloads, once the infiltration capacity of the soil is changed and the paving increases the flow rate and the peak flows. This paper presents an integrated analysis of land use dynamics over the course of 32 years and the behavior of the urban micro-drainage system to the current scenario of occupation of Catolé and Sandra Cavalcante neighborhoods, in Campina Grande, PB. It verifies the disability of the micro-drainage system to accompany the accelerated growth of the region, leading in points of flooding that generate losses and discomforts to the population in more concentrated rain periods.
RESUMEN
BACKGROUND/PURPOSE: Fecal incontinence after a pull-through is associated with different factors, although damage to the anal canal seems to be the most important. The objective of this article is to identify the variables related to the presence of fecal control and colitis in a homogeneous group of children after pull-through. METHODS: A retrospective cross-sectional study was performed in patients with HD for evaluation of post-operative problems from May 2014 to November 2016. The patients (39) had a transanal approach and were divided into two groups: Group 1 patients with fecal continence and Group 2 patients with fecal incontinence. RESULTS: Group 1 patients (13) had the anastomosis in the rectum, no damage to the anal canal, and a positive history of colitis. Group 2 (26) had the anastomosis at the skin, anoderm, pectinate line, or a combination of these and a negative history of colitis. CONCLUSIONS: We demonstrated that patients with a technical error in the anastomosis have fecal incontinence, but not colitis. Preservation of the anal canal is associated with fecal control and colitis because it is a high-pressure zone. Education for proper identification of the anal canal during a pull-through is an absolute necessity. TYPE OF STUDY: Retrospective Comparative Study. LEVEL OF EVIDENCE: Level III.