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RESUMO Objetivo: identificar as manifestações apresentadas pelos pais de crianças e adolescentes que necessitam de atenção especial à saúde e que podem impactar a sua saúde mental. Métodos: pesquisa exploratória, qualitativa, fundamentada no conceito de vulnerabilidade, com coleta de dados realizada por meio de entrevistas com 18 pais de crianças e adolescentes com necessidades de atenção especial, hospitalizadas em unidade pediátrica de um hospital do Paraná, entre maio/2017 e maio/2018. Dados analisados pela análise temática indutiva. Resultados: os pais experienciaram situações de vulnerabilidades para o exercício do cuidado no domicílio, com repercussões em sua saúde mental, expressas por manifestações de desproteção, ansiedade e depressão. Considerações finais: é relevante que profissionais de saúde busquem ampliar as ações para promover o cuidado e reduzir as situações que geram ameaças, inseguranças, preocupações e danos para a saúde dos pais, que podem impactar e fragilizar ainda mais o cuidado às crianças e adolescentes que necessitam de atenção especial à saúde. Objetivo mental Métodos exploratória qualitativa vulnerabilidade 1 Paraná maio2017 maio 2017 maio/201 maio2018 2018 maio/2018 indutiva Resultados domicílio desproteção depressão finais ameaças inseguranças maio201 201 maio/20 maio20 20 maio/2 maio2 2 maio/

ABSTRACT Objective: To identify the manifestations presented by parents of children and adolescents who require special health attention that can impact their mental health. Methods: exploratory, qualitative research, based on the concept of vulnerability, with data collection carried out through interviews with 18 parents of children and adolescents with special health care needs, hospitalized in the pediatric ward of a hospital in Paraná, between May/2017 and May/ 2018. Data analyzed by inductive thematic analysis. Results: parents experienced situations of vulnerability when providing care at home, with repercussions on their mental health, expressed by manifestations of lack of protection, anxiety and depression. Final considerations: It is important that health professionals seek to expand actions to promote care and reduce situations that generate threats, insecurities, concerns and damage to the health of parents, which can impact and further weaken care for children and adolescents who need attention especially health. Objective Methods exploratory research 1 needs Paraná May2017 May 2017 May/201 2018 analysis Results home protection depression considerations threats insecurities May201 201 May/20 May20 20 May/2 May2 2

RESUMEN Objetivo: identificar las manifestaciones presentadas por los padres de niños y adolescentes que necesitan atención especial en salud que puedan afectar su salud mental. Métodos: Es una investigación exploratoria, cualitativa, basada en el concepto de vulnerabilidad, con datos examinados mediante el análisis temático inductivo y recolectados a través de entrevistas a 18 padres de niños y adolescentes con necesidades de cuidados especiales, internados en la unidad de pediatría de un hospital de Paraná, entre mayo de 2017 y mayo de 2018. Resultados: los padres experimentaron situaciones de vulnerabilidad en el ejercicio del cuidado domiciliario, con repercusiones en su salud mental, expresadas por manifestaciones de desprotección, ansiedad y depresión. Consideraciones finales: es importante que los profesionales sanitarios busquen ampliar sus acciones para promover el cuidado y reducir las situaciones que generen amenazas, inseguridades, preocupaciones y daños a la salud de los padres y perjudiquen el cuidado de los niños y adolescentes que necesitan atención especial. Objetivo mental Métodos exploratoria cualitativa 1 especiales Paraná 201 2018 Resultados domiciliario desprotección depresión finales amenazas inseguridades 20 2

https://doi.org/10.1590/0034-7167-2023-0457

Adaptación y Validación del Examen de Estado Mental del Autismo (AMSE) en Chile: buscando reducir la brecha diagnóstica
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Irarrázaval, Matías

; López, Isabel

; Figueroa, Cecilia

; Cabezas, Marcia

; Yáñez, Cristián

; Rodillo, Eliana

; Riesle, Sofia

; Rivera, Tamara

; Garcia, Ricardo

Andes pediatrica

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aug 2023, Volume 94 N. 4 Pages 475 - 484

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen: La detección precoz del Autismo es un desafío en Chile y América Latina. Las evaluaciones gold-standard son de alto costo y difícil disponibilidad. El Examen de Estado Mental para Autismo (AMSE) es un instrumento breve, estructurado, observacional, para uso clínico con promisorios resultados. Objetivo: Adaptar y validar AMSE en muestra de niños, niñas y adolescentes (NNA) hispanohablantes con riesgo de Espectro Autista (EA) utilizando como comparación ADOS-2. Sujetos y Métodos: NNA de 15m-17a, consultantes por problemas de lenguaje, comunicación y/o sospecha de EA. AMSE fue administrado durante evaluación clínica. ADOS-2 fue administrado por evaluadores independientes, ciegos, determinando categorías: No Espectro Autista (NoEA), Espectro Autista (EA) o Autismo (AUT). Se evaluó características psicométricas de AMSE y usando curva ROC se calculó punto de corte, identificando sensibilidad, especificidad, valor predictivo positivo y negativo. Resultados: Participaron 64 NNA, 56 varones (87,5%), con edad promedio 6,6 años (DE:3,6). Se distribuyeron según ADOS-2 en NoEA:12 (18,8%), EA:19 (29,7%), AUT:33 (51,6%). Los puntajes AMSE difirieron significativamente entre las tres categorías (p < 0,0001). AMSE tuvo consistencia interna moderada, con Alfa de Cronbach 0,61. Punto de corte ≥ 6 puntos (sensibilidad 0,79 especificidad 0,92, AUC: 0,91). Un segundo análisis según nivel de lenguaje sugiere mayor precisión diagnóstica de AMSE para el grupo con menor desarrollo de lenguaje, manteniéndose punto de corte óptimo de ≥ 6 puntos. Conclusión: AMSE muestra adecuadas propiedades psicométricas, buena capacidad y precisión para respaldar el diagnóstico de EA. Su brevedad, bajo costo y fácil integración a la práctica clínica, lo hacen una alternativa de gran potencial para el reconocimiento y derivación oportunos de NNA en EA.

Abstract: Early detection of Autism is a challenge in Chile and Latin America. Gold-standard evaluations are expensive and difficult to access. The Autism Mental Status Exam (AMSE) is a brief, structured, observational instrument for clinical use with promising results. Objective: To adapt and validate the AMSE in a sample of Spanish-speaking children and adolescents at risk of Autism Spectrum Disorder (ASD) using the ADOS-2 as a comparison. Subjects and Method: Children and adolescents aged 15m-17yo consulting due to language and communication problems and/or suspected ASD. The AMSE was administered during clinical evaluation. The ADOS-2 was administered by independent evaluators, blinded to the study, which determined diagnostic categories as: Non-Autism Spectrum Disorder (Non-ASD), Autism Spectrum Disorder (ASD), or Autism (AUT). Psychometric characteristics of the AMSE were assessed and, using the ROC curve, a cut-off point was calculated, identifying sensitivity, specificity, positive, and negative predictive value. Results: Sixty-four children participated, 56 were males (87.5%), with a mean age of 6.6y (SD: 3.6). They were distributed as Non- ASD: 12 (18.8%), ASD: 19 (29.7%), and AUT: 33 (51.6%) according to the ADOS-2. The AMSE scores differed significantly among the three categories (p<0.0001). Internal consistency was moderate and Cronbach’s alpha was 0.61. The cut-off point was ≥ 6 (Sensitivity 0.79, Specificity 0.92, AUC: 0.91). A second analysis according to language level suggests a greater diagnostic accuracy of the AMSE for the group with lower language development, maintaining the same optimal cut-off point (≥6). Conclusions: The AMSE shows adequate psychometric properties, good capacity, and accuracy to support the diagnosis of ASD. Its brevity, low cost, and easy integration into clinical practice make it an alternative with great potential for timely recognition and referral of children with ASD.

https://doi.org/10.32641/andespediatr.v94i4.4476

Implementation of a methodological protocol for the national survey on tuberculosis catastrophic costs in Brazil
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Maciel, Ethel Leonor Noia

; Negri, Leticya dos Santos Almeida

; Guidoni, Leticia Molino

; Fregona, Geisa Carlesso

; Loureiro, Rafaela Borge

; Daré, Isadora Bianchi

; Prado, Thiago Nascimento do

; Sanchez, Mauro Niskier

; Diaz-Quijano, Fredi Alexander

; Tonini, Maiko

; Zandonade, Eliana

; Baena, Inés Garcia

; Ershova, Julia

Revista da Sociedade Brasileira de Medicina Tropical

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2023, Volume 56 elocation e0493-2022

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/0037-8682-0493-2022

IMPACTO-MR: um estudo brasileiro de plataforma nacional para avaliar infecções e multirresistência em unidades de terapia intensiva IMPACTOMR IMPACTO MR IMPACTO-MR
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Tomazini, Bruno M

; Nassar Jr, Antonio Paulo

; Lisboa, Thiago Costa

; Azevedo, Luciano César Pontes de

; Veiga, Viviane Cordeiro

; Catarino, Daniela Ghidetti Mangas

; Fogazzi, Debora Vacaro

; Arns, Beatriz

; Piastrelli, Filipe Teixeira

; Dietrich, Camila

; Negrelli, Karina Leal

; Jesuíno, Isabella de Andrade

; Reis, Luiz Fernando Lima

; Mattos, Renata Rodrigues de

; Pinheiro, Carla Cristina Gomes

; Luz, Mariane Nascimento

; Spadoni, Clayse Carla da Silva

; Moro, Elisângela Emilene

; Bueno, Flávia Regina

; Sampaio, Camila Santana Justo Cintra

; Silva, Débora Patrício

; Baldassare, Franca Pellison

; Silva, Ana Cecilia Alcantara

; Veiga, Thabata

; Barbante, Leticia

; Lambauer, Marianne

; Campos, Viviane Bezerra

; Santos, Elton

; Santos, Renato Hideo Nakawaga

; Laranjeiras, Ligia Nasi

; Valeis, Nanci

; Santucci, Eliana

; Miranda, Tamiris Abait

; Patrocínio, Ana Cristina Lagoeiro do

; Carvalho, Andréa de

; Sousa, Eduvirgens Maria Couto de

; Sousa, Ancelmo Honorato Ferraz de

; Malheiro, Daniel Tavares

; Bezerra, Isabella Lott

; Rodrigues, Mirian Batista

; Malicia, Julliana Chicuta

; Silva, Sabrina Souza da

; Gimenes, Bruna dos Passos

; Sesin, Guilhermo Prates

; Zavascki, Alexandre Prehn

; Sganzerla, Daniel

; Medeiros, Gregory Saraiva

; Santos, Rosa da Rosa Minho dos

; Silva, Fernanda Kelly Romeiro

; Cheno, Maysa Yukari

; Abrahão, Carolinne Ferreira

; Oliveira Junior, Haliton Alves de

; Rocha, Leonardo Lima

; Nunes Neto, Pedro Aniceto

; Pereira, Valéria Chagas

; Paciência, Luis Eduardo Miranda

; Bueno, Elaine Silva

; Caser, Eliana Bernadete

; Ribeiro, Larissa Zuqui

; Fernandes, Caio Cesar Ferreira

; Garcia, Juliana Mazzei

; Silva, Vanildes de Fátima Fernandes

; Santos, Alisson Junior dos

; Machado, Flávia Ribeiro

; Souza, Maria Aparecida de

; Ferronato, Bianca Ramos

; Urbano, Hugo Corrêa de Andrade

; Moreira, Danielle Conceição Aparecida

; Souza-Dantas, Vicente Cés de

; Duarte, Diego Meireles

; Coelho, Juliana

; Figueiredo, Rodrigo Cruvinel

; Foreque, Fernanda

; Romano, Thiago Gomes

; Cubos, Daniel

; Spirale, Vladimir Miguel

; Nogueira, Roberta Schiavon

; Maia, Israel Silva

; Zandonai, Cassio Luis

; Lovato, Wilson José

; Cerantola, Rodrigo Barbosa

; Toledo, Tatiana Gozzi Pancev

; Tomba, Pablo Oscar

; Almeida, Joyce Ramos de

; Sanches, Luciana Coelho

; Pierini, Leticia

; Cunha, Mariana

; Sousa, Michelle Tereza

; Azevedo, Bruna

; Dal-Pizzol, Felipe

; Damasio, Danusa de Castro

; Bainy, Marina Peres

; Beduhn, Dagoberta Alves Vieira

; Jatobá, Joana D’Arc Vila Nova

; Moura, Maria Tereza Farias de

; Rego, Leila Rezegue de Moraes

; Silva, Adria Vanessa da

; Oliveira, Luana Pontes

; Sodré Filho, Eliene Sá

; Santos, Silvana Soares dos

; Neves, Itallo de Lima

; Leão, Vanessa Cristina de Aquino

; Paes, João Lucidio Lobato

; Silva, Marielle Cristina Mendes

; Oliveira, Cláudio Dornas de

; Santiago, Raquel Caldeira Brant

; Paranhos, Jorge Luiz da Rocha

; Wiermann, Iany Grinezia da Silva

; Pedroso, Durval Ferreira Fonseca

; Sawada, Priscilla Yoshiko

; Prestes, Rejane Martins

; Nascimento, Glícia Cardoso

; Grion, Cintia Magalhães Carvalho

; Carrilho, Claudia Maria Dantas de Maio

; Dantas, Roberta Lacerda Almeida de Miranda

; Silva, Eliane Pereira

; Silva, Antônio Carlos da

; Oliveira, Sheila Mara Bezerra de

; Golin, Nicole Alberti

; Tregnago, Rogerio

; Lima, Valéria Paes

; Silva, Kamilla Grasielle Nunes da

; Boschi, Emerson

; Buffon, Viviane

; Machado, André Sant’Ana

; Capeletti, Leticia

; Foernges, Rafael Botelho

; Carvalho, Andréia Schubert de

; Oliveira Junior, Lúcio Couto de

; Oliveira, Daniela Cunha de

; Silva, Everton Macêdo

; Ribeiro, Julival

; Pereira, Francielle Constantino

; Salgado, Fernanda Borges

; Deutschendorf, Caroline

; Silva, Cristofer Farias da

; Gobatto, Andre Luiz Nunes

; Oliveira, Carolaine Bomfim de

; Dracoulakis, Marianna Deway Andrade

; Alvaia, Natália Oliveira Santos

; Souza, Roberta Machado de

; Araújo, Larissa Liz Cardoso de

; Melo, Rodrigo Morel Vieira de

; Passos, Luiz Carlos Santana

; Vidal, Claudia Fernanda de Lacerda

; Rodrigues, Fernanda Lopes de Albuquerque

; Kurtz, Pedro

; Shinotsuka, Cássia Righy

; Tavares, Maria Brandão

; Santana, Igor das Virgens

; Gavinho, Luciana Macedo da Silva

; Nascimento, Alaís Brito

; Pereira, Adriano J

; Cavalcanti, Alexandre Biasi

Revista Brasileira de Terapia Intensiva

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dec 2022, Volume 34 N. 4 Pages 418 - 425

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Descrever o IMPACTO-MR, um estudo brasileiro de plataforma nacional em unidades de terapia intensiva focado no impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Métodos: Descrevemos a plataforma IMPACTO-MR, seu desenvolvimento, critérios para seleção das unidades de terapia intensiva, caracterização da coleta de dados, objetivos e projetos de pesquisa futuros a serem realizados na plataforma. Resultados: Os dados principais foram coletados por meio do Epimed Monitor System® e consistiram em dados demográficos, dados de comorbidades, estado funcional, escores clínicos, diagnóstico de internação e diagnósticos secundários, dados laboratoriais, clínicos e microbiológicos e suporte de órgãos durante a internação na unidade de terapia intensiva, entre outros. De outubro de 2019 a dezembro de 2020, 33.983 pacientes de 51 unidades de terapia intensiva foram incluídos no banco de dados principal. Conclusão: A plataforma IMPACTO-MR é um banco de dados clínico brasileiro de unidades de terapia intensiva focado na pesquisa do impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Essa plataforma fornece dados para o desenvolvimento e pesquisa de unidades de terapia intensiva individuais e ensaios clínicos observacionais e prospectivos multicêntricos. Objetivo IMPACTOMR, IMPACTOMR IMPACTO MR, MR saúde Métodos Resultados System demográficos comorbidades funcional secundários laboratoriais outros 201 2020 33983 33 983 33.98 5 principal Conclusão multicêntricos 20 202 3398 3 98 33.9 2 339 9 33.

ABSTRACT Objective: To describe the IMPACTO-MR, a Brazilian nationwide intensive care unit platform study focused on the impact of health care-associated infections due to multidrug-resistant bacteria. Methods: We described the IMPACTO-MR platform, its development, criteria for intensive care unit selection, characterization of core data collection, objectives, and future research projects to be held within the platform. Results: The core data were collected using the Epimed Monitor System® and consisted of demographic data, comorbidity data, functional status, clinical scores, admission diagnosis and secondary diagnoses, laboratory, clinical, and microbiological data, and organ support during intensive care unit stay, among others. From October 2019 to December 2020, 33,983 patients from 51 intensive care units were included in the core database. Conclusion: The IMPACTO-MR platform is a nationwide Brazilian intensive care unit clinical database focused on researching the impact of health care-associated infections due to multidrug-resistant bacteria. This platform provides data for individual intensive care unit development and research and multicenter observational and prospective trials. Objective IMPACTOMR, IMPACTOMR IMPACTO MR, MR careassociated associated multidrugresistant multidrug resistant bacteria Methods selection collection objectives Results System status scores diagnoses laboratory stay others 201 2020 33983 33 983 33,98 5 Conclusion trials 20 202 3398 3 98 33,9 2 339 9 33,

https://doi.org/10.5935/0103-507x.20220209-pt

Licencia por enfermedad en Colombia en el período 2016-2018: Estudio observacional transversal retrospectivo
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Valero-Pacheco, Ivonne Constanza

; Riaño-Casallas, Martha Isabel

; Garcia-Bedoya, Olmer

; Rodriguez-Páez, Fredy Guillermo

; Cardona Medina, Fabián

; Téllez-Avila, Eliana Milena

; Palma-Parra, Ruth Marien

Universidad y Salud

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dec 2022, Volume 24 N. 3 Pages 218 - 226

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Introducción: Comprender la situación de incapacidad por enfermedad, causas y efectos de una pérdida temporal de la capacidad de trabajo fortalece las políticas y la gestión en la prestación de servicios de salud. Objetivo: Analizar las incapacidades por enfermedad en Colombia en el período 2016-2018. Materiales y métodos: Estudio observacional transversal retrospectivo, con cálculo del riesgo relativo. Se procesaron 12.410.837 registros de trabajadores formales entre 18 y 70 años de edad y con al menos una incapacidad temporal, según los informes del Ministerio de Salud y Protección Social. Resultados: La edad promedio de las personas fue de 37,11 años, 53% fueron mujeres. En promedio, el 90,6% de las incapacidades fue para trabajadores dependientes y el 5,6% trabajadores independientes. Las principales causas de incapacidad fueron las enfermedades del sistema musculoesquelético más frecuentes en hombres adultos según RR. Los hombres en comparación con las mujeres y los adultos en comparación con los jóvenes tienen menos probabilidades de tener licencia por enfermedad respiratoria. Conclusiones: Las mujeres presentaron más incapacidades temporales por enfermedad, aunque los hombres tuvieron más días de incapacidad, la mediana fue de tres días en ambos géneros. Los jóvenes y los adultos tenían más días de baja por enfermedad.

Abstract Introduction: To understand the sick leave situation and the causes and effects of a temporary loss of capacity to work allows for the strengthening of policies and management in the provision of health services. Objective: To analyze sick leave in Colombia in the 2016-2018 period. Materials and methods: A retrospective cross-sectional observational study and the relative risk was calculated. Sick leave reports were provided by the Ministry of Health and Social Protection. 12,410,837 reports from formal workers between the ages of 18-70 years and had at least one temporary disability were processed. Results: The average age of people with sick leave was 37.11 years, 53% corresponding to females. On average, sick leave was 90.6% and 5.6% for dependent and independent workers, respectively. The principal causes of disability were musculoskeletal diseases and were more likely in men and adults according to RR. Men in comparison to females and adults in comparison to youths are less likely to have sick leave due to respiratory disease. Conclusions: In Colombia, females presented more temporary sick leave, even if males had more days of disability, even though the median was three days in both genders. Youth and adults had more sick leave days.

https://doi.org/10.22267/rus.222403.276 48 downloads

Decline in head circumference growth and associated factors in congenital Zika syndrome
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Takahasi, Eliana Harumi Morioka

; Alves, Maria Teresa Seabra Soares de Britto e

; Ribeiro, Marizélia Rodrigues Costa

; Santos, Alcione Miranda dos

; Campos, Marcos Adriano Garcia

; Simões, Vanda Maria Ferreira

; Amaral, Gláucio Andrade

; Sousa, Patrícia da Silva

; Miranda-Filho, Demócrito de Barros

; Silva, Antônio Augusto Moura da

Cadernos de Saúde Pública

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2022, Volume 38 N. 8 elocation e00296021

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Pouco se sabe sobre a evolução do perímetro cefálico (PC) em crianças com síndrome congênita associada à infecção pelo vírus Zika (SCZ) em acompanhamentos contínuos. Este estudo buscou avaliar o crescimento do PC em crianças com SCZ nos primeiros três anos de suas vidas e identificar os fatores associados a ele. Os dados do PC ao nascimento e obtidos em consultas neuropediátricas de 74 crianças com SCZ foram coletados no Cartão da Criança, nos laudos paternos e em seus prontuários. Os preditores de escore-z para PC foram investigados utilizando-se diferentes modelos de efeitos mistos. O critério de informação de Akaike foi utilizado para selecionar os modelos usados. O escore-z de PC diminuiu de -2,7 ± 1,6 ao nascimento para -5,5 ± 2,2 aos 3 meses de idade, mas permaneceu relativamente estável desde então. No modelo ajustado selecionado, a presença de atrofia parênquimal cerebral grave e sintomas maternos de infecção no primeiro trimestre de sua gravidez estiveram associados a uma redução mais acentuada no escore-z de PC nos primeiros três anos de vida dos participantes. A diminuição do escore-z de PC em crianças com SCZ nos primeiros 3 meses de sua vida monstra o potencial reduzido de crescimento e desenvolvimento do sistema nervoso central dessas crianças. O prognóstico de crescimento do perímetro cefálico nos primeiros 3 anos de vida é pior quando a infecção materna ocorreu no primeiro trimestre gestacional e em crianças que tiveram atrofia parênquimal grave.

Little is known about the evolution of head circumference (HC) in children with congenital Zika syndrome (CZS). This study aims to evaluate HC growth in children with CZS in the first three years of life and identify associated factors. HC data obtained at birth and in neuropediatric consultations from 74 children with CZS were collected from the Child’s Health Handbook, parents’ reports, and medical records. Predictors of HC z-score were investigated using different mixed-effects models; Akaike’s information criterion was used for model selection. The HC z-score decreased from -2.7 ± 1.6 at birth to -5.5 ± 2.2 at 3 months of age, remaining relatively stable thereafter. In the selected adjusted model, the presence of severe brain parenchymal atrophy and maternal symptoms of infection in the first trimester of pregnancy were associated with a more pronounced reduction in the HC z-score in the first three years of life. The decrease of HC z-score in CZS children over the first three months demonstrated a reduced potential for growth and development of the central nervous system of these children. The prognosis of head growth in the first 3 years of life is worse when maternal infection occurs in the first gestational trimester and in children who have severe brain parenchymal atrophy.

Se conoce poco sobre la evolución del perímetro cefálico (PC) en niños con síndrome de Zika congénito (SZC) en los seguimientos continuos. El objetivo del estudio fue evaluar el crecimiento del PC en niños con SZC en los primeros 3 años de vida e identificar los factores asociados. Se recogieron datos del PC al nacimiento y obtenidos en las consultas de neuropediatría de 74 niños con SZC a partir de la Tarjeta del Niño, los informes de los padres y los registros médicos. Se investigaron los predictores de la puntuación Z del PC mediante diferentes modelos de efectos mixtos; se utilizó el criterio de información de Akaike para la selección del modelo. La puntuación Z del PC disminuyó de -2,7 ± 1,6 al nacer a -5,5 ± 2,2 a los 3 meses de edad, pero a partir de entonces se mantuvo relativamente estable. En el modelo ajustado seleccionado, la presencia de atrofia grave del parénquima cerebral y los síntomas maternos de infección en el primer trimestre del embarazo se asociaron con una reducción más pronunciada de la puntuación Z del PC en los primeros 3 años de vida. La disminución de la puntuación Z del PC en los niños con SZC durante los primeros 3 meses demuestra el menor potencial de crecimiento y desarrollo del sistema nervioso central de estos niños. El pronóstico del crecimiento de la cabeza en los primeros 3 años de vida es peor cuando la infección materna se produjo en el primer trimestre gestacional y en los niños que tenían una atrofia grave del parénquima cerebral.

https://doi.org/10.1590/0102-311xen296021

Decline in head circumference growth and associated factors in congenital Zika syndrome
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Takahasi, Eliana Harumi Morioka

; Alves, Maria Teresa Seabra Soares de Britto e

; Ribeiro, Marizélia Rodrigues Costa

; Santos, Alcione Miranda dos

; Campos, Marcos Adriano Garcia

; Simões, Vanda Maria Ferreira

; Amaral, Gláucio Andrade

; Sousa, Patrícia da Silva

; Miranda-Filho, Demócrito de Barros

; Silva, Antônio Augusto Moura da

Cadernos de Saúde Pública

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2022, Volume 38 N. 8 elocation e00296021

Abstract: En Pt Es | Text: En Pt Es | PDF: En | PDF: Pt | PDF: Es

https://doi.org/10.1590/0102-311xen296021

Brazilian Guidelines for Nutrition in Cystic Fibrosis
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Neri, Lenycia de Cassya Lopes

; Simon, Miriam Isabel Souza dos Santos

; Ambrósio, Valéria Laguna Salomão

; Barbosa, Eliana

; Garcia, Monique Ferreira

; Mauri, Juliana Ferreira

; Guirau, Renata Rodrigues

; Neves, Mirella Aparecida

; Cunha, Carolina de Azevedo Pedrosa

; Nogueira, Marcelo Coelho

; Alves, Anna Carolina Di Creddo

; Gurmini, Jocemara

; Servidoni, Maria de Fatima

; Epifanio, Matias

; Athanazio, Rodrigo

einstein (São Paulo)

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2022, Volume 20 elocation eRW5686

Abstract: En | Text: En | PDF: En

ABSTRACT Objective To develop a scientific consensus on nutrition in cystic fibrosis. Methods Sixteen coordinators elaborated relevant questions on nutritional therapy in cystic fibrosis, which were divided into six sections: nutritional assessment, nutritional recommendations, nutritional intervention, dietary counseling, special situations and enzyme replacement, and gastrointestinal manifestations. Two to three specialists in the field were responsible for each section and obtaining answers formulated based on standardized bibliographic searches. The available literature was searched in the PubMed®/MEDLINE database, after training and standardization of search strategies, to write the best level of evidence for the questions elaborated. Issues related to disagreement were discussed until a consensus was reached among specialists, based on the current scientific literature. Results Forty-two questions were prepared and objectively answered, resulting in a consensus of nutritional therapy in cystic fibrosis. Conclusion This work enabled establishing a scientific consensus for nutritional treatment of cystic fibrosis patients.

https://doi.org/10.31744/einstein_journal/2022rw5686

Biological effects of formulation containing curcuminoids and Bidens Pilosa L. in oral carcinoma cell line
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Arantes, Diego Antonio Costa

; Silva, Artur Christian Garcia da

; Lima, Eliana Martins

; Alonso, Ellen Cristine Pineze

; Marreto, Ricardo Neves

; Mendonça, Elismauro Francisco

; Valadares, Marize Campos

; Batista, Aline Carvalho

Brazilian Oral Research

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2021, Volume 35 elocation e063

Abstract: En | Text: En | PDF: En

Abstract: FITOPROT, which contains curcuminoids and Bidens pilosa L. extract, is an innovative mucoadhesive formulation indicated for the topical treatment of chemoradiotherapy-induced oral mucositis (OM) in patients with advanced and visible oral squamous cell carcinoma. The formulation is used as a mouthwash directly on tumor tissue of patients with advanced neoplasms, without triggering cancer cell proliferation or tumor invasiveness. Thus, the aim of this study was to evaluate the biological effects of FITOPROT on an oral squamous cell carcinoma cell line (SCC-4). The viability of SCC-4 cells was assessed after exposure to FITOPROT using MTT reduction assay. The effects of the mucoadhesive formulation on cell cycle progression and cell death parameters were evaluated using flow cytometry. In addition, the inflammatory profile of the tumor cells was evaluated using the cytometric bead array (CBA) assay. FITOPROT promoted a concentration-dependent decrease in cell viability and cell cycle arrest at the G2/M phase (p < 0.05). Mitochondrial membrane potential was also altered after exposure to the formulation (p < 0.05), in parallel with a reduction in VEGF and IL-8 production (p = 0.01 and p = 0.05, respectively). In summary, the results indicate that FITOPROT reduces SCC-4 cell viability, promotes cell cycle arrest, modulates mitochondrial membrane potential, and exhibits antiangiogenic and anti-inflammatory properties, thus indicating its potential for topical use in patients with OM and visible tumors in the mouth.

https://doi.org/10.1590/1807-3107bor-2021.vol35.0063 217 downloads

10.

Ralstonia spp. in a dialysis unit: an experience in the identification and control of an outbreak
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Saldarriaga-Quintero, Eliana Andrea

; Mosquera-Palacios, Yanira

; Pinzón-Gómez, Elisa María

; Lesmes-Duque, María Cristina

; Victoria-Garcia, Maria Constanza

; Hurtado-Palacios, Isabel Cristina

Infectio

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dec 2020, Volume 24 N. 4 Pages 243 - 247

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Objetivo: describir la experiencia en la identificación y control de un brote por Ralstonia spp. en una unidad renal. Material y Método: investigación epidemiológica de brote hospitalario en 2 sedes y servicio extramural de una unidad renal. Se incluyeron pacientes que presentaron fiebre o escalofrío, durante o después de la terapia dialítica, y que tuvieran hemocultivo positivo para Ralstonia spp. Resultados: De los 709 pacientes para hemodiálisis, se identificaron 124 con bacteriemia por Ralstonia spp., 98,4% tenían acceso por catéter. La tasa de ataque global fue del 16,1% y la tasa de letalidad 0,8%. Se realizaron cultivos ambientales y trazabilidad de medicamentos y dispositivos, pero ante la presencia de casos extramurales la hipótesis fue redireccionada. La heparina prellenada había sido cultivada en varias oportunidades siguiendo la metodología de la farmacopea internacional. Sin embargo, la técnica de aislamiento microbiano recomendada por expertos fue la que permitió aislar el microorganismo y confirmar la fuente. Conclusiones: El brote que se describe excedió el número de pacientes documentados en la literatura y fue causado por un lote contaminado de heparina. Se aporta evidencia de una técnica recomendada por expertos utilizada para el aislamiento de Ralstonia spp. a fin de lograr el control de brotes de manera oportuna, minimizando el impacto clínico, económico y social.

Abstract Objective: to describe an experience in identification and control of an outbreak of Ralstonia spp. in a renal unit. Material and Method: an epidemiological investigation of a hospital outbreak in 2 sites and extramural service of a renal unit. The investigation included patients who presented fever or chills, during or after dialysis, and who had positive blood culture for Ralstonia spp. Results: Of 769 hemodialysis patients, 124 were identified with bacteremia by Ralstonia spp.; of these, 98.4% had catheter access and 1.6% had fistula. The overall attack rate was 16.1% and the case fatality rate was 0.8%. Environmental cultures were taken and drugs and devices were tracked. Several cultures were taken of the prefilled heparin following the methods described in the International Pharmacopoeia. However, it was the technique of microbial isolation recommended by experts that enabled the isolation of the microorganism and confirmed the source. Conclusions: The outbreak described exceeded the number of patients affected documented in literature. It was caused by a contaminated batch of heparin. Evidence is provided of a recommended by expert technique used for the isolation of Ralstonia spp. in order to achieve control of outbreaks in a timely manner, minimizing clinical, economic, and social impact.

https://doi.org/10.22354/in.v24i4.883 653 downloads

11.

Colonization profile and duration by multi-resistant organisms in a prospective cohort of newborns after hospital discharge
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Sakai, Andressa Midori

; Iensue, Thayla Nadrielly Aparecida Nicolino

; Pereira, Kauana Olanda

; Silva, Renata Lima da

; Pegoraro, Leila Garcia de Oliveira

; Salvador, Marta Silva de Almeida

; Rodrigues, Renne

; Capobiango, Jaqueline Dario

; Souza, Nathália Aparecida Andrade de

; Pelisson, Marsileni

; Vespero, Eliana Carolina

; Yamauchi, Lucy Megumi

; Perugini, Marcia Regina Eches

; Yamada-Ogatta, Sueli Fumie

; Rossetto, Edilaine Giovanini

; Kerbauy, Gilselena

Revista do Instituto de Medicina Tropical de São Paulo

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2020, Volume 62 elocation e22

Abstract: En | Text: En | PDF: En

ABSTRACT The aim of this study was to determine the spontaneous decolonization period and characteristics in a prospective cohort of newborns colonized by multidrug-resistant organisms, after their discharge from the neonatal intensive care unit. Multidrug resistance is defined as bacterial non-susceptibility to ≥ 1 agent of ≥ 3 antimicrobial categories. In total, 618 newborns were included in the study, of which 173 (28.0%) presented a positive culture for multidrug-resistant microorganisms, and of these, 52 (30.1%) were followed up in this study. The most frequent intrinsic factors were be born by cesarean section (86.5%), prematurity (84.6%), and very low birth weight (76.9%). The extrinsic factors were having remained hospitalized for an average of 27 days, during which 67.3% were submitted to invasive procedures and 88.5% received antimicrobials. The intrinsic and extrinsic factors of newborns were not associated to a decolonization period longer or shorter than 3 months, which was the average period of decolonization found in the present study. From the totality of colonization cultures sampled at hospital discharge, the Gram-negative Extended Spectrum β-lactamase producing bacteria were the most common, with 28.9% of babies colonized by Klebsiella spp. The median period of decolonization by multidrug-resistant microorganisms in the newborns population after hospital discharge was 3 months, but was highly dependent on the microbial species, and this period was not associated to any intrinsic and extrinsic factors of the newborn.

https://doi.org/10.1590/s1678-9946202062022 899 downloads

12.

A TRÍADE DA REFORMA DO ENSINO MÉDIO BRASILEIRO: LEI Nº 13.415/2017, BNCC E DCNEM
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NAVARRO, KOEPSEL, ELIANA CLÁUDIA

; OLIVEIRA, GARCIA, SANDRA REGINA DE

; SILVA, CZERNISZ, ELIANE CLEIDE DA

Educação em Revista

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2020, Volume 36 elocation e222442

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO: O texto discute a relação entre a Lei n.º 13.415/2017, a Base Nacional Comum Curricular - BNCC - e as Diretrizes Curriculares Nacionais para o Ensino Médio - DCNEM. Com aporte em discussão bibliográfica e documental, analisa a reforma do ensino médio, destaca as audiências públicas, evidencia os elementos controversos na proposta para formação e expõe a vinculação dessa proposição com os organismos internacionais no direcionamento neoliberal. Como resultados, aponta que a reforma traz traços reacionários e de acentuação da desigualdade educacional que impactam a formação da juventude e o trabalho desenvolvido pela escola. É um assunto importante a ser analisado por todos os professores que visam ao desenvolvimento da educação média para a formação emancipadora da juventude brasileira, num trabalho que leve em conta a compreensão do sujeito jovem enquanto ser social.

ABSTRACT: The text discusses the relationship between Law No. 13.415/2017, the National Common Curricular Base - BNCC, and the National Curricular Guidelines for Secondary Education - DCNEM. Based on bibliographical and document discussion, the article analyzes high school reform; highlights the public hearings; points out the controversial elements in the training proposal and shows the relation of this proposition with international bodies in a neoliberal direction. As results, we indicate that the reform has reactionary traits and accentuates educational inequality that impact youth formation and the work developed by school. It is an important issue to be analyzed by all teachers that aim the development of High School education for the emancipatory formation of Brazilian youth, in a work that understands youngsters as social beings.

RESÚMEN: El texto discute la relación entre la Ley n.º 13.415/2017, la Base Nacional Común Curricular - BNCC y las Directrices Curriculares Nacionales para la Enseñanza Mediana - DCNEM. Con contribución en discusión bibliográfica y documental, analiza la reforma de la enseñanza mediana, destaca las audiencias públicas; evidencia los elementos polémicos en la propuesta para formación y expone la vinculación de esta proposición a los organismos internacionales en el direccionamiento neoliberal. Como resultados, apunta que la reforma trae rasgos reaccionarios y de acentuación de la desigualdad educacional que impactan la formación de la juventud y el trabajo desarrollado por la escuela. Es un tema importante de analizar por todos los profesores que visan al desarrollo de la educación mediana para la formación emancipadora de la juventud brasileña, en un trabajo que toma en cuenta la comprensión del sujeto joven, mientras un ser social.

https://doi.org/10.1590/0102-4698222442 2827 downloads

13.

EDUCAÇÃO INTEGRAL E ATENDIMENTO EDUCACIONAL ESPECIALIZADO: COMO ESSAS POLÍTICAS SÃO IMPLEMENTADAS AO MESMO TEMPO?
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Sotero, Mariana da Cunha

; Cunha, Eliana Briense Jorge

; Garcia, Valéria Aroeira

Cadernos CEDES

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aug 2019, Volume 39 N. 108 Pages 237 - 250

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO: Esse artigo tem como propósito trazer problemáticas e levantar questões acerca de quais tempos e espaços o atendimento educacional especializado vem ocupando nas escolas de educação integral. Não apresentamos respostas, mas a partir do cotidiano das escolas de educação integral em suas organizações para a realização do atendimento educacional especializado, trazemos perguntas e reflexões sobre as dificuldades no atendimento à legislação tanto do atendimento educacional especializado quanto da educação integral, coadunando as necessidades das crianças e adolescentes público-alvo da educação especial.

ABSTRACT: This article aims to raise problems and questions about what time and spaces the Specialized Educational Care (SCE) are occupying in Full-time Education Schools. The article does not offer answers, instead, it raises questions and considerations from the everyday life of Full-time Education schools in their organizations for the achievement of the SCE, as well as the difficulties in compliance from both the SCE and the education in line with the needs of children and adolescents, the target audience of special education.

https://doi.org/10.1590/cc0101-32622019219694 3518 downloads

14.

Technologies for Jatoba Seedling Formation
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Costa, Edilson

; Lopes, Karina Garcia

; Binotti, Flávio Ferreira da Silva

; Binotti, Eliana Duarte Cardoso

; Dalastra, Cleiton

Floresta e Ambiente

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2019, Volume 26 N. 1 elocation e20150084

Abstract: En | Text: En | PDF: En

ABSTRACT This research evaluated protected environment and substrates for jatoba seedling. Two protected environments were used: (i) black shading screen on the sides and roof; and, (ii) black shading screen on the sides and thermal-reflective aluminized screen on the roof. In each environment the following substrates formulated with cattle manure (M) and vermiculite (V) were tested: 100% M; 90% M + 10% V; 80% M + 20% V; 70% M + 30% V; 60% M +40% V; 50% M + 50% V; 40% M +60% V; 30% M + 70% V; 20% M + 80% V; 10% M + 90%V. The environment protected with black shading screen was more favorable for the formation of jatoba seedlings, resulting in seedlings with higher shoot height and root collar diameter and, therefore, higher quality. Recommendation is to use substrates containing up to 30% of cattle manure to produce high quality jatoba seedlings.

https://doi.org/10.1590/2179-8087.008415 642 downloads

15.

Knowledge about HIV/AIDS in older adults using the services of Family Health Strategy
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Nardelli, Giovanna Gaudenci

; Gaudenci, Eliana Maria

; Silveira, Rodrigo Eurípedes da

; Garcia, Luan Augusto Alves

; Malaquias, Bruna Sthephanie Sousa

; Santos, Álvaro da Silva

Revista da Sociedade Brasileira de Medicina Tropical

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2019, Volume 52 elocation e20180355

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: This study evaluated knowledge about HIV/AIDS in elders using the services of Family Health Strategy. METHODS: Cross-sectional, descriptive, and analytical study involving 238 participants. Mini-Mental State Examination and QHIV3I were applied. RESULTS: About 30% of participants had active sexual lives and 5.5% used condoms consistently. The question with the highest score of right answers was about transmission through needles (95%) and the lowest (52.5%) was about whether individuals infected with the virus always displayed symptoms. CONCLUSIONS: It is necessary to train health professionals to develop actions that encourage elders to take preventive measures.

https://doi.org/10.1590/0037-86820355-2018 1070 downloads

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