Safe administration of yellow fever vaccine in patients with suspected egg allergy.

Background: The evidence available in the literature on the administration and safety of the yellow fever vaccine in patients with egg allergy is limited. Objective: We sought to describe the administration of yellow fever vaccine in children with suspected egg allergy using a simplified protocol. Methods: Children referred to the service from February 2018 to January 2020 with a history of possible egg allergy were classified as probably egg-allergic or not on the basis of history and specific IgE testing. A vaccine prick test was performed only in those with a history of an anaphylactic reaction to egg ingestion and if the result was positive the vaccine was administered in a 2-step protocol (2 equal doses of 0.25 mL with an interval of 30 minutes between the 2 applications). All other children received the vaccine as a single dose. Results: A total of 435 children were evaluated; 48.27% were probably not allergic, and 51.72% were probably allergic to egg, of which 32.88% were considered anaphylactic. A total of 414 (95.2%) children had no vaccine reactions. Of the 21 (4.8%) children who had some reaction, 10 experienced a local reaction, 9 a mild skin reaction distant from the vaccine site, 1 presented local cutaneous reaction distant to the vaccination site, and 1 patient developed possible anaphylaxis. The vaccine prick test did not predict a vaccine reaction (odds ratio, 1.29; 95% CI, 0.25-6.72; P = .67). Conclusions: Yellow fever vaccine can be safely administered as a single dose in children with a confirmed or suspected egg allergy.

Histomorphometric evaluation of the Ki-67 proliferation rate and CD34 microvascular and D2-40 lymphovascular densities drives the pulmonary typical carcinoid outcome.

Ki-67 has shown promise as a prognostic factor in pulmonary carcinoids. In this study, we sought to validate the importance of Ki-67 and study the relationships between Ki-67 and other stromal biomarkers of vascular density. We examined Ki-67, CD34, and D2-40 in tumor tissues from 128 patients with surgically excised typical carcinoid of the lung. We used immunohistochemistry and morphometry to evaluate the amount of tumor staining for cellular proliferation (Ki-67), microvascular density (CD34-MVD), and D2-40 lymphovascular density. The main outcome was overall survival, considered as life expectancy until death from metastasis. Specimens from patients with central tumors showed high CD34-MVD (P = .01), which was also significantly associated with a compromised surgical margin, lymph node metastasis, and clinical stage Ib. Equally significant was high D2-40 lymphovascular density in central specimens with a compromised surgical margin and lymph node metastasis. A high Ki-67 proliferation rate was significantly associated with tumors from patients with clinical stage IIb, IIIa, and IV disease. Multivariate Cox model analysis demonstrated that tumor location and stage, surgical margin, tumor size, and N stage were significantly related to survival time (P < .05). Quantitative staining of the tumor for Ki-67 and CD34-MVD served as prognostic factors (P < .05), which were more relevant than the surgical and pathological stage. Ki-67 greater than 5% and CD34-MVD greater than 7% staining comprise a subset of patients with higher death hazard; this outcome may harbor evidence for further prospective studies of target therapy after surgical resection.

Gastric emptying of solids and semi-solids in morbidly obese and non-obese subjects: an assessment using the 13C-octanoic acid and 13C-acetic acid breath tests.

BACKGROUND: It has been suggested that obesity is associated with an altered rate of gastric emptying. The objective of the present study was to determine whether the rates of solid and semi-solid gastric emptying differ between morbidly obese patients and lean subjects. METHODS: The Gastric-emptying time (GET) of solid and semi-solid meals were compared between lean healthy subjects and morbidly obese patients enrolled in two previously published studies. GET of solid and semi-solid meals was measured using the 13C-octanoic acid breath test and 13C-acetic acid breath test, respectively, in 24 lean and 14 morbidly obese individuals of both sexes. Student t-test was used to compare the mean data between the lean and morbidly obese groups. The influence of sex, gender, BMI and morbid obesity on the GET of solid meals was verified by linear regression analysis. RESULTS: Mean t(1/2) values of solid GET (+/- standard deviation) were 203.6 +/- 76.0 min and 143.5 +/- 19.1 min for lean and obese subjects, respectively (P = 0.0010). Mean t(lag) values of solid GET were 127.3 +/- 42.7 min and 98.4 +/- 13.0 min for lean and obese subjects, respectively (P = -0.0044). No significant difference in semi-solid GET was observed between the lean and morbidly obese groups. CONCLUSION: The present study demonstrated a significantly enhanced gastric emptying of the solid meal test in morbidly obese patients when compared to lean subjects. This finding is compatible with the hypothesis that rapid gastric emptying in morbidly obese subjects increases caloric intake due to a more rapid loss of satiety.

[Nutritional status and related factors among elderly Brazilians]. / Estado nutricional e fatores associados em idosos.

OBJECTIVE: This study describes the nutritional status and associated factors among elderly Brazilians. METHODS: Data from "Pesquisa sobre Padrões de Vida" (PPV- Life Pattern Research), conducted by the "Brazilian Geographic and Statistics Institute" in 1996/1997 were used. Body Mass Index (BMI) was applied to classify nutritional status and is the response variable of this study. Multivariate analysis with polytomous logistic regression was used. RESULTS: Prevalence of underweight was 5.7%, eutrophy 50.4%, overweight 32.3% and obesity 11.6%. Women have a 1.32 greater chance of overweight (CI 95% 0.99-1.74; p=0.05) and 4.11 of obesity (CI 95% 2.57-6.57; p<0.01). Higher age increased risk of underweight and diminished that of overweight and obesity. Elderly with a lower income have a higher risk of underweight and those with a greater income have higher risk of overweight and obesity. Elderly with a chronic disease have a higher risk of changes in the nutritional status. CONCLUSION: Results show a higher prevalence of overweight and eutrophy and a lower prevalence of obesity and underweight. Characteristics associated with nutritional status other than eutrophy are: gender, schooling, income, chronic health problem and age.

Recommendations for the use of body mass index for the classification of overweight and obese children and adolescents.

Brazilian national data were used to compare body mass index (BMI) cutoff values proposed by Cole et al. (2000), which are based on statistical criteria of continuity to adult cutoff values, and those proposed by Must et al. (1991), which are recommended by the World Health Organization (WHO). According to the cutoff points proposed by each author, 5,736 children and adolescents were classified as of normal weight, overweight, or obese. These classifications were compared by 3 x 3 tables, and a kappa index and a confidence interval were calculated. The good concordance (kappa = 0.82) between the two cutoff values supports the hypothesis that studies on the prevalence of childhood obesity and overweight based on these two different methods can be compared. However, some differences in classification can arise when these methods are used to classify individuals. Further studies to evaluate morbidity and mortality and the classification of obesity in children and adolescents are necessary.

[Overweight and obesity prevalence in Northeast and Southeast Regions of Brazil]. / Prevalência de sobrepeso e obesidade nas regiões Nordeste e Sudeste do Brasil.

OBJECTIVE: to evaluate the prevalence of overweight and obesity in children, adolescents, adults and elderlies from Northeast and Southeast regions of Brazil. METHODS: anthropometric evaluation of 17.184 people, studied in Life Pattern Research conducted by Brazilian Institute of Geographic and Statistics in 1996/97, by body mass index. Overweight and obesity definitions according to body mass index values proposed by Cole et al. which are related to adult definition. RESULTS: It was studied a little more females in this study (53.1%). Average age was 29 years and five months ( +/- 20 years), median was 25 years and six months. Overweight prevalence was 10.8% in children, 9.9% in adolescents and 28.3% among adults and obesity was 7.3%, 1.8% and 9.7% respectively. It was noticed a gradual increase in overweight or obesity prevalence since infancy through adult age with decrease among the elderly. CONCLUSION: Prevalence of overweight and obesity joined is higher among females. More than half of the women among 50 and 69 years old, from Northeast and Southeast regions of Brazil have overweight or obesity. There are few studies of overweight and obesity among children and adolescents and a lot of definition for obesity in children which makes more difficult the comparison of studies of prevalence among children.

Complex rhythmicity and age dependence of growth hormone secretion are preserved in patients with acromegaly: further evidence for a present hypothalamic control of pituitary somatotropinomas.

CONTEXT: Traditionally, acromegaly is viewed as a disease resulting from GH hypersecretion from an autonomous pituitary somatotropinoma. OBJECTIVE: To test the hypothesis that GH secretion in acromegaly is still subjected to normal hypothalamic control, we studied the daily rhythmicity of GH secretion in normal controls and patients with newly diagnosed, untreated acromegaly. DESIGN AND SETTING: This was an observational inpatient study in the General Clinical Research Center at the University of Michigan. PATIENTS OR OTHER PARTICIPANTS: One hundred four normal controls and 67 acromegalic patients were included in the study. INTERVENTION: The intervention consisted of frequent blood sampling over 24 hours. MAIN OUTCOME MEASURE(S): We hypothesized that acromegalic patients would show rhythmicity, sexual dimorphism, and age-related decline of GH secretion similar to normal controls. RESULTS: Both normal controls and the patients exhibited 3 major GH waves with the highest values at 12:00 pm, 5:00 pm, and 1:00 am (P < .001 for all). Both controls and patients exhibited a clear appearance of the nocturnal GH waves, irrespective of the gender (P < .001 for all). The amplitude of the maximal (nocturnal) GH secretory wave (1:00 am) as compared with the nadir GH secretion (9:00 am) was clearly different between the 2 groups, with a significantly smaller magnitude in acromegaly (P < .001). A subsequent subanalysis of both groups was performed separately for both genders. Similar to the entire groups, both controls and patients exhibited a clear appearance of the nocturnal GH waves, irrespective of the gender (P < .001 for all). Patients with clearly elevated GH values have shown an age-related decline of GH secretion (r = -0.35, P < .001), similar to controls. CONCLUSIONS: The analysis of GH profiles in multiple patients with untreated acromegaly discloses the persistence of the hallmarks of the central control of GH regulation, ie, nictohemeral rhythmicity, sexual dimorphism, and an age-related decline of GH output.

Evolução da produção científica na FHEMIG / Scientific production evolution at FHEMIG

São apresentadas informações sobre as ações indutoras da Diretoria de Gestão de Pessoas (DIGEPE) para integração das atividades de ensino e pesquisa na rede FHEMIG. Destacam-se o aumento inicial da produção cientifica com estabilização a partir de 2010 e o desafio de transformá-la em publicações de alto impacto científico.

This article presents information about the actions of Human Resources Department (Diretoria de Gestão de Pessoas - DIGEPE) to integrate teaching and research at Fhemig. It should be mentioned a steady increase in scientific production in the Foundation and challenge of high scientific impacts publication.

[Effect of the nutritional supplementation with glicine and glutamine, oral feeding, in the colonic cicatrization in rabbits]. / Efeito da suplementação nutricional com glicina e glutamina, por via oral, na cicatrização colônica em coelhos.

OBJECTIVE: To evaluate the effect of two amino-acids, glycine and glutamine, in the epithelialization of the colonic mucosa, size of the scar area, fibrous as well as the tensile strength of the intestinal anastomoses, after the removal of 17 cm of the colon and an end-to-end with interrupted suture. METHODS: Forty five male adult rabbits varying between 24 and 28 weeks of age with the starting average weight of 2,362 grams were randomly distributed into five groups, according to their respective type of feeding. Two animals died in each group due to different complications. The rabbits were divided into the following groups, according to the procedures performed on them: Group 1 - (n = 9) received supplemental feeding with glutamine for seven days before and as five days after the operation; Group 2 - (n = 9) received supplemental feeding with glycine for seven days before and five days after the operation; Group 3 - (n = 9) received supplemental feeding with glutamine for five days after the operation; Group 4 - (n = 9) received supplemental feeding with glycine for five days after the operation; Group 5 - (n = 9) did not receive any supplemental feeding. The resistance of the anastomoses was evaluated through the means of assay for pressure of rupture during intraluminal air insufflation. RESULTS: Group 2 was the only group that presented rupture values above those of Group 5 (p < 0.05). There was no difference among the groups concerning the histological aspects. CONCLUSION: Oral supplementation with glycine, in the pre and post-operative periods increases the tensile strength of colonic anastomoses after partial colectomy in rabbits. The oral supplementation with glutamine did not present detectable effect on the colonic anastomoses in rabbits.

Integração ensino, pesquisa e inovação tecnológica na FHEMIG / Integration of teaching, research and development at FHEMIG

Neste artigo são apresentadas informações sobre as ações indutoras da Diretoria de Gestão de Pessoas (DIGEPE) para integração das atividades de ensino e pesquisa na rede FHEMIG. Destacam-se o aumento progressivo da produção científica na Fundação, a realização do seu 3º Fórum Científico, a formação e o cadastro de Grupos de Pesquisa junto ao CNPq, o projeto residente pesquisador e a obtenção de recursos para realização de projetos científicos junto à FAPEMIG, CNPq e FINEP e a participação no sistema FINANCIAR.

This article presents information about the actions of Human Resources Department (Diretoria de Gestão de Pessoas ­ DIGEPE) to integrate teaching and research at Fhemig. It should be mentioned a steady increase in scientific production in the Foundation, the completion of its 3rd Scientific Forum, the formation and registration of Research Groups with CNPq, the project resident researcher and obtainment resources for realization of scientific projects from FAPEMIG, CNPq and FINEP and participation in FINANCIAR system.(AU)

O Núcleo de Apoio ao Pesquisador e o Comitê de Ética em Pesquisa: uma estratégia de fomento à pesquisa na Fundação Hospitalar do Estado de Minas Gerais / Researcher Support Centre and the Research Ethics Committee: a strategy of research promotion in Hospital Foundation of Minas Gerais

Introdução: Como integrante do Sistema Único de Saúde, a Fundação Hospitalar do Estado de Minas Gerais (Fhemig) considera estratégico o desenvolvimento da pesquisa para qualificação profissional e melhoria da assistência à saúde. O Núcleo de Apoio ao Pesquisador, já completamente implantado, e os Comitês de Ética em Pesquisa trabalham nessa perspectiva. Objetivos: Descrever os projetos de pesquisa cadastrados na Fhemig. Métodos: Realizou-se análise descritiva dos projetos submetidos ao Núcleo de Apoio ao Pesquisador e aos Comitês de Ética em Pesquisa da Fhemig, em 2010-2011. Resultados: Dos 330 projetos de pesquisa avaliados, 243 foram considerados adequados para se desenvolver nas Unidades da Rede Fhemig. Desses, 164 (50%) foram aprovados após um único parecer favorável por parte dos profissionais do Núcleo de Apoio ao Pesquisador e 79 (24%) foram aprovados após atender as recomendações quanto às questões metodológicas, principalmente. O Comitê de Ética em Pesquisa da Fhemig avaliou 196 projetos de pesquisa e o do Hospital Eduardo de Menezes avaliou 41 sendo que nenhum projeto de pesquisa foi reprovado. No entanto, a maior deles apresentou inadequações quanto ao Termo de Consentimento Livre e Esclarecido (54,3%). Conclusões: O grande número de projetos aprovados na primeira submissão ao Núcleo de Apoio ao Pesquisador indica uma maior qualidade desses projetos no biênio. O Núcleo de Apoio ao Pesquisador tem cumprido sua função de apoio aos pesquisadores em seus projetos de pesquisa.

Introduction: Hospital Foundation of Minas Gerais (Fhemig), member of Unified Health System, considers strategic the research development for qualifying professionals and improve health assistance. The Researcher Support Centre, now completely implanted, and the Research Ethics Committees work based in this perspective. Objectives: To describe research projects registered in Fhemig. Methods: Descriptive analysis of projects registered in the Researcher Support Centre and the Research Ethics Committees from Fhemig, were done in 2010-2011. Results: 243 out of 330 research projects analyzed were considered appropriate to develop in the Fhemig Network Units. Out of those, 164 (50%) were approved after only one favorable feedback from professionals of the Researcher Support Centre and 79 (24%) after complying with, mostly, of the methodological recommendations. Fhemig's Research Ethics Committee evaluated 196 projects and Eduardo de Menezes' Hospital Ethics Committee evaluated 41. None them was reproved. However, most of them presented inadequacies on their Term of Informed Consent (54,3%). Conclusions: The great number of approved projects in the first submission to the Research Support Centre indicates a higher quality of such projects in the couple of years. The Research Support Centre has reached its role in supporting researchers in their research projects.(AU)

Diabetes gestacional: perfil e evolução de um grupo de pacientes do Hospital das Clínicas da UFMG / Gestational diabetes: profile and evolution of a group ofpatients from the University Hospital of Minas Gerais

Objetivos: a finalidade deste trabalho foi avaliar a presença de fatores de risco, tipo e resposta ao tratamento, incidência de complicações maternas, fetais e perinatais, além de persistência do diabetes pós-parto. Métodos: foram acompanhadas 66 portadoras de diabetes mellitus gestacional (DMG) no período de janeiro de 2007 a dezembro de 2008. Para isso, utilizou-se protocolo preestabelecido. Resultados: a história familiar de diabetes foi positiva em 65% dos casos. Destaca-se o fato de que apenas 30% das pacientes apresentaram índice de massa corporal (IMC) pré-concepcional normal (entre 18 e 25). Em contrapartida, 35% apresentaram sobrepeso (IMC entre 25 e 29,9) e outros 35% encontraram-se distribuídas entre diversos graus de obesidade. Quanto ao IMC ao término da gestação, 35% das gestantes encontravam-se em obesidade grau I (entre 30 e 34,9) e 13% em obesidade grau III (IMC acima de 40). Os sintomas sugestivos de diabetes ocorreram em 45,5% das pacientes. O diagnóstico de DMG foi estabelecido por glicemias de jejum alteradas em 45% do grupo e a insulinoterapia foi necessária em 53%. As complicações maternas ocorreram em 42% das gestantes, principalmente pré- -eclâmpsia e infecção do trato urinário. As complicações fetais ocorreram em 46% dos casos, principalmente macrossomia e polidrâmnio. A morbidade perinatal foi elevada e acometeu 62% dos recém-nascidos, sendo hipoglicemia neonatal a complicação mais freqüente. A taxa de diabetes pós-parto foi de 18%. Destaca-se também alta porcentagem de pacientes (37%) que não retornaram ao serviço de endocrinologia após o parto para confirmação da persistência ou não do DM. Cesariana e parto vaginal tiveram praticamente a mesma prevalência, com 51,5 e 48,5%, respectivamente. Ocorreram quatro mortes súbitas intraútero, o que corresponde a 6% das pacientes analisadas. Conclusão: nossos achados estão em concordância com a literatura, tendo em vista a alta morbidade perinatal, fetal e materna observada e característica...

Objectives: This study aims at evaluating the presence of risk factors, type and response to treatment, incidence of maternal complications, fetal and perinatal, and persistence of postpartum diabetes. Methods: A total of 66 women with gestational diabetes mellitus (GDM) between January 2007 and December 2008 were studied. A pre-established protocol was followed. Results: a family history of diabetes was positive in 65% of the cases. Only 30% of patients had pre-conception normal (between 18 and 25) body mass index (BMI). On the other hand, 35% were overweight (BMI between 25 and 29.9) and 35% presented several degrees of obesity. According to the BMI at the end of pregnancy, 35% of the women were in obesity class I (between 30 and 34.9) and 13% in class III obesity (BMI above 40). Suggestive symptoms of diabetes were found in 45.5% of the patients. Diagnosis of GDM was established by impaired fasting blood glucose in 45% of the group. Insulin therapy was applied in 53% of the cases. Maternal complications were found in 42% of pregnant women, particularly preeclampsia and urinary tract infection. Fetal complications were found in 46% of the cases, especially macrosomia and polyhydramnios. The rate of perinatal morbidity was high and affected 62% of newborns, and neonatal hypoglycemia was the most frequent complication. Postpartum diabetes rate was 18%. Also, a high percentage of patients (37%) have not returned to the endocrinology service after delivery to confirm or not the persistence of DM. Cesarean and vaginal showed a very similar prevalence, with 51.5 and 48.5% respectively. Four intrauterine sudden deaths were registered, which represents 6% of patients analyzed. Conclusion: The findings of this study are in accordance to the literature, once high perinatal, fetal and maternal morbidity, are observed and characteristic of DMG.

Indução, estruturação e consolidação da produção científica e inovação tecnológica na FHEMIG / Induction, structuring and consolidation of scientific production and technological innovation at FHEMIG

Neste artigo são apresentadas informações sobre as ações indutoras da Diretoria de Desenvolvimento Estratégico e Pesquisa ­ Gerência de Pesquisa para estruturação e fomento à pesquisa científica e tecnológica na Rede FHEMIG. Destacam-se o aumento progressivo da produção científica na Fundação, a realização do seu 2º Fórum Científico, a formação e o cadastro de Grupos de Pesquisa junto ao CNPq, a obtenção de recursos para realização de projetos científicos junto à FAPEMIG, CNPq e FINEP e a participação no sistema FINANCIAR.(AU)

This paper presents information about the inducing process and structural actions of Strategic Development and Research Directorship - Management Research for the foment toward scientific and technological researches of FHEMIG community. The highlighted points are the increasing in scientific production of the Foundation, the realization of its 2nd Scientific Forum, the formation and registration of Research Groups in CNPq, the raising of funds to carry out scientific projects from FAPEMIG, CNPq and FINEP and the participation in FINANCIAR system.(AU)

A inserção da rede FHEMIG na assistência pública à saúde no Estado de Minas Gerais / The integration of the network FHEMIG in public health assistance in the State of Minas Gerais

São apresentados dados que apresentam a importante contribuição da rede Fhemig na assistência pública à saúde no Estado de Minas Gerais com a descrição detalhada de informações das regiões assistenciais em que a Fhemig está inserida. Comentários sobre a legislação do SUS, Plano Diretor de Regionalização e Contratualização são apresentados.(AU)

Data are presented that show the important contribution of the network FHEMIG in public health assistance in the State of Minas Gerais with a detailed description of the information in each region FHEMIG is inserted. Comments on the rules of the SUS, the "Plano Diretor de Regionalização and Contracts are presented.(AU)

Comparison of body mass index values proposed by Cole et al. (2000) and Must et al. (1991) for identifying obese children with weight-for-height index recommended by the World Health Organization.

OBJECTIVES: To calculate the sensitivity, specificity and agreement of body mass index (BMI) values proposed by Cole et al. (Br. Med. J. 2000; 320: 1) and Must et al. (Am. J. Clin. Nutr. 1991; 53: 839 & 54: 773) with weight-for-height index in the nutritional evaluation of children. DESIGN: Criterion standards for diagnostic tests. SETTING: : North-east and south-east Brazil. SUBJECTS: Two thousand nine hundred and twenty children studied in Life Pattern Research performed by the Brazilian Institute of Geography and Statistics in 1997. Main outcome measures are the sensitivity, specificity and agreement of BMI values proposed by Must et al. (1991) and Cole et al. (2000). RESULTS: Sensitivity of values proposed by both authors was around 90%. Specificity was almost 100% considering weight-for-height index as the gold standard. The agreement of both values with weight-for-height index, based on kappa results, was good and in pre-school children it was excellent. CONCLUSIONS: Values proposed by Cole et al. (2000) and Must et al. (1991) should be used carefully to screen obesity in childhood but can be used to "diagnose" overweight children with a very low chance of having false-positive results. Although the values proposed by both authors performed similarly, use of Cole et al.'s values should be encouraged. The latter cover children from 2 to 6 years old; their values are presented for six-month age intervals; they are based on a larger sample from six different countries; and they are related to the definition of adult obesity.

Efeito da suplementação nutricional com glicina e glutamina, por via oral, na cicatrização colônica em coelhos / Effect of the nutritional supplementation with glicine and glutamine, oral feeding, in the colonic cicatrization in rabbits

OBJETIVO: Avaliar o efeito de dois aminoácidos, glicina e glutamina, na epitelização da mucosa colônica, tamanho da área de cicatriz, fibroplasia e resistência tênsil da anastomose intestinal, após colectomia parcial e anastomose término-terminal. MÉTODOS: Quarenta e cinco coelhos adultos, com idade entre 24 e 28 semanas, do sexo masculino, com peso inicial médio de 2.362 g, foram distribuídos aleatoriamente, de forma dupla desconhecida, em cinco grupos, de acordo com o tipo de suplemento. Dois animais morreram em cada grupo por causas diversas. Os grupos de coelhos foram assim distribuídos: Grupo 1 - (n = 9) receberam suplementação alimentar com glutamina durante sete dias antes e cinco dias após a operação; Grupo 2 - (n = 9) receberam suplementação alimentar com glicina durante sete dias antes e cinco dias após a operação; Grupo 3 - (n = 9) receberam suplementação alimentar com glutamina durante cinco dias após a operação; Grupo 4 - (n = 9) receberam suplementação alimentar com glicina durante cinco dias após a operação; Grupo 5 - (n = 9) não receberam suplementação alimentar. A resistência da anastomose foi medida por meio de pressão de ruptura por insuflação de ar intraluminar. RESULTADOS: O Grupo 2 foi o único grupo que apresentou valores de ruptura superiores aos do Grupo 5 (p < 0,05). Não houve diferença entre os grupos quanto aos aspectos histológicos estudados. CONCLUSÃO: A suplementação oral com glicina, no período pré e pós-operatório, aumenta a resistência tênsil anastomótica colônica após colectomia parcial em coelhos.

OBJECTIVE: To evaluate the effect of two amino-acids, glycine and glutamine, in the epithelialization of the colonic mucosa, size of the scar area, fibrous as well as the tensile strength of the intestinal anastomoses, after the removal of 17 cm of the colon and an end-to-end with interrupted suture. METHODS: Forty five male adult rabbits varying between 24 and 28 weeks of age with the starting average weight of 2,362 grams were randomly distributed into five groups, according to their respective type of feeding. Two animals died in each group due to different complications. The rabbits were divided into the following groups, according to the procedures performed on them: Group 1 - (n = 9) received supplemental feeding with glutamine for seven days before and as five days after the operation; Group 2 - (n = 9) received supplemental feeding with glycine for seven days before and five days after the operation; Group 3 - (n = 9) received supplemental feeding with glutamine for five days after the operation; Group 4 - (n = 9) received supplemental feeding with glycine for five days after the operation; Group 5 - (n = 9) did not receive any supplemental feeding. The resistance of the anastomoses was evaluated through the means of assay for pressure of rupture during intraluminal air insufflation. RESULTS: Group 2 was the only group that presented rupture values above those of Group 5 (p < 0.05). There was no difference among the groups concerning the histological aspects. CONCLUSION: Oral supplementation with glycine, in the pre and post-operative periods increases the tensile strength of colonic anastomoses after partial colectomy in rabbits. The oral supplementation with glutamine did not present detectable effect on the colonic anastomoses in rabbits.

A experiência assistencial da Fhemig na atenção a doenças infecciosas respiratórias agudas durante o enfrentamento da epidemia de Influenza A H1N1, no estado de Minas Gerais em 2009 / Fhemig experience in the care of acute respiratory infectious diseases during the fight against the H1N1 Influenza epidemic in Minas Gerais State in 2009

A epidemia pelo vírus influenza A H1N1 no estado de Minas Gerais mobilizou a sociedade e a resposta articulada dos serviços de saúde em ações coordenadas pelo Comitê Estadual. Objetivo: descrever o atendimento ambulatorial e hospitalar para doenças respiratórias infecciosas agudas realizado nas Unidades da rede Fhemig nas semanas epidemiológicas 33 a 41 de 2009. Método: estudo prospectivo de dados fornecidos semanalmente pelas unidades assistenciais à administração central, para fins de monitoramento e gestão da clínica. Resultados: ocorreu um total de 1.396 atendimentos no período em 11 unidades na região metropolitana de Belo Horizonte e interior do estado, com 29 por cento de internações em enfermarias e 6,7 em CTI, predomínio de pacientes de 15-24 anos, 42,4 por cento sem fatores de risco para complicações e 2,4 por cento de óbitos; 50 por cento (698) dos casos receberam antiviral oseltamivir. O pico de atendimentos ocorreu na 35ª semana (entre 30/08 e 05/09/2009). Confirmou-se influenza A H1N1 em 2,4 por cento dos casos atendidos e 399 exames permaneciam pendentes. Insuficiência renal dialítica, uso de ventilação mecânica e vasopressores foram preditores de óbito. Pneumonia associada à ventilação elevou o risco de óbito em 76 por cento (RR:1,76; IC 95 por cento 1,07-2,88). Conclusão: a Fhemig participou de forma articulada no processo assistencial durante a epidemia e desenvolveu mecanismos de gestão da clínica de forma a garantir a qualidade assistencial e responder à demanda da sociedade, junto com os demais parceiros.

Estado nutricional e fatores associados em idosos / Nutritional status and related factors among elderly Brazilians

OBJETIVO: O presente estudo descreve o perfil nutricional e fatores associados de idosos brasileiros. MÉTODOS: Foram utilizados dados da Pesquisa sobre Padrões de Vida (PPV), realizada pelo IBGE entre 1996/1997. O índice de Massa Corporal-IMC (kg/m²), indicativo do estado nutricional, é a variável resposta do presente estudo. Foi utilizada análise multivariada com regressão logística politômica. RESULTADOS: A prevalência geral de baixo peso foi de 5,7 por cento, de eutrofia 50,4 por cento, sobrepeso 32,3 por cento e obesidade 11,6 por cento. O gênero feminino apresentou chance 1,32 vez maior de sobrepeso (IC 95 por cento 0,99-1,74, p=0,05) e 4,11 vezes maior de obesidade (IC 95 por cento 2,57-6,57, p=0,00). O envelhecimento aumentou o risco de baixo peso e diminuiu o de sobrepeso e obesidade. As menores faixas de renda domiciliar apresentaram aumento do risco de baixo peso; por outro lado, o aumento da renda domiciliar elevou o risco de sobrepeso e obesidade. Os idosos portadores de doença crônica apresentaram maior risco de alterações do estado nutricional. CONCLUSÃO: Os resultados indicam que há maior prevalência de eutrofia e sobrepeso, e baixa prevalência de obesidade e baixo peso. As variáveis associadas com alteração do estado nutricional em relação à eutrofia foram gênero feminino, escolaridade, renda familiar, problema crônico de saúde e idade.

A influência dos corticoesteróides no crescimento de crianças e adolescentes com síndrome nefrótica: [revisão] / Growth supression in children and adolescents with nephrotic syndrome by corticosteroid: [review]

Os corticoesteróides são usados no tratamento de várias doenças crônicas e apresentam diversos efeitos colaterais. Observa- se, especificamente, o atraso no crescimento, de crianças e adolescentes cuja fisiopatologia já esteja bem esclarecida. Os resultados publicados em diversos estudos demonstram que a dose total, tempo total de uso e tempo de uso diariamente ou em dias alternados de corticoesteróides estão associados negativamente com o crescimento em crianças e adolescentes, causando o déficit de crescimento. Poucos estudos consideraram conjuntamente na análise de aspectos do tratamento a intensidade da doença que, no caso de crianças e adolescentes com síndrome nefrótica, pode ser estimado pelo número de recidivas e proteinúria. No caso específico desta afecção, e em outras doenças crônicas, formas mais intensas da doença causam tratamento mais agressivo. Sendo assim, a intensidade da doença é um fator de confusão entre tratamento com corticoesteróides e déficit de crescimento, devendo sempre ser considerado nestes estudos. O uso de técnicas estatísticas de análise multivariada poderia identificar qual a importância da intensidade da doença e do tratamento no déficit de crescimento de crianças com síndrome nefrótica e outras doenças crônicas.

Corticosteroids are used in the treatment of a vast number of diseases and its chronic use is associated with several adverse effects. During childhood and adolescence, growth suppression is observed whose physiopathology is well known. Total dose, extension of use, daily or every other day administration of the drug are positively related to growth suppression. Few studies have considered the severity of the disease in children and adolescents with nephrotic syndrome that can be estimated by proteinuria and number of relapses. Specifically, in nephrotic syndrome, patients with more severe forms of manifestations are treated more aggressively. Studies involving multivariate statistical analysis could identify the importance of disease severity and corticosteroid treatment in growth deficit of children and adolescents with nephrotic syndrome and other chronic diseases.

Fatores associados à desnutrição protéico-energética em crianças menores de seis anos em Barbacena, Minas Gerais, 2004 / Associated factors for energy protein malnutrition in children minor of six years old in Barbacena, Minas Gerais, 2004

Objetivo: Avaliar as características sócioeconômicas, estado nutricional e fatores associados à desnutrição em crianças no município de Barbacena, MG. Método: Numa amostra de 359 crianças menores de seis anos de idade, selecionadas aleatoriamente (universo = 3172), foi aplicada a antropometria e o exame clínico para se identificar a desnutrição. Definiu-se como desnutrida a criança que possuía índices antropométricos de menos 2 desvios-padrão (DP), na distribuição gráfica do NCHS (padrão antropométrico norte-americano), preconizado pela Organização Mundial de Saúde (OMS). Foi também usado o critério de menos 1 desvio-padrão, para efeito de comparação com outros estudos. Aplicou-se um questionário para os responsáveis pela criança, investigando características sociais, demográficas, econômicas e assistência materna das famílias. Os dados colhidos foram armazenados e analisados nos programas Epiinfo 6.04 b (1997) e Stata 7.0 (2001). Resultados: Os desnutridos abaixo de -2 DP foram 6,1% para o peso/altura (desnutridos agudos) e 9,2% para a altura/idade (desnutridos crônicos). Houve associação estatística entre a desnutrição crônica com as variáveis "sexo masculino", "condições inadequadas de moradia", "ausência de utensílios domésticos" e "pertencer à escola pública". A desnutrição aguda associou-se às variáveis "ausência da amamentação", "idade da mãe ≤ 20 anos" e "pai sem alfabetização". Por sua vez, o indicador peso/idade mostrou-se correlacionado às variáveis "nunca ter amamentado", "pai sem alfabetização", "número de pessoas no lar maior ou igual a 10", e "pertencer à escola pública". Conclusão: Em relação ao índice altura/ idade, 9,2% das crianças em Barbacena apresentavam desnutrição, sendo este valor significativamente superior às médias da região Sul, Sudeste e nacional de acordo com PNSN (Pesquisa Nacional de Saúde e Nutrição - 1989). Já no índice peso/altura, 6,1% das crianças apresentavam desnutrição aguda...

Objective: To evaluate the relationship of socioeconomic variables, nutritional status, and associated factors to infant malnutrition in Barbacena, MG, Brazil. Methods: In an aleatoric sample of 359 infants below six years old from a universe of 3172, anthropometric and clinical examination were made to identify malnutrition. Infants with anthropometric data less than two standard deviations (SD) on graphic distribution of NCHS (North America Anthropometric Standard) were classified as malnutrition. The 1 SD criterion was used to compare with others studies. A questionnaire was applied to investigate demographic and socioeconomic variables and maternal assistance to the families. All data were processed by Epiinfo 6.04 b(1997) e Stata 7.0 (2001) programs. Results: Malnutrition less than 2 SD was detected in 6.1% (acute malnutrition) and chronic malnutrition was detected in 9.2% of the sample. Static association occurs between chronic malnutrition and the variables: male sex, inadequate conditions of habitation, absence of domestic utilities, and student of public school. The acute malnutrition was associated with the variables: lack of breast-feeding, mother age ≤ 20 years old, and father's illiteracy. The indicator weight/age was associated with the variables: never breast-feed, father's illiteracy, home with 10 or more persons, and student of public school. Conclusions: In the indicator of height/ age, 9.2% of infants in Barbacena were malnourished. This index was above the mean of South, Southwest, and the whole country, according to the PNSN (National Program of Health and Nutrition - 1989)?. In the indicator of weight/height, 6.1% of the infants had acute malnutrition.