Transferability and characterization of microsatellite markers from Byrsonima cydoniifolia A. Juss. (MALPIGHIACEAE) in seven related taxa from Cerrado biome reveal genetic relationships.

Byrsonima Rich. is one of the largest genera of the Malpighiaceae family with 97 species occurrence in Brazil and multiple potentialities, including pharmaceutical and food industries. In this study, 17 microsatellite markers characterized in Byrsonima cydoniifolia were tested for seven related taxa, all species are native to Brazil and four are endemic. Genomic DNA was extracted from leaves tissues and 17 microsatellite markers were used to cross-amplification of microsatellite regions. Polymorphism and genetic diversity were evaluated for B. intermedia, B. verbascifolia, B. laxiflora, B. subterranea, B. umbellata, B. linearifolia. from 16 individuals and for B. viminifolia from 14 individuals. Transferred microsatellite markers panels ranged from 11 (64.8%) in B. viminifolia to 6 (35.2%) in B. umbellata. The total number of alleles per locus ranged from 5 (B. linearifolia) to 8 (B. subterranea) alleles. B. umbellata showed lower values of observed and expected heterozygosity (HO = 0.312; HE = 0.436) and B. subterranea presented the highest values (HO = 0.687; HE = 0.778). A greater number of microsatellite markers should be developed for B. umbellata. The microsatellite marker panels transferred to the species B. intermedia, B. verbascifolia, B. laxiflora, B. subterranea, B. viminifolia and B. linearifolia are very informative, with a high combined probability of exclusion of paternity (Q ≥ 0.976) and the low combined probability of identity (I ≤ 9.91 × 10-6), potentially suitable for future genetic-population studies, supporting strategies for maintaining the genetic diversity and for exploration of Byrsonima species as genetic resources.

Endodontic treatment of hypertaurodontic teeth with anatomical variations: case reports.

Taurodontism, usually associated with genetic disorders, is an anomaly in dental development in which the tooth presents with a vertically elongated pulp chamber due to an invagination failure of the Hertwig epithelial sheath. This article presents 2 case reports describing the endodontic treatment of permanent taurodontic molars in systemically healthy patients. In case 1, a maxillary left first molar presented with hypertaurodontism and 5 root canals. In case 2, a mandibular left second molar presented with hypertaurodontism and a C-shaped canal. Treatment of both teeth was based on careful radiographic evaluation with magnification, which allowed the root canal orifices to be identified and the endodontic treatment to be performed. Chemical-mechanical preparation was performed with mechanized instruments and a 2.5% sodium hypochlorite solution. As an auxiliary protocol to finish cleaning, passive ultrasonic irrigation was performed, and a thermoplastic filling technique was used. When complex internal anatomy and accessory root canals are present, endodontic treatment of a tooth presenting with hypertaurodontism can be challenging. Given the complexities of the present cases, the positive outcomes can be attributed to the use of magnification during endodontic procedures and meticulous attention to tooth preparation and obturation techniques.

Optimization of arsenic phytoremediation using Eichhornia crassipes.

This study aimed to evaluate the pH, phosphate, and nitrate in the process of arsenic absorption by Eichhornia crassipes (water hyacinth), using the surface response methodology, in order to optimize the process. The plants were exposed to a concentration of arsenic of 0.5 mg L-1 (NaAsO2) over a period of 10 days. The results indicated optimal levels for the absorption of arsenic by E. crassipes at pH equal to 7.5, absence of phosphate, and minimum nitrate level of 0.0887 mmol L-1. For the tested concentration, E. crassipes was able to accumulate 498.4 mg kg-1 of As (dry base) in its plant tissue and to reduce 83% of the initial concentration present in the aqueous medium where it was cultivated. The concentration of phosphorus in solution linearly increased the phosphorus content in the plants and negatively influenced the absorption of arsenic. The concentration of 0.5 mg L-1 of As did not significantly affect the relative growth rate (RGR) and the tolerance index (TI). 94% of As (III) initially solubilized in water was converted by the end of the experiment period into As (V). The water hyacinth was important in the phytoremediation of arsenic when cultivated under optimal conditions for its removal.

Detection and genetic analysis of the enteroaggregative Escherichia coli heat-stable enterotoxin (EAST1) gene in clinical isolates of enteropathogenic Escherichia coli (EPEC) strains.

BACKGROUND: The enteroaggregative E. coli heat-stable enterotoxin 1 (EAST1) encoded by astA gene has been found in enteropathogenic E. coli (EPEC) strains. However, it is not sufficient to simply probe strains with an astA gene probe due to the existence of astA mutants (type 1 and type 2 SHEAST) and EAST1 variants (EAST1 v1-4). In this study, 222 EPEC (70 typical and 152 atypical) isolates were tested for the presence of the astA gene sequence by PCR and sequencing. RESULTS: The astA gene was amplified from 54 strains, 11 typical and 43 atypical. Sequence analysis of the PCR products showed that 25 strains, 7 typical and 18 atypical, had an intact astA gene. A subgroup of 7 atypical strains had a variant type of the astA gene sequence, with four non-synonymous nucleotide substitutions. The remaining 22 strains had mutated astA gene with nucleotide deletions or substitutions in the first 8 codons. The RT-PCR results showed that the astA gene was transcribed only by the strains carrying either the intact or the variant type of the astA gene sequence. Southern blot analysis indicated that astA is located in EAF plasmid in typical strains, and in plasmids of similar size in atypical strains. Strains carrying intact astA genes were more frequently found in diarrheic children than in non-diarrheic children (p < 0.05). CONCLUSION: In conclusion, our data suggest that the presence of an intact astA gene may represent an additional virulence determinant in both EPEC groups.

Real-time multiplex PCR assay and melting curve analysis for identifying diarrheagenic Escherichia coli.

A real-time multiplex PCR assay was designed to amplify the virulence genes eae, pEAF, aatA, daaC, elt, est, ipaH, stx(1), and stx(2) for the detection of all diarrheagenic Escherichia coli pathotypes. This assay proved to be more sensitive and rapid than a conventional multiplex PCR for diarrheagenic E. coli isolates from children with diarrhea.

Genotypic and phenotypic analysis of diarrheagenic Escherichia coli strains isolated from Brazilian children living in low socioeconomic level communities.

BACKGROUND: Childhood diarrheal diseases remain highly endemic in developing areas of Brazil. The importance of Escherichia coli among children with diarrhea in these areas was unknown. This study determined the prevalence of different E. coli categories in symptomatic and asymptomatic children from low socioeconomic level rural communities in southeastern Brazil. METHODS: A total of 560 stool samples were collected from 141 children with diarrhea (< 10 years) and 419 apparently healthy controls who resided in 23 communities. E. coli isolates (n = 1943) were subjected to two multiplex PCRs developed for the detection of enteropathogenic E. coli (EPEC), enteroaggregative E. coli (EAEC), diffusely adherent E. coli (DAEC), enterotoxigenic E. coli (ETEC), enteroinvasive E. coli (EIEC), and Shiga toxin-producing E. coli (STEC). Strains were also examined for the presence of EPEC, EAEC, and DAEC by assays of adhesion to HEp-2 cells and by hybridization with specific DNA probes. RESULTS: Diarrheagenic E. coli strains were isolated from 253 (45.2%) children, and were associated with diarrhea in children aged < 5 years (p < 0.001). EAEC (20.9%), DAEC (11.6%), EPEC (9.3%) were the most frequent pathotypes, followed by ETEC (2.7%), EIEC (0.5%), and STEC (0.2%). Depending of the assay, EPEC, EAEC, and DAEC (collectively termed enteroadherent E. coli) strains were isolated in 45% to 56% of diarrhea cases, a significantly higher incidence than in controls (P < 0.05). Individually, only DAEC showed significant association with diarrhea (p < 0.05), particularly in children aged 2-5 years. CONCLUSION: This study indicates that enteroadherent E. coli is an important cause of diarrhea in children living in low socioeconomic level communities in southeastern Brazil. Our results reveal that the PCR1 assay is an excellent tool for the identification of EAEC and DAEC.

Association between falls in older adults and prevention group.

OBJECTIVES: to assess the effectiveness of guidelines on fall prevention in a group of older adults in Primary Health Care. METHODS: a cross-sectional study, carried out with older adults selected by a simple random sample (274; N=1,234). Data covered sociodemographic and socioeconomic variables, marital status, health conditions, factors associated with falls and participation in the prevention group. Student's t test was used, and dichotomous variables were used by the chi-square test. The project met ethical requirements. RESULTS: sample with female profile (61.7%), married, with low education, mean age of 71.69 years. The factors associated with falls identified were female sex, medicalization and participation in the prevention group. There was no protective association between participation in a fall prevention group in older adults and a decrease in the number of falls. CONCLUSIONS: based on evidence, a personalized intervention during the nursing visit is suggested as a strategy to prevent falls.

In-hospital mortality and severe outcomes after hospital discharge due to COVID-19: A prospective multicenter study from Brazil.

Background: We evaluated in-hospital mortality and outcomes incidence after hospital discharge due to COVID-19 in a Brazilian multicenter cohort. Methods: This prospective multicenter study (RECOVER-SUS, NCT04807699) included COVID-19 patients hospitalized in public tertiary hospitals in Brazil from June 2020 to March 2021. Clinical assessment and blood samples were performed at hospital admission, with post-hospital discharge remote visits. Hospitalized participants were followed-up until March 31, 2021. The outcomes were in-hospital mortality and incidence of rehospitalization or death after hospital discharge. Kaplan-Meier curves and Cox proportional-hazard models were performed. Findings: 1589 participants [54.5% male, age=62 (IQR 50-70) years; BMI=28.4 (IQR,24.9-32.9) Kg/m² and 51.9% with diabetes] were included. A total of 429 individuals [27.0% (95%CI,24.8-29.2)] died during hospitalization (median time 14 (IQR,9-24) days). Older age [vs<40 years; age=60-69 years-aHR=1.89 (95%CI,1.08-3.32); age=70-79 years-aHR=2.52 (95%CI,1.42-4.45); age≥80-aHR=2.90 (95%CI 1.54-5.47)]; noninvasive or mechanical ventilation at admission [vs facial-mask or none; aHR=1.69 (95%CI 1.30-2.19)]; SAPS-III score≥57 [vs<57; aHR=1.47 (95%CI 1.13-1.92)] and SOFA score≥10 [vs <10; aHR=1.51 (95%CI 1.08-2.10)] were independently associated with in-hospital mortality. A total of 65 individuals [6.7% (95%CI 5.3-8.4)] had a rehospitalization or death [rate=323 (95%CI 250-417) per 1000 person-years] in a median time of 52 (range 1-280) days post-hospital discharge. Age ≥ 60 years [vs <60, aHR=2.13 (95%CI 1.15-3.94)] and SAPS-III ≥57 at admission [vs <57, aHR=2.37 (95%CI 1.22-4.59)] were independently associated with rehospitalization or death after hospital discharge. Interpretation: High in-hospital mortality rates due to COVID-19 were observed and elderly people remained at high risk of rehospitalization and death after hospital discharge. Funding: Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and Programa INOVA-FIOCRUZ.

Bone morphogenetic proteins in biomineralization of two endodontic restorative cements.

To assess the effect of biodentine (BD) and MTA-angelus (MTA) on biocompatibility, BMP2, BMP4, and osteocalcin (OC) expression. Subcutaneously implanted tubes of four groups (MTA, BD, Control, and Sham) were kept over 15, 30, and 60 days; histological analyses were performed using H&E and Von Kossa; ELISA quantified IL-1ß and IL-8 expression; and qRT-PCR verified gene expression of BMPs and OC. Sham showed slight changes in profile/intensity of inflammatory infiltrate in all periods. Control had an inflammatory score significantly higher than Sham at 15 days (p < .05). BD revealed a similar inflammatory response to Sham, without significant changes over periods. MTA group exhibited an increase in chronic inflammatory profile at 30 days, with significant reduction at 60 days, when compared to Sham (p < .05). At 30/60 days, experimental groups presented birefringent areas. At 30/60 days, BD and MTA significantly increase IL-1ß compared to Control, whereas an increase in IL-8 was observed only in BD. At 30/60 days, BD produces an expression of BMP2 whereas MTA influenced BMP4 and OC. Materials tested are biocompatible and they have osteoinductive activity; the materials influenced the expression of the tested mediators differently, suggesting different affinities with the substrate and the dental substrates.

Adherence factors in atypical enteropathogenic Escherichia coli strains expressing the localized adherence-like pattern in HEp-2 cells.

Although atypical enteropathogenic Escherichia coli (aEPEC) strains are frequently implicated in childhood diarrhea in developing countries, not much is known about their adherence properties. The phenotypic and genotypic characterization of 29 aEPEC strains expressing the localized adherence-like pattern points toward the involvement of E. coli common pilus (ECP), intimins, and other known E. coli adhesins in this pattern.

Genetic elements associated with antimicrobial resistance in enteropathogenic Escherichia coli (EPEC) from Brazil.

BACKGROUND: We recently observed an association of resistance with a certain enteropathogenic Escherichia coli (EPEC) serotypes and identified a conjugative plasmid, similar to plasmid pED208, that was conserved among archival O111:H2/NM and O119:H2 strains of diverse geographical origin. In this study, we sought to determine the prevalence and distribution of this plasmid among a collection of EPEC isolates from Brazil, as well as to study the susceptibilities of these isolates to antimicrobial agents. RESULTS: Resistance was more commonly seen in typical EPEC than atypical strains. The most prevalent resistances were to ampicillin, tetracycline, streptomycin and the sulfonamides. Markers for the EPEC conjugative multiresistance plasmid, were detected in 21 (30%) of typical but only 4 (5%) of atypical strains (p = 0.001, Chi-squared test). This plasmid, previously reported from only O111 and O119 strains was found in O55 and O127 strains and was associated with the presence of class 1 integrons. CONCLUSION: Our data suggest a limited but expanding host range for the EPEC resistance plasmid.

Pathologic Factors Affecting Colorectal Cancer Survival in a Jamaican Population-the UHWI Experience.

OBJECTIVE: Colorectal carcinoma (CRC) is the third most common cancer and a leading cause of cancer-related deaths in Jamaica. Globally, CRC mortality rates have been decreasing in developed countries; however, CRC mortality rates are trending upwards in low-income or developing countries. Our objectives are to estimate the overall 5-year survival and to determine the pathologic factors associated with overall survival of colorectal adenocarcinoma after surgery at the University Hospital of the West Indies (UHWI). METHODS: Retrospective, observational (cross-sectional) study on CRC patients. We summarized and analyzed demographic, clinical data, histopathological data, and survival rates. Single predictor Cox regression models were used to establish associations between survival and specified clinicopathological characteristics. RESULTS: A total of 217 patients who underwent operative resection of colorectal adenocarcinoma from January 2004 to December 2013. Median survival time post-therapeutic intervention was 48 months. Late stage at diagnosis, positive circumferential resection margins, neural and vascular invasion, as well as three or more nodal metastases were all associated with statistically significant worsened outcome. CONCLUSIONS: Despite surgical quality meeting USA standards, CRC survival rates in Jamaica are 13% lower than survival of CRC in non-Hispanic Blacks in the USA. The survival trends found by our study support the application of international indices for CRC prognostication to Jamaican patients.

Evidence of pathogenic subgroups among atypical enteropathogenic Escherichia coli strains.

We describe the characterization of 126 atypical enteropathogenic Escherichia coli (aEPEC) isolates from 1,749 Brazilian children. Classic aEPEC strains were more frequently found in children with diarrhea than in controls (P < 0.001), showing their importance as acute diarrhea agents in our country. Only aEPEC strains carrying either the ehxA or paa gene were significantly associated with diarrhea.

Phytoremediation of arsenic-contaminated water by Lemna Valdiviana: An optimization study.

Phytoremediation is a technique in which plants are used to treat contaminated media. The objective of this study was to monitor the influence of the parameters pH, phosphate concentration, and nitrate concentration in the process of arsenic absorption by Lemna valdiviana Phil. The response surface methodology was used to analyze the data to subsidize actions that maximize the phytoremediation process. A central composite rotational design (CCRD) was used with 3 variables including 6 axial points and 6 repetitions at the central point, totaling 20 trials. The plants were exposed to a constant concentration of arsenic in the optimization test of 0.5 mg L-1 (NaAsO2) and varied levels of pH, P-PO4, and N-NO3 in a period of 7 d. At the end of the experiment, the mass of arsenic removed from water and arsenic accumulated in the plants, the arsenic species present, the relative growth rate of plants (RGR), the tolerance index (TI), and the bioaccumulation factor (BAF) were calculated. Lemna valdiviana absorbed a greater amount of As when cultivated under pH conditions between 6.3 and 7.0, readily available phosphorus (P-PO4) concentration of 0.0488 mmol L-1, and nitrogen in the form of 7.9 mmol L-1 nitrate. Under these conditions, the plants were able to accumulate 1190 mg kg-1 As (in dry weight) from the aqueous media and reduce 82% of its initial concentration. Therefore, Lemna valdiviana has been shown to be an arsenic bioaccumulating macrophyte with high phytoremediation potential for media contaminated with the metalloid.

Accuracy of Determine TB-LAM Ag to detect TB in HIV infected patients associated with diagnostic methods used in Brazilian public health units.

BACKGROUND: Determine TB-LAM Ag (LAM) is a point of care test developed to diagnose tuberculosis (TB). The aim of this study was to evaluate the diagnostic performance of LAM in people living with HIV using Brazilian public health network algorithm for TB diagnosis. METHODS AND FINDINGS: A cross-sectional study design was used to enroll 199 adult patients in two sites in Rio de Janeiro and two in São Paulo. The study enrolled HIV-infected patients with CD4 counts ≤200 cells/mm3 (in the Alere PIMA CD4 assay at study screening), patients coughing for at least 2 weeks or presenting a chest radiography suggestive of TB. LAM, in conjunction with sputum smear microscopy or Xpert MTB/RIF (Xpert) as compared to Mycobacterium tuberculosis culture, which was used as a reference standard. TB prevalence was 24.6%. Overall accuracy of LAM was 79.9% (73.8%-84.9%), positive and negative predictive values were 62.2% (46.1%-75.9%) and 84% (77.5%-88.8%), respectively. The overall LAM sensitivity was 46.9% (33.7%-60.6%) and specificity was 90.7% (84.9%-94.4%). The best performance of LAM was observed among patients with CD4 counts ≤50 cells/mm3 (sensitivity = 70.4% and specificity = 85.9%). When 2 respiratory smears were used in conjunction with LAM, sensitivity increased 22%, as compared to just 2 smears. Furthermore, LAM when used in conjunction with two respiratory smears, was as sensitive as compared to a single one. However, no improvement in TB diagnosis occurred when LAM was used with Xpert as compared to Xpert alone. Among 14 LAM false positive tests, Non-Tuberculosis Mycobacteria were isolated in three cases. CONCLUSION: LAM is a point of care test that increased TB diagnosis in immunosuppressed HIV-infected patients when used in conjunction with smear microscopy, but not when used with Xpert in Brazilian public health network sites. Use of LAM test should be considered in settings where immunosuppressed HIV patients need rapid TB diagnosis.

Efficacy of sofosbuvir as treatment for yellow fever: protocol for a randomised controlled trial in Brazil (SOFFA study).

INTRODUCTION: An ongoing outbreak of yellow fever (YF) has been reported in Brazil with 1261 confirmed cases and 409 deaths since July 2017. To date, there is no specific treatment available for YF. Recently published papers describing in vitro and animal models suggest a potential effect of antiviral drugs (approved for the treatment of hepatitis virus) against flaviviruses, including YF. The primary aim of this study is to analyse the effect of sofosbuvir on viral kinetics and clinical outcomes among patients presenting with YF. This is a multicentre open-label randomised controlled trial with 1:1 individual allocation, stratified by severity and by recruiting centre. METHODS AND ANALYSIS: Adults with suspected or confirmed YF infection and symptoms lasting up to 15 days are screened. Eligible and consenting patients are randomised to receive oral sofosbuvir 400 mg daily for 10 days or to receive standard clinical care. Viral kinetics are measured daily and the reduction in YF plasma viral load from the sample at inclusion to 72 hours after randomisation will be compared between active and control groups. Clinical outcomes include severity meeting criteria for intensive care support, liver transplantation, in-hospital mortality and mortality within 60 days. ETHICS AND DISSEMINATION: Ethics approval was obtained at the participating sites and at the national research ethics committee (CAAE 82673018.6.1001.0068). The trial has been submitted for ethical approval at additional potential recruiting centres. Results of the study will be published in journals and presented at scientific meetings. TRIAL REGISTRATION: Brazilian Clinical Trials Registry (RBR-93dp9n).

Kinetics of arsenic absorption by the species Eichhornia crassipes and Lemna valdiviana under optimized conditions.

This work aimed to study the kinetics of arsenic absorption by Eichhornia crassipes and Lemna valdiviana under pre-established conditions of pH phosphate and nitrate in the nutrient solution. Additional aims were to evaluate the conversion kinetics between As(III) and As(V), and the effect of arsenic concentrations on development of the species. The plants were cultivated in nutrient solutions containing different arsenic concentrations: 0, 0.56, 0.89 and 1.38 mg L-1 for the water-hyacinth, and 0, 0.13, 0.48, 0.99 and 1.4 mg L-1 for Lemna. Monitoring of arsenic removal by the plants was performed by sampling at intervals of 0, 4, 8, 16, 24, 48, 96, 144, 192 and 240 h for the water hyacinth, and 0, 4, 8, 16, 24, 48, 96, 144 and 168 h for Lemna. The samples were submitted to analysis of total arsenic, As(III), As(V) and phosphorus. The first-order kinetics was fit to the arsenic removal kinetics by the plants, and it was observed that the decay coefficient (k) decreased with the increase of its initial concentration in the nutrient solution. For the, absorption was observed after 96 h of culture, the time coinciding with the greatest As(V) concentrations. For Lemna, the metal was only absorbed by the plant after decay of the phosphate levels of the medium, which occurred at 48 h. Concentrations above 1 mg L-1 implied deleterious effects in both plant species and in the phytoremediation process, and the bioaccumulation factor decreased for concentration above this for both E. crassipes and L. valdiviana.

Serotonin induces peripheral antinociception via the opioidergic system.

PURPOSE: Studies conducted since 1969 have shown that the release of serotonin (5-HT) in the dorsal horn of the spinal cord contributes to opioid analgesia. In the present study, the participation of the opioidergic system in antinociceptive effect serotonin at the peripheral level was examined. METHODS: The paw pressure test was used with mice (Swiss, males from 35 g) which had increased pain sensitivity by intraplantar injection of PGE2 (2 µg). Serotonin (250 ng), administered locally to the right paw of animals, produces antinociception in this model. RESULTS: The selective antagonists for mu, delta and kappa opioid receptors, clocinnamox clocinnamox (40 µg), naltrindole (60 µg) and nor-binaltorfimina (200 µg), respectively, inhibited the antinociceptive effect induced by serotonin. Additionally, bestatin (400 µg), an inhibitor of enkephalinases that degrade peptides opioids, enhanced the antinociceptive effect induced by serotonin (low dose of 62.5 ng). CONCLUSIONS: These results suggest that serotonin possibly induce peripheral antinociception through the release of endogenous opioid peptides, possible from immune cells or keratinocytes.

Association between falls in older adults and prevention group / Asociación entre caídas en ancianos y grupo de prevención / Associação entre quedas em idosos e grupo de prevenção

ABSTRACT Objectives: to assess the effectiveness of guidelines on fall prevention in a group of older adults in Primary Health Care. Methods: a cross-sectional study, carried out with older adults selected by a simple random sample (274; N=1,234). Data covered sociodemographic and socioeconomic variables, marital status, health conditions, factors associated with falls and participation in the prevention group. Student's t test was used, and dichotomous variables were used by the chi-square test. The project met ethical requirements. Results: sample with female profile (61.7%), married, with low education, mean age of 71.69 years. The factors associated with falls identified were female sex, medicalization and participation in the prevention group. There was no protective association between participation in a fall prevention group in older adults and a decrease in the number of falls. Conclusions: based on evidence, a personalized intervention during the nursing visit is suggested as a strategy to prevent falls.

RESUMEN Objetivos: evaluar la efectividad de las guías de prevención de caídas en un grupo de ancianos en la Atención Primaria de Salud. Métodos: estudio transversal, realizado con ancianos seleccionados por muestra aleatoria simple (274; N=1.234). Los datos abarcaron variables sociodemográficas y socioeconómicas, estado civil, condiciones de salud, factores asociados a caídas y participación en el grupo de prevención. Se utilizó la técnica estadística descriptiva de la Prueba t de Student, y las variables dicotómicas se utilizaron mediante la Prueba Chi-Cuadrado. El proyecto cumplió con los requisitos éticos. Resultados: una muestra con perfil femenino (61,7%), casada, con baja escolaridad, edad media de 71,69 años. Los factores asociados a las caídas identificados fueron sexo femenino, medicalización y participación en el grupo de prevención. No hubo asociación protectora entre la participación en un grupo de prevención de caídas en ancianos y una disminución en el número de caídas. Conclusiones: con base en la evidencia, se sugiere una intervención personalizada durante la visita de enfermería como estrategia para la prevención de caídas.

RESUMO Objetivos: avaliar a efetividade das orientações sobre prevenção de quedas em um grupo de idosos na Atenção Básica à Saúde. Métodos: estudo transversal, realizado com idosos selecionados por amostra aleatória simples (274; N=1.234). Os dados abrangeram variáveis sociodemográficas, socioeconômicas, estado civil, condições de saúde, fatores associados a quedas e participação no grupo de prevenção. Utilizou-se a técnica estatística descritiva teste t de Student, e as variáveis dicotômicas, pelo Teste do Qui-Quadrado. O projeto atendeu às exigências éticas. Resultados: amostragem com perfil feminino (61,7%), casados, apresentando baixa escolaridade, idade média de 71,69 anos. Os fatores associados a quedas identificados foram sexo feminino, medicalização e participação no grupo de prevenção. Não houve associação protetora entre realização de grupo de prevenção de quedas em idosos e diminuição do número de quedas. Conclusões: baseado nas evidencias, sugere-se uma intervenção personalizada durante a visita de enfermagem como estratégia para prevenção das quedas.

Reporting of violence against children and adolescents in a protective institution in southern Brazil.

OBJECTIVE: This study aimed to analyze the reports of violence against children and adolescents in the period between January 2009 and May 2014 in a municipality protection institution of Rio Grande, RS. METHODS: This is a descriptive and documentary study with a quantitative approach that analyzed 800 medical records of Specialized Reference Center for Social Assistance (CREAS), from the development of a research instrument containing the study variables. RESULTS: The results show that 44.5% of the notifications sent to the protection of organs were carried out by family members and evidence of physical signs was the reason that triggered them (34%). The dismissing by abandonment of families is very present in the institution (36.9%), which possibly supports the maintenance of the cycle of violence. CONCLUSION: The results of this study show that although there were improvements regarding the notification by the family, the number of notifications made by the health and education sectors are still reduced, thereby increasing the need for more effective and articulated actions in these sectors.