Sustainable Development Goals' health-related indicators for Brazil and Ecuador: an analysis for the period of 1990-2019.

OBJECTIVE: This article aims to analyse the evolution of 40 Sustainable Development Goals' (SDGs) health-related indicators in Brazil and Ecuador from 1990 to 2019. STUDY DESIGN: Epidemiological study of long-term trends in 40 SDGs' health-related indicators for Brazil and Ecuador from 1990 to 2019, using estimates from the Global Burden of Disease Study. METHODS: Forty SDGs' health-related indicators and an index from 1990 to 2017 for Brazil and Ecuador, and their projections up to 2030 were extracted from the Institute for Health Metrics and Evaluation's Global Burden of Disease website and analysed. The percent annual change (PC) between 1990 and 2019 was calculated for both countries. RESULTS: Both countries have made progress on child stunting (Brazil: PC = -38%; Ecuador: PC = -43%) and child wasting prevalences (Brazil: PC = -42%; Ecuador: PC = -41%), percent of vaccine coverage (Brazil: PC = +215%; Ecuador: PC = +175%), under-5 (Brazil: PC = -75%; Ecuador: PC = -60%) and neonatal mortality rates (Brazil: PC = -69%; Ecuador: PC = -51%), health worker density per 1000 population (Brazil: PC = +153%; Ecuador: PC = +175%), reduction of neglected diseases prevalences (Brazil: PC = -40%; Ecuador: PC = -58%), tuberculosis (Brazil: PC = -27%; Ecuador: PC = -55%) and malaria incidences (Brazil: PC = -97%; Ecuador: PC = -100%), water, sanitation and hygiene mortality rates (Brazil and Ecuador: PC = -89%). However, both countries did not show sufficient improvement in maternal mortality ratio to meet SDGs targets (Brazil: PC = -37%; Ecuador: PC = -40%). Worsening of indicators were found for violence, such as non-intimate partner violence for both countries (Brazil: PC = +26%; Ecuador: PC = +18%) and suicide mortality rate for Ecuador (PC = +66%), child overweight indicator for Brazil (PC = -67%), disaster mortality rates (Brazil: PC = +100%; Ecuador: PC = +325%) and alcohol consumption (Brazil: PC = +46%; Ecuador: PC = +35%). CONCLUSIONS: Significant improvements are necessary in both countries requiring the strengthening of health and other policies, particularly concerning the prevention and management of violence and alcohol consumption, and preparedness for dealing with environmental disasters.

Undernutrition, and overweight and obesity: the two faces of malnutrition in Brazil, analysis of the Global Burden of Disease, 1990 to 2019.

OBJECTIVES: The objective of this study was to analyse the global burden of disease attributable to undernutrition and high body mass index (BMI) in Brazil and its 27 states, as well as its association with the socio-demographic index (SDI) from 1990 to 2019. STUDY DESIGN: This is an epidemiological time-series study. METHODS: This study analysed the undernutrition and high BMI estimated by the Global Burden of Disease study conducted from 1990 to 2019 for Brazil and its states, using the following metrics: absolute number of deaths, standardised mortality rate, and disability-adjusted life years (DALYs). This study also analysed the correlation between the percentage variation of mortality rates and SDI. RESULTS: A decrease in the number of deaths (-75 %), mortality rate (-75.1 %), and DALYS (-72 %) attributable to undernutrition was found in Brazil and in all regions. As regarding the high BMI, an increase in the number of deaths was found (139.6 %); however, the mortality rate (-9.7) and DALYs (-6.4 %) declined in all regions, except in the North and Northeast regions, which showed an increase. A strong correlation was identified between undernutrition and high BMI with SDI. CONCLUSION: Our study observed a double burden of malnutrition in Brazil, with a reduction in the burden of diseases due to malnutrition in Brazil and variation in the burden due to high BMI according to the socioeconomic status of the region. Public policies are necessary in order to guarantee the human right to a healthy and sustainable diet, together with food and nutrition security and a diminishing of social inequality.

Mortality by road transport injury in Brazilian municipalities between 2000 and 2018.

OBJECTIVES: This study aimed to investigate patterns of mortality by road transport injury (RTI) in Brazilian municipalities, focused on deaths of motorcyclists, between 2000 and 2018, and their relation with population size and economic status. STUDY DESIGN: This was an ecological epidemiological study with a descriptive and analytical nature. METHODS: The age-standardized RTI mortality rates were calculated for the Brazilian municipalities, referring to the 3-year periods of 2000/2002 (T1), 2009/2011 (T2), and 2016/2018 (T3). The rates were stratified according to macroregion and population size and were compared in terms of percentage variation from one 3-year period to another. The Moran Global and Local indices were used in the spatial point-pattern analysis of the rates. To verify the association with the gross domestic product (GDP) per capita, the Spearman correlation coefficient was applied. RESULTS: A decline in RTI mortality rates was found between 2000 and 2018, with the most significant declines observed in municipalities from the South and Southeast regions of Brazil. However, increases were observed among motorcyclists. Clusters of municipalities were detected, which presented high mortality rates among the motorcyclists in the Northeast region and in some states of the North and Midwest regions. The mortality rates showed a negative correlation with the GDP per capita of the Brazilian municipalities. CONCLUSIONS: Although there were decreases in RTI mortality rates between 1990 and 2018, there was a significant increase in deaths among motorcyclists, especially in the Northeast, North, and Midwest regions of the country. Such differences can be explained by unequal growth in the size of the motorcycle fleet in those regions, by less law enforcement capability, and by the implementation of educational actions.

Unravelling growth trajectories from complicated otoliths - the case of Brazilian codling Urophycis brasiliensis.

Uncertainty regarding the age determination of the Brazilian codling Urophycis brasiliensis has hampered its stock assessment. Transverse sections of otoliths displayed up to seven (in males) and 12 (in females) alternate opaque and translucent bands that could not be conclusively validated as annuli, resulting in unrealistically high ages of first maturity (A50 ) (A50male = 4·5 years and A50female = 6 years). Therefore, growth was described by the von Bertalanffy (VB) model using an alternative approach that combined microstructure data (daily growth increments) and a fixed asymptotic total length (L∞ ). This approach was supported by applying it to two other co-occurring species, the whitemouth croaker Micropogonias furnieri and the king weakfish Macrodon atricauda, for which daily and annual ring formation has previously been validated. The sensitivity to realistic errors associated with the choice of the L∞ and the daily increment readings was shown to be low. The results show that U. brasiliensis has a fast growth rate (Kmale = 1·19 year-1 , Kfemale = 0·71 year-1 ) and early maturation (A50male = 1·1-1·5 years, A50female  = 1·6-1·8 years); typical life-history traits for a sub-tropical coastal gadiform. This novel study offers an alternative approach for age and growth reconstruction for species with complex patterns of opaque and translucent bands provided that daily growth increments in the yearlings can be counted and L∞ reliably estimated.

A genomic study on mammary gland acclimatization to tropical environment in the Holstein cattle.

This study aims at identifying mammary gland genes expressed in Brazilian Holstein cattle produced under tropical conditions, as compared to the Portuguese Holstein cattle produced in a temperate region. For this purpose, cDNA microarrays and real-time (RT) PCR transcriptomic techniques were utilized in 12 Holstein cows from the same lactating phase and management systems divided into two groups: Holstein Brazil (HB) originated from Brazil and Holstein Portugal (HP) from Portugal. The genomic results show that from a total of 4608 genes available from the microarray slide (Bovine Long Oligo (BLO) library), 65 transcripts were identified as differentially expressed in mammary glands. The genes associated with mammary gland development and heat stress responses showed greater expression in HB animals. In the HP group, upregulated genes related with apoptosis and vascular development and downregulated genes related with resistance to heat stress were observed. Validation of microarray results was done using RT-PCR. HB animals had higher blood levels of growth hormone than HP animals. Blood levels of prolactin and T3 were similar for both groups and GH levels were increased in the HB group. The results suggest a gene change towards long-term acclimatization of Brazilian Holstein cattle to cope with tropical heat stress conditions.

The Comet assay for detection of DNA damage in canine sperm.

Sperm DNA integrity is a fundamental prerequisite in fertilization and embryo development. Among DNA integrity tests, the Comet assay is an accurate and sensitive test for the detection of sperm oxidative damage. The aim of this work was to evaluate sperm oxidative damage using the Comet assay and to study the correlation between Comet and routine assays for the evaluation of semen quality. Dogs were divided in two groups: group A (n = 6), comprising dogs with abnormal spermiogram, that is astheno-, terato- or oligoasthenoteratozoospermic (OAT); and group B (n = 8), comprising normospermic dogs. The distribution of sperm oxidative damage was significantly different between the two groups (p = .001): group A-median: 31.55%, interquartile range (IQR): 30.18-38.01; group B-median: 0.90%, IQR: 0.65-1.96. The correlation between oxidative damage and abnormal morphology was high (r = .846; p < .001). There was a negative correlation between progressive motility and oxidative damage (r = -.792; p = .001). Basal and oxidative DNA damage of spermatozoa are increased in dogs with non-normospermic semen. In conclusion, and considering the elevated correlation with classical tests of sperm quality, the Comet assay has ample potential for clinical and research purposes in dogs.

Genetic diversity of Bacillus sp producers of amylase isolated from the soil.

The microorganisms are the best source of extracellular enzymes since they allow an economical technology with low-resource consumption compared to animals and plants. The amylases are among the most important enzymes being the genus Bacillus one of the most investigated due to its ability to produce this enzyme. The objective of this study was to isolate and analyze the genetic diversity among bacteria of the genus Bacillus sp producer of amylase originated from the soil. To this end, soil samples were collected and submitted to the condition of extreme temperature. The serial dilution procedure followed by seeding on solid medium containing starch was used for isolation of strains that produce amylase. The microorganisms isolated were subjected to standard morphological methods for presumptive identification of the genus Bacillus. The PCR assay with the universal genetic marker 16S rDNA was used for confirmation of bacterial strain. All the 10 isolates presumptively identified as bacteria amplified a fragment of 370 bp corresponding to the 16S rDNA gene. The enzymatic activity was expressed as an enzymatic index (EI), after 24 h of incubation. All isolate producers of amylase exhibited EI ≥ 2.0. The determination of the genetic profile and the clonal relationship among the isolates were performed by the method of ERIC-PCR polymorphism. The isolates of Bacillus spp were divided into 2 groups (I and II). Through this method, the discriminatory capacity of this analysis of polymorphisms was verified in differing producer strains from those not producing amylase.

Life history and initial assessment of fishing impacts on the by-catch species Dules auriga (Teleostei: Serranidae) in southern Brazil.

The life history of Dules auriga, a small hermaphrodite serranid species inhabiting deep waters and a frequent component of the discarded catch of bottom trawling in southern Brazil, was studied to assess the fishery effects on the stock through the estimation of the remaining spawning-potential ratio. Sampling was conducted throughout a year and included specimens to determine sex, maturity and age. Age was validated by the edge type and marginal-increment analysis. The oldest and the largest individuals were 9 years and 195 mm total length. Growth parameters fitted to the von Bertalanffy equation were L∞ = 178·34 mm, k = 0·641 year-1 and t0 = -0·341 years. Length and age at first maturity were 140·72 mm and 2 years, respectively. The reproductive season was throughout the austral spring and summer. The assessment of the effects of fishing showed that it may have resulted in a loss of 50% of the spawning potential. This loss may be higher when taking into account the uncertainty in the life-history parameters and could be considered of concern for the population. Fast growth, moderate longevity, long spawning season, small size and age at maturity make D. auriga relatively resilient to the removal of biomass by fishing. When considering the uncertainty, however, the losses of the spawning potential have been severely reducing the population resilience in the face of ecosystem changes.

Analysis of readmission rates to the intensive care unit after implementation of a rapid response team in a University Hospital.

OBJECTIVES: To compare readmission rates to the intensive care unit (ICU) before and after the implementation of a rapid response team (RRT), and to identify risk factors for readmission. DESIGN: A quasi-experimental before-after study was carried out. SETTING: A University Hospital. PATIENTS: All patients discharged from the ICU from January to December 2008 (control group) and from January 2010 to December 2012 (intervention group). INTERVENTION: Implementation of an RRT. MAIN VARIABLES OF INTEREST: The data included demographic parameters, diagnoses upon admission, ICU readmission, APACHE II, SOFA, and TISS 28 scores, and routine daily assessment by an RRT of patients discharged from the ICU. RESULTS: During the study interval, 380 patients were analyzed in the period prior to the implementation of the RRT and 1361 after implementation. There was a tendency toward decreased readmission rates one year after RRT implementation. The APACHE II score and SOFA score at ICU discharge were independent factors associated to readmission, as well as clinical referral to the ICU. CONCLUSIONS: The RRT intervention resulted in a sustained decrease in readmission rates one year after implementation of this service. The use of a specialized team in health institutions can be recommended for ICU survivors.

Strain-induced mechanotransduction through primary cilia, extracellular ATP, purinergic calcium signaling, and ERK1/2 transactivates CITED2 and downregulates MMP-1 and MMP-13 gene expression in chondrocytes.

OBJECTIVE: To determine the strain-induced signaling pathways involved in regulating the transactivation of the transcription regulator Cbp/p300 Interacting Transactivator with ED-rich tail 2 (CITED2) and downstream targets in chondrocytes. METHODS: Primary human chondrocytes or C28/I2 chondrocytic cells were subjected to various strain regimes. C57BL/6 mice were subjected to treadmill running. Loss-of-function was carried out using siRNA or inhibitors specific for targeted molecules. mRNA levels were assayed by RT-qPCR, and proteins by western blotting, immunofluorescence, and/or immunohistochemical staining. CITED2 promoter activity was assayed in chondrocytes using wild-type or mutant constructs. RESULTS: Cyclic strain at 5%, 1 Hz induced CITED2 expression and suppressed expression of matrix metalloproteinase (MMP)-1 and -13 at the messenger RNA (mRNA) and protein levels in human chondrocytes. Abolishing primary cilia through knockdown of intraflagellar transport protein (IFT88) attenuated CITED2 gene expression and decreased protein levels. Similar effects were observed with inhibitors of extracellular adenosine triphosphate (ATP) or P2 purinergic receptors, or antagonists of Ca(2+) signaling. Knockdown of IFT88 in articular chondrocytes in vivo diminished treadmill induced-CITED2 expression and upregulated MMPs. Knockdown of hypoxia-inducible factor (HIF)1α, specificity protein 1 (Sp1), or deletion of the shear stress response element (SSRE) in the CITED2 promoter limited cyclic strain-induced transactivation of CITED2. However, the strain induced-transactivation of CITED2 was abolished only on knockdown of HIF1α, Sp1, and SSRE or by loss-of-function of IFT88 or extracellular-signal-regulated kinases (ERK)1/2. CONCLUSIONS: CITED2 transactivation is a critical event in signaling generated by strain and transduced by primary cilia, extracellular ATP, P2 purinergic receptors, and Ca(2+) signaling. Strain-induced CITED2 transactivation requires HIF1α, Sp1, and an intact SSRE and leads to the downregulation of MMPs such as MMP-1 and MMP-13.

What Factors Contribute to Intimate Partner Violence Against Women in Urban, Conflict-Affected Settings? Qualitative Findings from Abidjan, Côte d'Ivoire.

Rapid urbanization is a key driver of the unique set of health risks facing urban populations. One of the most critical health hazards facing urban women is intimate partner violence (IPV). In post-conflict urban areas, women may face an even greater risk of IPV. Yet, few studies have examined the IPV experiences of urban-dwelling, conflict-affected women, including those who have been internally displaced. This study qualitatively examined the social and structural characteristics of the urban environment that contributed to the IPV experiences of women residing in post-conflict Abidjan, Côte d'Ivoire. Ten focus groups were conducted with men and women, both internally displaced (IDPs) and non-displaced. Lack of support networks, changing gender roles, and tensions between traditional gender norms and those of the "modern" city were reported as key contributors to IPV. Urban poverty and with it unemployment, food insecurity, and housing instability also played a role. Finally, IDPs faced heightened vulnerability to IPV as a result of displacement and discrimination. The relationship between economic strains and IPV are similar to other conflict-affected settings, but Abidjan's urban environment presented other unique characteristics contributing to IPV. Understanding these factors is crucial to designing appropriate services for women and for implementing IPV reduction interventions in urban areas. Strengthening formal and informal mechanisms for help-seeking, utilizing multi-modal interventions that address economic stress and challenge inequitable gender norms, as well as tailoring programs specifically for IDPs, are some considerations for IPV program planning focused on conflict-affected women in urban areas.

Characterization and molecular epidemiology of extensively prevalent nosocomial isolates of drug-resistant Acinetobacter spp.

Acinetobacter sp isolates deserve special attention once they have emerged globally in healthcare institutions because they display numerous intrinsic and acquired drug-resistance mechanisms. This study assessed the antibiotic susceptibility profile, the presence of the genetic marker blaOXA-23, and the clonal relationship among 34 nosocomial isolates of Acinetobacter spp obtained at a hospital in southeastern Brazil. Antibiotic sensitivity analysis was performed by the standard disc-diffusion method. All isolates were found to be extensively resistant to several drugs, but sensitive to polymyxin B. A polymerase chain reaction (PCR) assay was used to detect the blaOXA-23 gene, which is associated with carbapenem resistance. The genetic profile and the clonal relationship among isolates were analyzed via enterobacterial repetitive intergenic consensus (ERIC)-PCR. The Acinetobacter spp were divided into four groups with 22 distinct genetic subgroups. ERIC-PCR analysis revealed the genetic diversity among isolates, which, despite having a heterogeneous profile, displayed 100% clonality among 56% (19/34) of them.

Density-dependent changes in the feeding behaviour of Macrodon atricauda of southern Brazil.

Long-term density-dependent changes in the population dynamics of the king weakfish Macrodon atricauda of southern Brazil between 1976 and 2013 may be related to a change in diet and an increase in feeding intensity. The importance of the small crustacean, Artemesia longinaris, increased in the diet of adults, whereas the importance of teleosts decreased and the frequency of full stomachs increased. Macrodon atricauda currently benefits from a high availability of A. longinaris, which results in a higher energy intake per individual, which, in turn, induces faster body growth and an earlier onset of sexual maturation.

Abstract computation in schizophrenia detection through artificial neural network based systems.

Schizophrenia stands for a long-lasting state of mental uncertainty that may bring to an end the relation among behavior, thought, and emotion; that is, it may lead to unreliable perception, not suitable actions and feelings, and a sense of mental fragmentation. Indeed, its diagnosis is done over a large period of time; continuos signs of the disturbance persist for at least 6 (six) months. Once detected, the psychiatrist diagnosis is made through the clinical interview and a series of psychic tests, addressed mainly to avoid the diagnosis of other mental states or diseases. Undeniably, the main problem with identifying schizophrenia is the difficulty to distinguish its symptoms from those associated to different untidiness or roles. Therefore, this work will focus on the development of a diagnostic support system, in terms of its knowledge representation and reasoning procedures, based on a blended of Logic Programming and Artificial Neural Networks approaches to computing, taking advantage of a novel approach to knowledge representation and reasoning, which aims to solve the problems associated in the handling (i.e., to stand for and reason) of defective information.

Dispersion compensation by two-stage stretching in a sub-400 fs, 1.2 mJ Yb:CaF2 amplifier.

We generate 1.24 mJ, 390 fs pulses at 1035 nm in a CPA laser system featuring a 2.8 mJ Yb:CaF(2) regenerative amplifier, stretcher/compressor based on a single chirped volume Bragg grating and a compact, low-dispersion grating compressor. The auxiliary compressor is used to effectively pre-compensate the intra-cavity dispersion of the amplifier.

Association of TP53 polymorphisms on the risk of Wilms tumor.

BACKGROUND: Molecular factors influencing Wilms tumor (WT) development remain largely unknown. TP53 mutations seem to be restricted to the anaplastic WT subtype. However, TP53 polymorphisms do not have a defined role in the disease. PROCEDURE: To assess the impact of TP53 mutations and polymorphisms (PIN2, PIN3, and PEX4) on risk of development, age at diagnosis, and survival in WT, we analyzed 46 blood DNA samples and 31 fresh tumor DNA samples from 52 patients with WT. Sequencing of TP53 exons 2-11 was performed. RESULTS: Tumor DNA analysis revealed TP53 pathogenic missense mutations (p.V197M, p.R213Q, p.R248W, and p.R337C) in four samples (12.9%). Blood DNA samples revealed a novel intronic mutation, IVS2 + 37C > T, in one patient (2.2%). Bilaterality was associated with a twofold decrease in survival (P = 0.00037). Diffuse anaplasia also presented a lower survival probability compared to patients with non-anaplastic tumors, or with focal anaplasia (P = 0.045). Patients with a TP53 somatic mutation showed survival probability of 37.5% versus 85.0% for patients with no somatic mutations, although the difference was not statistically significant (P = 0.0706). PIN3 duplicated allele was associated with a 20-month later mean age at diagnosis (P = 0.0084). TP53 PEX4 C allele showed an increased risk for WT development (P = 0.0379). No relationship was found between survival and gender, age at diagnosis, or the less frequent alleles of PIN2, PIN3, and PEX4. CONCLUSIONS: Our results demonstrate an association between PIN3 and age at diagnosis, as well as an association of PEX4 and risk of development of WT.

Epidemiological review of Toxoplasma gondii infection in humans and animals in Portugal.

Toxoplasmosis is a worldwide zoonosis. However, data from Portugal are limited and a considerable part of the literature is in Portuguese. Currently, the rate of congenital infection in Portugal is unknown, and almost nothing is known of sequelae of congenital toxoplasmosis. There is no recent general population-based serological survey of Toxoplasma gondii in humans in Portugal. In addition, there is little information on genetic characteristics of T. gondii in animals and humans. In the present paper, we review prevalence, clinical spectrum and epidemiology of T. gondii in humans and animals in Portugal. This knowledge should be useful to biologists, public health workers, physicians and veterinarians.

Tortuosity and the Averaging of Microvelocity Fields in Poroelasticity.

The relationship between the macro- and microvelocity fields in a poroelastic representative volume element (RVE) has not being fully investigated. This relationship is considered to be a function of the tortuosity: a quantitative measure of the effect of the deviation of the pore fluid streamlines from straight (not tortuous) paths in fluid-saturated porous media. There are different expressions for tortuosity based on the deviation from straight pores, harmonic wave excitation, or from a kinetic energy loss analysis. The objective of the work presented is to determine the best expression for tortuosity of a multiply interconnected open pore architecture in an anisotropic porous media. The procedures for averaging the pore microvelocity over the RVE of poroelastic media by Coussy and by Biot were reviewed as part of this study, and the significant connection between these two procedures was established. Success was achieved in identifying the Coussy kinetic energy loss in the pore fluid approach as the most attractive expression for the tortuosity of porous media based on pore fluid viscosity, porosity, and the pore architecture. The fabric tensor, a 3D measure of the architecture of pore structure, was introduced in the expression of the tortuosity tensor for anisotropic porous media. Practical considerations for the measurement of the key parameters in the models of Coussy and Biot are discussed. In this study, we used cancellous bone as an example of interconnected pores and as a motivator for this study, but the results achieved are much more general and have a far broader application than just to cancellous bone.

Effect of temperature on embryonic development and first exogenous feeding of goldfish Carassius auratus (Linnaeus, 1758).

Goldfish or Kinguio is a widely marketed species worldwide due to the ornamental market. There is some lack of acknowledgment of the production of the species under specific climatic conditions. To evaluate the effect of temperature on embryonic development and the first exogenous feeding of goldfish, an experiment was proposed. Fifteen incubators, organized in five treatments (18, 22, 26, 30, and 34 °C) with three replications each, were used to keep the fertilized goldfish eggs until the first exogenous feeding of the larvae. The main development events were observed to understand the possible effects of these temperatures on embryos and larvae of the species. Temperature influences embryo development and the time of first exogenous feeding of goldfish. The temperature of 34 °C was lethal to the species causing 100% of anomalies in the embryos and larvae. The experiment data allow us to conclude that the species presents a maximum thermal limit during embryogenesis, and these data are important to the aquaculture industry and to understand the effect of climate changes on goldfish. The data obtained in this experiment will assist in the management of invasive species and production of the species (aquaculture).

Analysis of Incidence, Risk Factors and Outcomes Associated With Abdominal Hypertension in Major Burn Patients.

The objective of this study is to analyze incidence and risk factors for intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in major burn patients. Aprospective cohort study was conducted at a Burns Treatment Center, including all patients with a burned body surface area ≥20% admitted from August 2015 to January 2018. Intra-abdominal pressure was measured periodically during the first week of ICU stay. Sixty-four patients were analyzed, with median age of 39 years (interquartile range ITQ: 28-53) and 66% were male. Median burned body surface area was 30% (ITQ: 20-46). Twenty-eight (56%) patients presented criteria for IAH and seven (14%) developed clinical signs compatible with ACS. Burn severity was greater in the group that developed IAH, represented by the ABSI score. This group also presented higher values of creatinine and positive fluid balance. The group of patients with ACS showed a higher frequency of alterations in renal and respiratory functions. The organ systems most frequently affected in groups with diagnostic criteria for IAH and ACS were renal, cardiovascular and respiratory. Mortality rate at hospital outcome was 56%. In conclusion, the incidence of IAH during the study period was high in patients with extensive burns. The occurrence of ACS was associated with organic dysfunctions of the respiratory, cardiovascular and renal systems. The factors associated with intra-abdominal hypertension were age, extension of burned body surface, inhalation injury, and need for mechanical ventilation.

Cette étude a pour objectifs d'analyser l'incidence de l'hyperpression abdominale (HPA) et du syndrome du compartiment abdominal (SCA) chez les brûlés graves. Il s'agit d'une étude monocentrique prospective conduite auprès des 64 patients admis avec une brûlure >20% SCT entre août 2015 et janvier 2018. La préssion intraabdominale (PIA) était régulièrement mesurée pendant la première semaine. L'âge médian des patients était de 39 ans (IQR 28-53) et les 2/3 d'entre eux étaient des hommes. La SCT médiane était de 30% (IQR 20-46). Vingt huit (56%) patients avaient des critères d'HPA et 7 (14%) ont présenté des signes de SCA. Le score ABSI et la créatininémie étaient plus élevés chez les patients avec HPA, qui avaient aussi un bilan entrées-sorties positif. Les patients avec un SCA avaient plus de défaillances rénale et respiratoire. Les défaillances les plus fréquemment observées chez les patients avec HPA/SCA étaient rénales, cardio-vasculaires et respiratoires. La mortalité était de 56%. En conclusion, l'incidence de HPA est élevée chez les patients gravement brûlés. La survenue de SCA est une cause de défaillances rénale, cardio-vasculaire et respiratoire. Les facteurs prédicitifs de HPA étaient l'âge, la surface brûlée, l'inhalation de fumées et le recours à la ventilation mécanique.