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Clin Nutr ESPEN ; 35: 167-173, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31987112


BACKGROUND & AIMS: Overweight children and adolescents are more likely to evolve with high cholesterol, be obese adults and develop cardiovascular disease. The objective of this study was to identify the influence of anthropometric status on the changes in the lipid profile of children and adolescents during an 18-month follow-up period. METHODS: A cohort study involving 540 boys and girls from 7 to 15 years of age was conducted over 18 months' follow-up. The outcome variables were the lipid indicators and the principal exposure variable was anthropometric status, measured by different indicators. A generalized estimating equation (GEE) approach was used to identify the associations of interest. RESULTS: Irrespective of age, sex, socio-economic status, physical activity and diet, for each gain of 1 cm in the waist circumference (WC) mean in the adjusted model, triglyceride levels increased by a mean of 0.5 mg/dl (p < 0.000) and there was an increase of 0.21 mg/dL in the total cholesterol after the 18-month period. The increase of 0.1 in the mean body mass index (BMI) Z-score promoted a gain of 2.7 mg/dL in the triglycerides mean levels (p < 0.000) and an increase of 1.5 mg/dL in the total cholesterol mean levels (p = 0.014) after the follow-up period. Regarding the waist-to-height ratio (WHtR) and conicity index (CI), an increment of 40.6 mg/dL (p = 0.02) and of 30.1 mg/dL (p = 0.01) was observed in the triglycerides' mean when the participants increased 0.1 in the WHtR mean and CI mean, and the same was observed in the total cholesterol mean, with an increase of 45.4,g/dL (p = 0.02) and 19.3 mg/dL (p = 0.03), for each indicator, respectively. Changes of the traditional anthropometric indicators (WC and BMI) did not promote variations in the mean levels of LDL-cholesterol. HDL-cholesterol was not influenced by the changes in the anthropometric indicators. CONCLUSIONS: At the baseline, a higher triglyceride mean and lower levels of HDL-c were observed in children and adolescents with altered anthropometric status for all measures. Mean triglyceride and total cholesterol levels are influenced by changes in the anthropometric status, regardless of the measure, after 18 months of follow-up. However, for LDL-cholesterol, it was observed that changes in the traditional anthropometric indicators (WC and BMI) did not promote variations in the mean levels of this biochemical variable, while HDL-c was not influenced by changes in any of the anthropometric indicators.

Rev. Esc. Enferm. USP ; 53: e03484, Jan.-Dez. 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1020386


RESUMO Objetivo Relatar a experiência de estudantes e docentes de um projeto de extensão universitária no planejamento e realização de oficinas educativas sobre desenvolvimento infantil com educadoras de creche. Método Relato de experiência alicerçado nos referenciais das Necessidades Essenciais das Crianças e na Teoria Bioecológica do Desenvolvimento Humano. Resultados Participaram das oficinas oito graduandas, duas docentes de Enfermagem de uma universidade pública e 24 educadoras de uma creche localizada no município de São Paulo, em região de alta vulnerabilidade social. As oficinas educativas abordaram os temas: fundamentos do desenvolvimento infantil, marcos do desenvolvimento nas áreas pessoal e social, linguagem, motor fino e grosseiro e promoveram o desenvolvimento infantil na creche. Como estratégias pedagógicas, foram utilizadas dinâmicas interativas, jogos didáticos e recursos midiáticos. As oficinas educativas favoreceram a translação do conhecimento sobre o desenvolvimento infantil e as necessidades essenciais das crianças. Conclusão As ações de extensão proporcionaram articulação entre a universidade e a comunidade por meio do compartilhamento de saberes entre profissionais da saúde e da educação visando à promoção do desenvolvimento infantil.

RESUMEN Objetivo Relatar la experiencia de estudiantes y docentes de un proyecto de extensión universitaria en la planificación y realización de talleres educativos acerca del desarrollo infantil con educadoras de guarderías. Método Relato de experiencia cimentado en los marcos de referencia de las Necesidades Esenciales de los Niños y la Teoría Bioecológica del Desarrollo Humano. Resultados Participaron en los talleres ocho estudiantes de graduación, dos docentes de Enfermería de una universidad pública y 24 educadoras de una guardería ubicada en el municipio de São Paulo, en zona de alta vulnerabilidad social. Los talleres educativos abordaron los temas: fundamentos del desarrollo infantil, hitos del desarrollo en las áreas personal y social, lenguaje, motricidad fina y gruesa, y promovieron el desarrollo infantil en la guardería. Como estrategias pedagógicas, fueron utilizadas dinámicas interactivas, juegos didácticos y recursos mediáticos. Los talleres favorecieron la traslación del conocimiento acerca del desarrollo infantil y las necesidades esenciales de los niños. Conclusión Las acciones de extensión proporcionaron articulación entre la universidad y la comunidad mediante el intercambio de saberes entre los profesionales sanitarios y de la educación a fin de promover el desarrollo infantil.

ABSTRACT Objective To report the experience of students and teachers of a university extension project in the planning and performance of educational workshops on child development with educators of a day care center. Method Report of experience based on frameworks of The Irreducible Needs of Children and the Bioecological Theory of Human Development. Results The workshops included eight undergraduate students, two nursing professors from a public university and 24 educators from a day care center located in a region of high social vulnerability in São Paulo. The educational workshops promoted child development in the day care center and the following themes were addressed: child development fundamentals, developmental milestones in the personal and social areas, language, fine and gross motor coordination. Interactive dynamics, didactic games and media resources were used as pedagogical strategies. The educational workshops favored the transfer of knowledge on child development and irreducible needs of children Conclusion Extension activities provided a link between the university and the community through the sharing of knowledge among health and education professionals aimed at promoting child development.

Humanos , Feminino , Desenvolvimento Infantil , Educação em Saúde , Enfermagem Pediátrica , Creches , Saúde da Criança
Respiration ; 98(6): 467-472, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31694026


BACKGROUND: Malignant pleural effusion is one of the most important complications of metastatic cancer, and recurrent pleural effusions do not only have an impact on survival but also cause a huge repercussion on a patient's quality of life. OBJECTIVES: The main objective was to describe quality of life status before and after pleurodesis in patients with malignant pleural effusion. Secondary, we aimed to find predictors of quality of life improvement in such a population. METHODS: Retrospective analysis of a database collected prospectively. We included patients who underwent pleurodesis from June 2004 to July 2014. Quality of life was evaluated through the WHOQOL-BREF questionnaire and applied before and 30 days after pleurodesis. We used a paired t test and the Wilcoxon rank-sum to compare pre-/post-pleurodesis results, Kaplan-Meier curves for survival analysis, and multiple linear regressions to find predictors of quality of life improvement. RESULTS: 183 patients were included (145 were women). Mean age was 58.3 ± 12.3 years, the most numerous primary tumor was breast cancer. Median survival time was 9 months. Dyspnea was the most prevalent symptom. Baseline results showed that patients had low quality of life scores. After pleurodesis, there was a significant improvement in respiratory symptoms, physical domain, and general health. Linear regression showed an improvement in physical domain with the sclerosing agent nitrate (p = 0.005). Male gender (p = 0.002) and a higher lymphocyte count (p = 0.01) were inversely associated with improvement in physical domain. CONCLUSIONS: Pleurodesis improved symptoms and quality of life in patients with malignant pleural effusion. Gender, lymphocyte count, and sclerosing agent might interfere with quality of life improvement.

J Pediatr Nurs ; 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31492509


PURPOSE: Our purpose was to analyze hand hygiene compliance before and after a playful intervention, and caregivers' beliefs, perception of self-efficacy, and barriers to hand hygiene at a daycare center in Brazil. DESIGN AND METHODS: This a quasi-experimental study was conducted from January to July 2017 in a daycare center that provides full-time education for children aged zero to four years from low-income families. The playful intervention with 24 caregivers included an emoji card game to address their beliefs and perception of self-efficacy and a product that reveals dirty areas on washed hands. For 126 children aged two to four years we used a story told through puppets, card games, songs, and a practice of washing hands colored with tempera paint. RESULTS: The results showed that the playful intervention with children and caregivers increased hand hygiene compliance from 13.3% to 41.4% with a significant statistical difference (p < 0.001) after the intervention. The caregiver's perception of self-efficacy for hand hygiene was higher after bathroom use (59.8%) and lower after playing outdoors (28.6%). CONCLUSIONS: Playful interventions performed by nurses promote hand hygiene compliance among children and caregivers at daycare centers. PRACTICE IMPLICATIONS: Practice implications include that health education provided by pediatric nurses is essential in promoting health and preventing the dissemination of infectious diseases to children and caregivers at daycare centers.

Rev Esc Enferm USP ; 53: e03484, 2019 Aug 19.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31433015


OBJECTIVE: To report the experience of students and teachers of a university extension project in the planning and performance of educational workshops on child development with educators of a day care center. METHOD: Report of experience based on frameworks of The Irreducible Needs of Children and the Bioecological Theory of Human Development. RESULTS: The workshops included eight undergraduate students, two nursing professors from a public university and 24 educators from a day care center located in a region of high social vulnerability in São Paulo. The educational workshops promoted child development in the day care center and the following themes were addressed: child development fundamentals, developmental milestones in the personal and social areas, language, fine and gross motor coordination. Interactive dynamics, didactic games and media resources were used as pedagogical strategies. The educational workshops favored the transfer of knowledge on child development and irreducible needs of children. CONCLUSION: Extension activities provided a link between the university and the community through the sharing of knowledge among health and education professionals aimed at promoting child development.

Creches , Desenvolvimento Infantil , Educação em Enfermagem/métodos , Estudantes de Enfermagem , Criança , Docentes de Enfermagem , Feminino , Humanos , Universidades
Cad. saúde colet., (Rio J.) ; 27(2): 117-123, abr.-jun. 2019. tab
Artigo em Português | LILACS-Express | ID: biblio-1011747


Resumo Introdução A violência sexual afeta vários segmentos da sociedade e requer ação urgente. As mulheres são as principais vítimas desta injúria, que pode gerar inúmeras implicações. Assim, o papel dos serviços de saúde é essencial para o enfrentamento deste problema e garantia de maior adesão ao tratamento ambulatorial. Objetivo Objetivou-se analisar as características de mulheres vítimas de violência sexual e abandono de seguimento de tratamento ambulatorial. Método Estudo descritivo, analítico retrospectivo, quantitativo, de 161 prontuários de mulheres atendidas em um serviço de referência de violência sexual em Goiânia- G0, em 2015. Resultados A maioria das mulheres eram adultas (65,8%), residentes em Goiânia (55,3%), empregadas (50,3%), concluintes do ensino médio (30,4%), solteiras (55,3%), pardas (44,1%), heterossexuais (74,5%), sem deficiência (85,1%). Verificou- se uma associação entre o abandono de seguimento ambulatorial com o recebimento de profilaxia DSTs (p<0,001), imunoglobulina para hepatite B (p=0,002), contracepção de emergência (p=0,010), início do esquema de antirretrovirais (p=0,003) e abandono do seguimento após a primeira consulta (p <0,001). Houve significância entre vítimas gestantes e a conclusão do tratamento (p <0,001). Conclusão Conclui-se que, ao se conhecer os fatores relacionados à não adesão ao seguimento ambulatorial, novas estratégias poderão ser desenvolvidas pelos serviços especializados.

Abstract Background Sexual violence affects several segments of society and requires urgent action. Women are the main victims of this injury, that can generate countless implications. Thus, the role of health services is essential for coping with this problem and ensuring greater adherense to outpatient treatment. Objective The aim of this study was to analyze the characteristics of women victims of sexual violence and abandonment of ambulatorial treatment follow-up. Method This is a descriptive, retrospective analytical, quantitative study of 161 women's medical records attended at a referral service for sexual violence in Goiânia-GO, in 2015. Results Most women were adults (65.8%), residents in Goiânia (55.3%), employed (50.3%), high school graduates (30.4%), single (55,3%), browns (44.1%), heterosexuals (74.5%), without disabilities (85.1%). There was an association between the abandonment of ambulatorial follow-up and receipt of prophylaxis STD (p<0.001), immunoglobulin for hepatitis B (p=0.002), emergency contraception (p=0.010), initiate the antiretroviral regimen (p=0.003) and abandonment of follow-up after the first visit (p <0.001). There was significant between pregnant women victims and the completion of treatment (p <0.001). Conclusion It is concluded that when knowing the factors related to non-adherence for ambulatorial follow-up, new strategies should be developed by specialized services.

Regul Toxicol Pharmacol ; 105: 62-68, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30981719


The draft Step 2 ICH S5(R3) guideline includes an exposure-based endpoint as an option for selecting the high-dose in reproductive and developmental toxicity studies. To help determine an appropriate exposure margin for embryofetal developmental toxicity testing, a retrospective analysis was undertaken to determine what threshold would have been sufficient to detect hazards to embryofetal development in rats and rabbits for 18 known and 4 presumed human teratogens. The analysis showed that using a high dose that provided at least a 6-fold exposure margin in the developmental toxicity studies would have been sufficient to detect the teratogenic hazard with relevance for humans for all these therapeutics. With regards to human risk assessment practices for developmental toxicity, the analysis showed that, after excluding lenalidomide and pomalidomide data in rats, all available AUC margins at the NOAEL for the induction of malformations or embryofetal lethality were <4-fold of the exposure at the MRHD for all 22 therapeutics. These data support the proposed general approach of increased level of concern for human risk when exposure margins of the NOAEL to the MRHD are <10-fold, reduced concern when the exposure margins are 10- to 25-fold, and minimal concern when the exposure margin is > 25-fold.

Embrião de Mamíferos/efeitos dos fármacos , Medição de Risco/métodos , Teratogênios/toxicidade , Testes de Toxicidade/métodos , Animais , Área Sob a Curva , Relação Dose-Resposta a Droga , Feminino , Humanos , Nível de Efeito Adverso não Observado , Gravidez , Coelhos , Ratos , Estudos Retrospectivos , Especificidade da Espécie
Rev. enferm. UFPE on line ; 13(4): 1151-1156, abr. 2019. ilus, tab
Artigo em Português | BDENF - Enfermagem | ID: biblio-1021273


Objetivo: verificar a adesão a uma campanha de vacinação contra a influenza. Método: trata-se de um estudo quantitativo, transversal, conduzido em uma creche pública que atende 211 crianças. Contemplaramse, pela campanha de vacinação, a elaboração pelos enfermeiros e o envio às famílias de um folheto educativo, a solicitação de autorização para vacinar a criança, o uso do brinquedo terapêutico instrucional e a administração da primeira dose da vacina contra a influenza. Apresentaram-se os resultados em forma de figura e tabela. Resultados: verificou-se que a adesão foi de 79,1%, sendo significativamente menor nas famílias de crianças com menor média de idade, sendo que 149 crianças tiveram o esquema completo para o ano vigente e 77,8% daquelas que necessitavam da segunda dose foram vacinadas em um serviço de saúde. Conclusão: percebeu-se que o enfermeiro tem papel essencial nas ações de promoção da vacinação nos ambientes de educação infantil visando ao aumento da cobertura vacinal e à prevenção de agravos.(AU)

Objective: to check adherence to an influenza vaccination campaign. Method: this is a quantitative, crosssectional study conducted in a public day-care center serving 211 children. The preparation of the nurses and the sending of an educational leaflet, the application for authorization to vaccinate the child, the use of the therapeutic instructional toy and the administration of the first dose of the influenza vaccine were contemplated by the vaccination campaign. The results were presented in figure and table form. Results: it was verified that the adherence was 79.1%, being significantly lower in the families of children with lower average age, and 149 children had the complete scheme for the current year and 77.8% of those who needed the second were vaccinated at a health facility. Conclusion: it was noticed that the nurse plays an essential role in actions to promote vaccination in the environments of children's education aimed at increasing vaccination coverage and prevention of diseases.(AU)

Objetivo: verificar la adhesión a una campaña de vacunación contra la influenza. Método: se trata de un estudio cuantitativo, transversal, conducido en una guardería pública que atiende a 211 niños. Se incluyeron por la campaña de vacunación, la elaboración por los enfermeros y el envío a las familias de un folleto educativo, la solicitud de autorización para vacunar al niño, el uso del juguete terapéutico instruccional y la administración de la primera dosis de la vacuna contra la influenza. Se presentaron los resultados en forma de figura y tabla. Resultados: se verificó que la adhesión fue del 79,1%, siendo significativamente menor en las familias de niños con menor promedio de edad, siendo que 149 niños tuvieron el esquema completo para el año vigente y el 77,8% de las que necesitaban la segunda se vacunaron en un servicio de salud. Conclusión: se percibió que el enfermero tiene un papel esencial en las acciones de promoción de la vacunación en los ambientes de educación infantil con el objetivo de aumentar la cobertura de vacunación y la prevención de agravios.(AU)

Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Enfermagem Pediátrica , Vacinas contra Influenza , Família , Creches , Saúde da Criança , Educação em Saúde , Vacinação , Programas de Imunização , Cobertura Vacinal , Estudos Transversais , Papel do Profissional de Enfermagem
Health Promot Perspect ; 9(1): 50-54, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30788267


Background: To determine the effects of an educational playful intervention on nasal hygiene behaviors among preschool (3-4 years old) children. Methods: A quasi-experimental before-after study was conducted with 39 children attending public daycare center in Sao Paulo, Brazil. A group-based intervention consisted of two educational sessions to promote healthy behaviors for nasal hygiene. It was adopted playful strategies such as a story told by puppets, card games and simulation of nasal hygiene in front of the mirror. The outcome was evaluated by observing six healthy behaviors for nasal hygiene one week before and after the intervention. Differences in the outcome before and after the intervention were tested using Wilcoxon signed rank test and McNemar's test. Results: The median of healthy nasal hygiene behaviors went from 3.0 to 4.0 after the intervention, with a significant statistical difference (P=0.0004) and a difference of behaviors. After the intervention, forcing the air out of one opened nostril increased from 5.1%to 30.8% (P=0.001, CI 95%: 0-0.440), forcing the air out of the other nostril increased from 5.1% to 28.2% (P=0.003/CI 95%: 0-0.50), throwing the piece of toilet paper in the garbage increased from 53.8% to 87.21% (P=0.04, CI 95%: 0.035-0.65), and sanitizing the hands with soap and water increased from 15.4% to 43.6% (P=0.039-0.76). Conclusion: the educational playful intervention improved the autonomy of preschoolers to adopt healthy nasal hygiene behaviors.

Matern Child Nutr ; 15(3): e12796, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30768755


Recent studies on early infant feeding suggest that the type of diet and age of starting complementary foods may have a positive correlation with overweight in adolescence and adulthood. This study aimed to systematically review the evidence on the relationship between the age of introduction of complementary feeding and excess weight in adolescence and adulthood (PROSPERO: CRD42017067764). The preferred reporting items for systematic reviews and meta-analyses standards were used as a reference. Articles were researched on Medline via PubMed, Web of Science, Embase, Lilacs, Ovid, and Scopus, between June and December 2017. Descriptors were defined according to Medical Subject Heading. Of the 103 articles selected for complete reading, nine were included in the review. Of these, only three found an association between the age of introduction of complementary feeding and overweight. Despite these findings, the studies presented a high heterogeneity, mainly due to the difference in cut-off points for the age of introduction of complementary feeding and the classification of overweight. We concluded that the evidence was not consistent enough to confirm the existence of the association.

J Prosthet Dent ; 121(2): 271-275, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30722987


STATEMENT OF PROBLEM: Visual shade matching is subjective and a cause of concern for clinicians. Different measurement devices have been developed to assist in tooth color selection and to achieve better esthetic results. However, consensus is lacking as to which method of tooth shade selection provides more predictable results. PURPOSE: The purpose of this clinical study was to compare the reliability of different visual and instrumental methods for dental shade matching. MATERIAL AND METHODS: Visual shade matching was performed by 3 experienced clinicians using 2 different shade guides (VITA Classical A1-D4 and VITA Toothguide 3D-MASTER with 29 tabs; VITA Zahnfabrik) with and without the aid of a light-correcting device (Smile Lite; Smile Line). An intraoral scanner (TRIOS; 3Shape A/S) and a spectrophotometer (VITA Easyshade Advance 4.0; VITA Zahnfabrik) were also used for color shade matching. The instrumental methods were repeated 3 times to determine repeatability. Shade-matching sessions for each method were performed under controlled lighting on the middle third of the maxillary right central incisor of 28 participants. The Fleiss' kappa statistical test was used to assess the reliability of each method. The weighted kappa statistical test was used to assess the agreement between the shades matched by different methods (α=.05). RESULTS: Instrumental methods were more accurate than visual methods. The best performance was found for the intraoral scanner configured for the 3D-MASTER scale (Fleiss' kappa value of .874) and for the spectrophotometer configured for the VITA Classical scale (Fleiss' kappa value of .805). The best visual shade-matching method was the VITA Classical scale associated with the light-correcting device (Fleiss' kappa value of .322). The Classical scale without the light-correcting device showed the poorest reliability (Fleiss' kappa value of .177) (P<.05). CONCLUSIONS: Instrumental methods for color shade matching were more reliable than the visual methods tested.

Planejamento de Prótese Dentária , Pigmentação em Prótese , Cor , Percepção de Cores , Estética Dentária , Reprodutibilidade dos Testes , Espectrofotometria
Rev Bras Enferm ; 71(6): 2961-2968, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30517399


OBJECTIVE: To describe and analyze nursing diagnoses established on newborns' medical consultations in a primary health care service. METHOD: Descriptive, analytical and quantitative study performed in a primary health care clinic in São Paulo. Data were collected from the medical records of 37 children treated in 39 nursing consultations during their neonatal period. The identified nursing diagnoses were analyzed regarding: frequency, classification in strengthening or exhaustion in light of the health-disease process, and the correspondence with the essential needs of infants. RESULTS: 372 diagnoses were identified, most of them of strengthening (71%), such as efficient development (n = 37) and effective growth (n = 36). Among the exhaustion diagnoses (29%), there was a predominance of risk for suffocation (n = 15) and impaired tissue integrity (n = 14). Most diagnoses corresponded to the need of physical protection and security. CONCLUSION: Families are strengthened in the care of the essential needs of newborns, however, preventing diseases is necessary.

Diagnóstico de Enfermagem/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Deficiências do Desenvolvimento/terapia , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro/crescimento & desenvolvimento , Masculino , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/estatística & dados numéricos
Rev. bras. enferm ; 71(6): 2961-2968, Nov.-Dec. 2018. tab
Artigo em Inglês | LILACS-Express | ID: biblio-977586


ABSTRACT Objective: To describe and analyze nursing diagnoses established on newborns' medical consultations in a primary health care service. Method: Descriptive, analytical and quantitative study performed in a primary health care clinic in São Paulo. Data were collected from the medical records of 37 children treated in 39 nursing consultations during their neonatal period. The identified nursing diagnoses were analyzed regarding: frequency, classification in strengthening or exhaustion in light of the health-disease process, and the correspondence with the essential needs of infants. Results: 372 diagnoses were identified, most of them of strengthening (71%), such as efficient development (n = 37) and effective growth (n = 36). Among the exhaustion diagnoses (29%), there was a predominance of risk for suffocation (n = 15) and impaired tissue integrity (n = 14). Most diagnoses corresponded to the need of physical protection and security. Conclusion: Families are strengthened in the care of the essential needs of newborns, however, preventing diseases is necessary.

RESUMEN Objetivo: Describir y analizar los diagnósticos de enfermería establecidos en consultas de recién nacidos en un servicio de atención primaria de salud. Método: Estudio descriptivo, analítico y cuantitativo realizado en un ambulatorio de atención primaria de salud en São Paulo. Los datos fueron recolectados en los prontuarios de 37 niños atendidos en 39 consultas de enfermería en el período neonatal. Los diagnósticos de enfermería identificados fueron analizados en cuanto a: la frecuencia, la clasificación en fortalecimiento o desgaste frente al proceso salud-enfermedad, y la correspondencia con las necesidades esenciales de los niños. Resultados: Se identificaron 372 diagnósticos, siendo la mayoría de fortalecimiento (71%), como los de desarrollo eficaz (n = 37) y de crecimiento eficaz (n = 36). Entre los diagnósticos de desgaste (29%), predominaron el riesgo de asfixia (n=15) y la integridad de la piel perjudicada (n=14). La mayoría de los diagnósticos correspondió a la necesidad de protección física y seguridad. Conclusión: Las familias están fortalecidas en la atención a las necesidades esenciales del recién nacido, pero la prevención de agravios se hace necesaria.

RESUMO Objetivo: Descrever e analisar os diagnósticos de enfermagem estabelecidos em consultas de recém-nascidos num serviço de atenção primária à saúde. Método: Estudo descritivo, analítico e quantitativo realizado num ambulatório de atenção primária à saúde em São Paulo. Os dados foram coletados nos prontuários de 37 crianças atendidas em 39 consultas de enfermagem no período neonatal. Os diagnósticos de enfermagem identificados foram analisados quanto a: frequência, classificação em fortalecimento ou desgaste frente ao processo saúde-doença, e correspondência com as necessidades essenciais das crianças. Resultados: Foram identificados 372 diagnósticos, sendo a maioria de fortalecimento (71%), como os de desenvolvimento eficaz (n = 37) e de crescimento eficaz (n = 36). Entre os diagnósticos de desgaste (29%) predominaram risco de sufocação (n = 15) e integridade da pele prejudicada (n = 14). A maioria dos diagnósticos correspondeu à necessidade de proteção física e de segurança. Conclusão: As famílias estão fortalecidas na atenção às necessidades essenciais do recém-nascido, porém a prevenção de agravos se faz necessária.

Saúde debate ; 42(spe4): 223-235, Out.-Dez. 2018. tab, graf
Artigo em Português | LILACS-Express | ID: biblio-986099


RESUMO Este artigo objetivou descrever o perfil das Internações por Condições Sensíveis à Atenção Primária (ICSAP) nas 22 Regiões de Saúde do Ceará, através de um estudo quantitativo e transversal sobre as hospitalizações ocorridas entre 2010 e 2014. Houve redução das ICSAP nas regiões, com exceção de duas. Na maioria, a ampliação da cobertura da Estratégia Saúde da Família gerou redução na proporção de ICSAP. Entretanto, é necessário um compromisso mais contundente com relação à sua qualidade, à consolidação do processo de regionalização e ao desenvolvimento de ações intersetoriais que impactem em outros determinantes de saúde.

ABSTRACT This article aimed to describe the profile of Hospitalizations due to Conditions Sensitive to Primary Care (ICSAP) in the 22 Health Regions of Ceará, through a quantitative and cross-sectional study on hospitalizations between 2010 and 2014. There was a reduction of ICSAP in the regions, except for two. In the majority, the expansion of the coverage of the Family Health Strategy has generated a reduction in the proportion of ICSAP. However, a overwhelming commitment to quality is required, to the consolidation of the regionalization process and to the development of intersectoral actions that impact on other health determinants.

Rev. Pesqui. Fisioter ; 8(4): 551-557, nov., 2018. ilus
Artigo em Inglês, Português | LILACS | ID: biblio-968831


INTRODUÇÃO: A hidroterapia é cada vez mais utilizada no tratamento de pacientes com doença neurodegenerativas visando melhora da funcionalidade e redução de quedas. Permite treino de marcha em condições seguras, promove relaxamento e reduz o medo de cair. Há a necessidade de analisar a qualidade metodológica dos estudos existentes neste contexto. OBJETIVO: Sistematizar o conhecimento acerca da efetividade do treino de marcha na água para pessoas com Doença de Parkinson. MÉTODOS: Trata-se de uma revisão sistemática. Foi feita busca na base de dados do Pubmed e Lilacs no período de março de 2017 a maio de 2018 sem filtros. Foram incluídos ensaios clínicos randomizados que verificaram efeitos de um protocolo de treino de marcha na água para pacientes com Doença de Parkinson. Foram excluídos estudos que realizaram treino na água, porém não especificamente de marcha. Foi utilizada ferramenta da Colaboração Cochrane para avaliar a qualidade metodológica dos estudos. RESULTADOS: Foram encontrados quinze estudos na busca, três destes foram incluídos. Houve uma diferença entre os artigos quanto aos desfechos, em relação ao aumento da velocidade da marcha. A análise da qualidade metodológica mostrou falhas de randomização e cegamento na metodologia dos estudos. CONCLUSÃO: Foi evidenciado que o treino de marcha na água tem efeitos positivos na velocidade da marcha e na mobilidade destes indivíduos. Para um resultado clínico positivo na marcha, devem ser associados exercícios para mobilidade e equilíbrio. São necessários futuros ensaios clínicos randomizados que sigam as diretrizes e apresentem uma qualidade metodológica satisfatória. [AU]

INTRODUCTION: Hydrotherapy is increasingly used in the treatment of patients with neurodegenerative disease, being aimed at improving functionality and reduce falls. Allows safe walking, promotes relaxation and reduces fear of falling. There is a requirement to analyze the methodological quality of existing studies in this context. OBJECTIVE: To systematize the knowledge about the effectiveness of water walking training for people with Parkinson's disease. METHODS: This is a systematic review. We searched the Pubmed and Lilacs database from March 2017 to May 2018 without filters. We included randomized clinical trials that verified the effects of a water gait training protocol for patients with Parkinson's disease. We excluded studies that performed water training, but not specifically gait. A Cochrane Collaboration tool was utilized to evaluate the methodological quality of the studies. RESULTS: Fifteen studies were found in the search, three of these were included. There was different from those between the articles regarding outcomes, in relation to the increase in walking speed. The methodological quality analysis showed randomization and blindness failure in the methodology of the studies. CONCLUSION: It was evidenced that gait training in water has a positive effect on gait velocity and the mobility of these individuals. For a positive clinical outcome in walking, exercises for mobility and balance should be associated. Further randomized clinical trials are necessary for follow the guidelines and have satisfactory methodological quality. [AU]

Doença de Parkinson , Hidroterapia , Marcha
J. Bras. Patol. Med. Lab. (Online) ; 54(5): 288-295, Sept.-Oct. 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-975850


ABSTRACT INTRODUCTION: The success of Acinetobacter baumannii infections can be attributed to its various virulence factors and antimicrobial resistance mechanisms. OBJECTIVE: To evaluate the presence and correlation between different resistance and virulence factors in clinical A. baumannii strains. METHODS: Study conducted at a University Hospital in Belo Horizonte, Minas Gerais, Brazil. The confirmation of Acinetobacter baumannii-calcoaceticus complex was performed by detecting the blaOXA-51 gene through the polymerase chain reaction (PCR), as well as the search for genes: blaOXA-23, 24, 58, 143, blaVIM-1, csuE, ompA and ISAba1. Antimicrobials and metallo-betalactamase (MβL) expression were evaluated by E-test®; and genetic diversity, by enterobacterial repetitive intergenic consensus (ERIC)-PCR. Biofilm formation was classified into four categories according to the mean optical density obtained. RESULTS: 98.4% (61/62) of the strains were resistant to meropenem; 71%, to ceftazidime; and 61.3%, to ampicillin-sulbactam; while 98.4% were sensitive to polymyxin B; and 48.4%, to tigecycline. The production of MβL was detected in 95.2% of the strains. The blaOXA-51 gene was detected in all strains tested; blaVIM-1, in 83.9%; and ISAba1, in 90.3%. On the other hand, the csuE and ompA genes were present in 43.5% and 53.2% of the strains, respectively. CONCLUSION: There was a possible correlation between gentamicin resistant samples and those that were positive for the ompA gene. The csuE gene correlated positively with ISAba1.

RESUMO INTRODUÇÃO: O sucesso das infecções por Acinetobacter baumannii pode ser atribuído a seus vários fatores de virulência e a mecanismos de resistência a antimicrobianos. OBJETIVO: Avaliar a presença e a correlação entre diferentes fatores de resistência e virulência em amostras clínicas de A. baumannii. MÉTODOS: Estudo conduzido em um hospital universitário em Belo Horizonte, Minas Gerais, Brasil. A confirmação do complexo Acinetobacter baumannii-calcoaceticus foi realizada pela detecção do gene blaOXA-51, por meio da reação em cadeia da polimerase (PCR), assim como a pesquisa dos genes: blaOXA-23, 24, 58, 143, blaVIM-1, csuE, ompA e ISAba1. Os antimicrobianos e a expressão das metalobetalactamases (MβL) foram avaliados pelo E-test®; e a diversidade genética, por enterobacterial repetitive intergenic consensus (ERIC)-PCR. A formação de biofilme foi classificada em quatro categorias de acordo com a média da densidade ótica obtida. RESULTADOS: Do total de amostras, 98, 4% (61/62) foram resistentes ao meropenem; 71%, a ceftazidime; e 61, 3%, a ampicilina-sulbactam; enquanto 98, 4% foram sensíveis a polimixina B; e 48, 4%, a tigeciclina. A produção de MβL foi detectada em 95, 2% das amostras. O gene blaOXA-51 foi detectado em todas as amostras testadas; blaVIM-1, em 83, 9%; e ISAba1, em 90, 3%. Por outro lado, os genes csuE e ompA estiveram presentes em 43, 5% e 53, 2% das amostras, respectivamente. CONCLUSÃO: Houve uma possível correlação entre as amostras resistentes a gentamicina e aquelas positivas para o gene ompA. O gene csuE correlacionou-se positivamente com ISAba1.

ACS Appl Mater Interfaces ; 10(41): 35631-35638, 2018 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-30247018


The synergic combination of materials and interfaces to create novel functional devices is a crucial approach for various applications, including low-cost paper-based point-of-care systems. In this work, we demonstrate the implementation of surface-modified polypyrrole (PPy) structures, monolithically integrated into a three-dimensional multilayered paper-based microfluidic device, to locally assess humidity changes. The fabrication and integration of the system include the deterministic incorporation of PPy into the paper-based structure by gas-phase polymerization and the modification of the polymer properties to allow local humidity monitoring. The functionalization of PPy changes both the wettability and the chemical composition of the interface, what is of fundamental importance for the sensor's operation. The PPy structure has excellent mechanical stability, enduring at least 600 bending cycles, what is of relevance on flexible electronics. The electrical resistance correlates with the local relative humidity (RH) inside of the sealed microfluidic system, and the sensor response is fully reversible. The integrated system capable of locally monitoring the RH allowed us to verify that inside the microfluidic channel, water molecules can diffuse across the wax barriers-a possibility disregarded so far. Our results attest that RH variations of 5-10% can affect the flow of extended channels (>5 cm) even when they are fully enclosed.

J Psychopharmacol ; 32(12): 1369-1378, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30260267


BACKGROUND: Methamphetamine is an addictive stimulant that can cause many adverse physical, psychological and psychosocial effects. Preliminary evidence shows cannabidiol, a non-intoxicating constituent of the cannabis plant, may have efficacy in treating opioid and nicotine dependence. However, no study has yet examined whether cannabidiol treatment might impact on methamphetamine addiction. AIMS: The current study investigated whether cannabidiol administration reduces the motivation to self-administer methamphetamine and relapse to methamphetamine-seeking behavior following abstinence. METHODS: Thirty-two male Sprague Dawley rats with implanted jugular vein catheters were initially trained to self-administer methamphetamine via lever press during two-hour sessions on a fixed ratio 1 schedule of reinforcement. Rats in experiment 1 ( n=16) then advanced to a progressive ratio reinforcement schedule to examine the effects of cannabidiol (0, 20, 40, and 80 mg/kg intraperitoneal) on motivation to self-administer methamphetamine. Rats in experiment 2 ( n=16) were tested for cannabidiol effects on methamphetamine-primed reinstatement following extinction. RESULTS: Cannabidiol (80 mg/kg, but not 40 mg/kg, or 20 mg/kg) reduced the motivation to self-administer methamphetamine and attenuated methamphetamine-primed relapse to methamphetamine-seeking behavior after extinction. CONCLUSION: This is the first demonstration that cannabidiol can reduce the motivation to seek and consume methamphetamine, and suggests that cannabidiol might be worth trialing as a novel pharmacotherapy for methamphetamine dependence.

Transtornos Relacionados ao Uso de Anfetaminas/tratamento farmacológico , Canabidiol/farmacologia , Metanfetamina/administração & dosagem , Autoadministração , Animais , Canabidiol/administração & dosagem , Estimulantes do Sistema Nervoso Central/administração & dosagem , Relação Dose-Resposta a Droga , Comportamento de Procura de Droga/efeitos dos fármacos , Extinção Psicológica/efeitos dos fármacos , Masculino , Motivação , Ratos , Ratos Sprague-Dawley , Recidiva , Esquema de Reforço
Biosci. j. (Online) ; 34(4): 970-978, july/aug. 2018. tab
Artigo em Inglês | LILACS | ID: biblio-967168


The objectives of this study were to evaluate the serum biochemical profile in Quarter Horse mares in their peripartum, and neonates on their birth date, and to compare the values obtained for male and female foals, as well as values obtained for foals and mares on the day of delivery. Forty one adult, pregnant mares and their respective offspring on the day of delivery were analyzed, totaling 82 animals. Two samples of blood were collected from the mares, seven days before and on the day of delivery. From the foals, blood collection was performed on the day of their birth about 12 h after colostrum ingestion. The samples were centrifuged and the serum stored at -20 ºC for analyses. Each sample was used to determine the serum concentrations proteins, metabolites, minerals and enzymes. Physiological changes caused by peripartum led to higher serum total protein, albumin, and globulins on the day of delivery. Serum concentration of triglycerides and calcium /phosphorus ratio were greater seven days before delivery; iron concentration was higher than reference ranges in both moments of evaluation. In foals, albumin serum concentrations, albumin/globulins ratio, and aspartate aminotransferase remained below reference ranges. In foals, there was no influence of sex in the serum biochemical profile. When results obtained for foals on their birth date were compared with those obtained for the mares on the delivery day, cholesterol, triglycerides, phosphorus, iron, alkaline phosphatase, and gamma glutamyltransferase were higher in foals, and total protein, albumin, globulins, urea nitrogen, calcium/phosphorus ratio, and aspartate aminotransferase were higher in mares. Results showed variations in serum biochemistry in peripartum mares and neonates, as well as in the comparison between foals and mares on the day of delivery. Clinically, serum biochemistry values for peripartum mares and neonates should be considered in the analysis of laboratory results of tests carried out in this period.

Os objetivos deste estudo foram avaliar o perfil bioquímico sérico de éguas no periparto e potros no dia do nascimento, e confrontar os valores obtidos para potros machos e fêmeas, e desses com as éguas no dia do parto. Foram utilizadas 41 éguas adultas, gestantes, e suas respectivas crias no dia do nascimento, totalizando 82 animais. Das éguas foram coletadas duas amostras de sangue, sete dias antes do parto e no dia do parto. Dos potros, no dia do nascimento, aproximadamente 12 h após ingestão do colostro. As amostras foram centrifugadas e o soro estocado à ­ 20º C para análises. De cada amostra foram determinadas as concentrações séricas de proteínas, metabólitos, minerais e enzimas. Alterações fisiológicas decorrentes do periparto determinaram um quadro com maiores valores sérico das proteínas totais, albumina e globulinas no dia do parto. A concentração sérica dos triglicérides e a relação cálcio/fósforo foi maior aos sete dias antes do parto e, o ferro com valores superiores aos de referência, nos dois momentos avaliados. Nos potros as concentrações séricas da albumina, relação albumina/globulinas e aspartato aminotransferase permaneceram abaixo dos valores de referência. Não houve influencia do sexo nos valores dos constituintes bioquímicos séricos avaliados. Quando confrontados os resultados obtidos para potros, no dia do nascimento, com os das éguas no dia do parto, observou-se maiores valores do colesterol, triglicérides, fósforo, ferro, fosfatase alcalina e gama glutamiltransferase nos potros, e nas éguas maiores valores para proteínas totais, albumina, globulinas, nitrogênio ureico, relação cálcio/fósforo e aspartato aminotransferase. Os resultados revelaram variações nos valores dos constituintes bioquímicos séricos nas éguas no peripato, nos potros neonatos e dos potros em relação as éguas no dia do parto. Clinicamente, os valores dos constituintes bioquímicos séricos nas éguas no periparto e potros neonatos, devem ser considerados no momento da interpretação de resultados de análises laboratoriais nesses períodos.

Colostro , Parto , Período Periparto , Cavalos , Bioquímica , Biomarcadores , Soro
Br J Nutr ; 119(8): 859-879, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29644953


This study systematised and synthesised the results of observational studies that were aimed at supporting the association between dietary patterns and cardiometabolic risk (CMR) factors among adolescents. Relevant scientific articles were searched in PUBMED, EMBASE, SCIENCE DIRECT, LILACS, WEB OF SCIENCE and SCOPUS. Observational studies that included the measurement of any CMR factor in healthy adolescents and dietary patterns were included. The search strategy retained nineteen articles for qualitative analysis. Among retained articles, the effects of dietary pattern on the means of BMI (n 18), waist circumference (WC) (n 9), systolic blood pressure (n 7), diastolic blood pressure (n 6), blood glucose (n 5) and lipid profile (n 5) were examined. Systematised evidence showed that an unhealthy dietary pattern appears to be associated with poor mean values of CMR factors among adolescents. However, evidence of a protective effect of healthier dietary patterns in this group remains unclear. Considering the number of studies with available information, a meta-analysis of anthropometric measures showed that dietary patterns characterised by the highest intake of unhealthy foods resulted in a higher mean BMI (0·57 kg/m²; 95 % CI 0·51, 0·63) and WC (0·57 cm; 95 % CI 0·47, 0·67) compared with low intake of unhealthy foods. Controversially, patterns characterised by a low intake of healthy foods were associated with a lower mean BMI (-0·41 kg/m²; 95 % CI -0·46,-0·36) and WC (-0·43 cm; 95 % CI -0·52,-0·33). An unhealthy dietary pattern may influence markers of CMR among adolescents, but considering the small number and limitations of the studies included, further studies are warranted to strengthen the evidence of this relation.

Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Dieta/efeitos adversos , Comportamento Alimentar , Doenças Metabólicas/etiologia , Doenças Metabólicas/prevenção & controle , Adolescente , Humanos , Estudos Observacionais como Assunto , Fatores de Risco