Escala Bristol de forma fecal no diagnóstico clínico da constipação na infância, Porto Alegre, Brasil / The Bristol Stool Scale in the clinical diagnosis of childhood constipation

Introdução: A constipação é frequente na infância, podendo evoluir até a adolescência e vida adulta.O diagnóstico é clínico, realizado através da descrição subjetiva das fezes. A Escala Bristol facilita o diagnóstico, analisando a consistência das fezes. O objetivo deste estudo é descrever a utilização dessa escala no diagnóstico da constipação na infância. Métodos: Foi realizado um estudo transversal, no Ambulatório do HMIPV/Porto Alegre/RS, de abril a outubro de 2015, com pacientes consecutivos, de idade entre 05 e 12 anos. Todos foram submetidos à anamnese, para descrição subjetiva das fezes pelo responsável e pelo paciente. A médica pontuava a Escala Bristol baseada nesta descrição, seguida pela pontuação do paciente e do responsável. Resultados: Foram estudados 30 pacientes, com média de idade de 8,1± 2,5 anos. A pontuação da médica na Escala Bristol foi 1,83±0,38, a da mãe, 2,43±0,97 (P=0,001) e a do paciente, 2,27±0,87 (P=0,003). O coeficiente kappa entre o Bristol medido pela médica e pela mãe do paciente foi baixo, igual a 0,30 (P< <0,001) , bem como o coeficiente kappa entre o Bristol medido pela médica e pela criança, igual a 0,34(P< 0001). Conclusão: Houve diferença entre o Bristol pontuado pela médica e o Bristol pontuado pelas mães e pacientes. Os pacientes e as mães, ao pontuar na Escala Bristol, concordam pouco com a pontuação da médica. Os autores sugerem a multiplicação desta experiência em outros locais para continuar avaliando a utilização da Escala Bristol para Consistência Fecal na constipação da infância(AU)

Introduction: Constipation is common in childhood and can progress through adolescence and adulthood. Clinical diagnosis is performed by subjective description of the stools. The Bristol Scale facilitates the diagnosis by analyzing stool consistency. The aim of this study is to describe the use of this scale in the diagnosis of childhood constipation. Methods: A cross-sectional study was conducted at the Clinic of HMIPV/Porto Alegre from Apr to Oct 2015, with consecutive patients aged between 5 and 12 years. All were submitted to anamnesis for a subjective description of the stools by parent and patient. First the physician scored this description using the Bristol scale, followed by the patient's and parent's scores. Results: Thirty patients were studied with a mean age of 8.1 ± 2.5 years. The Bristol scale score by physician was 1.83 ± 0.38, by parent 2.43 ± 0.97 (P = 0.001), and by patient 2.27 ± 0.87 (P = 0.003). The kappa coefficient between physician and parent scores was low, 0.30 (P< 0.001), as well as between physician and child scores, 0.34 (P< 0001). Conclusion: There was a difference between the Bristol Scale scores by the physician and by the parents/patients. The Bristol scale scores by the patients/parents showed little agreement with those by the physician. The authors suggest the replication of this experience elsewhere to continue evaluating the use of the Bristol Stool Scale in childhood constipation(AU)

The adjusted effect of maternal body mass index, energy and macronutrient intakes during pregnancy, and gestational weight gain on body composition of full-term neonates.

OBJECTIVE: To evaluate the effect of prepregnancy body mass index (BMI), energy and macronutrient intakes during pregnancy, and gestational weight gain (GWG) on the body composition of full-term appropriate-for-gestational age neonates. STUDY DESIGN: This is a cross-sectional study of a systematically recruited convenience sample of mother-infant pairs. Food intake during pregnancy was assessed by food frequency questionnaire and its nutritional value by the Food Processor Plus (ESHA Research Inc, Salem, OR). Neonatal body composition was assessed both by anthropometry and air displacement plethysmography. Explanatory models for neonatal body composition were tested by multiple linear regression analysis. RESULTS: A total of 100 mother-infant pairs were included. Prepregnancy overweight was positively associated with offspring weight, weight/length, BMI, and fat-free mass in the whole sample; in males, it was also positively associated with midarm circumference, ponderal index, and fat mass. Higher energy intake from carbohydrate was positively associated with midarm circumference and weight/length in the whole sample. Higher GWG was positively associated with weight, length, and midarm circumference in females. CONCLUSION: Positive adjusted associations were found between both prepregnancy BMI and energy intake from carbohydrate and offspring body size in the whole sample. Positive adjusted associations were also found between prepregnancy overweight and adiposity in males, and between GWG and body size in females.

Incidence of constipation in an intensive care unit.

OBJECTIVES: To evaluate the incidence of constipation in critical patients on enteral nutrition in a hospital intensive care unit and to correlate this incidence with the variables found for critical patients. METHODS: The present investigation was a retrospective analytical study conducted in the intensive care unit of Hospital Regional da Asa Norte (DF) via the analysis of medical records of patients admitted during the period from January to December 2011. Data on the incidence of constipation and enteral nutritional support, gastrointestinal changes, stool frequency, ventilatory support, and outcomes were collected and analyzed. RESULTS: The initial sample consisted of 127 patients admitted to the unit during the period from January to December 2011. Eighty-four patients were excluded, and the final sample consisted of 43 patients. The incidence of constipation, defined as no bowel movement during the first 4 days of hospitalization, was 72% (n=31). The patients were divided into a control group and a constipated group. The group of constipated patients reached the caloric target, on average, at 6.5 days, and the control group reached the caloric target in 5.6 days (p=0.51). Constipation was not associated with the length of hospital stay, suspension of nutritional support, or outcome of hospitalization. There was an association between evacuation during hospitalization and a longer duration of hospitalization for a subgroup of patients who did not evacuate during the entire period (p=0.009). CONCLUSION: The incidence of constipation in the unit studied was 72%. Only the absence of evacuation during hospitalization was associated with longer hospital stays. Constipation was not associated with the length of hospital stay, suspension of nutritional support, or outcome of hospitalization.

Incidência de constipação intestinal em uma unidade de terapia intensiva / Incidence of constipation in an intensive care unit

OBJETIVOS: Avaliar a incidência de constipação em pacientes críticos em uso de nutrição enteral internados em uma unidade de terapia intensiva e correlacioná-la a variáveis encontradas em pacientes críticos. MÉTODOS: Estudo de caráter retrospectivo analítico, realizado na unidade de terapia intensiva do Hospital Regional da Asa Norte (DF), por meio da análise de prontuários de pacientes internados no período de janeiro a dezembro de 2011. Foram coletados e analisados dados referentes a incidência de constipação intestinal e ao suporte nutricional enteral, alterações gastrintestinais, frequência de evacuação, assistência ventilatória e desfechos. RESULTADOS: A amostra inicial foi de 127 pacientes admitidos na unidade no período de janeiro a dezembro de 2011. Foram excluídos 84 pacientes e a amostra final compôs-se de 43 pacientes. A incidência de constipação, definida como ausência de evacuação nos primeiros 4 dias de internação, foi de 72% (n=31). Os grupos foram divididos em constipados e controle. O grupo de pacientes constipados atingiu a meta calórica, em média, com 6,5 dias e o grupo controle em 5,6 dias (p=0,51). A constipação não se associou ao tempo de internação, suspensão do aporte nutricional e desfecho da internação hospitalar. Houve associação entre ausência de evacuação durante toda a internação por um subgrupo dos pacientes que não evacuaram em todo o período e tempo maior de internação (p=0,009). CONCLUSÃO: A incidência de constipação intestinal na unidade pesquisada foi de 72%. Somente a ausência de evacuação durante toda a internação associou-se a maior tempo de internação. Tempo de internação, suspensão do aporte nutricional e desfecho da internação hospitalar não apresentaram associação.

OBJECTIVES: To evaluate the incidence of constipation in critical patients on enteral nutrition in a hospital intensive care unit and to correlate this incidence with the variables found for critical patients. METHODS: The present investigation was a retrospective analytical study conducted in the intensive care unit of Hospital Regional da Asa Norte (DF) via the analysis of medical records of patients admitted during the period from January to December 2011. Data on the incidence of constipation and enteral nutritional support, gastrointestinal changes, stool frequency, ventilatory support, and outcomes were collected and analyzed. RESULTS: The initial sample consisted of 127 patients admitted to the unit during the period from January to December 2011. Eighty-four patients were excluded, and the final sample consisted of 43 patients. The incidence of constipation, defined as no bowel movement during the first 4 days of hospitalization, was 72% (n=31). The patients were divided into a control group and a constipated group. The group of constipated patients reached the caloric target, on average, at 6.5 days, and the control group reached the caloric target in 5.6 days (p=0.51). Constipation was not associated with the length of hospital stay, suspension of nutritional support, or outcome of hospitalization. There was an association between evacuation during hospitalization and a longer duration of hospitalization for a subgroup of patients who did not evacuate during the entire period (p=0.009). CONCLUSION: The incidence of constipation in the unit studied was 72%. Only the absence of evacuation during hospitalization was associated with longer hospital stays. Constipation was not associated with the length of hospital stay, suspension of nutritional support, or outcome of hospitalization.

Avaliação da validade de medicamentos homeopáticos preparados na forma de poção

O presente trabalho relata a realização de análises bacteriológicas em 3amostras de medicamentos homeopáticos preparados sob a forma de poção, e umaamostra, somente com água purificada (deionizada). O objetivo do trabalho émostrar e propor uma resposta quanto à validade de medicamentos preparados soba forma de poção e, com prescrição de uso por um período de 30 dias. O que sesugere, normalmente, uma validade de 48 horas para estes medicamentos quepossuem um teor alcoólico muito baixo ou praticamente zero.As análises foram realizadas em períodos que vão desde o ato de preparo dasamostras até o trigésimo dia, após o seu preparo. Foram sete períodos de análises,com o objetivo de poder acompanhar gradativamente os resultados das análises.Tivemos, também, a preocupação de verificar se algum detalhe iria interferir ounão no resultado das análises: a quantidade de gotas da matriz que foi preparadaem álcool 70% interfere ou não na validade do medicamento. Estar ou nãodinamizada a amostra interfere na validade. A amostra apresenta diferença devalidade ou resistência à contaminação, quando 3 frascos foram abertos somente 2vezes ao dia, e um deles, foi simulado a ingestão do medicamento 2 vezes ao dia.No término dos resultados das análises verificou-se que, no ato da análise elasestavam intactas, sem qualquer tipo de contaminação, mas, da segunda análise emdiante, já houve contaminação gradativa nas amostras, contaminação esta queocorreu após 24 horas do preparo das amostras.(AU)

Profile of audiometric thresholds and tympanometric curve of elderly patients.

AIM: to analyze the audiological profile of elderly patients seen in a clinic from an audiology school clinic in the city of Belo Horizonte. METHODS: we studied all the charts from the patients who underwent audiologic assessment from April of 2004 and August of 2007 in an audiology clinic in the city of Belo Horizonte. RESULTS: We studied the 313 audiological tests from patients 60 years of age or over. The results from the audiological evaluations as to the type of hearing loss were: auditory thresholds within normal standards - 22.28%; sensorineural hearing loss - 60.62%; mixed hearing loss - 14.70%, conductive hearing loss - 2.40%. The level varied between normal and profound. As to the tympanometry, 83.22% had the type A curve, and the other types of curves obtained made up a total of 16.3%. The percentage of individuals who did not undergo the test was 0.48%. 1.76% of the patients who had unilateral hearing loss and 98.24% had bilateral hearing loss. CONCLUSIONS: we found a greater prevalence of sensorineural hearing loss, and the degree of the loss varied from mild to profound, with a prevalence of the moderate degree.

Perfil dos limiares audiométricos e curvas timpanométricas de idosos / Profile of audiometric thresholds and tympanometric curve of elderly patients

OBJETIVO: Traçar o perfil audiológico dos idosos atendidos em uma clínica escola da cidade de Belo Horizonte. MÉTODOS: Foram analisados todos os prontuários de pacientes que realizaram avaliação audiológica no período de Abril de 2004 a Agosto de 2007 em um Centro Clínico de Fonoaudiologia da cidade de Belo Horizonte. RESULTADOS: Foram analisados 313 exames audiológicos de pacientes acima de 60 anos de idade. Os resultados das avaliações audiológicas quanto ao tipo da perda auditiva foram: limiares auditivos dentro dos padrões de normalidade - 22,28 por cento; perda auditiva neurossensorial - 60,62 por cento; perda auditiva mista - 14,70 por cento, perda auditiva condutiva - 2,40 por cento. O grau variou de normal a profundo. Quanto à timpanometria, prevaleceu com 83,22 por cento a curva tipo A, sendo que os demais tipos de curvas obtiveram um total de 16,3 por cento. A porcentagem dos indivíduos que não realizou o exame foi de 0,48 por cento. Dos pacientes que apresentaram perda auditiva foram unilaterais 1,76 por cento e 98,24 por cento bilaterais. CONCLUSÕES: Foi constatada uma maior prevalência de perda auditiva do tipo neurossensorial, sendo que o grau de perda variou de leve a profundo, com maior prevalência do grau moderado.

AIM: to analyze the audiological profile of elderly patients seen in a clinic from an audiology school clinic in the city of Belo Horizonte. METHODS: we studied all the charts from the patients who underwent audiologic assessment from April of 2004 and August of 2007 in an audiology clinic in the city of Belo Horizonte. RESULTS: We studied the 313 audiological tests from patients 60 years of age or over. The results from the audiological evaluations as to the type of hearing loss were: auditory thresholds within normal standards - 22.28 percent; sensorineural hearing loss - 60.62 percent; mixed hearing loss - 14.70 percent, conductive hearing loss - 2.40 percent. The level varied between normal and profound. As to the tympanometry, 83.22 percent had the type A curve, and the other types of curves obtained made up a total of 16.3 percent. The percentage of individuals who did not undergo the test was 0.48 percent. 1.76 percent of the patients who had unilateral hearing loss and 98.24 percent had bilateral hearing loss. CONCLUSIONS: we found a greater prevalence of sensorineural hearing loss, and the degree of the loss varied from mild to profound, with a prevalence of the moderate degree.

Prevalência dos tipos sangüíneos A, B e AB em gatos domésticos mestiços da cidade de Porto Alegre, Rio Grande do Sul, Brasil / Prevalence of blood types A, B and AB in mixed breed domestic cats of Porto Alegre, Rio Grande do Sul, Brazil

O presente estudo teve como objetivo determinar a prevalência dos tipos sangüíneos em felinos domésticos, mestiços, da cidade de Porto Alegre, Rio Grande do Sul, Brasil. Foram selecionados aleatoriamente 100 gatos, clinicamente saudáveis, mestiços e sem parentesco entre si. Amostras de sangue foram coletadas da veia jugular e a tipagem sangüínea foi realizada através do teste Rapid Vet H Feline (DMS Laboratories, Flemington, USA) e do teste hemaglutinação em tubo de ensaio. A tipagem reversa foi realizada para confirmar o tipo e a presença de aloanticorpos naturais. No presente estudo encontrou-seprevalência de 97% e 3% de gatos do tipo A e B, respectivamente. Não foram encontrados gatos do tipo AB. Os resultados indicam que no sul do Brasil há uma alta prevalência de gatos domésticos mestiços do tipo A, entretanto a prevalência de gatos do tipo B encontrada no trabalho é mais alta do que aquelas relatadas em alguns países. O conhecimento da prevalência dos tipos sangüíneos da população de gatos de uma região pode auxiliar na determinação dos riscos de reações transfusionais e de ocorrência de isoeritrólise neonatal, e estes podem ser prevenidos através de tipagem sangüínea e teste de compatibilidade sangüínea.

The present study was carried out to determine the prevalence of the blood types in mixed breed domestic cats of Porto Alegre, Rio Grande do Sul, Brasil. A hundred of clinically healthy mixed breed and non related cats were selected. Blood samples were collected from the jugular vein and the blood typing was performed by Rapid Vet H Feline test(DMS Laboratories, Flemington, USA) and by hemagglutination tube test. Reverse blood typing was done to confirm the blood types and the presence of alloantibodies. In the present study the prevalence of blood type A and B in cats were 97% and 3%, respectively. No AB blood type cats were found. These results indicate that there is a high prevalence of blood type A mixed breed domestic cats in the south of Brazil, although the prevalence o B cats found is higher than reported in some countries. The knowledge of feline blood types prevalence in cat population can help to determine the risks of transfusion reactions and neonatal isoerythrolysis, and these can beavoid by blood typing and cross-matching test.