Psychometric evaluation of the NTDT-PRO questionnaire for assessing symptoms in patients with non-transfusion-dependent beta-thalassaemia.

OBJECTIVES: The non-transfusion-dependent beta-thalassaemia-patient-reported outcome (NTDT-PRO) questionnaire was developed for assessing anaemia-related tiredness/weakness (T/W) and shortness of breath (SoB) among patients with NTDT. Psychometric properties were evaluated using blinded data from the BEYOND trial (NCT03342404). DESIGN: Analysis of a phase 2, double-blind, randomised, placebo-controlled trial. SETTING: USA, Greece, Italy, Lebanon, Thailand and the UK. PARTICIPANTS: Adults (≥18 years) (N=145) with NTDT who had not received a red blood cell transfusion within 8 weeks prior to randomisation, with mean baseline haemoglobin level ≤100 g/L. MEASURES: NTDT-PRO daily scores from baseline until week 24, and scores at select time points for the 36-Item Short Form Health Survey version 2 (SF-36v2), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) and Patient Global Impression of Severity (PGI-S). RESULTS: Cronbach's alpha at weeks 13-24 was 0.95 and 0.84 for the T/W and SoB domains, respectively, indicating acceptable internal consistency reliability. Among participants self-reporting no change in thalassaemia symptoms via the PGI-S between baseline and week 1, intraclass correlation coefficients were 0.94 and 0.92 for the T/W and SoB domains, respectively, indicating excellent test-retest reliability. In a known-groups validity analysis, least-squares mean T/W and SoB scores at weeks 13-24 were worse in participants with worse scores for the FACIT-F Fatigue Subscale (FS), SF-36v2 vitality or PGI-S. Indicating responsiveness, changes in T/W and SoB domain scores were moderately correlated with changes in haemoglobin levels, and strongly correlated with changes in SF-36v2 vitality, FACIT-F FS, select FACIT-F items and the PGI-S. Improvements in least-squares mean T/W and SoB scores were higher in participants with greater improvements in scores on other PROs measuring similar constructs. CONCLUSIONS: The NTDT-PRO demonstrated adequate psychometric properties to assess anaemia-related symptoms in adults with NTDT and can be used to evaluate treatment efficacy in clinical trials.

Relationship between Serum Ferritin and Outcomes in ß-Thalassemia: A Systematic Literature Review.

Among the difficulties of living with ß-thalassemia, patients frequently require blood transfusions and experience iron overload. As serum ferritin (SF) provides an indication of potential iron overload, we conducted a systematic literature review (SLR) to assess whether SF levels are associated with clinical and economic burden and patient-reported outcomes (PROs). The SLR was conducted on 23 April 2020 and followed by analysis of the literature. Dual-screening was performed at the title, abstract, and full-text levels using predefined inclusion and exclusion criteria. Ten studies identified by the SLR were eligible for inclusion in the analysis. Seven studies were conducted in Europe, and most were prospective or retrospective in design. The patient populations had a median age of 20.7-42.6 years, with a percentage of men of 38-80%. Sparse data were found on the correlation between SF levels and mortality, and hepatic, skeletal, and cardiac complications; however, in general, higher SF levels were associated with worsened outcomes. The bulk of the evidence reported on the significant association between higher SF levels and endocrine dysfunction in its many presentations, including a 14-fold increase in the risk of diabetes for patients with persistently elevated SF levels. No studies reporting data on PROs or economic burden were identified by the SLR. SF levels provide another option for prognostic assessment to predict a range of clinical outcomes in patients with ß-thalassemia.

Iron availability in an enteral feeding formulation by response surface methodology for mixtures.

BACKGROUND: The nutritional therapy with enteral diets has been getting specialized and those formulations to substitute the traditional diet for those patients who need to be fed by probe. This workís aim was to study the effect of the components of enteral diet formulation: fiber, calcium and medium-chain triglycerides, seeking optimize a formulation for the best dialysability of iron by Response Surface Methodology (RSM). METHODS: The ingredients used for the formulations of the diet were chosen according to the ones commercialized in the modules of a standard enteral diet, with which it was made an experimental diet and the applicability of the experimental limits. RESULTS: The found results in the model have shown that it depends on the proportion of the nutrients that were manipulated in the experimental design. When the level curve was obtained for the iron dialysable, it could be verified that the binary interaction fiber-calcium was the one that presented more synergism for the appraised formulation. Before the analyzed facts, the best formulation of enteral diet optimized for the dialysability of the iron was the proportion of 60% of fiber and 40% of calcium, showing to be the best formulation of the enteral diet for the availability of the iron.

Objetivos: La terapia nutricional con nutrición enterales se ha especializado en los últimos 2013s y estas formulaciones pueden sustituir a la dieta tradicional para aquellos pacientes que necesitan de infusiones de alimentación. El objetivo fue estudiar el efecto de los componentes de la formulación de nutrición enterales: fibra, calcio y triglicéridos de cadena media para optimizar una formulación para el hierro dialisibilidad. Métodos: La herramienta utilizada fue el análisis de múltiples variables, utilizando modelos de superficie de respuesta para las mezclas. Los ingredientes usados en las formulaciones de la dieta se presentan en el diseño experimental elegido de acuerdo con los módulos que se venden en dieta enteral estándar. Resultados: Los resultados mostraron la dependencia de la respuesta en la proporción de nutrientes que han sido manipulados en las mezclas preparadas en el diseño experimental. En el momento de obtener el contorno de hierro dialisible se puede ver que la interacción fibra y calcio era el más sinérgico presentado para la formulación evaluada. Teniendo en cuenta los hechos analizados la mejor formulación de la dieta enteral optimizado para el hierro dialisibilidad fue la proporción de 60% de fibra y 40% de calcio.

Bioavailability of iron measurement in two nutrients multiple solutions by in vitro and in vivo;a comparative methodology between methods.

OBJECTIVES: The bioavailability of dietary iron present in a nutritional formulation may be evaluated by in vitro and in vivo methods since they provide for a cohesive line study and provided in the literature. The aim of this study was to evaluate the bioavailability of iron targeting a comparative analysis of two nutritional supplement formulations (A and B). METHODS: For this study were using in vitro and in vivo methods, both described in the literature for availability of iron in an enteral feeding after ingestion supplement nutrition with much nutrients. RESULTS: The results obtained by in vitro simulation of the human gastrointestinal tract were 0.70 ± 0.02 and 0.80 ± 0.01 % iron availability by formulations A and B. In vivo studies, as measured by the curves of serum iron in humans after ingestion of formulations allowed the calculation of coefficient of variation Δ < 0, indicating that there was a low absorption of iron. The bioavailability of iron as two multi-nutrients solutions obtained by in vitro and in vivo showed that there were comparisons of those methodologies used in this study.

Objetivos: La biodisponibilidad de hierro presente en una formulación nutricional puede ser evaluada por in vitro y in vivo, ya que proporcionan para un estudio de línea cohesiva y proporcionado en la literatura. El objetivo de estudio fue evaluar la biodisponibilidad de hierro con in vitro y in vivo, dirigida a un análisis comparativo de dos formulaciones de suplementos nutricionales (A y B). Métodos: Fueron utilizados dos métodos descritos en la literatura que para evaluar la biodiponibilidad de hierro. Uno que es la simulación de digestión humana y otro por los niveles de hierro sérico después de la ingestión de la formulación en los seres humanos. Resultados: Los resultados obtenidos por la simulación in vitro de la digestión del tracto gastrointestinal humano fueron 0,70 ± 0,02 y 0,80 dialisibilidad 0,01% de hierro, respectivamente, para las formulaciones A y B. Los estudios in vivo, segú n se mide por las curvas de hierro en suero en seres humanos después de la ingestión de las formulaciones mostró coeficiente de variación Δ < 0, lo que indica que había una baja absorción de hierro. La biodisponibilidad de hierro a los dos multi-nutrientes soluciones fueron obtenidos por in vitro y in vivo mostraron que había una comparación de las metodologías utilizadas en soluciones acuosas de muchos nutrientes.

Iron (FeSo4) bioavailability in obese subjects submitted to bariatric surgery.

BACKGROUND: Iron bioavailability in obese subjects after the ingestion of a nutritional supplement was the aim of this work. METHODS: Fourteen persons were studied before and after bariatric surgery after the ingestion of a nutritional formulation containing 25 mg iron, 25 g fiber and 800 mg calcium. RESULTS: The following ferremia values (median and minimum--maximum) were obtained before and after bariatric surgery, respectively: Fasting, 105 (70 - 364) µg/dL and 198 (38 - 617) µg/dL; 1 hour, 103 (63 - 305) µg/dL and 160 (11 - 207) µg/dL; 2 hours, 103 (62 - 150) µg/dL and 141 (10 - 412) µg/dL; 3 hours. 97 (63 - 190) µg/dL and 153 (6 - 270) µg/dL; 4 hours, 91 (58 - 163) µg/dL and 156 (40 - 251) µg/dL (p>0.05), with no association of serum iron levels with time. There was a difference in total triglycerides (95 ± 29 mg/dL and 60 ± 10 mg/dL) which were correlated with a decrease in serum ferritin levels (r = 0,926, p = 0.008), UIBC (r = 0.910, p = 0.01), total cholesterol (r = 0,918, p = 0.01) and LDL-c fraction (r = 0.830, p = 0.04), with an increase in HDL-c fraction (r = 0,807, p = 0.05). CONCLUSION: Iron bioavailability in obese subjects was affected by the ingestion of the nutritional formulation containing calcium and fiber, a fact that may cause these patients to develop iron deficiency.

Objetivo: Obesos sometidos a cirugía bariátrica muestran la utilización de deterioro de hierro. Evaluar la biodisponibilidad del hierro en los obesos por el consumo de suplemento nutricional que contiene múltiples nutrientes antes y después de seis meses de la cirugía bariátrica. Material y Métodos: El estudio incluyó a 14 voluntarios antes y después de la cirugía bariátrica que recibieron formulaciones que contienen múltiples nutrientes y medir las concentraciones séricas de hierro en ayunas y cada 1 hora después de la ingestión de formulaciones, con un total de cuatro horas. Resultados: Ferremia por el consumo de entre dos formulaciones de pre-y post-operatorios fueron: El ayuno 104.50 (70,00-363,00) mg / dl y 198.00 (38.00 a 617.00) mg / dl, 103.00 horas (63,00 a 305,00) mg / dl y 160.00 (11,00- 206,90) mg / dL, 2 horas 102.50 (62.00 a 150.00) mg / dL y 141.30 (10.00 a 412.20) mg / dl, 3 horas 97.00 (63.00 a 190.00) mg mg / dl y 153,00 (6,00 hasta 269,60) / dl , 4 horas 91,00 (58,00 a 163,00) mg / dl y 156.10 (40.00 a 250.50) mg / dl y no hubo asociación estadísticamente significativa entre los dos períodos para los niveles de hierro suero. Los valores de la zona de las curvas en el suero fueron 453,50 ± 202,80 mg / dl / hora, p = 0,000 y 579,00 ± 380,30 mg / dl / hora, p = 0,007 y fue estadísticamente diferente entre los dos períodos. La biodisponibilidad del hierro en soluciones que contienen múltiples nutrientes se vio afectada antes y después de seis meses de la cirugía bariátrica. Conclusión: Se encontró que los niveles se redujeron ferremia con la cirugía, que puede poner en peligro estos pacientes presentaron deficiencia de hierro.

Bioavailability of iron measurement in two nutrients multiple solutions by in vitro and in vivo: a comparative methodology between methods / Biodisponibilidad de hierro en dos soluciones nutritivas estudiadas por in vitro y in vivo; una comparación entre dos métodos

Objectives: The bioavailability of dietary iron present in a nutritional formulation may be evaluated by in vitro and in vivo methods since they provide for a cohesive line study and provided in the literature. The aim of this study was to evaluate the bioavailability of iron targeting a comparative analysis of two nutritional supplement formulations (A and B). Methods: For this study were using in vitro and in vivo methods, both described in the literature for availability of iron in an enteral feeding after ingestion supplement nutrition with much nutrients. Results: The results obtained by in vitro simulation of the human gastrointestinal tract were 0.70 ± 0.02 and 0.80 ± 0.01 % iron availability by formulations A and B. In vivo studies, as measured by the curves of serum iron in humans after ingestion of formulations allowed the calculation of coefficient of variation Δ < 0, indicating that there was a low absorption of iron. The bioavailability of iron as two multinutrients solutions obtained by in vitro and in vivo showed that there were comparisons of those methodologies used in this study (AU)

Objetivos: La biodisponibilidad de hierro presente en una formulación nutricional puede ser evaluada por in vitro y in vivo, ya que proporcionan para un estudio de línea cohesiva y proporcionado en la literatura. El objetivo de estudio fue evaluar la biodisponibilidad de hierro con in vitro y in vivo, dirigida a un análisis comparativo de dos formulaciones de suplementos nutricionales (A y B). Métodos: Fueron utilizados dos métodos descritos en la literatura que para evaluar la biodiponibilidad de hierro. Uno que es la simulación de digestión humana y otro por los niveles de hierro sérico después de la ingestión de la formulación en los seres humanos. Resultados: Los resultados obtenidos por la simulación in vitro de la digestión del tracto gastrointestinal humano fueron 0,70 ± 0,02 y 0,80 dialisibilidad 0,01% de hierro, respectivamente, para las formulaciones A y B. Los estudios in vivo, segú n se mide por las curvas de hierro en suero en seres humanos después de la ingestión de las formulaciones mostró coeficiente de variación Δ < 0, lo que indica que había una baja absorción de hierro. La biodisponibilidad de hierro a los dos multinutrientes soluciones fueron obtenidos por in vitro y in vivo mostraron que había una comparación de las metodologías utilizadas en soluciones acuosas de muchos nutrientes (AU)

Iron (FeSo4) bioavailability in obese subjects submitted to bariatric surgery / Biodisponibilidad de hierro (FeSO4) de los sujetos obesos sometidos a cirugía bariátrica

Background: Iron bioavailability in obese subjects after the ingestion of a nutritional supplement was the aim of this work. Methods: Fourteen persons were studied before and after bariatric surgery after the ingestion of a nutritional formulation containing 25 mg iron, 25 g fiber and 800 mg calcium. Results: The following ferremia values (median and minimum - maximum) were obtained before and after bariatric surgery, respectively: Fasting, 105 (70 - 364) μg/dL and 198 (38 - 617) μg/dL; 1 hour, 103 (63 - 305) μg/dL and 160 (11 - 207) μg/dL; 2 hours, 103 (62 - 150) μg/dL and 141 (10 - 412) μg/dL; 3 hours. 97 (63 - 190) μg/dL and 153 (6 - 270) μg/dL; 4 hours, 91 (58 - 163) μg/dL and 156 (40 - 251) μg/dL (p>0.05), with no association of serum iron levels with time. There was a difference in total triglycerides (95 ± 29 mg/dL and 60 ± 10 mg/dL) which were correlated with a decrease in serum ferritin levels (r = 0,926, p = 0.008), UIBC (r = 0.910, p = 0.01), total cholesterol (r = 0,918, p = 0.01) and LDL-c fraction (r = 0.830, p = 0.04), with an increase in HDL-c fraction (r = 0,807, p = 0.05). Conclusion: Iron bioavailability in obese subjects was affected by the ingestion of the nutritional formulation containing calcium and fiber, a fact that may cause these patients to develop iron deficiency (AU)

Objetivo: Obesos sometidos a cirugía bariátrica muestran la utilización de deterioro de hierro. Evaluar la biodisponibilidad del hierro en los obesos por el consumo de suplemento nutricional que contiene múltiples nutrientes antes y después de seis meses de la cirugía bariátrica. Material y Métodos: El estudio incluyó a 14 voluntarios antes y después de la cirugía bariátrica que recibieron formulaciones que contienen múltiples nutrientes y medir las concentraciones séricas de hierro en ayunas y cada 1 hora después de la ingestión de formulaciones, con un total de cuatro horas. Resultados: Ferremia por el consumo de entre dos formulaciones de pre-y post-operatorios fueron: El ayuno 104.50 (70,00-363,00) mg / dl y 198.00 (38.00 a 617.00) mg / dl, 103.00 horas (63,00 a 305,00) mg / dl y 160.00 (11,00-206,90) mg / dL, 2 horas 102.50 (62.00 a 150.00) mg / dL y 141.30 (10.00 a 412.20) mg / dl, 3 horas 97.00 (63.00 a 190.00) mg mg / dl y 153,00 (6,00 hasta 269,60) / dl , 4 horas 91,00 (58,00 a 163,00) mg / dl y 156.10 (40.00 a 250.50) mg / dl y no hubo asociación estadísticamente significativa entre los dos períodos para los niveles de hierro suero. Los valores de la zona de las curvas en el suero fueron 453,50 ± 202,80 mg / dl / hora, p = 0,000 y 579,00 ± 380,30 mg / dl / hora, p = 0,007 y fue estadísticamente diferente entre los dos períodos. La biodisponibilidad del hierro en soluciones que contienen múltiples nutrientes se vio afectada antes y después de seis meses de la cirugía bariátrica. Conclusión: Se encontró que los niveles se redujeron ferremia con la cirugía, que puede poner en peligro estos pacientes presentaron deficiencia de hierro (AU)

Iron availability in an enteral feeding formulation by response surface methodology for mixtures / Disponibilidad del hierro en la formulación de alimentos enteral por la metodología de superficie de respuesta para las mezclas

Background: The nutritional therapy with enteral diets has been getting specialized and those formulations to substitute the traditional diet for those patients who need to be fed by probe. This workís aim was to study the effect of the components of enteral diet formulation: fiber, calcium and medium-chain triglycerides, seeking optimize a formulation for the best dialysability of iron by Response Surface Methodology (RSM). Methods: The ingredients used for the formulations of the diet were chosen according to the ones commercialized in the modules of a standard enteral diet, with which it was made an experimental diet and the applicability of the experimental limits. Results: The found results in the model have shown that it depends on the proportion of the nutrients that were manipulated in the experimental design. When the level curve was obtained for the iron dialysable, it could be verified that the binary interaction fiber-calcium was the one that presented more synergism for the appraised formulation. Before the analyzed facts, the best formulation of enteral diet optimized for the dialysability of the iron was the proportion of 60% of fiber and 40% of calcium, showing to be the best formulation of the enteral diet for the availability of the iron (AU)

Objetivos: La terapia nutricional con nutrición enterales se ha especializado en los últimos años y estas formulaciones pueden sustituir a la dieta tradicional para aquellos pacientes que necesitan de infusiones de alimentación. El objetivo fue estudiar el efecto de los componentes de la formulación de nutrición enterales: fibra, calcio y triglicéridos de cadena media para optimizar una formulación para el hierro dialisibilidad. Métodos:La herramienta utilizada fue el análisis de múltiples variables, utilizando modelos de superficie de respuesta para las mezclas. Los ingredientes usados en las formulaciones de la dieta se presentan en el diseño experimental elegido de acuerdo con los módulos que se venden en dieta enteral estándar. Resultados: Los resultados mostraron la dependencia de la respuesta en la proporción de nutrientes que han sido manipulados en las mezclas preparadas en el diseño experimental. En el momento de obtener el contorno de hierro dialisible se puede ver que la interacción fibra y calcio era el más sinérgico presentado para la formulación evaluada. Teniendo en cuenta los hechos analizados la mejor formulación de la dieta enteral optimizado para el hierro dialisibilidad fue la proporción de 60% de fibra y 40% de calcio (AU)

Alkylphospholipids - a promising class of chemotherapeutic agents with a broad pharmacological spectrum.

PURPOSE: Since when alkylphospholipds (ALPs) were discovered and, even further after miltefosine's approval for the treatment of cutaneous metastasis of breast cancer and leishmaniasis, their activity against many other diseases have been extensively studied. This review aims to provide a summary of the alkylphospholipids' applications investigated so far. RESULTS: The mechanism of action of ALPs is not fully understood, however it is believed that they interfere with lipid homeostasis leading to cell apoptosis. Due to ALPs cytotoxic activity, this class of molecules has shown to be effective against many diseases and conditions. Besides the approval of miltefosine for application in cutaneous metastasis of breast cancer and visceral and cutaneous leishmaniasis, several other analogs have proved efficacy and are promising as less toxic alternatives. ALPs have also shown in vitro and in vivo activity against Trypanosoma spp., amoebae, Tricomonas vaginalis, Schistosoma mansoni, HIV, and some fungi and bacteria species. The use of ALPs for intraocular lens coating is also under investigation. In addition, a clinical trial comparing miltefosine with usual treatments to spontaneous urticaria is also being conducted. CONCLUSIONS: Alkylphospholipids present such a broad pharmacological spectrum that justifies the need for further investigations of the drug class mechanisms of action, as well as the search for new analogs with improved activity and toxicological profiles.

Transfusion-transmitted malaria: case report of asymptomatic donor harboring Plasmodium malariae.

Malaria in Brazil is endemic in the Amazon region, but autochthonous cases with low parasitaemia occur in the Atlantic Forest area of the country. According to Brazilian legislation no test is mandatory for blood donors from non-endemic areas. However if they have traveled to malaria transmission regions they are deferred for six months before they can donate. This report describes a transfusion-transmitted malaria case in Sao Paulo, Brazil, where one recipient received infected blood and developed the disease. He lived in Sao Paulo and had no previous transfusion or trips to endemic areas, including those of low endemicity, such as Atlantic Forest. Thick blood smears confirmed Plasmodium malariae. All donors lived in Sao Paulo and one of them (Donor 045-0) showed positive hemoscopy and PCR. This asymptomatic donor had traveled to Juquia, in the Atlantic Forest area of S ao Paulo State, where sporadic cases of autochthonous malaria are described. DNA assay revealed P. malariae in the donor's (Donor 045-0) blood. Serum archives of the recipient and of all blood donors were analyzed by ELISA using both P. vivax and P. falciparum antigens, and IFAT with P. malariae. Donor 045-0's serum was P. malariae IFAT positive and the P. vivax ELISA was reactive. In addition, two out of 44 donors' archive sera were also P. vivax ELISA reactive. All sera were P. falciparum ELISA negative. This case suggests the need of reviewing donor selection criteria and deferral strategies to prevent possible cases of transfusion-transmitted malaria.

Transfusion-transmitted malaria: case report of asymptomatic donor harboring Plasmodium malariae / Malária transfusional: relato de caso de doador assintomático infectado por Plasmodium malariae

Malaria in Brazil is endemic in the Amazon region, but autochthonous cases with low parasitaemia occur in the Atlantic Forest area of the country. According to Brazilian legislation no test is mandatory for blood donors from non-endemic areas. However if they have traveled to malaria transmission regions they are deferred for six months before they can donate. This report describes a transfusion-transmitted malaria case in Sao Paulo, Brazil, where one recipient received infected blood and developed the disease. He lived in Sao Paulo and had no previous transfusion or trips to endemic areas, including those of low endemicity, such as Atlantic Forest. Thick blood smears confirmed Plasmodiummalariae. All donors lived in Sao Paulo and one of them (Donor 045-0) showed positive hemoscopy and PCR. This asymptomatic donor had traveled to Juquia, in the Atlantic Forest area of S ao Paulo State, where sporadic cases of autochthonous malaria are described. DNA assay revealed P. malariae in the donor's (Donor 045-0) blood. Serum archives of the recipient and of all blood donors were analyzed by ELISA using both P. vivax and P. falciparum antigens, and IFAT with P. malariae. Donor 045-0's serum was P. malariae IFAT positive and the P. vivax ELISA was reactive. In addition, two out of 44 donors' archive sera were also P. vivax ELISA reactive. All sera were P. falciparum ELISA negative. This case suggests the need of reviewing donor selection criteria and deferral strategies to prevent possible cases of transfusion-transmitted malaria.

No Brasil a malária é endêmica na Amazônia, porém casos autóctones com baixas parasitemias ocorrem na área costeira de Mata Atlântica. De acordo com a legislação brasileira, não são obrigatórios testes para detecção de malária em doadores de sangue de áreas não-endêmicas; entretanto são excluídos por seis meses aqueles com relato de deslocamento para áreas de transmissão. Este trabalho descreve um caso de malária transfusional ocorrido em São Paulo, Brasil, em que um paciente recebeu sangue infectado, desenvolvendo a doença. Ele residia em São Paulo e não apresentava histórico de transfusão anterior ou deslocamentos para áreas endêmicas, incluindo as de baixa endemicidade, como a Mata Atlântica. A gota espessa revelou Plasmodium malariae. Os doadores eram residentes em São Paulo e um deles (045-0) apresentou hemoscopia e PCR positivos. Este era assintomático com PCR positiva para P. malariae e viagem para Juquiá, Mata Atlântica de São Paulo, onde são descritos casos esporádicos de malária autóctone. Amostras de soro do receptor e de todos os doadores foram ensaiadas por ELISA com antígenos de P. vivax e P. falciparum e RIFI com P. malariae. O doador 045-0 apresentou RIFI positiva para P. malariae. ELISA-P. vivax foi reagente no doador infectado (045-0) e em dois dos 44 doadores. Todos os soros foram negativos com antígeno de P. falciparum. Este caso aponta a necessidade de revisão dos critérios de triagem clínico-epidemiológica para evitar casos transfusionais e também adequar as estratégias de exclusão de doadores de sangue.

Elaboração de uma dieta enteral otimizada para o ferro dialisado através da aplicação de um modelo de superfície de resposta / Elaboration of a enteral diet optimized for the iron dialysable through the application of one model of response surface

A terapia nutricional com dietas enterais vem se especializando muito nos últimos anos. Hospitais da rede pública e privada fazem uso dessas formulações que substituem a dieta tradicional para aqueles pacientes que precisam ser alimentados por sonda. Este trabalho teve por objetivo estudar o efeito dos componentes das formulações de dietas enterais: fibra, cálcio e triglicerídeos de cadeia média, visando otimizar uma formulação para a melhor dialisabilidade de ferro. A ferramenta utilizada foi a análise de múltiplas variáveis, através de modelos de Superfície de Resposta para Misturas. Os ingredientes utilizados para as formulações da dieta foram escolhidos de acordo com os comercializados nos módulos de dieta enteral padrão, com os quais foi feita uma dieta experimental e, em seguida, a aplicabilidade do delineamento experimental...

A enfermeira, a mulher e o processo de parturição: compreendendo as necessidades assistenciais no pré-parto

Este estudo focaliza os diferentes comportamentos de parturientes durante o trabalho de parto e a assistência de enfermagem. Tem como objetivos: Descrever as (re)ações das parturientes durante o trabalho de parto e Analisar compreensivamente o significado das (re)ações da parturiente durante o trabalho de parto. Constitui uma pesquisa qualitativa, utilizando a abordagem fenomenológica de Alfred Schutz como método para compreender a vida social, onde as reações mútuas ocorrem de maneira consciente. Os sujeitos da pesquisa foram onze mulheres internadas em uma Maternidade Municipal do Rio de Janeiro. Estas foram observadas no período do pós-parto imediato. As observações tendo por referência as três fases do trabalho de parto permitiram identificar o predomínio dos comportamentos como interesse no que ocorre ao redor, movimentação corporal mais intensa e gritos ou pedidos freqüentes de ajuda, respectivamente. A entrevista, do tipo fenomenológica, consistiu da questão central: O que você tinha em vista quando reagiu assim? A análise dos depoimentos apontam para o típico da ação Alívio da dor, tendo surgido durante a análise duas importantes categorias Receber atenção profissional e Acalmar-se. Este típico da ação permite identificar que na sala de pré-parto, independente da fase de parturição, a mulher está envolvida consigo mesma, sendo que seu comportamento relaciona-se principalmente a necessidade de aliviar a sua dor. Estas perspectivas contribuem para fundamentar a ação da enfermagem no contexto da humanização da assistência a mulher no pré-natal, durante o trabalho de parto e parto.

Quimioterapia em tumores de cabeça e pescoço / Chemotherapy for head and neck tumors

A cirurgia e a radioterapia säo modalidades terapêuticas eficazes no tratamento de carcinoma de cabeça e pescoço em estados precoces. Neste caso, pode se obter uma taxa de cura variando entre 50 a 100. Entretanto, em estados avançados o prognóstico é reservado e a quimioterapia surge como um alternativa que pode contribuir para o processo de cura da doença, mais especificamente quando combinada à radioterapia e/ou cirurgia(quimioterapia neoadjuvante), ou quando aplicada concomitantemente à radioterapia(quimioradioterapia). Nestes casos, deve-se avaliar qual das duas modalidades pode trazer melhor benefício, sem nos esquecermos da preservaçäo do órgäo. Em estágios avançados ou na doença recidivante, a quimioterapia é empregada somente como forma paliativa de tratemento, na tentativa de melhorar a disfagia e a dor ou de preservar o órgäo acometido. As drogas quimioterápicas que demonstram eficácia comprovada no tratamento dos tumores de cabeça e pescoço säo: Methotrexate, 5-fluorouracil, Cisplatina, Carboplatina e Bleomicina. Novas drogas estäo sendo estudadas, como a Vinorrelbina e os taxóides. A quimioterapia representa uma adiçäo importante aos algoritmos atuais de tratamento multidisciplinar dos tumores de cabeça e pescoço, seja pela possibilidade de cura ou pela melhora na qualidade de vida dos pacientes, já que pode potencialmente melhorar os resultados locais e até mesmo, em alguns casos, permitir a preservaçäo do órgäo acometido

Tomada de depoimento pessoal de enfermeiras hospitalares da década de 50: subsídios para a compreensäo da enfermagem atual / Obtaing personal declarations of hospital nurses that actuated in the 1950s: elementes to nursing comprehension

Este estudo é parte de um projeto mais amplo que visa resgatar aspectos significativos relacionados à evoluçäo da assistência de enfermagem nas décadas de 50 a 90. Este resgate é feito através da técnica de depoimentos orais de enfermeiros em exercício e aposentados, no contexto de um Hospital Escola de Interior Paulista. O presente estudo particulariza os resultados obtidos, referentes à decada de 50. Como resultado evidencia-se o esforço empreendido pelas enfermeiras na luta pelo reconhecimento e prestígio da profissäo; as tranformaçöes intensas e profundas relacionadas aos novos papéis da enfermeira enquanto líder da equipe e membro da equipe médica.