Risk and protective factors for suicide: a populational case-control study, Brazil, 2019

ABSTRACT OBJETIVE To estimate risk and protection factors associated with suicide in Campinas, Brazil, in 2019. METHODS This is a populational case-control study analyzing 83 cases of suicide that occurred in 2019 in Campinas, a Brazilian city with about 1.2 million inhabitants. Controls were composed of 716 inhabitants. An adjusted multiple logistic regression was used. Cases and controls were the dichotomous response variables. Sociodemographic and behavioral variables were the predictor variables. RESULTS The categories which presented higher risk of suicide were: males [OR = 5.26 (p < 0.001)]; people aged 10-29 years [OR = 5.88 (p = 0.002)]; individuals without paid work [OR = 3.06 (p = 0.013)]; individuals presenting problematic use of alcohol [OR = 33.12 (p < 0.001)] and cocaine [14.59 (p < 0.007)]; and people with disabilities [OR = 3.72 (p < 0.001)]. Moreover, the perception of fear was associated with reduced suicide risk [OR = 0.19 (p = 0.015)]. Higher district HDI levels also showed a 4% decrease in risk for each 0.01 increase in district HDI levels [OR = 0.02 (p = 0.008)]. CONCLUSIONS This study evidenced the association between sociodemographic and behavioral variables and suicide. It also emphasized the complexity in the dynamics between personal, social, and economic factors to this external cause of death.

Hábito alimentar de adultos brasileiros segundo a condição na força de trabalho / Eating behavior of Brazilian adults according to workforce position / Hábitos alimentarios de los adultos brasileños según su situación laboral

Resumo O objetivo desse artigo é avaliar o hábito alimentar da população adulta no Brasil segundo a condição na força de trabalho. Realizou-se estudo transversal com dados de 63.782 adultos (18 a 59 anos), participantes da Pesquisa Nacional de Saúde (PNS) 2019. A condição na força de trabalho - ocupado, desocupado ou fora da força - foi relacionada com marcadores de consumo alimentar saudável e não saudável. Estimaram-se razões de chance (odds ratio) ajustadas com regressão logística multinomial. Os resultados apontam que, entre os adultos brasileiros, 71,3% estavam ocupados, 6,7% desocupados e 21,9% encontravam-se fora da força de trabalho. Os ocupados apresentaram maior frequência de consumo de frutas, hortaliças e carne vermelha, e menor de feijão. O consumo de frango, bebidas de frutas, cereais, ovos, margarina e pratos prontos/semiprontos foi mais frequente para os desocupados versus ocupados, enquanto o de peixes e tubérculos foi menos frequente. Os adultos fora da força de trabalho, comparados aos ocupados, mostraram menor frequência de consumo de refrigerantes, embutidos, pães de pacote, oleaginosas, assim como do costume de substituir o almoço por lanches. Observaram-se discrepâncias na alimentação segundo a condição de trabalho, sobretudo no consumo de hortaliças, frutas, carnes e feijão, denotando a necessidade de iniciativas de promoção da alimentação adequada e saudável voltadas para a saúde do trabalhador.

Abstract Objective: To evaluate eating habits of the adult population in Brazil according to workforce status. Methods: Cross-sectional study with data from 63,782 adults (18-59 years old) participating in the National Health Interview Survey, PNS 2019. Workforce status - employed, unemployed or not part of the workforce - was related to markers of healthy and unhealthy food intake. Adjusted odds ratios were estimated with multinomial logistic regression. Results: Of Brazilian adults, 71.3% were employed, 6.7% were unemployed and 21.9% were outside the workforce. Employed adults showed a higher frequency of fruit, vegetable and red meat intake, and a lower frequency of beans consumption. The consumption of chicken, fruit drinks, cereals, eggs, margarine and ready-made/semi-ready meals was more frequent among the unemployed versus the employed, while fish and root vegetables were less frequently consumed. Adults outside the workforce, compared to the employed, showed a lower frequency of consumption of soft drinks, sausages, packaged bread, oilseeds, as well as the habit of replacing lunch for snacks. Conclusion: Discrepancies in diet were observed according to working condition, especially in the consumption of vegetables, fruits, meat, and beans, denoting the need for initiatives to promote adequate and healthy eating habits to improve workers' health.

Resumen Objetivo: Evaluar hábitos alimentarios de la población adulta según su situación laboral. Métodos: Estudio transversal con datos de 63.782 adultos brasileros (18-59 años), participantes de la Encuesta Nacional de Salud, PNS-2019. La situación en la población activa, ocupada, desocupada o fuera de ella, estaba relacionada con marcadores de ingesta de alimentos saludables y no saludables. Las odds ratio ajustadas (odds ratio) se estimaron con regresión logística multinomial. Resultados: De los adultos, 71,3% estaban ocupados, 6,7% desocupados y 21,9% fuera de la población activa. Los empleados mostraron mayor frecuencia de consumo de frutas, verduras y carne roja, y una menor de frijoles. El consumo de pollo, bebidas de frutas, cereales, huevos, margarina y platos preparados/semipreparados era más frecuente entre los desocupados frente a los ocupados, mientras que el pescado y los tubérculos eran menos frecuentes. Los adultos fuera de la fuerza de trabajo, en comparación con los empleados, mostraron menor frecuencia de consumo de refrescos, embutidos, pan envasado, semillas oleaginosas, así como el hábito de sustituir el almuerzo por bocadillos. Conclusión: Se observaron discrepancias en la alimentación según la condición de trabajo, especialmente en el consumo de hortalizas, frutas, carnes, frijol, denotando la necesidad de iniciativas de promoción de alimentación saludable dirigida a la salud de los trabajadores.

Uso del sildenafilo oral en el tratamiento del linfangioma orbitario / Use of Oral Sildenafil in the Treatment of Orbital Lymphangioma

Los linfangiomas orbitarios son malformaciones vasculares benignas, de crecimiento lento, abortivas y no funcionales, que se presentan principalmente en la primera década de la vida. Las opciones terapéuticas en estos casos presentan una resolutividad limitada, algunos tratamientos suelen ser agresivos y provocar daños del aparato visual. Se presenta un caso de una paciente femenina de 6 años de edad atendida por proptosis del ojo izquierdo a la que se le realizó el diagnóstico clínico-imagenológico de linfangioma de la órbita, con el objetivo de mostrar el resultado alcanzado en el manejo de la misma mediante el uso del sildenafilo por vía oral, modalidad terapéutica en estudio a nivel mundial en el tratamiento de estas afecciones. El tratamiento con sildenafilo en el linfangioma orbitario demostró ser eficaz en la mejoría del cuadro clínico y por imágenes. Durante el tratamiento no se reportaron reacciones adversas(AU)

Orbital lymphatic malformations are benign, slow-growing, abortive, nonfunctional vascular malformations that occur mainly in the first decade of life. Therapeutic options in these cases present limited resolution, some treatments are usually aggressive and cause damage to the visual apparatus. We present a case of a 6-year-old female patient treated for proptosis of the left eye. The clinical-imaging diagnosis of lymphangioma of the orbit was made to show the results achieved in its treatment through the use of oral sildenafil, a therapeutic modality under study worldwide in the treatment of these conditions. The treatment with sildenafil in orbital lymphangioma proved to be effective in the improvement of the clinical and imaging picture. No adverse reactions were reported during treatment(AU)

Ocorrência simultânea de uso abusivo de álcool e alimentação não saudável em adultos

Objetivo Estimar a prevalência da coocorrência do uso abusivo de álcool e alimentação não saudável em adultos brasileiros e verificar sua relação com o consumo alimentar, segundo o sexo. Métodos Estudo com dados do inquérito telefônico Vigitel, 2016. Considerou-se uso abusivo de álcool: ingestão ≥5 doses/homens e ≥4/mulheres em uma única ocasião, pelo menos uma vez no último mês. Alimentação não saudável foi caracterizada a partir de um indicador composto por oito alimentos. Foram usados os testes Qui-quadrado de Pearson e Wald, com nível de significância de 5%, e razões de chances ajustadas com regressão logística. Resultados A coocorrência dos fatores de risco (24,7% vs. 10,0%) foi superior nos homens, nos indivíduos com melhor escolaridade, sem cônjuge, com plano de saúde, nas mulheres que se declararam pretas, e foi menor nos adultos (40-59 anos) e idosos. A coocorrência associou-se com menores chances de consumo de hortaliças cruas e cozidas, frutas, suco, leite e frango (≥5 dias/semana), e com maiores chances de consumo de carne vermelha, refrigerante (≥3 dias/semana) e carnes com excesso de gordura. Conclusão Os resultados mostram os prejuízos da coocorrência do uso excessivo de álcool e alimentação inadequada sobre os padrões alimentares da população adulta.

Objective To estimate the prevalence of co-occurrence of alcohol abuse and unhealthy eating in Brazilian adults and to verify its relationship with food intake, according to sex. Methods Study with data from Vigitel telephone survey, 2016. Alcohol abuse was considered as: ingestion ≥5 doses/men and ≥4 doses/women on a single occasion, at least once in the last month. Unhealthy eating was characterized from an indicator consisting of eight foods. Pearson's chi-square and Wald tests were used, with a 5% significance level, and adjusted odds ratios with logistic regression. Results The co-occurrence of risk factors (24.7% vs. 10.0%) was higher in men, in individuals with better education, without a spouse, with health insurance, in women who declared themselves black, and was lower in adults (40-59 years) and the elderly. The co-occurrence was associated with lower odds of consumption of raw and cooked vegetables, fruits, juice, milk, and chicken (≥5 days/week) and with higher odds of consumption of red meat, soda (≥3 days/week), and meats with excess fat. Conclusion The results show the harms of the co-occurrence of excessive alcohol use and inadequate diet on the dietary patterns of the adult population.

Objetivo Estimar la prevalencia de la coocurrencia de abuso de alcohol y alimentación no saludable en adultos brasileños y verificar su relación con el consumo de alimentos según el sexo. Métodos Estudio con datos de la encuesta telefónica Vigitel, 2016. Se consideró abuso de alcohol: ingestión ≥5 dosis para hombres y ≥4 para mujeres en una única ocasión, al menos una vez en el último mes. La alimentación poco saludable se caracterizó a partir de un indicador compuesto por ocho alimentos. Se utilizaron las pruebas de chi-cuadrado de Pearson y de Wfeld, con un nivel de significación del 5% y las odds ratio (OR) ajustadas con regresión logística. Resultados La coocurrencia de factores de riesgo (24,7% vs. 10,0%) fue mayor en los hombres, en los individuos con mayor educación, sin cónyuge, con seguro médico y en las mujeres que se declararon negras, y fue menor en los adultos (40-59 años) y los ancianos. La coocurrencia se asoció con menores probabilidades de consumo de verduras crudas y cocidas, frutas, zumos, leche y pollo (≥5 días/semana) y con mayores probabilidades de consumo de carne roja, refrescos (≥3 días/semana) y carnes con exceso de grasa. Conclusión Los resultados muestran el daño de la coexistencia del consumo excesivo de alcohol y la dieta inadecuada en los patrones dietéticos de la población adulta.

Biological properties of Schinus terebinthifolia Raddi essential oil

Abstract Schinus terebinthifolia Raddi green fruits essential oil (EO) was evaluated regarding its phytochemical profile, antimicrobial and cytotoxic activities, and toxicity. Gas chromatography with mass spectrometry was applied to identify its constituents, thereafter the minimum inhibitory concentration, minimum bactericidal and fungicidal concentrations, and its antibiofilm activity were evaluated. The EO cytotoxicity was assessed in tumor and non-tumor human cells, and in vivo toxicity was evaluated in a Galleria mellonella model. The major constituents of S. terebinthifolia EO were alpha-phellandrene and beta-phellandrene. The EO had a weak activity against all strains of Candida albicans (MIC 1000µg/mL) and had no activity against non-albicans strains, bacteria, and C. albicans biofilm. Cytostatic activity against all tumor cell lines was shown. Additionally, cell viability remained at EO concentrations up to 62.5 µg/mL. At 16 mg/mL, 50% hemolysis was observed, and it had low toxicity in vivo. Overall, the S. terebinthifolia EO was characterized by low antimicrobial and antibiofilm activities, with no evidence of toxicity to human tumor and non-tumor cells

Autocuidado para hipertensos: desenvolvimento de um e-book como material educativo / Self-care to hipertensives: development of an e-book as an educative material

Objetivo: apresentar o desenvolvimento do material educativo intitulado "Auto-cuidado para Hipertensos: um guia para cuidar da sua saúde". Métodos: este material foi desenvolvido com base nas orientações para construção de materiais de orientação para o cuidado em saúde, teve como ponto de partida o estudo multicêntrico: "Efetividade de uma estratégia NUtricional para controle PRESSórico em pacientes com hipertensão arterial sistêmica usuários do Sistema Único de Saúde: estudo NUPRESS". Para a elaboração do material foi feito um levantamento bibliográfico. Em seguida, foi realizada a escrita dos temas abordados em forma de capítulos e, por último, foi montada a parte gráfica. Quando finalizado, o e-book foi enviado a 10 juízes que o avaliaram e validaram conforme a sua organização, estilo da escrita, aparência e apelo do material. Foram aceitas as sugestões dos juízes e realizadas as alterações. Resultados: os juízes (n=10), com média de idade de 43,7±17,6 anos e sendo 70% do sexo feminino, avaliaram em sua maioria, com concordância que o conteúdo do e-book possuía boa organização e aparência. Já os domínios de estilo de escrita e apelo foram os que apresentaram menor percentual de concordância entre os juízes, embora tenham obtido uma aprovação de 83,3% em cada dimensão. Conclusões: o e-book desenvolvido pode ser utilizado tanto por profissionais da saúde quanto por pessoas com hipertensão com o propósito de educação sobre a doença, saúde e autocuidado. O material tem linguagem objetiva e de fácil compreendimento, sem usar termos técnicos, além disso foram utilizados recursos gráficos para cativar e facilitar a leitura.

Aims: to present the development of the educational material entitled: "Autocuidado para Hipertensos: um guia para cuidar da sua saúde". Methods: this material was developed based on the guidelines for the construction of orientation materials for health care, taking as its starting point the multicenter study: "Effectiveness of a NUTRITION strategy for PRESSURE control in patients with systemic arterial hypertension users of the Unified Health System: NUPRESS study". For the elaboration of the material, a bibliographical surveywas made, then the themes were written in chapters, and finally, the graphic part was assembled. When finished, the e-book was sent to 10 judges who evaluated and validated it according to its organization, writing style, appearance, and appeal. The judges' suggestions were accepted, and the changes were made. Results: the judges (n=10), with a mean age of 43.7±17. 6 years and wich 70% were female, mostly agreed that the E-book content had good organization and appearance. The domains of writing style and appeal, on the other hand, presented the lowest percentage of agreement among the judges, although they obtained 83.3% approval in each dimension. Conclusions: the e-book developed can be used both by health professionals and people with hypertension for the purpose of education about the disease, health and self-care. The material has an objective and easy-to-understand language, without using technical terms, and graphic resources were used to captivate and facilitate reading.

Hábito Alimentar de Idosos Diabéticos e não Diabéticos: Vigitel, Brasil, 2016 / Eating Behavior of Older Adults with and Without Diabetes: The Vigitel Survey, Brazil, 2016

Resumo Fundamentos A alimentação saudável é um fator de proteção contra o diabetes tipo 2 e desempenha importante papel no tratamento do diabetes e das comorbidades associadas. Objetivo Caracterizar o hábito alimentar de idosos diabéticos e não diabéticos com 65 anos ou mais, residentes nas capitais brasileiras e no Distrito Federal. Métodos Estudo transversal com dados da pesquisa Vigilância de Fatores de Risco e Proteção para as Doenças Crônicas por Inquérito Telefônico (Vigitel, 2016). Foram estimadas as prevalências de diabetes melito segundo variáveis sociodemográficas, inatividade física, autoavaliação da saúde e índice de massa corporal (IMC). O hábito alimentar foi avaliado pela frequência (semanal e diária) de consumo de alimentos saudáveis e não saudáveis, e pela substituição da comida por lanches. As diferenças foram verificadas por meio do teste Qui-quadrado de Pearson (Rao-Scott) com nível de significância de 5%. Resultados Foram entrevistados 13.649 idosos, e a prevalência de diabetes autorreferido foi de 27,2% (IC95%:25,5; 29,0). Nos pacientes diabéticos, observou-se maior consumo de hortaliças cruas (32,1% vs. 26,5%/3-4 dias/semana) e menor de frango (3,8% vs. 6,4%/quase nunca/nunca), suco (24,0% vs. 29,6%) e doces (6,8% vs. 16,2%) ≥5 dias/semana. Os percentuais de idosos com consumo de leite desnatado (51,5% vs. 44,6%) e refrigerante dietético (60,0% vs. 17,3%) ≥5 dias/semana, hortaliças cruas (9,1% vs. 2,5%/no jantar) e doces (37,7% vs. 20,5%/2 vezes/dia) 3-4 dias/semana foram maiores nos diabéticos, comparados aos não diabéticos. Conclusão As diferenças observadas sinalizam a necessidade de promover intervenções para alimentação saudável entre todos os idosos, bem como orientações específicas para os diabéticos.

Abstract Background A healthy diet is a protection factor against type 2 diabetes and plays an important role in the treatment of the disease, as well as associated comorbidities. Objective Characterize the eating habits of older adults (≥ 65 years) with and without diabetes residing in capital cities and the Federal District of Brazil. Methods A cross-sectional study was conducted using data from the Surveillance of Risk and Protection Factors for Chronic Diseases Through a Telephone Survey (Vigitel, 2016). The prevalence of diabetes mellitus was estimated according to sociodemographic variables, physical inactivity level, self-rated health status and body mass index. Dietary habits were assessed based on the frequency (weekly and daily) of consumption of healthy and unhealthy foods and the replacement of food by snacks. Differences were determined using Pearson's chi-square test (Rao-Scott), with the significance level set at 5%. Results A total of 13,649 older adults were interviewed. The prevalence of self-reported diabetes was 27.2% (95% CI: 25.5; 29.0). Compared to non-diabetics, diabetic individuals had a higher consumption of raw vegetables (32.1% vs. 26.5%/3-4 days/week) and lower consumption of chicken (3.8% vs. 6.4%/hardly ever/never), fruit juice (24.0% vs. 29.6%) and sweets (6.8% vs. 16.2%) ≥ 5 days/week. Compared to non-diabetics, diabetic individuals consumed more skim milk (51.5% vs. 44.6%) and diet soda (60.0% vs. 17.3%) ≥ 5 days/week, raw vegetables (9.1% vs. 2.5%/at dinner) and sweets (37.7% vs. 20.5%/twice/day) 3-4 days/week. Conclusion The observed differences emphasize the need for healthy eating interventions for all older adults, as well as specific counseling for those with diabetes.

Características epidemiológicas, clínicas y oftalmológicas de pacientes con queratoconjuntivitis seca / Epidemiological, clinical and ophthalmologic characteristics of patients with keratoconjunctivitis Sicca

Introducción: La queratoconjuntivitis seca es una enfermedad de causa multifactorial, que afecta la producción de lágrimas y la superficie ocular, a la vez que ocasiona malestar, visión borrosa e inestabilidad de la película lagrimal. Métodos: Se realizó un estudio descriptivo y transversal de 50 pacientes con diagnóstico de queratoconjuntivitis seca, atendidos en el Centro Oftalmológico del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, desde enero hasta julio de 2020. Objetivo: Caracterizar a los pacientes con queratoconjuntivitis seca según variables epidemiológicas clínicas y oftalmológicas. Resultados: En la serie predominaron las féminas (66,0 %), los pacientes mayores de 60 años (40,0 %), la lectura excesiva como factor de riesgo (42,0 %), la irritación, la fatiga ocular y la visión borrosa como criterios diagnósticos, además de la disminución del tiempo de rotura de la película lagrimal en 68,0 % de la muestra, entre otros resultados. Conclusión: La queratoconjuntivitis seca, desde el punto de vista clínico y epidemiológico fue similar a lo descrito en la bibliografía especializada en cuanto a los grupos de edades, sexo y principales síntomas descritos.

Introduction: The keratoconjunctivitis sicca is a disease of multifactorial cause that affects the production of tears and the ocular surface, at the same time that causes discomfort, blurred vision and instability of the lacrimal thin layer. Methods: A descriptive and cross-sectional study of 50 patients with diagnosis of keratoconjunctivitis sicca, assisted in the Ophthalmolgic Center of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, was carried out from January to July, 2020. Objective: To characterize patients with keratoconjunctivitis sicca according to clinical, epidemiologic and ophthalmologic variables. Results: In the series there was a prevalence of the females (66.0 %), patients over 60 years (40.0 %), excessive reading as risk factor (42.0 %), irritation, ocular fatigue and blurred vision as diagnostic criteria, besides the decrease of the lacrimal thin layer break up time in 68.0 % of the sample, among other results. Conclusion: The keratoconjunctivitis sicca was similar to that described in the specialized literature review as for the age groups, sex and main described symptoms from the clinical and epidemiologic points of view.

Psoriasis verrugosa en un hombre con antecedentes de psoriasis en placa, reporte de caso y revisión de la literatura / Verrucous psoriasis in a male patient with a history of vulgar psoriasis: Case report and literature review

Resumen La psoriasis verrugosa es una variante atípica y poco frecuente de la psoriasis, con pocos casos reportados en la literatura. Se caracteriza por la presencia de placas hipertróficas y verrugosas simétricas en extremidades y tronco. Se presenta el caso de un paciente de 63 años con diagnóstico de psoriasis en placa 20 años atrás, tratado con esteroide tópico y quien 10 años antes había desarrollado una placa de aspecto verrugoso en el tercio distal de la cara posterior de la pierna izquierda. Se tomó la biopsia de la lesión por sospecha de un carcinoma escamocelular (verrugoso). El estudio histopatológico mostró cambios indicativos de psoriasis verrugosa y descartó la presencia de malignidad.

Abstract Verrucous psoriasis is an atypical and rare variant of psoriasis with few cases reported in the literature. It is characterized by the presence of symmetric hypertrophic and verrucous plaques on the limbs and trunk. We present the case of a 63-year-old male patient with a history of vulgar psoriasis for 20 years who was receiving treatment with topical steroids and had developed a verrucous plaque in the distal third of the posterior aspect of the leg 10 years before. We conducted a biopsy of the lesion to confirm or discard the diagnostic impression of squamous cell carcinoma (verrucous). The histopathological study showed changes compatible with verrucous psoriasis ruling out the presence of malignancy.

Consumption of healthy food and ultra-processed products: comparison between pregnant and non-pregnant women, Vigitel 2018 / Consumo de alimentos saudáveis e produtos ultraprocessados: comparação entre gestantes e não gestantes, Vigitel 2018

Abstract Objectives: to characterize pregnant women's eating habits and compare them to women of reproductive age, and to analyze the association between pregnancy and eating habits. Methods: a cross-sectional study with 13,108 women aged 18 to 50 years (179 pregnant women), included in the Vigitel 2018 telephone survey. Eating habits were assessed by the frequency of food consumption considered as food quality markers and by food eaten in previous day. NOVA classification was used to categorize food into: natural/minimally processed, and ultra-processed food products. The differences were verified by Pearson's Chi-square test and Poisson multiple regression. Results: in pregnant women, we observed lower percentages of natural juice intake (27.5%) and fruit (10.1%) 0-2 times/week, and higher percentages of juice (36.4%) 3-4 times and fruit (74.2%) ≥ 5 times/week compared to non-pregnant women. No differences were detected in the daily frequencies of food intake among the women. The day before the interview, almost 95% of the pregnant women consumed ultra-processed products. Pregnant women reported a lower frequency of soft drink consumption (12.3%) and sauces (7.4%) than non-pregnant women. Conclusion: pregnant women and non-pregnant women had high consumption of ultraprocessed products, highlighting the necessity of interventions, aiming to promote healthy eating.

Resumo Objetivos: caracterizar o hábito alimentar de gestantes e compará-lo ao de mulheres em idade fértil, e analisar a associação entre gestação e hábito alimentar. Métodos: estudo transversal com 13.108 mulheres de 18 a 50 anos (179 gestantes), incluídas no inquérito telefônico Vigitel 2018. O hábito alimentar foi avaliado pela frequência de consumo de alimentos considerados marcadores de qualidade alimentar e por alimentos ingeridos no dia anterior. Utilizou-se a classificação NOVA para categorizar os alimentos em: in natura/minimamente processados e ultraprocessados. As diferenças foram verificadas pelo teste Qui-quadrado de Pearson e regressão múltipla de Poisson. Resultados: nas gestantes, observaram-se menores percentuais de ingestão de suco natural (27,5%) e frutas (10,1%) de 0-2 vezes/semana, e maiores percentuais de suco (36,4%) de 3-4 vezes e frutas (74,2%) ≥5 vezes/semana, comparadas às mulheres não gestantes. Não foram detectadas diferenças nas frequências diárias de ingestão de alimentos entre as mulheres. No dia anterior à entrevista, quase 95% das gestantes consumiram produtos ultraprocessados. As gestantes referiram menor frequência de consumo de refrigerante (12,3%) e molhos (7,4%) do que as não gestantes. Conclusão: as gestantes e as não gestantes apresentaram elevado consumo de produtos ultraprocessados, destacando a necessidade de intervenções voltadas à promoção da alimentação saudável.

Abordaje rehabilitador de la deglución en adultos mayores con enfermedades neurodegenerativas / Rehabilitative approach to swallowing in older adults with neurodegenerative diseases

a presente revisión se planteó con el fin de recopilar la evidencia existente sobre el abordaje rehabilitador de la disfagia en adultos mayores con enfermedades neurodegenerativas, con la intención de encontrar propuestas de tratamientos que influyan de manera positiva en la salud de los pacientes. Los métodos de búsqueda se implementaron bajo un proceso ordenado de revisión sistemática bajo el modelo Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), a través de la cual se recolecta información de forma cronológica sobre la evidencia científica de un tema en particular. Para ello se usaron descriptores como: "Adulto; Neurodegenerativa; Disfagia; Rehabilitación". En la revisión sistemática se incluyeron 21 artículos, entre estos se mencionaron estudios y revisiones sobre los tratamientos empleados en las enfermedades neurodegenerativas. En los hallazgos es evidente la intervención multidisciplinar, modificación del entorno, uso de fármacos como medio para mitigar síntomas principalmente motores, procedimientos quirúrgicos; además, maniobras deglutorias, compensatorias, rehabilitadoras, entre otras. Algunas alternativas requieren de la participación del Fonoaudiólogo/Logopeda debido a que en la mayoría de personas que padecen enfermedades neurodegenerativas se ve afectada la fase oral y/o faríngea de la deglución, desencadenando disfagia en diferentes grados de severidad y comprometiendo de forma directa la ingesta de alimentos debido al riesgo de aspiración, neumonía y/o muerte y a su vez, la calidad de vida. Esta revisión sistemática permite identificar la necesidad de realizar más propuestas terapéuticas, estudios que evidencien su eficacia y que, sobre todo, generen cambios significativos en quienes padecen las enfermedades descritas

The present review was proposed in order to compile the existing evidence on the rehabilitative approach in older adults with neurodegenerative diseases, since these treatments directly influence the health of patients. The search methods were implemented under an ordered systematic review process under the Preferred Reporting Items for Systematic Reviews, PRISMA model, in which information is collected chronologically on the scientific evidence of a particular topic. Descriptors such as: Adult, Neurodegenerative, Dysphagia; Rehabilitation. Twenty-one articles were included in the systematic review, including studies and reviews on the treatments used in neurodegenerative diseases. In the findings it is evident inter-transdisciplinary intervention, modification of the environment, use of drugs as a means to mitigate mainly motor symptoms, surgical procedures; in addition, swallowing, compensatory, rehabilitative maneuvers, among others. Some alternatives require the participation of the speech pathologist because in most people suffering from neurodegenerative diseases the oral and / or pharyngeal phase of swallowing is affected, triggering dysphagia in different degrees of severity and directly compromising food intake. due to the risk of aspiration, pneumonia and / or death and, in turn, the quality of life, This systematic review allows us to identify the need to make more proposals for therapeutic options, studies that show their efficacy and that above all generate significant changes in those who suffer described diseases

La Voz del Silencio: Evaluación Cualitativa de Prácticas de Bullying en Personas con Discapacidad Intelectual / The Voice of Silence: Qualitative Evaluation of Bullying Practices in People with Intellectual Disability

RESUMEN: En los múltiples movimientos académicos acaecidos en pos de la inclusión del alumnado, las instituciones universitarias están abriendo sus títulos a colectivos tradicionalmente olvidados en el ámbito de la educación superior, como las personas con discapacidad intelectual. El acoso escolar es una realidad que puede afectar a todo el alumnado, siendo más complejo conforme avanza la edad de los estudiantes. El objetivo de este trabajo radica en recabar información acerca de la percepción de las personas con discapacidad intelectual sobre el bullying y reconocer las diferentes manifestaciones de acoso a personas con discapacidad intelectual. A través de una investigación biográfico-narrativa y bajo un diseño evaluativo de carácter mixto, se ha contado con la participación de 17 estudiantes que cursan el Título Universitario de Estudios Propios Todos Somos Campus para fomentar la inserción socio-laboral del colectivo de jóvenes con discapacidad intelectual. A través de un análisis cualitativo de los datos, los resultados muestran que existe una situación de acoso, tanto físico como psicológico, basada en críticas y percepciones negativas acerca de la discapacidad, lo cual les hace más sensibles a la condición de diferentes. Igualmente, se refuerza la imagen de autoridad como eje de las acciones contra el bullying, destacando el papel de la mediación en la exposición de soluciones. Se concluye que las relaciones establecidas entre las manifestaciones del acoso en el ámbito académico y sus posibles soluciones no se presentan de forma aislada, sino que se muestran como una red que facilita respuesta a dicha problemática.

ABSTRACT: In the multiple academic movements for the inclusion of students, university institutions are opening their undergraduate degrees to groups traditionally forgotten in the field of Higher Education, such as people with intellectual disabilities. Bullying is a reality that can affect all students, being more complex as the age of the students advances. The objective of this work is to gather information about the perception of people with intellectual disabilities about bullying and, thus, recognize the different manifestations of harassment to people with intellectual disabilities. Through a biographical-narrative research and a mixed evaluative design, we counted on the participation of 17 students who are attending the Título Universitario de Estudios Propios Todos Somos Campus - University Degree of Own Studies We are all Campus - to promote the social and labor insertion of the collective of young people with intellectual disabilities. Through a qualitative data analysis, the results showed that there is a situation of harassment, both physical and psychological, based on criticism and negative perceptions about the disability, which make it more sensitive to the status of different. In the same way, it reinforces the image of authority as an anti-bullying action, highlighting the role of mediation in the exposition of solutions. It is concluded that the relations established between the manifestations of bullying in the academic sphere and their possible solutions are not presented in isolation, but they are shown as a network that facilitates the answer to this problem.

Actividad antiproliferativa de Aldama arenaria (Baker) E. E. Schill. & Panero / Antiproliferative activity from Aldama arenaria (Baker) E. E. Schill. & Panero

El extracto de cloroformo (CE) y las fracciones obtenidas de las raíces de Aldama arenaria se evaluaron para determinar su actividad antiproliferativa in vitro contra 10 líneas celulares tumorales humanas [leucemia (K-562), mama (MCF-7), ovario que expresa un fenotipo resistente a múltiples fármacos (NCI/ADR-RES), melanoma (UACC-62), pulmón (NCI-H460), próstata (PC-3), colon (HT29), ovario (OVCAR-3), glioma (U251) y riñón (786-0)]. CE presentó actividad antiproliferativa débil a moderada (log GI50 medio 1.07), mientras que las fracciones 3 y 4, enriquecidas con diterpenos de tipo pimarane [ent-pimara-8 (14), ácido 15-dien-19-oico y ent-8(14),15-pimaradien-3ß-ol], presentaron actividad moderada a potente para la mayoría de las líneas celulares, con un log GI50 medio de 0.62 y 0.59, respectivamente. Los resultados mostraron una acción antiproliferativa in vitro prometedora de las muestras obtenidas de A. arenaria, con los mejores resultados para NCI/ADR-RES, HT29 y OVCAR-3, y valores de TGI que van desde 5.95 a 28.71 µg.mL-1, demostrando que los compuestos de esta clase pueden ser prototipos potenciales para el descubrimiento de nuevos agentes terapéuticos.

Chloroform extract (CE) and fractions obtained from Aldama arenaria roots were evaluated for their in vitro antiproliferative activity against 10 human tumor cell lines [leukemia (K-562), breast (MCF-7), ovary expressing a multidrug-resistant phenotype (NCI/ADR-RES), melanoma (UACC-62), lung (NCI-H460), prostate (PC-3), colon (HT29), ovary (OVCAR-3), glioma (U251), and kidney (786-0)]. CE presented weak to moderate antiproliferative activity (mean log GI50 1.07), whereas fractions 3 and 4, enriched with pimarane-type diterpenes [ent-pimara-8(14),15-dien-19-oic acid and ent-8(14),15-pimaradien-3ß-ol], presented moderate to potent activity for most cell lines, with mean log GI50 of 0.62 and 0.59, respectively. The results showed promising in vitro antiproliferative action of the samples obtained from A. arenaria, with the best results for NCI/ADR-RES, HT29, and OVCAR-3, and TGI values ranging from 5.95 to 28.71 µg.mL-1, demonstrating that compounds of this class may be potential prototypes for the discovery of new therapeutic agents.

ESTUDIOS MORFO-ANATÓMICOS, CITOGENÉTICOS Y MOLECULARES EN Talinum (TALINACEAE): UNA NUEVA ENTIDAD PARA EL NOROESTE ARGENTINO / Morfo-anatomical, cytogenetic and molecular studies in Talinum (TALINACEAE): a new entity from the northwest of Argentina

RESUMEN Talinum paniculatum es una hierba adventicia ampliamente distribuida en Argentina, que tiene importancia económica como maleza de cultivos resistente a herbicidas. Esta especie se presenta en el campo con dos morfotipos y ellos se distinguen por la forma, tamaño y color de sus flores, frutos y hojas. El objetivo de este trabajo fue determinar las características morfo-anatómicas (de hoja y tallo), citogenéticas y moleculares en dos morfotipos de la provincia de Tucumán (Argentina), y establecer diferencias entre ellos. Se utilizaron técnicas morfo-anatómicas y citogenéticas clásicas y se realizaron análisis moleculares con el marcador ITS2. Los resultados evidencian que las características morfológicas, anatómicas, citogenéticas y moleculares de Talinum paniculatum permitieron diferenciar los morfotipos MT1 y MT2. Se concluye que el MT1 corresponde a T. paniculatum y el MT2 a un taxón diferente que aún no se mencionó para la flora de Argentina.

ABSTRACT Talinum paniculatum is an adventitious herb widely distributed in the Argentina. This plant is considered as an economically important herbicide-resistant weed. This species shows two morphotypes in the field which are differentiated by shape, size and colour of their flowers leaves and fruits. The aims of this work were to determinate morpho-anatomical (leave and stem), cytogenetic and molecular traits of two morphotypes from Tucumán province (Argentina) and to establish differences between them. Classical morpho-anatomical and cytogenetic techniques were used, molecular analysis based on the ITS2 marker were performed. The results showed that morphological, anatomical, cytogenetic and molecular traits of T. paniculatum allow us to differentiate the MT1 and MT2 morphotypes. We concluded that MT1 match with T. paniculatum and MT2 is a different taxon still not described for the flora of Argentina.

Reporte de un caso: eritema discrómico perstans en paciente con diagnóstico de virus de inmunodeficiencia humana / Case report: dyschromic erythema perstans in a patient diagnosed with human immunodeficiency virus

El eritema discrómico perstans o dermatitis cenicienta, es un trastorno pigmentario de la piel poco común, de etiología desconocida. Se describe el caso de un adulto de 35 años con antecedente de VIH, quien consulta por aparición de lesiones irregulares, bien definidas café-grises localizadas en cuello, área mandibular inferior, espalda y brazos, de borde levemente eritematoso. El diagnóstico de eritema discrómico perstans se realizó con base en los hallazgos clínicos e histopatológicos.

Erythema dyschromicum perstans also known as ashy dermatosis is a rare skin pigmentary disorder of unknown etiology. We describe the case of a 35-year-old man HIV positive who presented irregular, well defined brown-gray lesions with slightly erythematous border located in neck, lower jaw, back and arms. Diagnosis of erythema dyschromicum perstans in this patient was made based on clinical and histopathological criteria.

Comportamiento del riesgo reproductivo preconcepcional en mujeres fértiles de San Juan y Martínez / Preconception reproductive risk behavior in fertile women from San Juan and Martinez municipality

RESUMEN Introducción: el control de la natalidad ha sido una constante preocupación desde los albores de la humanidad. El control y manejo del riesgo preconcepcional es de vital importancia, pues está condicionado por una serie de factores, enfermedades o circunstancias únicas o asociadas, que pueden repercutir de manera desfavorable en el binomio madre-hijo durante la gestación, parto o puerperio. Objetivo: caracterizar el riesgo reproductivo preconcepcional en mujeres en edad fértil, pertenecientes a los consultorios médicos 26 y 46 del municipio San Juan y Martínez, en el 2016. Métodos: se realizó un estudio observacional, descriptivo y longitudinal, el universo estuvo constituido por las 117 mujeres en edad fértil de los consultorios seleccionados y la muestra quedó conformada por 53 mujeres que cumplían los criterios de inclusión. Los datos se resumieron en frecuencias absolutas y relativas. Resultados: predominó el grupo de edad entre 30 y 39 años, en la mayoría se encontró la hipertensión arterial como enfermedad crónica asociada, como afecciones ginecológicas las más representativa fue la vulvovaginitis, y como factor de riesgo obstétrico predominó el periodo intergenésico corto. La preclampsia leve prevaleció como complicación de embarazo anterior y el tabaquismo fue el hábito tóxico más encontrado. Conclusiones: se caracterizó el riesgo reproductivo preconcepcional en las mujeres en edad fértil, se contribuyó así a una mayor atención y seguimiento en las consultas de planificación familiar.

ABSTRACT Introduction: birth control has been a constant concern since the dawn of humankind. Preconception risk control and management is of crucial importance, it is conditioned by a series of factors, diseases, unique or associated circumstances that may adversely affect the mother-child binomial during gestation, childbirth or puerperium. Objective: to characterize preconception reproductive risk factors women of childbearing ages, belonging to the medical offices No- 26 and No-46 of San Juan and Martinez municipality in 2016. Methods: an observational, descriptive and longitudinal study was carried out, the target group comprised 117 women of childbearing ages from the chosen clinics and the sample included 53 women who met the inclusion criteria. Data were summarized in absolute and relative frequencies. Results: there was predominance of the age group between 30 and 39 years old, in the majority of them hypertension was found as an associated chronic disease, as gynecological conditions the most representative were vulvovaginitis, and as obstetric risk factor, shorter intergenesis period predominated. Mild preeclampsia prevailed as a complication of previous pregnancy and smoking was the most common toxic habit. Conclusions: preconception reproductive risk was characterized in women of childbearing age; therefore it contributes to greater awareness and follow-up in family planning clinics.

Cáncer cérvicouterino. Algo para reflexionar / Cervical cancer. A call for reflection

RESUMEN El cáncer se presenta como un importante problema de salud, dada la alta morbilidad y mortalidad que produce. Es uno de los procesos más complejos de la naturaleza y resulta el más complicado en la esfera de la medicina. El objetivo de esta revisión es exponer brevemente información útil y actualizada sobre cáncer cérvicouterino. Se consultó un total de 25 fuentes bibliográficas, entre ellos, artículos de revistas científicas, y otros, a los que se accedió a través de las principales bases de datos nacionales e internacionales de la red informática de Infomed, como Scielo, Google Scholar, PubMed, entre otras. Quedó demostrado que en Cuba el sistema de salud realiza innumerables esfuerzos para disminuir la tasa de mortalidad por esta causa. Las actitudes negativas de las mujeres, la insuficiente información acerca del examen citológico, que es el principal pilar de la prevención, así como la infección por el virus del papiloma humano, constituyen algunos factores para el incremento del cáncer cérvico uterino. Resulta de vital importancia lograr que todas las mujeres se realicen la prueba citológica y aumenten su percepción de riesgo, para mejorar la prevención.

ABSTRACT Cancer is a major health problem, given the high morbidity and mortality it produces. It is one of nature's most complex processes and is the most complicated in the field of medicine. The purpose of this review is to briefly present useful and updated information on cervical cancer. A total of 25 bibliographic sources were consulted, including articles from scientific journals, and others, which were accessed through the main national and international databases of the Infomed computer network, such as Scielo, Google Scholar, PubMed, among others. It was demonstrated that in Cuba the health system makes significant efforts to reduce death rate due to this cause. The women´s negative attitudes, insufficient information about cytological examination, which is the main pillar for prevention, as well as infection with the human papillomavirus, constitute some factors for the increase in cervical cancer. It is of crucial importance to ensure that all women have a cytological test and increase their perception of risk, to improve prevention.

Nacer prematuro: encrucijadas vinculares a lo largo de la niñez y la adolescencia / Being born prematurely: crossroads linked throughout childhood and adolescence

A partir de datos de investigaciones realizadas y experiencia clínica adquirida en seguimientos alejados de niñas y niños nacidas con un peso inferior a 1500 gramos (RNMBPN) plantearemos cuestiones ligadas a cómo mantienen su eficacia desde lo psíquico las representaciones parentales ("parentalidad compensatoria", "preocupación médica parental") en la construcción de vínculos con el niño y la niña y la imagen de éstos y éstas cómo "vulnerable y frágil" a lo largo del tiempo. En este artículo reflexionaremos cómo se re-escribe la historia de la prematurez en jóvenes que nacieron prematuros, profundizando sobre las filiaciones narrativas descriptas por Marie Rose Moro y Bernard Golse (2019) a través de la lectura del libro "770 gramos" de M. Josch M. (2018) y materiales clínicos de adolescentes nacidos prematuros y nacidas prematuras(AU)

Based on data from research carried out and clinical experience gained in remote followup of girls and boys born with a weight of less than 1500 grams (RNMBPN), we will ask questions related to how parental representations maintain their efficacy from the psychological point of view ("compensatory parenting", " parental medical concern") in building ties with the boy and girl and their image as "vulnerable and fragile "over time. In this article we will reflect on how the history of prematurity is rewritten in young people who were born prematurely delving into the narrative affiliations described by Marie Rose Moro and Bernard Golse (2019) through the reading of the book "770 grams" by M. Josch M. (2018) and clinical materials of adolescents born prematurely(AU)

El papel de la paradoja de la obesidad y el conteo linfocitario en sepsis / The role of the obesity paradox and lymphocytic count on sepsis / O papel do paradoxo da obesidade e contagem de linfócitos na sepse

Resumen: Introducción: La obesidad es un factor protector para mortalidad en la sepsis, a este fenómeno se le conoce como «paradoja de la obesidad¼. La obesidad es un estado inflamatorio crónico, que incluye mediadores de la inmunidad innata y adaptativa. Un marcador de inmunidad adaptativa es la linfopenia, ésta es relacionada con peor evolución y mayor mortalidad. Objetivo: Determinar la relación del índice de masa corporal (IMC) con conteo linfocitario y su relación con supervivencia en pacientes sépticos. Material y métodos: Estudio de cohortes, retrospectivo, en pacientes con sepsis y/o choque séptico mayores de 18 años, sin enfermedades autoinmunes, ni tratamiento inmunosupresor, determinando IMC y linfopenia. Resultados: Se incluyeron 206 pacientes, 8.7% con peso bajo, 46.6% peso normal, 24.8% con sobrepeso, 19.9% con obesidad. El grupo de mayor mortalidad con linfopenia tuvo los menores valores de IMC 21.37 kg/m2. El análisis de supervivencia reveló que un IMC < 22.5 kg/m2 y linfopenia son factores de riesgo independientes para mortalidad. Conclusiones: La obesidad se relaciona con mayor conteo linfocitario y mayor supervivencia en sepsis y choque séptico, por lo que el IMC y el conteo linfocitario son factores independientes para mortalidad estadísticamente significativos, proponemos la escala APACHE II ajustada con estas variables.

Abstract: Introduction: Obesity is a mortality protector factor in sepsis; this phenomenon is known as «obesity paradox¼. Furthermore, obesity is a chronic inflammatory state in which adaptive and innate immunity mediators play key roles. Lymphopenia is an adaptive immunity marker and it has been related to poor outcomes and greater mortality. Objective: To determine the relationship between body mass index and lymphocyte count and its association with the survival of septic patients. Methods and materials: A cohort retrospective study of patients older than 18 years old with sepsis, septic shock and no history of autoimmune diseases nor immunosuppressor treatments. Outcomes included determining BMI and lymphopenia. Results: 206 patients were included, 8.7% with low weight, 46.6% with normal weight, 24.8% with normal weight, 19.9% with obesity. The group with the lowest BMI (median of 21.37) and lymphopenia was associated with the greatest mortality. The survival analysis revealed that a BMI lower than 22.5 and lymphopenia are independent risk factors for mortality. Conclusions: Obesity is associated to a higher lymphocyte count and a greater survival in sepsis and septic shock. Since BMI and lymphocyte count are statistically significant independent risk factors for mortality, we propose an APACHE II score adjusted to these variables.

Resumo: Introdução: Na sepse, a obesidade é um fator de proteção para mortalidade, denominando esse fenômeno de «paradoxo da obesidade¼. A obesidade é um estado inflamatório crônico, incluindo mediadores da imunidade inata e adaptativa. Um marcador de imunidade adaptativa é a linfopenia, que está relacionada a uma evolução desfavorável e maior mortalidade. Objetivo: Determinar a relação do índice de massa corporal (IMC) com a contagem de linfócitos e sua relação com a sobrevida em pacientes sépticos. Material e métodos: Estudo de coorte, retrospectivo em pacientes com sepse e / ou choque séptico com mais de 18 anos, sem doenças autoimunes ou tratamento imunossupressor, determinando o IMC e a linfopenia. Resultados: Foram incluídos 206 pacientes, sendo 8.7% com baixo peso, 46.6% com peso normal, 24.8% com sobrepeso, 19.9% com obesidade. O grupo com maior mortalidade com linfopenia apresentou os menores valores de IMC de 21.37 kg/m2. A análise de sobrevivência revelou que um IMC < 22.5 kg/m2 e a linfopenia são fatores de risco independentes para a mortalidade. Conclusão: A obesidade está relacionada à maior contagem de linfócitos e maior sobrevida em sepse e choque séptico. Como o IMC e a contagem de linfócitos são fatores independentes para mortalidade estatisticamente significante, propomos a escala APACHE II ajustada com essas variáveis.