ABSTRACT Objective Determining the etiology of hyperprolactinemia is fundamental for selecting the most appropriate treatment strategy. The aim of this study was to evaluate the usefulness and accuracy of prolactin levels in predicting the etiology of nonphysiological hyperprolactinemia. Subjects and methods In this retrospective study, we reviewed medical records of patients with nonphysiological hyperprolactinemia seen at two neuroendocrine reference centers located in Recife, Brazil, from January 2000 to December 2019. Results The study included 770 patients aged 12-73 years (65% female). The three most frequent etiologies of hyperprolactinemia were prolactinomas (n = 263; 34.2%), drug-induced hyperprolactinemia (n = 160; 20.8%), and macroprolactinemia (n = 120; 15.6%). The highest mean prolactin levels were observed in cases of prolactinomas and idiopathic hyperprolactinemia. Most patients with hyperprolactinemia due to other etiologies had prolactin levels < 100 ng/mL, but these levels were also found in 16.5% of patients with microproplactinomas and in 20% of those with idiopathic hyperprolactinemia. Likewise, prolactin levels largely overlapped among patients with microprolactinomas, macroprolactinemia, and drug-induced hyperprolactinemia. Notably, prolactin levels > 250 ng/mL enabled a clear distinction between the etiologies of macroprolactinoma and nonfunctioning pituitary adenoma. Moreover, prolactin levels > 500 ng/mL were highly suggestive of macroprolactinomas, although they were also found in very few patients (<2%) with microprolactinomas or drug-induced hyperprolactinemia. Conclusion Despite considerable overlap in prolactin levels among the different etiologies of hyperprolactinemia, values > 250 ng/mL allowed a clear distinction between macroprolactinomas and nonfunctioning pituitary adenomas. Furthermore, prolactin levels > 500 ng/mL were almost exclusively found in patients with prolactinomas. strategy Recife Brazil 200 2019 77 1273 12 73 12-7 65% 65 (65 female. female . female) n 263 34.2%, 342 34.2% , 34 2 34.2%) druginduced drug induced 160 20.8%, 208 20.8% 20 8 20.8%) 120 15.6%. 156 15.6% 15 6 15.6%) 10 ngmL ng mL 165 16 5 16.5 Likewise Notably 25 adenoma Moreover 50 <2% (<2% adenomas Furthermore 201 7 127 1 12- (6 26 34.2 3 20.8 15.6 16. <2 (<2 ( 34. 20. 15. (<

ABSTRACT OBJECTIVE To assess risk factors associated with motor development delay at three months of age. METHODS Cross-sectional study with mothers and their three-month-old babies in Southern Brazil. The Bayley-III Scale of Infant and Toddler Development (BSID-III) and the Alberta Infant Motor Scale (AIMS) were used to assess motor development. RESULTS We evaluated 756 mothers and their three-month-old babies. The overall mean motor development assessed by the BSID-III and the AIMS was 104.7 (SD 13.5) and 55.4 (SD 25.4), respectively. When assessed by the BSID-III, the lowest motor development scores were among babies born by cesarean delivery (p = 0.002), prematurely (p < 0.001), and with low birth weight (p < 0.001). When assessed by the AIMS, babies born prematurely (p = 0.002) and with low birth weight (p=0.004) had the lowest motor development means. After a cluster analysis, we found that babies born by cesarean delivery, with low birth weight, and prematurely had more impaired motor development compared with children born without any risk factors. CONCLUSION Identifying risk factors allows the implementation of early interventions to prevent motor development delay and, therefore, reduce the probability of other future problems. age Crosssectional Cross sectional threemonthold month old Brazil BayleyIII Bayley III BSIDIII BSID (BSID-III (AIMS 75 1047 104 7 104. SD 13.5 135 13 5 554 55 4 55. 25.4, 254 25.4 , 25 25.4) respectively BSIDIII, III, p 0.002, 0002 0.002 0 002 0.001, 0001 0.001 001 0.001) 0.001. . p=0.004 p0004 004 (p=0.004 means analysis therefore problems 10 13. 1 25. 2 000 0.00 00 p=0.00 p000 (p=0.00 0.0 p=0.0 p00 (p=0.0 0. p=0. p0 (p=0. p=0 (p=0 p= (p=

ABSTRACT OBJECTIVE To assess risk factors associated with motor development delay at three months of age. METHODS Cross-sectional study with mothers and their three-month-old babies in Southern Brazil. The Bayley-III Scale of Infant and Toddler Development (BSID-III) and the Alberta Infant Motor Scale (AIMS) were used to assess motor development. RESULTS We evaluated 756 mothers and their three-month-old babies. The overall mean motor development assessed by the BSID-III and the AIMS was 104.7 (SD 13.5) and 55.4 (SD 25.4), respectively. When assessed by the BSID-III, the lowest motor development scores were among babies born by cesarean delivery (p = 0.002), prematurely (p < 0.001), and with low birth weight (p < 0.001). When assessed by the AIMS, babies born prematurely (p = 0.002) and with low birth weight (p=0.004) had the lowest motor development means. After a cluster analysis, we found that babies born by cesarean delivery, with low birth weight, and prematurely had more impaired motor development compared with children born without any risk factors. CONCLUSION Identifying risk factors allows the implementation of early interventions to prevent motor development delay and, therefore, reduce the probability of other future problems.

ABSTRACT Clinical similarities among viral diseases become even more relevant considering the current scenario, especially in Brazil, where there is a high incidence of these diseases and overlapping seasonality. We report the case of a patient with acute clinical manifestations composed of predominant respiratory symptoms and alveolar hemorrhage in which three etiologies (dengue, influenza and COVID-19) were investigated concomitantly. Only the diagnosis of dengue was confirmed. Then, the patient’s immunological profile in response to stimulation of mononuclear cells with dengue virus antigen was analyzed in an attempt to identify specific characteristics that could be associated with the clinical manifestation.

RESUMO: Esta pesquisa foi realizada com o objetivo de se avaliar a produtividade da biomassa e valor nutricional da silagem e do feno provenientes do consórcio entre o capim-Tamani e diferentes espécies de leguminosas. Para as características produtivas das diferentes culturas consorciadas, adotamos o delineamento de blocos ao acaso, para avaliação da interação dos consórcios com técnicas de conservação usamos esquema fatorial 5 x 2 (cinco consórcios e duas técnicas de conservação). Os tratamentos foram o capim-Tamani em monocultura, e o consórcio de capim-Tamni associado a crotalária, soja, feijão-caupi ou feijão-guandu. As plantas foram semeadas em fileiras alternadas, com espaçamento de 45 cm. As técnicas de conservação foram silagem pré-secada (520 g / kg de MS) e feno (870 g / kg de MS). Avaliamos a produção de biomassa de gramínea e leguminosa, a altura do dossel, a composição química e a digestibilidade in vitro da matéria seca (ivDMD). Não houve diferenças na produção total de biomassa entre os consórcios e o monocultivo de capim-Tamani. Os tratamentos consorciados com feijão-caupi e soja tiveram maior participação de leguminosas na mistura, promovendo aumento no teor de proteína bruta e ivDMD da silagem pré-secada e feno. A silagem pré-secada e o feno tinham a mesma composição química, embora a silagem pré-secada apresentou maior ivDMD do que o feno. Concluímos que o consórcio de capim-Tamani com soja ou feijão-caupi manteve a produtividade da biomassa total e melhorou o valor nutricional da silagem pré-secada e do feno.

ABSTRACT: This research evaluated the biomass productivity and nutritional value of the haylage and hay from intercropping between Tamani grass and different legume species. For the productive characteristics of the different intercrops, we adopted a randomized block design, for evaluation of the combination of intercropping and conservation technic we used 5 x 2 factorial scheme (five intercrops and two types of conservation techniques). The treatments were Tamani grass as monoculture, and the intercrops of Tamani grass with crotalaria, soybean, cowpea, or pigeon pea. The conservation techniques were haylage (520 g/kg of DM) and hay (870 g/kg of DM). Plants were sown in alternate rows, with 45 cm of spacing between the rows. The parameters evaluated were grass and legume biomass production, canopy height, and haylage and hay chemical composition, and in vitro dry matter digestibility (ivDMD). There were no differences in the total biomass production between the intercrops and TA grass monoculture. The treatments intercropped with cowpea and soybean had the highest legume participation in the mixture, promoting an increase in crude protein and ivDMD content of haylage and hay. Haylage and hay had the same chemical composition, although haylage had higher ivDMD than hay. We concluded that intercropping Tamani grass with soybeans or cowpea maintained total biomass productivity and improved the nutritional value of haylage and hay.

RESUMO Objetivo: Sintetizar e interpretar resultados e conclusões de pesquisas qualitativas sobre a experiência do pai no cuidado do filho com câncer. Método: Metassíntese de 16 estudos qualitativos capturados em seis bases de dados e analisados por meio da análise taxonômica. Resultados: O câncer infantojuvenil impõe inúmeras repercussões ao cotidiano do pai, sobretudo relacionadas ao estigma da doença, ao medo do desconhecido e ao papel social e familiar. Diante da doença e da necessidade de cuidado do filho, o pai busca resgatar a normalidade na família e transita entre comportamentos hegemonicamente masculinizantes e práticas reconhecidas culturalmente como femininas. Considerações finais: Evidenciou-se a complexa experiência paterna influenciada pelas masculinidades. As limitações referem-se à restrita compreensão das especificidades contextuais das experiências, pelas escassas características dos pais e filhos descritas nos estudos. O conhecimento produzido revela-se útil para promover o engajamento paterno no cuidado do filho, bem como fortalecê-lo e auxiliá-lo nesta tarefa.

ABSTRACT Objective: To synthesize and interpret findings and conclusions of qualitative research addressing the experience of the father in the care of the child with cancer. Method: Meta-synthesis of 16 qualitative studies from six databases, analyzed through taxonomic analysis. Results: Child and adolescent cancer have several repercussions on the daily life of the father, especially related to the stigma around the disease, the fear of the unknown and the social and family role. Faced with the illness and the need to care for the child, the father seeks to recover normality in the family and transitions between hegemonic masculine behaviors and practices culturally recognized as female. Final Considerations: The complex experience of the father, influenced by masculinities, was evidenced. The limitations regard the restricted understanding of the contextual specificities of the experiences, due to the limited characteristics of the parents and children described in the studies. The knowledge produced is useful to promote involvement of fathers in the care of the child, as well as to strengthen and assist him in this task.

RESUMEN Objetivo: Sintetizar e interpretar resultados y conclusiones de investigaciones cualitativas sobre la experiencia del padre en el cuidado del hijo con cáncer. Método: Metasíntesis de 16 estudios cualitativos recogidos en seis bases de datos y examinados mediante análisis taxonómica. Resultados: El cáncer infantojuvenil repercute considerablemente en la vida cotidiana del padre, sobre todo con relación al estigma de la enfermedad, al miedo a lo desconocido y al papel social y familiar. Ante la enfermedad y la necesidad de cuidar del hijo, el padre busca rescatar la normalidad en la familia y transita entre comportamientos hegemónicamente masculinos y prácticas reconocidas culturalmente como femeninas. Consideraciones finales: Se puso en evidencia la compleja experiencia paterna influenciada por las masculinidades. Las limitaciones se refieren a la estricta comprensión de las especificidades contextuales de las experiencias por las escasas características de los padres e hijos descritos en los estudios. El conocimiento producido puede llegar a ser útil para promover el compromiso paterno en el cuidado del hijo, así como fortalecerlo y ayudarlo en esta tarea.

ABSTRACT Objective: To synthesize and interpret findings and conclusions of qualitative research addressing the experience of the father in the care of the child with cancer. Method: Meta-synthesis of 16 qualitative studies from six databases, analyzed through taxonomic analysis. Results: Child and adolescent cancer have several repercussions on the daily life of the father, especially related to the stigma around the disease, the fear of the unknown and the social and family role. Faced with the illness and the need to care for the child, the father seeks to recover normality in the family and transitions between hegemonic masculine behaviors and practices culturally recognized as female. Final Considerations: The complex experience of the father, influenced by masculinities, was evidenced. The limitations regard the restricted understanding of the contextual specificities of the experiences, due to the limited characteristics of the parents and children described in the studies. The knowledge produced is useful to promote involvement of fathers in the care of the child, as well as to strengthen and assist him in this task.

RESUMEN Objetivo: Sintetizar e interpretar resultados y conclusiones de investigaciones cualitativas sobre la experiencia del padre en el cuidado del hijo con cáncer. Método: Metasíntesis de 16 estudios cualitativos recogidos en seis bases de datos y examinados mediante análisis taxonómica. Resultados: El cáncer infantojuvenil repercute considerablemente en la vida cotidiana del padre, sobre todo con relación al estigma de la enfermedad, al miedo a lo desconocido y al papel social y familiar. Ante la enfermedad y la necesidad de cuidar del hijo, el padre busca rescatar la normalidad en la familia y transita entre comportamientos hegemónicamente masculinos y prácticas reconocidas culturalmente como femeninas. Consideraciones finales: Se puso en evidencia la compleja experiencia paterna influenciada por las masculinidades. Las limitaciones se refieren a la estricta comprensión de las especificidades contextuales de las experiencias por las escasas características de los padres e hijos descritos en los estudios. El conocimiento producido puede llegar a ser útil para promover el compromiso paterno en el cuidado del hijo, así como fortalecerlo y ayudarlo en esta tarea.

RESUMO Objetivo: Sintetizar e interpretar resultados e conclusões de pesquisas qualitativas sobre a experiência do pai no cuidado do filho com câncer. Método: Metassíntese de 16 estudos qualitativos capturados em seis bases de dados e analisados por meio da análise taxonômica. Resultados: O câncer infantojuvenil impõe inúmeras repercussões ao cotidiano do pai, sobretudo relacionadas ao estigma da doença, ao medo do desconhecido e ao papel social e familiar. Diante da doença e da necessidade de cuidado do filho, o pai busca resgatar a normalidade na família e transita entre comportamentos hegemonicamente masculinizantes e práticas reconhecidas culturalmente como femininas. Considerações finais: Evidenciou-se a complexa experiência paterna influenciada pelas masculinidades. As limitações referem-se à restrita compreensão das especificidades contextuais das experiências, pelas escassas características dos pais e filhos descritas nos estudos. O conhecimento produzido revela-se útil para promover o engajamento paterno no cuidado do filho, bem como fortalecê-lo e auxiliá-lo nesta tarefa.

RESUMO Objetivo: identificar, analisar e sintetizar os resultados de estudos qualitativos primários que abordaram a experiência do pai no cuidado ao filho hospitalizado. Método: trata-se de metassíntese qualitativa por meio da qual analisaram-se 12 artigos, selecionados nas bases de dados Cumulative Index to Nursing and Allied Health Literature, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Public Medline, Scopus, PsycINFO e Web of Science, publicados entre 1995 e 2015. As etapas metodológicas propostas por Sandelowski e Barroso foram utilizadas para sistematizar a revisão, bem como conceitos da antropologia das masculinidades, para análise e discussão da síntese. Resultados: a síntese foi apresentada por dois temas: 1) dilemas paternos - o que o homem sente e enfrenta durante a hospitalização do filho, destacando o envolvimento emocional e mudança na relação familiar e laboral, e 2) identidades paternas - masculinidades reajustadas diante do adoecimento do filho, que revela marcas identitárias e a paternidade reprimida, no ambiente hospitalar. Ambos os temas ilustram os desafios e o reajuste da identidade paterna. Considerações finais: conhecer as vivências do pai durante a hospitalização do filho e a maneira como os desafios para o reajuste de papéis relativos à masculinidade poderá ampliar o alcance da enfermagem, e dos demais profissionais de saúde, alertando para a importância de incluir o pai como protagonista ou coadjuvante no cuidado à criança hospitalizada.

ABSTRACT Objective: to identify, analyze and synthesize the father’s experience in care for a hospitalized child from results of primary qualitative studies. Method: this is a qualitative meta-synthesis through which 12 articles were analyzed, selected in the Cumulative Index to Nursing and Allied Health Literature databases, Latin American and Caribbean Literature in Health Sciences, Public Medline, Scopus, PsycINFO and Web of Science, published between 1995 and 2015. The methodological steps proposed by Sandelowski and Barroso were used to systematize the review, as well as concepts from the anthropology of masculinities to analyze and discuss the synthesis. Results: the synthesis was presented by means of two themes: 1) paternal dilemmas - what man feels and faces during the hospitalization of the child, highlighting the emotional involvement and change in the family and work relationship, and 2) paternal identities - masculinities readjusted in view of the child’s illness, which reveals identity marks and repressed fatherhood in the hospital environment. Both themes illustrate the challenges and readjustment of parental identity. Final considerations: to get to know the experiences of the father during the hospitalization of the child and the way in which the challenges for the readjustment of roles related to masculinity could broaden the range of nursing and other health professionals, alerting to the importance of including the father as a protagonist or coadjuvant in the care for hospitalized children.

RESUMEN Objetivo: identificar, analizar y sintetizar los resultados de estudios cualitativos primarios que discuten la experiencia del padre en el cuidado al hijo hospitalizado. Método: se trata de metasíntesis cualitativa por medio de la cual fueron analizados 12 artículos, seleccionados en las bases de datos Cumulative Index to Nursing and Allied Health Literature, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Public Medline, Scopus, PsycINFO y Web of Science, publicados entre 1995 y 2015. Las etapas metodológicas propuestas por Sandelowski y Barroso se utilizaron para sistematizar la revisión, así como conceptos de la antropología de las masculinidades, para análisis y discusión de la síntesis. Resultados: la síntesis fue presentada por dos temas: 1) dilemas paternos - lo que el hombre siente y enfrenta durante la hospitalización del hijo, destacando el involucramiento emocional y cambio en la relación familiar y laboral, y 2) identidades paternas - masculinidades reajustadas ante el adolecer del hijo, que revela marcas identitarias y la paternidad reprimida, en el ambiente hospitalario. Ambos temas ilustran los retos y el reajuste de la identidad paterna. Consideraciones finales: conocer las vivencias del padre durante la hospitalización del hijo y la manera como los desafíos para el reajuste de papeles relativos a la masculinidad puede ampliar el alcance de la enfermería, y de los demás profesionales de salud, alertando sobre la importancia de incluir al padre como protagonista o coadyuvante en el cuidado del niño hospitalizado.

ABSTRACT Objective: to identify, analyze and synthesize the father’s experience in care for a hospitalized child from results of primary qualitative studies. Method: this is a qualitative meta-synthesis through which 12 articles were analyzed, selected in the Cumulative Index to Nursing and Allied Health Literature databases, Latin American and Caribbean Literature in Health Sciences, Public Medline, Scopus, PsycINFO and Web of Science, published between 1995 and 2015. The methodological steps proposed by Sandelowski and Barroso were used to systematize the review, as well as concepts from the anthropology of masculinities to analyze and discuss the synthesis. Results: the synthesis was presented by means of two themes: 1) paternal dilemmas - what man feels and faces during the hospitalization of the child, highlighting the emotional involvement and change in the family and work relationship, and 2) paternal identities - masculinities readjusted in view of the child’s illness, which reveals identity marks and repressed fatherhood in the hospital environment. Both themes illustrate the challenges and readjustment of parental identity. Final considerations: to get to know the experiences of the father during the hospitalization of the child and the way in which the challenges for the readjustment of roles related to masculinity could broaden the range of nursing and other health professionals, alerting to the importance of including the father as a protagonist or coadjuvant in the care for hospitalized children.

RESUMEN Objetivo: identificar, analizar y sintetizar los resultados de estudios cualitativos primarios que discuten la experiencia del padre en el cuidado al hijo hospitalizado. Método: se trata de metasíntesis cualitativa por medio de la cual fueron analizados 12 artículos, seleccionados en las bases de datos Cumulative Index to Nursing and Allied Health Literature, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Public Medline, Scopus, PsycINFO y Web of Science, publicados entre 1995 y 2015. Las etapas metodológicas propuestas por Sandelowski y Barroso se utilizaron para sistematizar la revisión, así como conceptos de la antropología de las masculinidades, para análisis y discusión de la síntesis. Resultados: la síntesis fue presentada por dos temas: 1) dilemas paternos - lo que el hombre siente y enfrenta durante la hospitalización del hijo, destacando el involucramiento emocional y cambio en la relación familiar y laboral, y 2) identidades paternas - masculinidades reajustadas ante el adolecer del hijo, que revela marcas identitarias y la paternidad reprimida, en el ambiente hospitalario. Ambos temas ilustran los retos y el reajuste de la identidad paterna. Consideraciones finales: conocer las vivencias del padre durante la hospitalización del hijo y la manera como los desafíos para el reajuste de papeles relativos a la masculinidad puede ampliar el alcance de la enfermería, y de los demás profesionales de salud, alertando sobre la importancia de incluir al padre como protagonista o coadyuvante en el cuidado del niño hospitalizado.

RESUMO Objetivo: identificar, analisar e sintetizar os resultados de estudos qualitativos primários que abordaram a experiência do pai no cuidado ao filho hospitalizado. Método: trata-se de metassíntese qualitativa por meio da qual analisaram-se 12 artigos, selecionados nas bases de dados Cumulative Index to Nursing and Allied Health Literature, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Public Medline, Scopus, PsycINFO e Web of Science, publicados entre 1995 e 2015. As etapas metodológicas propostas por Sandelowski e Barroso foram utilizadas para sistematizar a revisão, bem como conceitos da antropologia das masculinidades, para análise e discussão da síntese. Resultados: a síntese foi apresentada por dois temas: 1) dilemas paternos - o que o homem sente e enfrenta durante a hospitalização do filho, destacando o envolvimento emocional e mudança na relação familiar e laboral, e 2) identidades paternas - masculinidades reajustadas diante do adoecimento do filho, que revela marcas identitárias e a paternidade reprimida, no ambiente hospitalar. Ambos os temas ilustram os desafios e o reajuste da identidade paterna. Considerações finais: conhecer as vivências do pai durante a hospitalização do filho e a maneira como os desafios para o reajuste de papéis relativos à masculinidade poderá ampliar o alcance da enfermagem, e dos demais profissionais de saúde, alertando para a importância de incluir o pai como protagonista ou coadjuvante no cuidado à criança hospitalizada.