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RESUMO Objetivo: Descrever a população de recém-nascidos com síndrome de Patau (T13) e Edwards (T18) portadores de cardiopatias congênitas, que permaneceram em Unidades de Terapia Intensiva (UTI) de um complexo hospitalar quaternário, com relação a conduta cirúrgica ou não, cuidados paliativos e seus desfechos. Métodos: Série de casos de pacientes internados entre janeiro de 2014 a dezembro de 2018, com análise dos prontuários de portadores de T13 ou T18 que permaneceram internados em UTI que recebem neonatos nesse hospital quaternário. Utilizou-se análise estatística descritiva. Resultados: Foram identificados 33 prontuários para análise — 27 T18 (81,8%) e seis T13 (18,2%); 64% do sexo feminino e 36% do sexo masculino. Oito foram prematuros, nascidos com 30 a 36 semanas (24,2%), e apenas quatro nasceram com mais de 2500 g (12,1%). Quatro pacientes foram submetidos a cirurgia cardíaca e um deles foi a óbito. A mortalidade intra-hospitalar foi de 83% para T13 e 59% para T18. A maioria apresentava outras malformações e foi submetida a outras cirurgias. Cuidados paliativos foram oferecidos a 54% dos pacientes. A mediana do tempo de hospitalização para T18 e T13 foi respectivamente de 29 dias (variação: 2–304) e 25 dias (13–58). Conclusões: Pacientes com T13 e T18 cursam com alta morbimortalidade e longa permanência hospitalar em UTI. São necessários estudos multicêntricos para melhor análise de aspectos importantes para a criação de protocolos que, buscando proporcionalidade terapêutica, tragam melhor qualidade de vida para os pacientes e suas famílias. Objetivo recémnascidos recém T (T13 (T18 congênitas (UTI quaternário não desfechos Métodos 201 2018 T1 Utilizouse Utilizou se descritiva Resultados 3 2 81,8% 818 81 8 (81,8% 18,2% 182 18 (18,2%) 64 masculino prematuros 24,2%, 242 24,2% , 24 (24,2%) 250 12,1%. 121 12,1% . 12 1 (12,1%) óbito intrahospitalar intra 83 59 cirurgias 54 variação (variação 2–304 2304 304 13–58. 1358 13–58 13 58 (13–58) Conclusões terapêutica famílias (T1 20 81,8 (81,8 18,2 (18,2% 6 24,2 (24,2% 12,1 (12,1% 5 2–30 230 135 13–5 (13–58 (T 81, (81, 18, (18,2 24, (24,2 12, (12,1 2–3 23 13– (13–5 (81 (18, (24, (12, 2– (13– (8 (18 (24 (12 (13 ( (1 (2

ABSTRACT Objective: To describe the newborn population with Patau (T13) and Edwards Syndrome (T18) with congenital heart diseases that stayed in the Intensive Care Unit (ICU) of a quaternary care hospital complex, regarding surgical and non-surgical medical procedures, palliative care, and outcomes. Methods: Descriptive case series conducted from January/2014 to December/2018 through analysis of records of patients with positive karyotype for T13 or T18 who stayed in the ICU of a quaternary hospital. Descriptive statistics analysis was applied. Results: 33 records of eligible patients were identified: 27 with T18 (82%), and 6 T13 (18%); 64% female and 36% male. Eight were preterm infants with gestational age between 30–36 weeks (24%), and only 4 among the 33 infants had a birth weight >2500 g (12%). Four patients underwent heart surgery and one of them died. Intrahospital mortality was 83% for T13, and 59% for T18. The majority had other malformations and underwent other surgical procedures. Palliative care was offered to 54% of the patients. The median hospitalization time for T18 and T13 was 29 days (range: 2–304) and 25 days (13–58), respectively. Conclusions: Patients with T13 and T18 have high morbidity and mortality, and long hospital and ICU stays. Multicentric studies are needed to allow the analysis of important aspects for creating protocols that, seeking therapeutic proportionality, may bring better quality of life for patients and their families. Objective T (T13 (T18 (ICU complex nonsurgical non procedures outcomes Methods January2014 January 2014 January/201 December2018 December 2018 December/201 T1 applied Results 3 identified 2 82%, 82 82% , (82%) 18% 18 (18%) 64 36 male 3036 30 30–3 24%, 24 24% (24%) 2500 >250 12%. 12 12% . (12%) died 83 59 54 range (range 2–304 2304 304 13–58, 1358 13–58 13 58 (13–58) respectively Conclusions stays proportionality families (T1 January201 201 January/20 December201 December/20 8 (82% 1 (18% 303 30– (24% 250 >25 (12% 5 2–30 230 135 13–5 (13–58 (T January20 20 January/2 December20 December/2 (82 (18 (24 >2 (12 2–3 23 13– (13–5 January2 January/ December2 December/ (8 (1 (2 > 2– (13– ( (13

https://doi.org/10.1590/1984-0462/2024/42/2023053

Advantages of whole-exome sequencing over immunomapping in 67 Brazilian patients with epidermolysis bullosa wholeexome whole exome 6
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Kelmann, Samantha Vernaschi

; Stephan, Bruno de Oliveira

; Barbosa, Silvia Maria de Macedo

; Polastrini, Rita Tiziana Verardo

; Oliveira, Zilda Najjar Prado de

; Rivitti-Machado, Maria Cecília

; Spolador, Gustavo Marquezani

; Honjo, Rachel Sayuri

; Saida, Ken

; Matsumoto, Naomichi

; Kim, Chong Ae

Anais Brasileiros de Dermatologia

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2024, Volume 99 N. 3 Pages 350 - 356

Abstract: En | Text: En | PDF: En

Abstract Background Epidermolysis bullosa (EB) is characterized by skin fragility and blistering. In Brazil, the diagnosis is usually obtained through immunomapping, which involves a skin biopsy. Most recently, whole exome sequencing (WES) has become an important tool for the diagnosis of the subtypes of EB, providing information on prognosis as well as allowing appropriate genetic counseling for the families. Objective To compare the results of immunomapping and molecular analysis and to describe the characteristics of a Brazilian cohort of patients with EB. Methods Patients were submitted to clinical evaluation and WES using peripheral blood samples. WES results were compared to those obtained from immunomapping testing from skin biopsies. Results 67 patients from 60 families were classified: 47 patients with recessive dystrophic EB (DEB), 4 with dominant DEB, 15 with EB simplex (EBS), and 1 with junctional EB (JEB). Novel causative variants were: 10/60 (16%) in COL7A1 associated with recessive DEB and 3 other variants in dominant DEB; one homozygous variant in KRT5 and another homozygous variant in PLEC, both associated with EBS. Immunomapping was available for 59 of the 67 patients and the results were concordant with exome results in 37 (62%), discordant in 13 (22%), and inconclusive in 9 patients (15%). Study limitations Even though EB is a rare disease, for statistical purposes, the number of patients evaluated by this cohort can still be considered limited; other than that, there was a significant difference between the proportion of types of EB (only one case with JEB, against more than 50 with DEB), which unfortunately represents a selection bias. Also, for a small subset of families, segregation (usually through Sanger sequencing) was not an option, usually due to deceased or unknown parent status (mostly the father). Conclusion Although immunomapping has been useful in services where molecular studies are not available, this invasive method may provide a misdiagnosis or an inconclusive result in about 1/3 of the patients. This study shows that WES is an effective method for the diagnosis and genetic counseling of EB patients. (EB blistering Brazil biopsy recently (WES samples biopsies 6 classified , (DEB) EBS, EBS (EBS) JEB. JEB . (JEB) 1060 10 10/6 16% 16 (16% COLA COL A COL7A KRT PLEC 5 62%, 62 62% (62%) 22%, 22 22% (22%) 15%. 15% (15%) disease purposes limited only DEB) bias Also option mostly father. father father) 1/ (DEB (EBS (JEB 106 10/ (16 (62% 2 (22% (15% (1 (62 (22 (15 ( (6 (2

https://doi.org/10.1016/j.abd.2023.07.002

Exploring the Brazilian pediatric palliative care network: a quantitative analysis of a survey data network
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Ferreira, Esther Angélica Luiz

; Valete, Cristina Ortiz Sobrinho

; Barbosa, Silvia Maria de Macedo

; Costa, Graziela de Araujo

; Molinari, Poliana Cristina Carmona

; Iglesias, Simone Brasil de Oliveira

; Castro, Ana Cristina Pugliese de

Revista Paulista de Pediatria

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2023, Volume 41 elocation e2022020

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

RESUMO Objetivo: Identificar as características dos serviços que compõem a Rede Brasileira de Cuidados Paliativos Pediátricos (CPP). Métodos: Estudo do tipo survey online entre representantes de serviços de CPP. O total de 90 serviços do Brasil participaram da pesquisa e responderam a um questionário sobre a caracterização do serviço, os profissionais de saúde que nele atuam, o acesso à prescrição de opioides e a educação e pesquisa em CPP. Resultados: Oitenta serviços (88,9) foram criados após 2010, 52 (57,9%) estão na Região Sudeste, 56 (62,2%) em hospitais públicos, 63 (70%) têm até cem leitos e 57 (63,3%) estão no nível terciário. Oitenta e oito serviços (97,8%) tinham um médico na equipe e, em 68 (75,5%), os profissionais dedicavam parte de seu tempo aos CPP. Trinta e três serviços (36,7%) revelaram preocupação com o atendimento aos profissionais de saúde. Trinta e seis (40%) relataram dificuldade ou nenhum acesso à prescrição de opioides. Foi reportada a realização de pesquisas em 29 (32,2%). Conclusões: Este mapeamento aponta para a concentração dos serviços de CPP na Região Sudeste, com dedicação parcial dos profissionais, e para a necessidade de cuidar deles. Foi relatada dificuldade no acesso aos opioides. É necessário estender a participação na rede de CPP para outras regiões do Brasil, aumentar o tempo dedicado aos CPP pelos profissionais e cuidar destes, além de melhorar o acesso à prescrição de opioides. Objetivo . (CPP) Métodos 9 serviço atuam Resultados 88,9 889 88 (88,9 2010 5 57,9% 579 (57,9% Sudeste 62,2% 622 62 2 (62,2% públicos 6 70% 70 (70% 63,3% 633 3 (63,3% terciário 97,8% 978 97 8 (97,8% 75,5%, 755 75,5% , 75 (75,5%) 36,7% 367 36 7 (36,7% 40% 40 (40% 32,2%. 322 32,2% 32 (32,2%) Conclusões deles destes (CPP 88, (88, 201 57,9 (57,9 62,2 (62,2 (70 63,3 (63,3 97,8 (97,8 75,5 (75,5% 36,7 (36,7 4 (40 32,2 (32,2% (88 20 57, (57, 62, (62, (7 63, (63, 97, (97, 75, (75,5 36, (36, (4 32, (32,2 (8 (57 (62 ( (63 (97 (75, (36 (32, (5 (6 (9 (75 (3 (32

Abstract Objective: The aim of this study was to identify the characteristics of services in Brazil that compound the Brazilian Pediatric Palliative Care (PPC) Network. Methods: An online survey was conducted among representatives from PPC services. A total of 90 services from Brazil completed the online survey and answered a questionnaire about the service’s characterization, health professionals working in PPC, access to opioid prescription and education, and research in PPC. Results: In total, 80 services (88.9%) were created after 2010, 52 (57.9%) were in the southeast region, 56 (62.2%) were in public hospitals, 63 (70%) had up to 100 beds, and 57 (63.3%) were at the tertiary level. Notably, 88 (97.8%) had a physician in the team and 68 (75.5%) dedicated part-time to PPC. Also, 33 (36.7%) revealed concern with the care of health professionals and 36 (40%) reported difficulty or no access to opioid prescription. Research studies were reported to be conducted in 29 (32.2%) services. Conclusions: This mapping points out to a concentration of PPC services in the southeast region, with part-time professional dedication, and the need to improve professionals’ care. Difficulty in opioid access was reported. It is necessary to extend PPC participation to other Brazilian regions, increase time dedicated to PPC, improve professionals’ care and improve access to opioid prescription. Objective (PPC Network Methods 9 service s characterization education Results 8 88.9% 889 (88.9% 2010 5 57.9% 579 (57.9% region 62.2% 622 62 2 (62.2% hospitals 6 70% 70 (70% 10 beds 63.3% 633 3 (63.3% level Notably 97.8% 978 97 (97.8% 75.5% 755 75 (75.5% parttime part Also 36.7% 367 7 (36.7% 40% 40 (40% 32.2% 322 32 (32.2% Conclusions dedication regions 88.9 (88.9 201 57.9 (57.9 62.2 (62.2 (70 1 63.3 (63.3 97.8 (97.8 75.5 (75.5 36.7 (36.7 4 (40 32.2 (32.2 88. (88. 20 57. (57. 62. (62. (7 63. (63. 97. (97. 75. (75. 36. (36. (4 32. (32. (88 (57 (62 ( (63 (97 (75 (36 (32 (8 (5 (6 (9 (3

https://doi.org/10.1590/1984-0462/2023/41/2022020

Detoxified castor-bean meal replaces soybean meal in the diet of pasture-finished steers
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Ribeiro Lima, Antônio Carlos

; Rodrigues Silva, Robério

; Andrade Teixeira, Fábio

; Ferreira da Silva, Fabiano

; Mendes Machado, Silvia Layse

; de Melo Lisboa, Mateus

; Silva Pereira, Maria Magna

; Macedo Carvalho, Venício

; da Conceição Santos, Marceliana

; Morais de Lima Júnior, Dorgival

Chilean journal of agricultural research

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sep 2022, Volume 82 N. 3 Pages 371 - 379

Abstract: En | Text: En | PDF: En

ABSTRACT The use of agroindustrial byproducts in cattle diets, such as castor-bean (Ricinus communis L.) meal, is a more sustainable practice because it does not compete with human food and reduces the volume of organic waste deposited in the environment. The aim of this study was to examine the effect of replacing soybean (Glycine max (L.) Merr.) meal with castor-bean meal on the intake, digestibility, feeding behavior and performance of crossbred steers supplemented while on Urochloa brizantha (Hochst. ex A. Rich.) R.D. Webster ‘Marandu’ pasture. The experiment was laid out in a randomized complete design with 40 animals, which started the experiment weighing 227.1 kg, at 10 mo of age, and were divided into four treatment groups. Castor-bean meal was added to replace soybean meal at the levels of 0, 90, 180, and 280 g kg-1 in the supplement, which was supplied at the rate of 0.4% of body weight. Total DM, pasture DM and neutral detergent fiber intakes did not change (P > 0.05) with the castor-bean levels added to the supplement. Ether extract intake and digestibility decreased linearly (P < 0.05). The animals showed no differences (P > 0.05) in production performance (average daily gain), which averaged 0.65 kg d-1. Grazing, idle, and rumination times were not influenced (P > 0.05) by the treatments. Castor-bean meal can be included up to 280 g kg-1 in the total diet without changing the performance of crossbred steers finished on tropical pasture.

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Clinical management of fever in children in Brazil: practical recommendations from an expert panel
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Simon Junior, Hany

; Pedreira, Marcello Creado

; Barbosa, Silvia Maria de Macedo

; Fernandes, Tadeu Fernando

; Escobar, Ana Maria de Ulhôa

einstein (São Paulo)

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2022, Volume 20 elocation eRW6045

Abstract: En | Text: En | PDF: En

ABSTRACT The objective of this study was to answer several questions related to the assessment and treatment of fever, as well as other controversies that exist during its management in pediatric patients. First, an advisory board with medical experts was conducted to discuss the clinical journey of these patients, considering the main challenges and possible solutions. After this discussion, a non-systematic literature review was performed, between November 2019 and January 2020, to collect the most relevant evidence available in the scientific databases MEDLINE, Lilacs, and SciELO. A narrative review was carried out based on scientific evidence and on extensive experience of experts in clinical practice. The experts developed a set of recommendations and clarifications about the assessment of the severity of fever in pediatrics, the need for treatment and the choice of the most appropriate antipyretic. The most common controversies in the management of fever in pediatric patients were also addressed, such as alternating antipyretics, persistent fever, and dose equivalence. In primary management of pediatric patients, fever should be seen as a relevant symptom that requires treatment with antipyretics in potentially more complex or severe cases, when it causes discomfort to children or is associated with infectious diseases.

https://doi.org/10.31744/einstein_journal/2022rw6045

Coping da equipe de enfermagem no processo morte-morrer em unidade neonatal
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Silveira, Cindy Macedo da

; Bellaguarda, Maria Lígia dos Reis

; Canever, Bruna

; Costa, Roberta

; Knihs, Neide da Silva

; Caldeira, Silvia

Acta Paulista de Enfermagem

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2022, Volume 35 elocation eAPE02261

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

Resumo Objetivo Compreender o coping dos profissionais de enfermagem no processo morte- morrer em neonatologia. Método Estudo qualitativo na abordagem exploratória descritiva, participaram dez profissionais da enfermagem. Histórias rememoradas dos profissionais no cuidado do processo da morte e do morrer em neonatologia foi o meio para a coleta de dados. Organização, tratamento e análise dos dados fundamentado na análise de conteúdo de Bardin e no software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. Resultados Emergiram duas categorias da interface da análise e os fundamentos da Teoria Motivacional de Coping de Skinner, Equipe de enfermagem e a teoria motivacional de coping na morte em neonatologia; Ação regulatória de ameaça e o enfrentamento da morte em neonatologia. As estratégias de coping da equipe de enfermagem estudada mostram que os padrões cognitivos e respostas comportamentais referem-se à própria maneira de lidar com o cotidiano do sofrimento vivenciado em família, onde os profissionais buscam informação para ultrapassar a ameaça, num enfrentamento de desamparo e de fuga do acolhimento. Conclusão Os processos autorreferenciais experienciados em situações estressantes por profissionais da enfermagem favorecem à empatia, o vínculo e a comunicação com a família de neonatos à morte. Os indicativos de fragilidade na formação mantêm-se predisponentes para as dificuldades no enfrentamento da morte-morrer.

Abstract Objective This understanding is essential to subsidize interventions of nursing professionals in order to care for families. Method A qualitative study in descriptive exploratory approach involved ten nursing professionals. Recollected stories collected from professionals in the care of the process of death and dying in neonatology was the means for data collection. Data organization, treatment and analysis was based on Bardin’s content analysis and the software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. Results Two categories emerged from the analysis interface and the foundations of Skinner’s Motivational Theory of Coping, nursing staff and Motivational Theory of Coping in death in neonatology; Threat regulatory action and coping with death in neonatology. The coping strategies of the nursing team studied show that cognitive patterns and behavioral responses refer to the very way of dealing with the daily suffering experienced in the family, where professionals seek information to overcome the threat, a coping with helplessness and escape from welcoming. Conclusion The self-referential processes experienced in stressful situations by nursing professionals favor empathy, bonding and communication with the family of infants. The indicators of frailty in training remain predisposing to difficulties in coping with death-dying.

Resumen Objetivo Comprender el coping de los profesionales de enfermería en el proceso muerte-morir en neonatología. Métodos Estudio cualitativo de enfoque exploratorio descriptivo, donde participaron diez profesionales de enfermería. Las historias contadas por los profesionales sobre el cuidado del proceso de muerte y del morir en neonatología fue el medio para la recopilación de datos. La organización, el tratamiento y el análisis de los datos fue fundamentado en el análisis de contenido de Bardin y en el software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. Resultados Surgieron dos categorías de la interfaz de análisis y fundamentos de la teoría motivacional de coping de Skinner: Equipo de enfermería y la teoría motivacional de coping respecto a la muerte en neonatología y Acción reguladora de amenaza y el afrontamiento a la muerte en neonatología. Las estrategias de coping del equipo de enfermería estudiado muestran que los patrones cognitivos y las respuestas de comportamiento se refieren a la propria manera de lidiar con la cotidianidad del sufrimiento vivido en familia, donde los profesionales buscan información para superar la amenaza, en un enfrentamiento de desamparo y de fuga de la acogida. Conclusión Los procesos autorreferenciales vividos en situaciones estresantes por profesionales de enfermería favorecen la empatía, el vínculo y la comunicación con la familia de neonatos a fallecer. Los indicios de fragilidad en la formación se mantienen predisponentes para las dificultades de afrontar la muerte-morir.

https://doi.org/10.37689/acta-ape/2022ao02261

Retirement Resources Inventory in Portugal: An Adaptation and Validation Study
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França, Lucia Helena de Freitas Pinho

; Amorim, Silvia Miranda

; Pedreiro, Ana Teresa Martins

; Loureiro, Helena Maria Almeida Macedo

Paidéia (Ribeirão Preto)

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2022, Volume 32 elocation e3213

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

Resumo Um quarto da população de Portugal tem 65 anos ou mais, sendo a maioria aposentada. Apesar disso, há uma carência de estudos e instrumentos para facilitar o planejamento para a aposentadoria. O objetivo deste estudo foi validar o Retirement Resources Inventory - RRI neste país para utilizá-lo em futuras intervenções. Participaram deste estudo 450 aposentados portugueses de todas as regiões, que responderam ao inventário e a questões sociodemográficas. Das análises exploratórias e confirmatórias emergiram 23 itens, confirmando o modelo de quatro fatores [χ2 (gl) = 404.63(216); CFI = 0.90; TLI = 0.88; RMSEA = 0.06; SRMR = 0.06], com boas evidências de validade interna e convergente. O primeiro fator correspondeu aos aspetos físicos e financeiros, o segundo aos recursos sociais e familiares, o terceiro ao suporte recebido e o quarto aos recursos emocionais e cognitivos. Recomenda-se a replicação do RRI em estudo longitudinal antes e após o evento da aposentadoria.

Abstract A quarter of Portugal’s population is aged 65 years or over, mostly retired individuals. However, there is a lack of studies and instruments to facilitate retirement planning. This study aims to validate the Retirement Resources Inventory in Portugal to use it in future interventions. In total, 450 Portuguese retirees from all regions who responded to the inventory and sociodemographic questions participated in this study. According to the exploratory and confirmatory analyses, 23 items were found, confirming the four-factor model [χ 2 (gl) = 404.63(216); CFI = 0.90; TLI = 0.88; RMSEA = 0.06; SRMR = 0.06], with good evidence of internal and convergent validity. The first factor corresponded to physical and financial aspects, the second to social and family resources, the third to received support, and the fourth to emotional and cognitive resources. We recommend the replication of the RRI in a longitudinal study before and after retirement.

Resumen Una cuarta parte de la población de Portugal tiene 65 años o más, y la mayoría está jubilada. Sin embargo, faltan estudios e instrumentos que faciliten la planificación de la jubilación. El objetivo de este estudio fue validar el Retirement Resources Inventory (RRI) en este país para que sea utilizado en futuras intervenciones. Participaron 450 jubilados portugueses de todas las regiones, quienes respondieron al inventario y a preguntas sociodemográficas. De los análisis exploratorio y confirmatorio emergieron 23 ítems, confirmando el modelo de cuatro factores [χ2 (gl) = 404,63 (216); CFI = 0,90; TLI = 0,88; RMSEA = 0,06; SRMR = 0,06], con buena evidencia de validez interna y convergente. El primer factor correspondió a los aspectos físicos y económicos, el segundo a los recursos sociales y familiares, el tercer al apoyo recibido, y el cuarto a los recursos emocionales y cognitivos. Se recomienda la replicación del RRI en un estudio longitudinal antes y después del evento de jubilación.

https://doi.org/10.1590/1982-4327e3213

The Assessment of Vitamin D Levels in Pregnant Women is not Associated to Fetal Growth Restriction: A Cross Sectional Study
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Marçal, Vivian Macedo Gomes

; Sousa, Francisco Lázaro Pereira

; Daher, Silvia

; Grohmann, Raquel Margiotte

; Peixoto, Alberto Borges

; Araujo Júnior, Edward

; Nardozza, Luciano Marcondes Machado

Revista Brasileira de Ginecologia e Obstetrícia

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oct 2021, Volume 43 N. 10 Pages 743 - 748

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

Resumo Objetivo Avaliar o nível sérico materno de vitamina D em fetos adequados para idade gestacional (AIG), pequenos para idade gestacional (PIG) e com restrição de crescimento (RCF) de acordo com a estimativa de peso fetal (EPF). Métodos Realizou-se um estudo transversal envolvendo 87 gestantes entre 26 e 36 semanas, sendo: 38 do grupo AIG, 24 do grupo PIG e 25 do grupo RCF. A dosagem sérica materna de vitamina D foi realizada pelo método de quimiluminescência. Para as comparações entre os grupos, utilizou-se o teste exato de Fisher. Resultados A média ± desvio-padrão (DP) da idade materna (anos) e do índice de massa corporal (kg/m2) nos grupos AIG, PIG e RCF foram 25,26 ± 8,40 / 26,57 ± 4,37; 25,04 ± 8,44 / 26,09 ± 3,94; e 25,48 ± 7,52 / 26,24 ± 4,66, respectivamente (p>0,05). A concentração sérica materna de vitamina D (médias ± desvios-padrão) dos grupos AIG, PG e RCF foram 22,47±8,35 ng/ml; 24,80_10,76 ng/ml; e 23,61 ± 9,98 ng/ml, respectivamente, contudo, sem diferenças significativas entre os grupos (p=0,672). Conclusão A concentração sérica materna de vitamina D não apresentou diferenças significantes entre gestantes com fetos AIG, PIG ou RCF entre 26 e 36 semanas de acordo com a EPF.

Abstract Objective To assess maternal serum levels of vitamin D in fetuses appropriate for gestational age (AGA), small for gestational age (SGA), and with fetal growth restriction (FGR) according to estimated fetal weight (EFW). Methods This cross-sectional study included 87 pregnant women between 26 and 36 weeks of gestation: 38 in the AGA group, 24 in the SGA group, and 25 in the FGR group. Maternal serum vitamin D levels were assessed using the chemiluminescence method. The Fisher exact test was used to compare the results between the groups. Results The mean ± standard deviation (SD) of maternal age (years) and body mass index (kg/m2) in the AGA, SGA, and FGR groups were 25.26 8.40 / 26.57 ± 4.37; 25.04 ± 8.44 / 26.09 ± 3.94; and 25.48 ± 7.52 / 26.24 ± 4.66, respectively (p > 0.05). The maternal serum vitamin D levels (mean ± SD) of the AGA, SGA, and FGR groups were 22.47 ± 8.35 ng/mL, 24.80 ± 10.76 ng/mL, and 23.61 ± 9.98 ng/mL, respectively, but without significant differences between the groups (p = 0.672). Conclusion Maternal serum vitamin D levels did not present significant differences among pregnant women with AGA, SGA, or FGR fetuses between 26 and 36 weeks of gestation according to EFW.

https://doi.org/10.1055/s-0041-1735158

Posicionamento sobre o Consumo de Gorduras e Saúde Cardiovascular – 2021
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Izar, Maria Cristina de Oliveira

; Lottenberg, Ana Maria

; Giraldez, Viviane Zorzanelli Rocha

; Santos Filho, Raul Dias dos

; Machado, Roberta Marcondes

; Bertolami, Adriana

; Assad, Marcelo Heitor Vieira

; Saraiva, José Francisco Kerr

; Faludi, André Arpad

; Moreira, Annie Seixas Bello

; Geloneze, Bruno

; Magnoni, Carlos Daniel

; Scherr, Carlos

; Amaral, Cristiane Kovacs

; Araújo, Daniel Branco de

; Cintra, Dennys Esper Corrêa

; Nakandakare, Edna Regina

; Fonseca, Francisco Antonio Helfenstein

; Mota, Isabela Cardoso Pimentel

; Santos, José Ernesto dos

; Kato, Juliana Tieko

; Beda, Lis Mie Masuzawa

; Vieira, Lis Proença

; Bertolami, Marcelo Chiara

; Rogero, Marcelo Macedo

; Lavrador, Maria Silvia Ferrari

; Nakasato, Miyoko

; Damasceno, Nagila Raquel Teixeira

; Alves, Renato Jorge

; Roberta Soares, Lara

; Costa, Rosana Perim

; Machado, Valéria Arruda

Arquivos Brasileiros de Cardiologia

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jan 2021, Volume 116 N. 1 Pages 160 - 212

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

https://doi.org/10.36660/abc.20201340 9969 downloads

10.

Evaluation of pain in vaginal and caesarean section birth newborns before and after intramuscular injection
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Ferreira, Esther Angélica Luiz

; Nassif, Damaris Souza

; Silva, Matheus Jordão Danza

; Barbosa, Silvia Maria de Macedo

; Módolo, Norma Sueli Pinheiro

; Barros, Guilherme Antônio Moreira

BrJP

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mar 2020, Volume 3 N. 2 Pages 123 - 126

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

RESUMO JUSTIFICATIVA E OBJETIVOS: As experiências dolorosas as quais o recém-nascido é submetido podem ter relação com reações futuras e que existem diferenças no comportamento de resposta à dor nos recém-nascidos oriundos de diferentes vias de parto. O estudo teve como objetivo avaliar a resposta à dor em bebês nascidos por cesariana e parto vaginal. MÉTODOS: Estudo coorte prospectivo que incluiu recém-nascidos nascidos a termo, de cesariana e parto vaginal. Utilizou-se, como estímulo doloroso agudo, a injeção intramuscular de vitamina K rotineira ao nascimento. Os recém-nascidos foram avaliados quanto à dor pela escala unidimensional Neonatal Facial Coding System e pela multidimensional COMFORT Behavior Scale (Comfort b), além da frequência cardíaca nos momentos antes, imediatamente após e 10 minutos após o estímulo. Foi utilizado teste t de Student para a análise estatística com significância de 5%. RESULTADOS: Foram avaliadas 83 crianças. A intensidade da dor avaliada por ambas as escalas antes do estímulo doloroso foi maior no grupo de recém-nascidos de cesariana, porém não foi estatisticamente significativa. Os valores da frequência cardíaca após o estímulo mostraram diferença estatisticamente significativa (p<0,05) maiores no grupo cesariana que no parto vaginal. CONCLUSÃO: Os dados obtidos não evidenciaram diferenças na percepção da dor entre recém-nascidos de parto vaginal e cesariana.

ABSTRACT BACKGROUND AND OBJECTIVES: It is already known that the painful experiences to which the newborn is subjected may be related to future reactions and differences in the behavioral response to pain in newborns from different birth routes. This study aimed to evaluate the response to pain in infants born by cesarean section and vaginal delivery routes. METHODS: This is a prospective cohort study. Newborns born at full term were allocated into two groups: cesarean section and vaginal delivery. The intramuscular vitamin K injection was performed as an acute pain stimulus because it is a routine injection at birth. The newborns were evaluated for pain on two scales, a one-dimensional, the Neonatal Facial Coding System, and a multidimensional, the COMFORT Behavior Scale (Comfort b), in addition to heart rate counting, moments before, immediately after and 10 minutes after the stimuli. Students t-test was used for statistical analyzes, and the level of significance was 5%. RESULTS: Eighty-three children were evaluated. The pain intensity assessed by both scales before the pain stimulus was higher in the cesarean section group, but not statistically significant. Heart rate values after the stimulus showed a statistically significant difference (p<0.05), higher in the cesarean section group than in the vaginal delivery. CONCLUSION: The results did not suggest that there are differences in the perception of pain among newborns born vaginally and cesarean section.

https://doi.org/10.5935/2595-0118.20200021 583 downloads

11.

BREAKING BAD NEWS IN A NEONATAL INTENSIVE CARE: THE PARENT’S EVALUATION
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Marçola, Ligia

; Zoboli, Ivete

; Polastrini, Rita Tiziana Verardo

; Barbosa, Silvia Maria Macedo de

Revista Paulista de Pediatria

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2020, Volume 38 elocation e2019092

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

RESUMO Objetivo: Descrever os relatos dos pais de recém-nascidos (RNs) com malformações congênitas internados em uma Unidade de Terapia Intensiva Neonatal (UTIN) a respeito de como receberam as más notícias, buscando identificar as questões relacionadas à percepção de uma má notícia fornecida de forma adequada ou inadequada. Métodos: Realizou-se estudo transversal de janeiro a outubro de 2018, no qual se entrevistaram pais de RNs portadores de malformações congênitas internados em UTIN selecionados segundo critérios de inclusão e presentes em horário de visita. O questionário utilizado tinha questões semiestruturadas pertinentes ao recebimento de más notícias. A análise foi descritiva. Resultados: Entrevistaram-se 28 mães e dois pais, dos quais 16 (53,3%) apontaram ter tido pelo menos uma má notícia na UTIN. Destes, 10 (62,5%) consideraram adequada a maneira de dar essa notícia. As justificativas foram: sinceridade do profissional, delicadeza para dar a notícia, dar esperança à família, uso de palavras adequadas e cuidado demonstrado com o RN. Seis participantes (37,5%) avaliaram como inadequada a comunicação de más notícias. Motivos foram despreparo e falta de conhecimento, uso de linguagem difícil, pressa ou ansiedade e desencorajamento de esperanças da família. A maior parte das notícias foi dada por um profissional sozinho, muitas vezes por um médico residente. Conclusões: A percepção da comunicação de más notícias foi considerada adequada por parte dos pais, embora não tenha sido unânime. Este estudo aponta ser necessário melhorar a comunicação dessas notícias na UTIN analisada. O treinamento dos profissionais, nesse sentido, pode auxiliar nesse processo.

ABSTRACT Objective: To describe the reports of parents of newborns (NB) with congenital malformations hospitalized in a Neonatal Intensive Care Unit (NICU) who received bad news, in order to identify the issues related to the perception of bad news given adequately or inadequately. Methods: A cross-sectional study was conducted from January to October 2018, in which parents of newborns with congenital malformations hospitalized in NICUs were interviewed at visiting hours, according to inclusion criteria. The questionnaire had semi-structured questions related to reception of bad news. Analysis of the data was descriptive. Results: 28 mothers and two fathers were interviewed and 16 (53.3%) reported having had at least one bad news in the NICU. Of those, 10 (62.5%) considered appropriate the way in which the news was given. The justifications were: sincerity of the professional, delicacy to give the news, giving hope to the family, use of appropriate words and demonstration of caring about the newborn. Six participants (37.5%) considered inadequate the way of breaking bad news. The reasons were: unpreparedness and lack of knowledge about the child’s case, use of difficult language, haste or anxiety and discouragement of family hope. Most of the news was given by a professional alone, often by a medical resident. Conclusions: The communication of bad news was considered adequate by the parents, although this perception was not unanimous. This study, therefore, indicates that it is necessary to improve the communication of bad news in this NICU. Training professionals can assist in this process.

https://doi.org/10.1590/1984-0462/2020/38/2019092 1305 downloads

12.

ANÁLISE DOS ÓBITOS E CUIDADOS PALIATIVOS EM UMA UNIDADE DE TERAPIA INTENSIVA NEONATAL
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Marçola, Ligia

; Barbosa, Silvia Maria Macedo de

; Zoboli, Ivete

; Polastrini, Rita Tiziana Verardo

; Ceccon, Maria Esther Jurfest

Revista Paulista de Pediatria

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jun 2017, Volume 35 N. 2 Pages 125 - 129

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

RESUMO Objetivo: Caracterizar as crianças admitidas na Unidade de Terapia Intensiva Neonatal de um hospital universitário terciário que foram a óbito no período de 1.º/01/2012 a 31/07/2014 e que necessitavam de cuidados paliativos e/ou para as quais foram indicados tal tipo de cuidado. Métodos: Realizou-se estudo descritivo retrospectivo. Foi feita revisão dos prontuários desses pacientes para coleta de dados e análise estatística descritiva. Resultados: No período estudado 49 crianças morreram após, no mínimo, 48 horas de internação. Destas, 18% eram prematuros extremos e 77% apresentavam malformações maiores. Apesar de necessários a todos, cuidados paliativos foram realizados apenas em 20% dos casos de óbito. Dos 12 bebês que não foram reanimados, 33% não estavam em cuidados paliativos. A Unidade de Dor e Cuidados Paliativos da instituição acompanhou somente quatro crianças que ficaram em cuidados paliativos. Foram observados uso de muitos dispositivos invasivos e alto investimento terapêutico, além de escores de escala de dor alterados. Conclusões: Detectou-se neste estudo grande proporção de recém-nascidos com doenças e condições graves de saúde. Em alguns poucos casos foram estabelecidos cuidados paliativos, porém para a maior parte não foi nem discutido tal cuidado. Espera-se que este trabalho chame a atenção para a necessidade da proposição de protocolos nessa unidade e capacitação de equipes para o melhor tratamento dessas crianças.

ABSTRACT Objective: To characterize cases of children admitted to the Neonatal Intensive Care Unit of a tertiary university hospital who died in the period ranging from January 01, 2012 to July 31, 2014, and who required palliative care and/or were subjected to it. Methods: A retrospective descriptive study was carried out by reviewing the medical records of these patients to collect data and to perform descriptive statistical analysis. Results: During the study period, 49 children died after at least 48 hours from the time of admission. Of those, 18% children were extremely premature infants and 77% children had malformations. Although necessary for all of the patients in this study, palliative care was provided for only 20% of patients who died. Among the 12 babies who were not resuscitated, 33% of babies were not in palliative care. The Pain and Palliative Care Unit of the institution followed only four neonates in palliative care. These patients were using many invasive devices, had high therapeutic investment, and also altered pain scale scores. Conclusions: This study exhibited a large proportion of newborn infants with serious diseases and health conditions. In a few cases the patients received palliative care, but most of them were not even discussed under palliative point of view. We hope that this study will call attention to the need to propose protocols and implement training for the best treatment of these children.

https://doi.org/10.1590/1984-0462/;2017;35;2;00012 4820 downloads

13.

Comportamento durante o desmame de peixe-boi-da-amazônia Trichechus inunguis (Natterer, 1883) em cativeiro
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IESPA, Bruno Barbosa

; RIBEIRO, Ana Silvia Sardinha

; BARRETO, Uiara Hanna Araújo

; KLAUTAU, Alex Garcia Cavalleiro de Macedo

; CINTRA, Israel Hidenburgo Aniceto

Revista Brasileira de Saúde e Produção Animal

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mar 2017, Volume 18 N. 1 Pages 183 - 192

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

RESUMO O peixe-boi-da-amazônia Trichechus inunguis (Natterer, 1883) é uma espécie que foi amplamente explorada pela caça, sendo um dos mamíferos aquáticos mais caçados no século XX. Atualmente sua caça é proibida. Todavia, os dispositivos legais não impedem que espécimes jovens, por razões diversas, encalhem e necessitem de cuidados nos cativeiros destinados à reabilitação dessa espécie. O Instituto Chico Mendes de Conservação da Biodiversidade (ICMBio) manteve uma base do Centro de Pesquisa Conservação e Manejo de Mamíferos Aquáticos (CMA) instalada no campus da Universidade Federal Rural da Amazônia (UFRA) com recintos destinados à reabilitação de peixes-boi-da-amazônia. Como alguns animais chegam pequenos, em fase de amamentação, conforme crescem, são submetidos ao desmame que, no cativeiro em tela, ocorreu em trinta dias. O comportamento de sete exemplares dessa espécie foi objeto deste estudo, comparando os padrões de execução de alguns comportamentos antes (mamando), durante (desmamando) e depois (herbivoria) da fase de desmame. Os resultados da análise de variância apontam diferença significativa para as frequências de execução do comportamento relacionado à alimentação pelo teste estatístico de Kruskal-Wallis (p valor <0,0001) havendo resposta comportamental dos animais para a diminuição da oferta de nutrientes proporcionada pelas mamadas. Com o mesmo teste estatístico, um dos comportamentos que foi classificado como uma estereotipia de cativeiro (deslocar-se em círculos) foi diminuindo à medida que o animal saia da fase de amamentação para herbivoria (p < 0,0023).

SUMMARY The Amazonian manatee Trichechus inunguis (Natterer, 1883) is a species that was widely exploited by hunting, one of the most hunted aquatic mammals in the twentieth century. Currently its hunting is prohibited. However, the regulations do not prevent young specimens, for various reasons, beached and require care in captivity for rehabilitation of this species. The Chico Mendes Institute for Biodiversity Conservation (ICMBio) maintained a base of the Center for Research and Conservation of Aquatic Mammals Management (CMA) installed on the campus of the Federal Rural University of Amazonia (UFRA) with enclosures for rehabilitation of the Amazonian manatees. As some small animals arrive in breastfeeding, as they grow, are submitted to weaning that in the screen in captivity occurred in thirty days. The seven examples of behavior of this species has been the subject of this study, comparing the behavior of some performance standards before (nursing), during (weaning) and after (herbivory) of weaning. The results of the variance analysis indicate, among other behaviors, significant difference to the behavior of the execution frequencies related to food by the statistical test of Kruskal-Wallis test (p value <0.0001) having behavioral response of animals to decrease the supply of nutrients provided by breastfeeding. With the same statistical test, a behavior that has been classified as a stereotype captivity (moving in circles) was decreasing as the animal leaves the breastfeeding to herbivory (p <0.0023).

https://doi.org/10.1590/s1519-99402017000100017 2715 downloads

14.

Effects of periodontal treatment on primary sjȫgren’s syndrome symptoms
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AMBRÓSIO, Lucas Macedo Batitucci

; ROVAI, Emanuel da Silva

; FRANÇA, Bruno Nunes de

; BALZARINI, Danilo Andrés

; ABREU, Ieda Santos

; LOPES, Sheyla Batista Bologna

; NUNES, Thaís Borguezan

; LOURENÇO, Silvia Vanessa

; PASOTO, Sandra Gofinet

; SARAIVA, Luciana

; HOLZHAUSEN, Marinella

Brazilian Oral Research

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2017, Volume 31 elocation e8

Abstract: En | Text: En | PDF: En

Abstract The aim of this longitudinal prospective study was to evaluate the effects of periodontal treatment on the clinical, microbiological and immunological periodontal parameters, and on the systemic activity (ESSDAI) and subjective (ESSPRI) indexes in patients with primary Sjögren’s Syndrome (pSS). Twenty-eight female patients were divided into four groups: pSS patients with or without chronic periodontitis (SCP, SC, respectively), and systemically healthy patients with or without chronic periodontitis (CP, C, respectively). Periodontal clinical examination and immunological and microbiological sample collection were performed at baseline, 30 and 90 days after nonsurgical periodontal treatment (NSPT). Levels of interleukin IL-1β, IL-8 and IL-10 in saliva and gingival crevicular fluid (GCF) were evaluated by ELISA, as well as the expression of Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans, (Aa) Tannerella forsythia (Tf), and Treponema denticola (Td), by qPCR. Systemic activity and pSS symptoms were evaluated by ESSDAI and ESSPRI. NSPT resulted in improved periodontal clinical parameters in both SCP and CP groups (p>0.05). Pg, Aa, and Tf levels decreased after NSPT only in CP patients (p<0.05). Significantly greater levels of IL-10 in GCF were verified in both SCP and CP groups (p<0.05). SCP patients showed increased salivary flow rates and decreased ESSPRI scores after NSPT. In conclusion, NSPT in pSS patients resulted in improved clinical and immunological parameters, with no significant effects on microbiological status. pSS patients also showed increased salivary flow and lower ESSPRI scores after therapy. Therefore, it can be suggested that NSPT may improve the quality of life of pSS patients.

https://doi.org/10.1590/1807-3107bor-2017.vol31.0008 3703 downloads

15.

Situação da alimentação complementar de crianças entre 6 e 24 meses assistidas na Rede de Atenção Básica de Saúde de Macaé, RJ, Brasil
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Marinho, Leticia Maia Forte

; Capelli, Jane de Carlos Santana

; Rocha, Camilla Medeiros Macedo da

; Bouskela, Alice

; Carmo, Cleber Nascimento do

; Freitas, Silvia Eliza Almeida Pereira de

; Anastácio, Alexandra da Silva

; Almeida, Maria Fernanda Larcher de

; Pontes, Juliana da Silva

Ciência & Saúde Coletiva

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mar 2016, Volume 21 N. 3 Pages 977 - 986

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

Resumo O estudo objetivou analisar a situação da alimentação complementar de crianças entre 6-24 meses assistidas na Atenção Básica de Saúde de Macaé/RJ. Realizou-se um estudo seccional e os dados foram obtidos do SisvanWEB, sendo incluídos e analisados todos os registros (n = 218) de crianças entre 6-24 meses, no ano de 2013. Em lactentes entre 6-12 meses detectou-se o consumo de 72,3% de verduras/legumes, 75,3% de frutas e 63,4% de carnes, sendo considerados indicadores de alimentação complementar saudável. Em contrapartida, 23,8% já consumiam alimentos fontes de açúcar (mel, melado, açúcar simples e rapadura), 34,7% suco industrializado e 17,8% refrigerantes. O consumo de suco industrializado foi significativamente maior em meninos (p valor < 0,001). Em crianças entre 12-18 meses detectou-se que 77,6% consumiam verduras/legumes, 77,4% frutas e 86,3% carnes. O consumo de alimentos fontes de açúcar era de 31%, 58,6% de suco industrializado e 50% de refrigerantes. Entre 18-24 meses, observou-se 89,9% das crianças consumindo verduras/legumes, 83,1% frutas e 96,7% carnes. O consumo de alimentos fontes de açúcar foi de 33,9%, 69,5% de suco industrializado e 55,5% de refrigerantes. Conclui-se que os indicadores de alimentação complementar saudável se aproximam da meta do Ministério da Saúde (80%).

Abstract This study aimed to analyze the supplementary nutritional situation of children aged 6-24 months attended by the Primary Care unit of Macaé/RJ. It was conducted as a cross-sectional study, and data was obtained from the SISVAN Web website, including and analyzing all of the records (n=218) of children between 6-24 months in the year 2013. In infants between 6-12 months, the consumption of 72.3% of vegetables, 75.3% of fruits, and 63.4% of meats was detected, considered indicators of healthy supplementary nutrition. In contrast, 23.8% were already consuming sugar-based food sources (honey, molasses, simple sugar, and unrefined cane sugar), 34.7% industrialized juice, and 17.8% soft drinks. The consumption of industrialized juice was significantly greater in boys (p-value <0.001). In children between 12-18 months, 77.6% consumed vegetables, 77.4% fruits, and 86.3% meats. The consumption of sugar-based foods was 31%, 58.6% for industrialized juices, and 50% for soft drinks. Between 18-24 months, it was recorded that 89.9% of children consumed vegetables, 83.1% fruits, and 96.7% meat. The consumption of sugar-based foods was 33.9%, 69.5% for industrialized juices, and 55.5% for soft drinks. We conclude that the indicators of healthy complementary nutrition come close to the target set by the Ministry of Health (80%).

https://doi.org/10.1590/1413-81232015213.06532015 7619 downloads

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