Dehydroepiandrosterone for depressive symptoms: A systematic review and meta-analysis of randomized controlled trials.

Depression is a mental disorder that affects millions of people around the world. However, depressive symptoms can be seen in other psychiatric and medical conditions. Here, we investigate the effect of DHEA treatment on depressive symptoms in individuals with depression and/or other clinical conditions in which depressive symptoms are present. An electronic search was performed until October 2019, with no restrictions on language or year of publication in the following databases: Medline, EMBASE, LILACS, and Cochrane Library. Randomized controlled trials comparing DHEA versus placebo were included if the depressive symptoms were assessed. Fifteen studies with 853 female and male individuals were included in this review. To conduct the meta-analysis, data were extracted from 14 studies. In comparison with placebo, DHEA improved depressive symptoms (standardized mean difference [SMD] -0.28, 95% (CI) -0.45 to -0.11, p =.001, 12 studies, 742 individuals (375 in the experimental group and 367 in the placebo group), I2  = 24%), very low quality of evidence, 2 of 14 studies reporting this outcome were removed in a sensitivity analysis as they were strongly influencing heterogeneity between studies. No hormonal changes that indicated any risk to the participants' health were seen. Side effects observed were uncommon, mild, and transient, but commonly related to androgyny. In conclusion, DHEA was associated with a beneficial effect on depressive symptoms compared to placebo. However, these results should be viewed with caution, since the quality of evidence for this outcome was considered very low according to the GRADE criteria.

Nursing management practicum: impact to the team in medical-surgical units. / Estágio de administração em enfermagem: repercussões para a equipe em unidades clínico-cirúrgicas.

OBJECTIVE: Learn the perceptions of nursing professionals of a university hospital regarding the interactive process with nursing management practicum students. METHODS: A qualitative, exploratory, descriptive study was conducted by means of 11 semi-structured interviews with nurses, nursing technicians and nursing aides in medical-surgical units. The information, collected between December 2013 and January 2014, was submitted to a thematic analysis and discussed according to Pichon-Rivière. RESULTS: Results were grouped into three categories: Practicum students and the nursing team: interaction that can provide learning, mutual help and satisfaction; Despite the pre-task, work must go on; and Nursing team: the practicum facilitator. CONCLUSION: In the beginning, their coexistence was full of basic anxieties, but while elaborating these feelings, the group was created and shifts into teamwork. In this logic, issues like patience, empathy, communication and coherence facilitate the interactive process, and are essential for a critical (re)reading of the reality.

Validity and reliability assessment of the Brazilian version of the game addiction scale (GAS).

BACKGROUND: The uncontrolled use of video games can be addictive. The Game Addiction Scale (GAS) is an instrument that was developed to assess this type of addiction. The GAS consists of 21 items that are divided into the following seven factors: salience, tolerance, mood modification, relapse, withdrawal, conflict and problems. This study assessed the convergent validity and reliability of the GAS according to measures of internal consistency and test-retest stability. MATERIAL AND METHODS: Three hundred and eighty four students completed the GAS, the Internet Addiction Test (IAT), the Liebowitz Social Anxiety Scale (LSAS), the Beck Depression Inventory (BDI) and the Video Game Addiction Test (VAT). A subgroup of the participants (n=76) completed the GAS again after 30days to determine test-retest stability. RESULTS: The GAS demonstrated excellent internal consistency (Cronbach's alpha=0.92), was highly correlated with the VAT (r=0.883) and was moderately correlated with the BDI (r=0.358), the LSAS (r=0.326) and the IAT (r=0.454). CONCLUSION: In the Brazilian Portuguese population, the GAS shows good internal consistency. These data indicate that the GAS can be used to assess video game addiction due to its demonstrated psychometric validity.

Psychometric evidence of the Brazilian version of Driving Cognitions Questionnaire (DCQ).

This paper examined the psychometric data obtained by the Brazilian version DCQ (Driving Cognitions Questionnaire) and its convergence with DBS (Driving Behavior Survey). The research included 187 participants of both genders, aged between 19 and 79years (mean 34years), with driving license in category 'B' (cars). The internal consistency obtained by research (Cronbach's alpha) was α=0.96 for full DCQ; α=0.89 for the subscale panic in the direction, α=0.91 for the subscale of concern in causing accidents and α=0.92 for the subscale of social concern. Psychometrically the results are positive and confirm the relevance of using the instrument. The survey also found positive convergence (although less pronounced) with the DBS, which is another instrument that comes to difficulties when driving or dealing with traffic or driving a car. Thus, this article demonstrates psychometric results that point to the profitable use of the Brazilian version of DCQ as an adjunct in the diagnosis of difficulty in driving.

Predictors of suicidal ideation in coronary artery disease.

CONTEXT: In clinical practice, the importance of screening for anxiety and depression in patients with medical illness is highlighted. In many cases, the suicidal ideation makes up the framework of mental disorders, which may be exacerbated in these individuals. OBJECTIVE: To investigate the role of symptoms of mental disorders in the presence of suicidal ideation. METHODS: A total of 103 patients with diagnosis of coronary artery disease in cardiac treatment were interviewed for symptoms of anxiety and depression using the Beck Depression Inventory and Hospital Anxiety and Depression Scale. All patients were also analyzed for presence of suicidal ideation, wishes, attitude and suicidal plans using the Beck Suicidal Ideation Scale. The relationship between social and demographic variables and mental disturbances and the presence of suicidal ideation was assessed using chi-square test and coefficient of sperm. Logistic regression analysis was used to explain the change in the role of each of the variables in suicidal ideation. RESULTS: The results showed that predictors for suicidal ideation were isolated anxiety (B=0.29; Wald 4.77; p=0.03) with an odds ratio of 1.34 (CI 1.03-1.75) and isolated depression (B=0.33; Wald 5.35; p=0.02) with an odds ratio of 1.39 (CI 1.05-1.85). Frequencies of interaction depression and anxiety were higher among patients who were single, widowed and divorced. Chi-square test and the coefficient of sperm showed an association between marital status and suicidal ideation (χ(2)(2)=9.17; p=0.01). CONCLUSION: Anxiety and depression are risk factors for isolated patients with suicidal ideation. Early clinical identification of mental disorders in patients with medical illness contributed to preventing the risk of suicide.

[Preventive treatment alternatives in pediatric patients with autism spectrum disorder in the dental practice. literature review]. / Alternativas de tratamiento preventivo en pacientes pediátricos con trastorno del espectro autista en la consulta odontológica. revisión de la literatura.

Autism comes from the Greek word auto, which means "self." Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social interaction and communication. Dental treatment in patients with ASD can be challenging due to their behavior. Therefore, this review discusses preventive treatment techniques for pediatric patients with ASD at the dental office, as the prevalence of children with autism is growing. Thus, dentists would face more patients with autism in their daily practice. Regarding treatment protocols, they would require specialized attention in dental management. Information was searched in the following databases: PubMed, SciELO, Redalyc, Elsevier, and the International Association of Paediatric Dentistry (IAPD). The descriptors used were: Pediatric Dentistry, Autism, ASD, Autism Spectrum Disorder, and Management of the autistic patient.

[Group process: reflections of a nursing team]. / Processo grupal: reflexões de uma equipe de enfermagem.

The objective of this qualitative, exploratory-descriptive study was to analyze the group process of a nursing team at Hospital de Clínicas de Porto Alegre (HCPA), under the light of Pichon-Rivière's Operative Group Theory. Data collection took place in 2008, using a semi-structured questionnaire and focal group. The group work concept is one of the four categories that resulted from the study, and is the object of approach in the present article. It was found that the knowledge about the group process must be shared, disseminated and discussed since the undergraduate studies and developed across the professional career. As the team learns and is able to identify the main indicators of the group process, it becomes possible to improve operatively, considering not only the outcomes but mainly the course covered until achieving the goal, aiming at group learning.

Routine workflow in a reference clinical research center in face of COVID-19.

OBJECTIVE: To develop and validate the content of workflows for trial participants care in a clinical research center during the Covid-19 pandemic. METHOD: development study by consensus of experts carried out from March to July 2020 in southern Brazil. The flowcharts were developed following literature and validated by specialists considering comprehensiveness, clarity and pertinence, obtaining a 100% agreement index on each item of the developed instruments. The study was approved by the Ethics Committee of the institution. RESULTS: two flowcharts of care were elaborated and validated: "Flow diagram to conduct protocols with research participant " and "Flow diagram in protocols with research participant with suspected or confirmed COVID-19 infection"; which describes activities to ensure continuity of care. FINAL CONSIDERATIONS: a routine workflow can promote the continuity and safety of clinical research protocols. It is expected that the adopted flowcharts in this study can guide other institutions with a similar research profile.

[Correlation between the number of brushes per day and the dmft index in 12-year-old school children from the El Vecino parish in Cuenca, Ecuador 2016]. / Correlación entre número de cepillados por día y cpod en escolares de 12 años de la parroquia El Vecino (Cuenca, Ecuador) 2016.

Objective: Correlate the number of brushes per day and the decay-missing-filled teeth (DMFT) index in 12-year-old school children from the parish "El Vecino Cuenca - Ecuador 2016". Materials and Methods: The study was communicational, quantitative, descriptive and relational. The population consisted of 279 records from the study of the epidemiological map of schoolchildren in the "El Vecino" parish. The database included the registration number, age, sex, parish and DMFT Index. Results: There was an statistically significant inverse correlation between the number of brushes per day and the DMFT index with a p value = 0.029. Conclusion: The present study shows that there is a correlation between the number of brushes per day and the DMFT index.

Elaboration and validation of a drug administration checklist for patients in research protocols. / Elaboração e validação de checklist para administração de medicamentos para pacientes em protocolos de pesquisa.

OBJECTIVE: To describe the elaboration and validation of a checklist as a strategy for safe drug administration. METHOD: It is a Validation study by consensus of experts conducted from January to June 2018, in a Clinical Research Center of a university hospital. The checklist was validated by three nurses, two nursing technicians, a pharmacist, two nurse teachers and one medical teacher, all with extensive experience in drug administration and in clinical research. For the final version of the checklist, a consensus of 100% was considered. RESULTS: A guide was prepared consisting of six items to be checked by the care team before, during and after administration of Clinical Research drugs. CONCLUSION: The validation of the checklist provided guiding elements for the prevention of behaviors that could lead to the risk of adverse events and also allowed the care teams to seek safe strategies of care in drug administration.

Relationship between sexual hormones, quality of life and postmenopausal sexual function.

OBJECTIVE: To assess the relationship between sexual hormones, sexual function and quality of life in postmenopausal women. METHOD: A cross-sectional study was conducted with a convenience sample of 36 postmenopausal women between the ages of 45 and 65 in follow-up at a climacteric outpatient clinic. Mood, quality of life, sexual function and hormonal profile were assessed. RESULTS: With regard to sexual hormones and sexual function, a relationship was found between orgasm and luteinizing hormone (r=0.37), orgasm and sex hormone-binding globulin (SHBG) (r=0.39), SHBG and less pain (r=0.44), dehydroepiandrosterone (DHEA) and desire (r=-0.45), as well as between prolactin and lubrication (r=0.33). Sexual hormones and quality of life were related as follows: progesterone and limitations due to physical aspects (r=0.35), SHBG and social aspects (r=0.35), cortisol and pain (r=0.46), DHEA and social aspects (r=-0.40). Finally, the following relationships were found between sexual function and quality of life: sexual desire and vitality, social aspects, state of general health and mental health (r=0.46, r=0.51, r=0.35, and r=0.38, respectively). Arousal, orgasm and satisfaction with sexual life showed a relationship with less physical pain (r=0.40, r=0.42, and r=0.43, respectively). Satisfaction with sexual life was correlated with vitality (r=0.33). CONCLUSION: Different correlations than expected were found in this study regarding the effect of some hormones on sexual function and some aspects of the quality of life of postmenopausal women.

Dehydroepiandrosterone (DHEA) for Depression: A Systematic Review and Meta-Analysis.

BACKGROUND: Depression is a mental disorder that affects a large part of the world's population. DHEA is a hormone that has long been attributed to the ability to improve depressive symptoms. However, few studies were conducted with depression individuals not resulting from other medical conditions. OBJECTIVE: To investigate whether DHEA is more effective than placebo in the treatment of depressive symptoms in subjects with depression not resulting from other psychiatric or medical comorbidities. METHODS: An electronic search was carried out using the keywords Dehydroepiandrosterone (Mesh) AND Depression (Mesh) in the following databases: Medical Literature databases Analysis and Retrieval System Online (Medline), Excerpta Medical Database (EMBASE), Latin American and Caribbean Health Sciences (LILACS) and the Cochrane Library through their website for relevant publications until June 2018. Only randomized clinical trials were included. The critical appraisal of the articles was performed using the Risk of Bias Tool from Cochrane Collaboration. RESULTS: The meta-analysis applied in this review pointed to a significant effect in favor of treatment with DHEA compared to placebo. CONCLUSION: DHEA may be one more effective alternative between the drugs used in the treatment of depression.

Uso del twin-block en niños de 5 a 12 años con maloclusión Clase II y III. Revisión de la literatura / Use of the twin-block in patients aged 5 to 12 years with class II and III malocclusion. Literature Review

Introducción: las maloclusiones Clase II y III pueden ser tratadas desde edades tempranas y su manejo oportuno incluye el reconocimiento, diagnóstico y tratamiento adecuado. Desde la visión ortopédica, teniendo en cuenta la presencia de momentos de crecimiento y desarrollo, podrían planificarse diversas aparatologías removibles, ortopédicas, miofuncionales y/o fijas. El twin-block está constituido por bloques de mordida superior e inferior con un plano inclinado que dirige la fuerza de oclusión a fomentar la función mandibular normal. Objetivo: efectuar una revisión de la literatura sobre el uso del twin-block y su efectividad en pacientes de 5 a 12 años con maloclusión Clase II y III. Métodos: se realizó una revisión de literatura en las bases de datos electrónicas en inglés PUBMED/MEDLINE, Elsevier, Epistemonikos y Google Schoolar; y en idioma español, imbiomed. org, Scielo.org y Google académico. Se incluyeron un total de 16 artículos. Los años límites para la búsqueda fueron enero de 2011 a junio de 2022. La revisión abarcó aspectos referidos al uso del twin-block en niños con maloclusión Clase II y III. Resultados: los estudios reportaron resultados favorables al uso efectivo del twin-block para la corrección de las maloclusiones, con cambios esqueléticos y dentoalveolares en dentición permanente y mixta. Conclusiones: la evidencia científica revisada sugiere que el uso del twin-block es efectivo en pacientes pediátricos con maloclusión Clase II o III.

Introduction: Class II and III malocclusions could be treated from early ages and their timely management includes recognition, diagnosis and adequate treatment; this from the orthopedic view due to the presence of moments of growth and development, various removable, orthopedic, myofunctional and/or fixed appliances could be planned. The twinblock consists of upper and lower bite blocks with an inclined plane that directs the occlusal force to promote normal mandibular function. Objective: To review the literature on the use of the twin-block in patients 5 to 12 years of age with class II and III malocclusion. Methods: A descriptive, retrospective research was carried out in the electronic databases PUBMED/MEDLINE, Elsevier, Epistemonikos and Google Scholar; and in the Spanish language imbiomed.org, Scielo.org and Google Scholar a total of 16 articles were included. The years for the search were January 2011 to June 2022. The review covered aspects referring to the effectiveness of the use of the twin-block in children with type II and III malocclusion. Results: The studies reported favorable results for the effective use of the twin-block for the correction of malocclusions producing skeletal and dentoalveolar changes in permanent and mixed dentition. Conclusions: The scientific evidence reviewed suggests that the use of the twin-block is effective in pediatric patients with class II or III malocclusion

Survival of Trypanosoma cruzi in sugar cane used to prepare juice.

Chagas disease can be transmitted to man by many different means, including contact with infected triatomine feces, blood transfusion, laboratory accidents, organ transplants, and congenital or oral routes. The latter mode has received considerable attention recently. In this assay, we evaluate the survival of Trypanosoma cruzi contaminating sugar cane used to prepare juice, as well as the viability and capacity for infection by the parasite after recovery. Thirty triatomines were contaminated with T. cruzi Y strain and 45 days later pieces of sugar cane were contaminated with the intestinal contents of the insects. The pieces were ground at different intervals after contamination (time=0, 1, 4, 6, 12 and 24 hours) and the juice extracted and analyzed. Different methods were used to show T. cruzi in the juice: direct analysis, hematocrit tube centrifugation and QBC, and experimental inoculation in 47 female BALB/c mice (five control mice and seven mice for each interval examined (five inoculated orally and two intraperitoneally). Positive results were found using the direct analysis and QBC methods for juice prepared up to 12 hours after initial contamination. However, by the centrifugation technique, positivity was found only up to four hours after contamination of the sugar cane. Inoculated animals showed parasitemia during a 14 day observation period, demonstrating the high survival rate of T. cruzi in sugar cane.

Cross-cultural adaptation of the Cyberchondria Severity Scale for Brazilian Portuguese.

INTRODUCTION: The internet has proven to be a valuable resource for self-care, allowing access to information and promoting interaction between professionals, caregivers, users of health care services and people interested in health information. However, recurring searches are often related to excessive health anxiety and a phenomenon known as cyberchondria can have impacts on physical and mental health. Within this background, a Cyberchondria Severity Scale has been developed to differentiate healthy and unhealthy behavior in internet searches for health information, based on the following criteria: compulsion, distress, excesses, and trust and distrust of health professionals. OBJECTIVE: To conduct cross-cultural adaptation of the Cyberchondria Severity Scale for Brazilian Portuguese, because of the lack of an appropriate instrument for Brazil. METHODS: This study was authorized by the original author of the scale. The process was divided into the following four steps: 1) initial translation, 2) back-translation, 3) development of a synthesized version, and 4) experimental application. RESULTS: Translation into Brazilian Portuguese required some idiomatic expressions to be adapted. In some cases, words were not literally translated from English into Portuguese. Only items 7, 8, 12, 23 and 27 were altered, as a means of both conforming to proper grammar conventions and achieving easy comprehension. The items were rewritten without loss of the original content. CONCLUSION: This paper presents a translated version of the Cyberchondria Severity Scale that has been semantically adapted for the Brazilian population, providing a basis for future studies in this area, which should in turn contribute to improved understanding of the cyberchondria phenomenon in this population.

Correlación entre número de cepillados por día y cpod en escolares de 12 años de la parroquia El Vecino (Cuenca, Ecuador) 2016 / Correlation between the number of brushes per day and the DMFT index in 12-year-old school children from the El Vecino parish in Cuenca, Ecuador 2016

Objetivo: Correlacionar el número de cepillados por día y el índice CPOD en los escolares de 12 años de la parroquia El Vecino (Cuenca, Ecuador) en 2016. Materiales y métodos: El estudio fue de tipo comunicacional, cuantitativo, descriptivo y relacional. La población estuvo conformada por 279 fichas que pertenecen al estudio del mapa epidemiológico para los escolares de la parroquia El Vecino. La ficha de observación incluyó los siguientes datos: número de registro, edad, sexo, parroquia, índice de COPD. Resultados: En lo referente a la correlación entre el número de cepillado por día y el índice de CPOD, se demostró que existe una correlación inversa, la estadística significativa presentó un valor de p = 0,029. Conclusión: El presente estudio demostró que existe una correlación entre el número de cepillados por día y el índice CPOD. (AU)

Objective: Correlate the number of brushes per day and the decay-missing-filled teeth (DMFT) index in 12-year-old school children from the parish "El Vecino Cuenca - Ecuador 2016". Materials and Methods: The study was communicational, quantitative, descriptive and relational. The population consisted of 279 records from the study of the epidemiological map of schoolchildren in the "El Vecino" parish. The database included the registration number, age, sex, parish and DMFT Index. Results: There was an statistically significant inverse correlation between the number of brushes per day and the DMFT index with a p value = 0.029. Conclusion: The present study shows that there is a correlation between the number of brushes per day and the DMFT index. (AU)

Intra-hospital lethality among infants with pyogenic meningitis.

Predictor variables of intra-hospital lethality among infants with pyogenic meningitis due to Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae were identified using data from a follow-up study of infants with bacterial meningitis. The infants who were admitted to Couto Maia Hospital from March 1, 1997 to December 31, 1997 presenting with symptoms of bacterial meningitis were identified and included in a database. An analysis of the clinical and laboratory information was performed using EPI info 6.01b and SPSS 6.1 statistical programs. The total mortality rate was 17.1%, and the majority of deaths occurred within 48 hours of hospitalization. Factors associated most frequently with poor outcome included absence of respiratory infection, high cerebrospinal fluid protein, and compromised cranial nerves. Early identification of major risk groups is important to adopt measures to improve prognosis.

The utilization of unified protocols in behavioral cognitive therapy in transdiagnostic group subjects: A clinical trial.

BACKGROUND: The practicing of protocols based on behavioral cognitive therapy (CBT) have been frequently used in the last decades and adapted to better manage the necessities of patients and providers. OBJECTIVES: The goal is to build a treatment that is evidence-based - for that reason the unified protocol for multiple emotional disorders (transdiagnostics) have been utilized to simplify treatment - without losing scientific traits. The main goal of this study is to evaluate the unified protocol in groups of patients with depression and anxiety disorders. MATERIALS AND METHODS: In a pool of 48 subjects, divided in two groups, one was submitted to 12 intervention sessions of the unified protocol while the other was solely given medication. MINI, BAI and BDI were the instruments used at the beginning and at the end of treatment. RESULTS: The results were highly significant (p<0.001) in as much as with the improvement of anxiety and depressive disorders as it was in the group which was treated with the unified protocol compared with the group which was only given medication LIMITATIONS: Limitations of this study were the number of sample participants and the non-randomization of subjects in both groups. CONCLUSION: Group therapy has not been largely implemented though it is deemed very useful for treatments when the unified protocol is used in transdiagnostic patients. Not only does it allow for emotional stabilizing and socialization but it also enables subjects with an altruistic feeling amongst themselves.

Avaliação de desempenho: percepção de profissionais da saúde em uma instituição hospitalar pública / Evaluación del desempeño: percepción de los profesionales de la salud en un hospital público / Performance Evaluation: perception of health professionals in a public hospital institution

Objetivo: compreender a percepção de profissionais da saúde sobre o processo de avaliação de desempenho. Método: pesquisa qualitativa exploratório-descritiva, realizada em um hospital público brasileiro com 65 profissionais membros da equipe multiprofissional de saúde da instituição. Os dados foram coletados por meio de questionário semiestruturado e submetidos à análise de conteúdo temática. A interpretação embasou-se no quadro teórico do referencial Freireano e em outras pesquisas relacionadas. Resultados: destacou-se a confidencialidade, privacidade, instrumento utilizado e periodicidade da avaliação. Ainda, os participantes elencaram a necessidade de preparação para a entrevista e a ênfase nas potencialidades dos trabalhadores. Tendo concluído a avaliação, emergiram questões referentes à motivação dos profissionais e aos sentimentos vivenciados ao longo da avaliação. Considerações finais: os resultados reforçam o entendimento da complexidade inerente ao ato de avaliar e a necessidade de exercício contínuo, ampliado a avaliadores e avaliados, no intuito de suscitar um processo participativo e de reflexão crítica.

Aim: to comprehend the perception of health professionals about the process of performance evaluation. Method: qualitative exploratory-descriptive research developed in a Brazilian public hospital with 65 professionals that are member of a health multiprofessional team of the institution. Data were collected through semi-structured questionaire and submitted to thematic content analysis. Interpretation was based on the Freirean theroretical framework and on another related research. Results: we highlighted confidentiality, privacy, the instrument used and periodicity of the evaluation. Still, participants listed the need to prepare for the interview and the emphasis on the potentialities of workers. Concluding the evaluation, issues referred to the motivation of the professionals and feelings they experienced throughout the evaluation. Final considerations: results reinforce the comprehension of complexity inherent to the act of evaluate and the need of continuous exercise, amplifying evaluators and those evaluated, in order to evoke a participative and critically reflexive process.

Objetivo: comprender la percepción de los profesionales de la salud sobre el proceso de evaluación del desempeño. Método: investigación cualitativa exploratoria descriptiva, realizada en un hospital público brasileño con 65 miembros profesionales del equipo de salud multiprofesional de la institución. Los datos fueron recolectados a través de un cuestionario semiestructurado y sometidos a análisis de contenido temático. La interpretación se basó en el marco teórico del marco freireano y otras investigaciones relacionadas. Resultados: se destacaron la confidencialidad, la privacidad, el instrumento utilizado y la periodicidad de la evaluación. Aun así, los participantes mencionaron la necesidad de preparación para la entrevista y el énfasis en el potencial de los trabajadores. Una vez completada la evaluación, surgieron preguntas sobre la motivación de los profesionales y los sentimientos experimentados durante la evaluación. Consideraciones finales: los resultados refuerzan la comprensión de la complejidad inherente al acto de evaluar y la necesidad de ejercicio continuo, extendido a los evaluadores y evaluados, con el fin de alentar un proceso de reflexión participativa y crítica.

[Clinical and laboratory aspects of acute bacterial meningitis in infants]. / Aspectos clínicos e laboratoriais de meningite piogênica em lactentes.

OBJECTIVE: to describe clinical and laboratorial characteristics of acute bacterial meningitis in infants. METHOD: data from the prospective follow-up of infants with acute bacterial meningitis, admitted at the Hospital Couto Maia between March and December 1997, were analyzed with specific statistical software. RESULTS: acute bacterial meningitis was more prevalent in infants with ages varying from 6 months to 1 year. The most frequent etiologic agent was Haemophilus influenzae. The global lethality was 25.9% and among the survivors 39.3% left the hospital with some abnormality in the neurological exam compatible with the brain involvement. CONCLUSION: acute bacterial meningitis in infants is a high lethality disease that in the majority of cases can be prevented. We consider of great relevance the adoption of health prevention strategies in order to reduce the incidence of this disease.