Desarrollo de un modelo por inteligencia artificial con hemodinamia no invasiva para predecir preeclampsia en embarazos de alto riesgo / Artificial Intelligence Modeling with Non-Invasive Hemodynamics to Predict Preeclampsia in High-Risk Pregnancy

RESUMEN Introducción: la preeclampsia (PE) es la principal causa de morbimortalidad materno-fetal en nuestro país. Alteraciones hemodinámicas precoces durante el embarazo podrían predecir la evolución a PE. El machine learning (ML) permite el hallazgo de patrones ocultos que podrían detectar precozmente el desarrollo de PE. Objetivos: desarrollar un árbol de clasificación con variables de hemodinamia no invasiva para predecir precozmente desarrollo de PE. Material y métodos: estudio observacional prospectivo con embarazadas de alto riesgo (n=1155) derivadas del servicio de Obstetricia desde enero 2016 a octubre 2022 para el muestreo de entrenamiento por ML con árbol de clasificación j48. Se seleccionaron 112 embarazadas entre semanas 10 a 16, sin tratamiento farmacológico y que completaron el seguimiento con el término de su embarazo con evento final combinado (PE): preeclampsia, eclampsia y síndrome HELLP. Se evaluaron simultáneamente con cardiografía de impedancia y velocidad de onda del pulso y con monitoreo ambulatorio de presión arterial de 24 hs (MAPA). Resultados: presentaron PE 17 pacientes (15,18%). Se generó un árbol de clasificación predictivo con las siguientes variables: índice de complacencia arterial (ICA), índice cardíaco (IC), índice de trabajo sistólico (ITS), cociente de tiempos eyectivos (CTE), índice de Heather (IH). Se clasificaron correctamente el 93,75%; coeficiente Kappa 0,70, valor predictivo positivo (VPP) 0,94 y negativo (VPN) 0,35. Precisión 0,94, área bajo la curva ROC 0,93. Conclusión: las variables ICA, IC, ITS, CTE e IH predijeron en nuestra muestra el desarrollo de PE con excelente discriminación y precisión, de forma precoz, no invasiva, segura y con bajo costo.

ABSTRACT Background: Preeclampsia (PE) is the main cause of maternal-fetal morbidity and mortality in our country. Early hemodynamic changes during pregnancy could predict progression to PE. Machine learning (ML) enables the discovery of hidden patterns that could early detect PE development. Objectives: The aim of this study was to build a classification tree with non-invasive hemodynamic variables for the early prediction of PE occurrence. Results: Seventeen patients (15.18%) presented PE. A predictive classification tree was generated with arterial compliance index (ACI), cardiac index (CI), cardiac work index (CWI), ejective time ratio (ETR), and Heather index (HI). A total of 93.75% patients were correctly classified (Kappa 0.70, positive predictive value 0.94 and negative predictive value 0.35; accuracy 0.94, and area under the ROC curve 0.93). Conclusion: ACI, CI, CWI, ETR and HI variables predicted the early development of PE in our sample with excellent discrimination and accuracy, non-invasively, safely and at low cost.

Atención integrada madre-niño. efectos sobre adherencia y conocimientos de métodos anticonceptivos / Integrated mother-child care. Effects on adherence and knowledge of contraceptive methods

Resumen Introducción : La evidencia científica sugiere que es trategias de atención conjunta madre-hijo facilitarían el conocimiento de métodos anticonceptivos (MAC) y su acceso. El objetivo fue evaluar el efecto del Modelo de atención integrada de la madre y el niño sobre la adherencia y conocimientos de MAC en mujeres durante el primer semestre postparto. Métodos : Se realizó un estudio de intervención, se conformaron 2 grupos, GI: grupo de intervención (3 con troles hasta los 6 meses postparto) y GC: grupo control (un control a los 6 meses postparto). La intervención consistió en asesoramiento presencial acerca de MAC combinada con folletería informativa y mensajes de WhatsApp®. Se recabaron datos sociodemográficos, an tecedentes gineco-obstétricos, uso y conocimientos de MAC. Se comparó la adherencia al uso y el conocimiento de MAC en ambos grupos a los 6 meses post parto. El análisis se realizó mediante el software R versión 4.0.3. Resultados : Se incorporaron 39 mujeres en cada grupo. Se halló una diferencia en el uso de MAC entre grupos a los 6 meses (92.3% vs. 64.1%), siendo más eleva do su uso en el GI. Se hallaron diferencias significativas en el conocimiento de algunos MAC a los 6 meses. Un mayor porcentaje de mujeres del GI conocía las pastillas anticonceptivas (p = 0.009), ligadura de trompas (p = 0.04) y la vasectomía (p = 0.010), en comparación con el GC. Discusión : La intervención en el postparto temprano con diversas estrategias de comunicación e información pueden ser útiles para elegir el MAC que se considere más adecuado para cada mujer y su utilización correcta.

Abstract Introduction : Scientific evidence suggests that moth er-child joint care strategies would facilitate knowledge of contraceptive methods (MAC) and their access. The objective was to evaluate the effect of the Integrated Mother and Child Care Model on adherence and knowl edge of CAM in women during the first postpartum semester. Methods : An intervention study was carried out, 2 groups were formed, GI: intervention group (3 controls up to 6 months postpartum) and GC: control group (one control at 6 months postpartum). The intervention con sisted of face-to-face counseling about MAC combined with informative brochures and WhatsApp® messages. Sociodemographic data, gynecological and obstetric history, use and knowledge of contraceptive methods were collected. Adherence to the use and knowledge of MAC were compared in both groups at 6 months post partum. The analysis was performed using R software version 4.0.3. Results : Thirty-nine women were incorporated into each group. A difference was found in the use of MAC between groups at 6 months (92.3% vs. 64.1%), its use being higher in GI. Significant differences were found in the knowledge of some MAC at 6 months. A higher percentage of women in GI knew about birth control pills (p = 0.009), tubal ligation (p = 0.04) and vasectomy (p = 0.010), compared to GC. Discussion : Early postpartum intervention with vari ous communication and information strategies can be useful to choose the MAC that is considered most ap propriate for each woman and its correct use.

Análisis de tesis médicas de pregrado en una universidad de Perú, 2011-2020: publicación en revistas indizadas y factores asociados / Analysis of undergraduate medical theses at a Peruvian university, 2011-2020: publication in indexed journals and associated factors

Los factores cuantitativos asociados a la publicación de tesis médicas en el pregrado no han sido lo suficientemente estudiados. Por ello, la investigación describió las tasas de publicación, así como la asociación con las características de las tesis, del asesor y del tesista. Se accedió, de manera virtual, a las tesis médicas de pregrado de la Universidad Nacional de San Agustín de Arequipa, Perú, durante el período 2011-2020. Mediante el análisis de regresión logística múltiple, se evaluó la asociación entre la publicación de la tesis en revistas indizadas (Scopus) y la experiencia previa en publicación en revistas indizadas en Scopus del asesor y del tesista, la unidad de análisis, el tamaño de muestra, diseño de estudio, número de páginas, aprobación por el comité de ética de investigación y el sexo del tesista. De 884 tesis solo 12 (1,5 por ciento) se publicaron; lo que constituye el 1,23 por ciento de las tesis publicadas anualmente, con tendencia constante. La experiencia previa en publicación del asesor se asoció con la colocación de las tesis en revistas indizadas (OR = 8,97 [1,70-42,98]; p = 0,005) y en revistas indizadas a Scopus (OR = 14,64 [1,24-336,11]; p = 0,037). Presentar la aprobación del comité de ética de la institución se asoció con publicar la tesis en revistas indizadas a Scopus (OR = 12,45 [1,06-285,94]; p = 0,050). La publicación de tesis médicas de pregrado en esta universidad es baja y constante. Se asoció con tener un asesor de tesis con experiencia previa en publicaciones en revistas indizadas a Scopus y a tener aprobación por comité de ética. Urge implementar estrategias para aumentar la publicación de tesis(AU)

Quantitative factors associated with the publication of undergraduate medical theses have not been sufficiently studied. Therefore, the research described publication rates, as well as the association with thesis, advisor, and thesis writer characteristics. Undergraduate medical theses from the Universidad Nacional de San Agustín de Arequipa, Peru, during the period 2011-2020 were accessed virtually. Multiple logistic regression analysis was used to evaluate the association between thesis publication in indexed journals (Scopus) and the previous publication experience in indexed journals in Scopus of the advisor and the thesis author, the unit of analysis, sample size, study design, number of pages, approval by the research ethics committee and the gender of the thesis author. Out of 884 theses only 12 (1.5percent) were published; this constitutes 1.23percent of the theses published annually, with a constant trend. The previous publication experience of the advisor was associated with the placement of theses in indexed journals (OR = 8.97 [1.70-42.98]; p = 0.005) and in journals indexed to Scopus (OR = 14.64 [1.24-336.11]; p = 0.037). Presenting the approval of the institution's ethics committee was associated with publishing the thesis in journals indexed to Scopus (OR = 12.45 [1.06-285.94]; p = 0.050). Publication of undergraduate medical theses at this university is low and consistent. It was associated with having a thesis advisor with previous experience in publishing in Scopus-indexed journals and having approval by an ethics committee. There is an urgent need to implement strategies to increase thesis publication(AU)

Comportamiento imagenológico de las deformidades faciales

RESUMEN Fundamento Para el manejo quirúrgico del paciente con deformidad facial resulta vital el uso del examen clínico y radiográfico de cada caso, pues en dependencia de los hallazgos se decide entre las diversas alternativas terapéuticas disponibles en este campo. Objetivo describir el comportamiento imagenológico de las deformidades faciales en pacientes adultos. Métodos se realizó un estudio descriptivo de corte transversal, en 46 pacientes mayores de 18 años, con diagnóstico de deformidad facial, los cuales acudieron al Servicio de Cirugía Maxilofacial, del Hospital Calixto García, en el período comprendido desde noviembre de 2017 a noviembre de 2019. Se analizaron las variables: tipo de tejido, magnitud, y plano en el que se evidenciaron las alteraciones. Se utilizó la prueba exacta de Fisher, con un nivel de confianza al 95 %, para determinar las relaciones analíticas entre las variables; así como los índices tau b de Kendall y el Rho de Spearman. Resultados el 45,7 % de las deformidades se presentó en ambos planos; el 50 % de ellas con magnitudes entre 11-30 mm; y en el 41,3 % de los pacientes afectaron al tejido blando. Las correlaciones entre la distribución de pacientes y los conjuntos de variables plano/tipo de tejido y plano/magnitud resultaron negativas débiles; mientras que tipo de tejido/magnitud presentó una correlación positiva moderada muy significativa, con valores de significación entre 0,001 a 0,003. Conclusión predominaron las deformidades de tejido blando, en ambos planos y con magnitudes entre 11-30 mm. Las variables imagenológicas estudiadas mostraron un comportamiento interdependiente.

ABSTRACT Background For the surgical management of the patient with facial deformity, the use of the clinical and radiographic examination of each case is vital, since depending on the findings, a decision is made between the various therapeutic alternatives available in this field. Objective to describe the imaging behavior of facial deformities in adult patients. Methods a descriptive cross-sectional study was carried out in 46 patients older than 18 years old, with a diagnosis of facial deformity, who attended the Maxillofacial Surgery Service, Calixto García Hospital, from November 2017 to November 2019. The analyzed variables were: type of tissue, magnitude, and plane in which the alterations were evidenced. Fisher's exact test was used, with a confidence level of 95 %, to determine the analytical relationships between the variables; as well as Kendall's tau b and Spearman's Rho rates. Results The 45.7 % of the deformities presented in both planes; 50 % of them with magnitudes between 11-30 mm; and in 41.3 % of the patients they affected the soft tissue. The correlations between the distribution of patients and the sets of variables plane/tissue type and plane/magnitude were weakly negative; while tissue type/magnitude presented a very significant moderate positive correlation, with significance values between 0.001 and 0.003. Conclusion soft tissue deformities predominated, in both planes and with magnitudes between 11-30 mm. The imaging variables studied showed an interdependent behavior.

Evolução de práticas alimentares não saudáveis entre adolescentes: Pesquisa Nacional de Saúde do Escolar 2009-2015 / Evolution of unhealthy eating practices among adolescents: National School Health Survey 2009-2015

Descrever a evolução das práticas alimentares não saudáveis entre adolescentes nas três últimas versões da Pesquisa Nacional de Saúde do Escolar. Estudo ecológico, no qual foram estudadas questões referentes ao consumo de refrigerante, guloseimas, ultraprocessados, hábito de comer enquanto assiste televisão e hábito de realizar refeições acompanhado do responsável. Houve redução do consumo de guloseimas (9,1%), refrigerante (8,2%) e de ultraprocessados (9%), sendo este último com maior redução observada na região Nordeste. Alunos com mães de ensino superior completo apresentaram redução de 3,5% no consumo de ultraprocessados, e de 12,2% entre os alunos com mães de ensino fundamental completo. Embora tenha sido observada redução no consumo de alimentos não saudáveis, a ingestão destes alimentos ainda foi significativamente alta em 2015. Considerando a associação entre alimentação não saudável com o desenvolvimento de doenças crônicas, é fundamental que sejam desenvolvidas estratégias de práticas alimentares saudáveis no contexto escolar.

The evolution of unhealthy eating practices among adolescents in the last three versions of the National School Health Survey is analyzed. Current ecological study comprises issues with regard to the consumption of soft drinks, candies, ultra-processed food, eating while watching television and having meals within the family. There was a decrease in the consumption of sweets (9.1%), soft drinks (8.2%) and ultra-processed foods (9%). The consumption of ultra-processed food had the largest reduction rate reported in the Northeast region of Brazil. Students whose mothers had higher education revealed a 3.5% reduction in the consumption of ultra-processed food, whilst there was a 12.2% decrease among students whose mother had full primary education. Although a reduction in the consumption of unhealthy foods has been observed, the intake of these foods was still significantly high in 2015. Since there is an association between unhealthy eating and the development of chronic diseases, it is essential that healthy eating practices strategies should be developed in the school context.

Further insights into the eco-epidemiology of American cutaneous leishmaniasis in the Belem metropolitan region, Pará State, Brazil

Abstract INTRODUCTION: In the Belém Metropolitan Region (BMR), Pará State, Brazil, American cutaneous leishmaniasis (ACL) is endemic; however, very little is known regarding its causative agents. Therefore, we used our standard diagnostic approach combined with an RNA polymerase II largest subunit (RNAPOIILS)-polymerase chain reaction (PCR) followed by analysis of restriction fragment length polymorphism (PCR-RFLP) to identify Leishmania spp. ACL agents in this region. METHODS: Thirty-two Leishmania spp. isolates from patients with ACL in the BMR during 1995-2018 were analyzed. Leishmania spp. DNA samples were amplified using the primers RPOR2/RPOF2, and the 615-bp PCR products were subjected to enzymatic digestion using TspRI and HgaI endonucleases. RESULTS: ACL etiological agents in the BMR comprised Leishmania (Viannia) lindenbergi (43.7%) followed by Leishmania (Viannia) lainsoni (34.4%), Leishmania (Leishmania) amazonensis (12.5%), and Leishmania (Viannia) braziliensis (9.4%). CONCLUSIONS: To our knowledge, the results of the study revealed for the first time that L. (V.) lindenbergi and L. (V.) lainsoni are the main ACL agents in BMR.

Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Adults / Consenso Brasileiro de Nutrição em Transplante de Células-Tronco Hematopoiéticas: Adultos

ABSTRACT The nutritional status of patients submitted to hematopoietic stem cell transplant is considered an independent risk factor, which may influence on quality of life and tolerance to the proposed treatment. The impairment of nutritional status during hematopoietic stem cell transplant occurs mainly due to the adverse effects resulting from conditioning to which the patient is subjected. Therefore, adequate nutritional evaluation and follow-up during hematopoietic stem cell transplant are essential. To emphasize the importance of nutritional status and body composition during treatment, as well as the main characteristics related to the nutritional assessment of the patient, the Brazilian Consensus on Nutrition in Hematopoietic Stem Cell Transplant: Adults was prepared, aiming to standardize and update Nutritional Therapy in this area. Dietitians, nutrition physicians and hematologists from 15 Brazilian centers thar are references in hematopoietic stem cell transplant took part.

RESUMO O estado nutricional do paciente submetido ao transplante de células-tronco hematopoéticas é considerado fator de risco independente, podendo influenciar na qualidade de vida e na tolerância ao tratamento proposto. O comprometimento do estado nutricional durante o transplante de células-tronco hematopoéticas ocorre principalmente devido aos efeitos adversos decorrentes do condicionamento ao qual o paciente é submetido. Desta forma, a adequada avaliação nutricional e o acompanhamento durante o transplante de células-tronco hematopoéticas tornam-se imprescindíveis. Com o objetivo de salientar a importância do estado nutricional e da composição corporal durante o tratamento, bem como as principais características relacionadas à avaliação nutricional do paciente, o Consenso Brasileiro de Nutrição em Transplante de Células-Tronco Hematopoiéticas: Adulto foi elaborado visando uniformizar e atualizar a Terapia Nutricional nesta área. Com a participação de nutricionistas, nutrólogos e hematologistas de 15 centros brasileiros referências em transplante de células-tronco hematopoéticas

Ticks infesting captive and free-roaming wild animal species at the São Paulo Zoo, São Paulo, Brazil / Carrapatos infestando espécies de animais silvestres cativas e de vida livre no Zoológico de São Paulo, São Paulo, Brasil

Abstract Ticks are ectoparasites of worldwide distribution that affect vertebrates and can transmit pathogens to animals and humans. The Zoological Park Foundation of São Paulo (FPZSP) is located in a Conservation Unit in one of the most important remaining fragments of the Atlantic Rainforest biome in the suburbs of São Paulo, Brazil. The FPZSP houses more than 3,000 wild animals on exhibit, in breeding programs and in environmental education programs, and also attracts migratory birds and free-roaming wildlife. This study focused on identifying the diversity of tick species that infest captive and free-roaming animals at the FPZSP. The collection of ticks kept at the FPZSP contains 523 specimens that were collected from different host species between 1990 and 2017. Ten tick species were found. In addition, Amblyomma aureolatum (Pallas) was found on stray cats living in the Atlantic forest fragment in the FPZSP. This study reveals a low occurrence of parasitism in captive animals and a high diversity of tick species collected from hosts in this Atlantic forest fragment, contributing information about host-parasite relationships and potential vectors of zoonotic diseases, since the vectors of Brazilian spotted fever, A. aureolatum and Amblyomma sculptum Berlese, were found in some hosts.

Resumo Os carrapatos são ectoparasitas da classe Arachnida, conhecidos como importantes vetores de agentes infecciosos para animais e humanos. A Fundação Parque Zoológico de São Paulo (FPZSP) localizada em uma Unidade de Conservação do bioma Mata Atlântica e inserida na cidade de São Paulo, mantém mais de 3.000 animais selvagens cativos, abrigando ainda diversas espécies silvestres nativas da Mata Atlântica. Devido à importância do conhecimento dos carrapatos que parasitam a fauna selvagem, o objetivo deste trabalho foi identificar a coleção de carrapatos da FPZSP e analisar a diversidade desses parasitas em animais cativos e de vida livre. O acervo de carrapatos mantidos pela FPZSP contém 523 exemplares que foram coletados de diferentes espécies hospedeiras, desde 1990 até 2017. Dez espécies de carrapatos foram encontradas. Além dos animais silvestres, foram encontrados Amblyomma aureolatum (Pallas) em gatos domésticos errantes que circulam nas áreas da FPZSP. Este trabalho demonstra a baixa ocorrência de parasitismo em animais cativos e a alta diversidade de carrapatos nos hospedeiros deste fragmento de Mata Atlântica, contribuindo com informações sobre a relação parasita-hospedeiro e potenciais vetores de doenças zoonóticas, já que os vetores da Febre Maculosa Brasileira A. aureolatum e Amblyomma sculptum Berlese, foram encontrados em alguns hospedeiros.

Behavioral alterations induced by repeated saxitoxin exposure in drinking water

Background: Blooms of the saxitoxin-producing cyanobacterium Cylindrospermopsis raciborskii have been contaminating drinking water reservoirs in Brazil for many years. Although acute effects of saxitoxin intoxication are well known, chronic deleterious outcomes caused by repeated saxitoxin exposure still require further investigation. The aim of the present work is to investigate the effects of consumption of drinking water contaminated with C. raciborskii for 30 days on learning and memory processes in rats. Methods: The effects of saxitoxin (3 or 9 µg/L STX equivalents) or cyanobacteria on behavior was determined using the open field habituation task, elevated plus maze anxiety model task, inhibitory avoidance task, and referential Morris water maze task. Results: No effects of saxitoxin consumption was observed on anxiety and motor exploratory parameters in the elevated plus maze and open field habituation tasks, respectively. However, groups treated with 9 µg/L STX equivalents displayed a decreased memory performance in the inhibitory avoidance and Morris water maze tasks. Conclusions: These results suggest an amnesic effect of saxitoxin on aversive and spatial memories.(AU)

Behavioral alterations induced by repeated saxitoxin exposure in drinking water

Blooms of the saxitoxin-producing cyanobacterium Cylindrospermopsis raciborskii have been contaminating drinking water reservoirs in Brazil for many years. Although acute effects of saxitoxin intoxication are well known, chronic deleterious outcomes caused by repeated saxitoxin exposure still require further investigation. The aim of the present work is to investigate the effects of consumption of drinking water contaminated with C. raciborskii for 30 days on learning and memory processes in rats. Methods The effects of saxitoxin (3 or 9 g/L STX equivalents) or cyanobacteria on behavior was determined using the open field habituation task, elevated plus maze anxiety model task, inhibitory avoidance task, and referential Morris water maze task. Results No effects of saxitoxin consumption was observed on anxiety and motor exploratory parameters in the elevated plus maze and open field habituation tasks, respectively. However, groups treated with 9 g/L STX equivalents displayed a decreased memory performance in the inhibitory avoidance and Morris water maze tasks. Conclusions These results suggest an amnesic effect of saxitoxin on aversive and spatial memories.

Halotolerant bacteria in the São Paulo Zoo composting process and their hydrolases and bioproducts

Halophilic microorganisms are able to grow in the presence of salt and are also excellent source of enzymes and biotechnological products, such as exopolysaccharides (EPSs) and polyhydroxyalkanoates (PHAs). Salt-tolerant bacteria were screened in the Organic Composting Production Unit (OCPU) of São Paulo Zoological Park Foundation, which processes 4 ton/day of organic residues including plant matter from the Atlantic Rain Forest, animal manure and carcasses and mud from water treatment. Among the screened microorganisms, eight halotolerant bacteria grew at NaCl concentrations up to 4 M. These cultures were classified based on phylogenetic characteristics and comparative partial 16S rRNA gene sequence analysis as belonging to the genera Staphylococcus, Bacillus and Brevibacterium. The results of this study describe the ability of these halotolerant bacteria to produce some classes of hydrolases, namely, lipases, proteases, amylases and cellulases, and biopolymers. The strain characterized as of Brevibacterium avium presented cellulase and amylase activities up to 4 M NaCl and also produced EPSs and PHAs. These results indicate the biotechnological potential of certain microorganisms recovered from the composting process, including halotolerant species, which have the ability to produce enzymes and biopolymers, offering new perspectives for environmental and industrial applications.

Participação de crianças em pesquisas: uma proposta considerando os avanços teórico-metodológicos / Participation of children in research: a proposal considering the theoretical and methodological advances / Participación de niños en investigaciones: una propuesta considerando los avances teorico-metodológicos

Nas pesquisas em Psicologia do Desenvolvimento e outras áreas do conhecimento, as crianças foram mais consideradas como objetos do que sujeitos, sendo mais observadas do que escutadas. Esse posicionamento, que vem mudando recentemente, conduziu à limitação da construção do conhecimento a respeito do desenvolvimento do self na infância, especialmente, durante experiências de transição. Neste texto, apresentamos uma breve revisão da literatura, com estudos que consideram especificidades do envolvimento das crianças na pesquisa e, a fim de aprofundarmos a compreensão de suas interpretações a respeito de si mesmas, do outro e do mundo nesta experiência, e das diferentes dinâmicas de interação mediadas por essas interpretações, desenvolvemos uma proposta de estudo longitudinal com crianças de 5 a 7 anos, durante a transição da Educação Infantil para o primeiro ano do Ensino Fundamental...

In research in Developmental Psychology and other areas of knowledge, children are considered mainly as objects rather than subjects as they are mostly observed than heard. That perspective restrained construction of knowledge on the development of the self in childhood, specially, during transitional experiences. We present a review of the literature, with studies concerning the specificities of the involvement of children in research. In order to broaden the understanding of their interpretations about themselves, the others and the world in experience of school transition and the different dynamics of interaction mediated by children´s interpretations, we develop a proposal for a longitudinal study with 5 to 7 year old children, during the transition from kindergarten to first grade in elementary school...

En las investigaciones en Psicología del Desarrollo y otras áreas del conocimiento, los niños fueron considerados más como objetos que como sujetos, siendo, por tanto, más observados que escuchados. Esta posición, que ha ido cambiando recientemente, llevó a restricciones sobre la construcción del conocimiento y sobre el desarrollo del self en la infancia, especialmente en las experiencias de transición. En este artículo se presenta una breve revisión de la literatura, con estudios que tienen en cuenta las especificidades sobre la implicación por parte de los niños en las investigaciones, así como una profundización en la comprensión respecto a sus interpretaciones acerca de sí mismo, del otro y del mundo en tales experiencias. Igualmente discutimos las diferentes dinámicas de interacción que pueden surgir debido a estas interpretaciones. Hemos desarrollado una propuesta para un estudio longitudinal con niños de 5 a 7 años durante la transición del preescolar al primer grado de la Escuela primaria...

Perfil epidemiológico dos pacientes atendidos pelo serviço de cirurgia plástica do hospital João XXIII em Belo Horizonte/MG no período de março à agosto de 2013 / Epidemiological profile of patients treated by the plastic surgery service of the João XXIII hospital in Belo Horizonte/MG from March to August 2013

Introdução: O Serviço de Cirurgia Plástica Programada do Hospital João XXIII exerce o suporte às demais especialidades através de inter-consultas e, realiza atendimento aos pacientes com entrada no Hospital pela cirurgia plástica. O escopo deste estudo foi analisar o perfil epidemiológico dos pacientes atendidos durante o período de Março à Agosto de 2013. Métodos: Trata-se de um estudo observacional prospectivo com coleta de dados realizada através de anamnese e exame físico. Resultados: Dentre os pacientes avaliados 75,23% eram do sexo masculino e 21,34% do sexo feminino. A faixa etária predominante foi a economicamente ativa com 62,86% dos pacientes entre 16 e 45 anos. Foi observado que os acidentes de trânsito figuraram como os principais determinantes de atendimentos (44,85%). As escaras constituíram os diagnósticos mais frequentes e dentre as outras lesões avaliadas, observou-se que se concentraram nos membros. A Clínica Médica e a Ortopedia solicitaram o maior número de inter-consultas. Evidenciou-se que o tratamento através de abordagem cirúrgica (52,9%) e o acompanhamento com cuidados locais (47,1%) apresentaram frequências aproximadas. Conclusão: Na busca por propor medidas para prevenir e tratar as lesões próprias de abrangência da cirurgia plástica reparadora destacaram-se dois pontos: os acidentes de trânsito e as escaras de decúbito. Ambos com fatores determinantes bem elucidados, porém mantendo alta prevalência. Torna-se evidente a necessidade de atuação nas esferas públicas para uma melhor educação no trânsito e redução da ocorrência de acidentes. No âmbito hospitalar é primordial que se adotem medidas eficazes que impeçam o surgimento das temíveis escaras de decúbito.

Introduction: The Plastic Surgery Service of the João XXIII Hospital provides support to other specialties through interdepartmental consultation and follows patients admitted to the hospital for plastic surgery. This study analyzed the epidemiological profile of patients treated from March to August 2013. Methods: This was a prospective observational study with data collection performed by medical history and physical examination. Results: Of the patients evaluated, 75.23% were male and 21.34% female. The predominant age group was economically active, with 62.86% of the patients between 16 and 45 years. Traffic accidents were the main reason for care (44.85%). Pressure ulcers were the most frequent diagnoses, and other lesions evaluated were predominantly of the extremities. Internal Medicine and Orthopedics requested most consultations. Surgical treatment (52.9%) and follow-up with local care (47.1%) showed similar frequencies. Conclusion: In order to propose measures for prevention and treatment of injuries within the scope of reconstructive plastic surgery, two issues were highlighted: traffic accidents and pressure ulcers. Both have well-defined causes, but remain at high prevalence. The need for public action that promotes better traffic education and reduction of accidents is clear. In the hospital environment, it is essential to take effective measures to prevent the emergence of dreaded pressure ulcers.

Diseño de una crema regeneradora con quitina para después del bronceado / Design of a regenerative chitin cream for use after sun tanning

Introducción: después de tomar el sol resulta indispensable reparar la piel agredida por los rayos nocivos. Los cosmecéuticos para después del sol contienen elementos antinflamatorios, calmantes, hidratantes, suavizantes y regeneradores del epitelio, los cuales evitan o mitigan la sensación de dolor, tirantez, ardor y prurito.Objetivo: desarrollar una crema regeneradora con quitina para después del bronceado con la calidad requerida para reparar e hidratar la piel. Métodos: se realizaron dos diseños experimentales 22 (F1 y F2), en los que se utilizaron humectantes diferentes, glicerina y propilenglicol respectivamente. Se midieron como variables respuestas: el pH y la extensibilidad; además se analizaron las propiedades psicofisiológicas, la tensión de cizalla y las pruebas de centrifugación e influencia de la temperatura durante 60 días.Resultados: no existieron diferencias significativas entre el uso del propilenglicol o la glicerina, mientras que si fue notable la incidencia del alcohol cetílico en los valores de extensibilidad y pH. Se obtuvo como la mejor variante la I del diseño F2, en la que el alcohol cetílico se encontraba al 4 por ciento y el propilenglicol al 3 por ciento; el pH resultó 7,05 ± 0,00; la extensibilidad igual a 68,15 ± 1,51 y la tensión de cizalla de 1,93 ± 0,01; las propiedades psicofisiológicas resultaron satisfactorias y no hubo cremado ni coalescencia.Conclusiones: se puede considerar, atendiendo a las mediciones realizadas en el tiempo evaluado, características satisfactorias para las cremas elaboradas siendo la de menor costo, la variante I del diseño F2. La estabilidad física de las formulaciones, sometidas incluso las bases a pruebas de centrifugación e influencia de la temperatura, es indicativo de una buena compatibilidad entre el biopolímero estudiado y los excipientes de la formulación

Introduction: after taking the sun, it is indispensable to repair the skin affected by harmful rays. The cosmeceuticals for use after sunbath have antinflammatory, relaxing, hydrating, soothing and regenerative elements of the epithelium, which prevent or mitigate the feeling of pain, tautness, burning and rash. Objective: to develop a regenerative chitin cream to be used after sun tanning, with due quality to repair and hydrate the skin. Methods: two experimental designs 2² (F1 and F2) were created in which glycerin and propilenglycol were used as humectants respectively. Ph and extensibility were measured as variables in addition to analyzing the psychophysiological properties, the shearing tension and the centrifugation tests as well as the temperature impact during 60 days. Results: there were no significant differences between propilenglycol and glycerin whereas the incidence of cetyl alcohol in extensibility and pH values was noticeable. The best variant was the no. 1 in the F2 design in which the cetyl alcohol was found at 4 percent and the propilenglycol at 3 percent. The pH value was 7.05 ± 0.00; the extensibility was 68.15 ± 1.51 and the shear tension was 1.93 ± 0.01. The psychophysiological properties were satisfactory and there was no creaming or coalescence. Conclusions: it may be considered that, according to the measurements made in the evaluated period of time, the characteristics are satisfactory for the prepared creams; being variant I of the F2 design the least expensive. The physical stability of formulations undergoing tests of centrifugation and temperature impact indicates good compatibility between the studied polymer and the excipients

A specific polymerase chain reaction method to identify Stenotrophomonas maltophilia

Stenotrophomonas maltophilia is a multidrug-resistant nosocomial pathogen that is difficult to identify unequivocally using current methods. Accordingly, because the presence of this microorganism in a patient may directly determine the antimicrobial treatment, conventional polymerase chain reaction (PCR) and real-time PCR assays targeting 23S rRNA were developed for the specific identification of S. maltophilia. The PCR protocol showed high specificity when tested against other species of Stenotrophomonas, non-fermentative Gram-negative bacilli and 100 clinical isolates of S. maltophilia previously identified using the Vitek system.

Terapia nutricional no paciente queimado / Nutritional therapy in burn patient

Em pacientes queimados, o hipermetabolismo estimula o aumento das necessidades protéico-calóricas, influencia no início da nutrição precoce,assim que estabilizados hemodinamicamente. O suporte nutricional e metabólico atenua a sepse, diminui o risco de complicações em pacientes graves, minimiza a resposta metabólica ao trauma e suas consequências, como a perda de peso, a redução dos mecanismos de defesa e a diminuição do processo cicatricial. Alguns nutrientes, como glutamina, arginina, antioxidantes e ácidos graxos, têm efeito imunomodulador. É indicada terapia nutricional enteral (TNE) em pacientes que apresentem superfície corporal queimada (SCQ) acima de 30% em adultos, 20% em crianças ou ainda apresentando lesões graves. A terapia nutricional parenteral (TNP)só deve ser indicada em casos de íleo paralítico ou na impossibilidade total de utilização do tubo digestivo. Várias equações foram propostas para estimar o gasto energético em pacientes queimados; a mais popular é a de Curreri, porém indica-se a calorimetria indireta como avaliação de gasto energético basal em pacientes com SCQ superior a 40%. As medidas antropométricas, bioquímicas e imunológicas sofrem alterações, devido à grande instabilidade hemodinâmica comum na fase inicial das queimaduras. O indicativo de uma resposta terapêutica adequada é a estabilização dos níveis séricos de albumina e de outras proteínas, além da evolução do processo cicatricial das lesões. O objetivo deste trabalho é demonstrara importância da terapia nutricional em pacientes grandes queimados.

In burn patients, the hypermetabolism stimulates increased protein and caloric needs, influences the onset of early nutrition, so stabilized hemodynamically. The nutritional and metabolic support attenuates sepsis, reduces the risk of complications in critically ill patients, minimizing the metabolic response to trauma and its consequences such as weight loss, reduction of defense mechanisms and the reduction of the healing process. Some nutrients such as glutamine, arginine, antioxidants, fatty acids have immunomodulating effect. Enteral nutrition therapy (ENT) is indicated in patients who have above 30% bodysurface area (BSA) in adults, 20% in children presenting or serious injury. Parenteral nutrition therapy (NPT) should only be recommended in cases of ileus or inability to use the total digestive tract. Several equations have been proposed to estimate energy expenditure in burn patients; the most popular is the Curreri, but indicates the indirect calorimetry and assessment of resting energy expenditure in patientswith BSA greater than 40%. The anthropometric, biochemical andimmunological changes are suffering because of hemodynamic instabilitycommon in the early stage of burns. The indicator of an adequate therapeutic response is the stabilization of serum albumin and other proteins, and the evolution of the healing process of injuries. The objective of this study is to demonstrate the importance of nutritiontherapy in severe burn patients.

An MLSA-based online scheme for the rapid identification of Stenotrophomonas isolates

An online scheme to assign Stenotrophomonas isolates to genomic groups was developed using the multilocus sequence analysis (MLSA), which is based on the DNA sequencing of selected fragments of the housekeeping genes ATP synthase alpha subunit (atpA), the recombination repair protein (recA), the RNA polymerase alpha subunit (rpoA) and the excision repair beta subunit (uvrB). This MLSA-based scheme was validated using eight of the 10 Stenotrophomonas species that have been previously described. The environmental and nosocomial Stenotrophomonas strains were characterised using MLSA, 16S rRNA sequencing and DNA-DNA hybridisation (DDH) analyses. Strains of the same species were found to have greater than 95 percent concatenated sequence similarity and specific strains formed cohesive readily recognisable phylogenetic groups. Therefore, MLSA appeared to be an effective alternative methodology to amplified fragment length polymorphism fingerprint and DDH techniques. Strains of Stenotrophomonas can be readily assigned through the open database resource that was developed in the current study (www.steno.lncc.br/).

Diseño y desarrollo de dos mascarillas faciales para el acné con quitina como sustancia bioactiva / Design and development of two face packs for the acne where chitin is the bioactive substance

La industria cosmética brinda importancia al logro de un cosmético más completo, un cosmecéutico, que represente seguridad en el mantenimiento de la salud y la belleza. En este trabajo se diseñaron y desarrollaron 2 mascarillas faciales para el acné con quitina al 2 por ciento como sustancia activa. Este polímero de origen marino posee propiedades hidratantes, filmógenas, ha sido demostrada su acción cicatrizante y antimicrobiana. Se realizaron 2 diseños de experimentos con mezcla D-optimal, y se estudió la incidencia de 3 componentes en ambas mascarillas: polyquaternium-7 (salcare SC91®) en una de las variantes a ensayar y carboximetil celulosa sódica (CMC) en la otra, propilenglicol y agua en ambos casos. Se analizaron en el tiempo el pH y la extensibilidad; resultó óptima la variante 4 del diseño (salcare SC91 2 por ciento , propilenglicol 2 por ciento y agua al 91,6 por ciento ) en el caso de la formulación con salcare y la variante 5 (CMC 2 por ciento , propilenglicol 4 por ciento y agua 89,6 por ciento ) en la formulación con CMC

The cosmetics industry attaches importance to the achievement of a more complete cosmetic, a cosmoceutic representing safety in health and beauty maintenance. In present paper were designed and developed two face packs for acne using 2 chitin as active substance. This polymer of marine origin has phylmogen and hydration properties and a demonstrated healing and antimicrobial action. Two experimental designs were carried out with a D-optimal mixture and also the study of incidence of three components of both face packs, polyquaaterium-7 (salcare SC91®) in one of the variants be assayed and sodium cellulose carboxymethyl (SCC) in the other one, 2 percent propylene glycol and 91,6 percent water) in the case of salcare formula and the 5 variant (2 percent SCC, 4 percent propylene glycol and 89,6 percent water) in SCC formula

Titers of ABO antibodies in group O blood donors

BACKGROUND: Plasma components of group O blood donations are rarely submitted to ABO antibody titrations even though it is well known that passively acquired antibodies may destroy the recipient's own red cells and tissue grafts. OBJECTIVE: Thus, group O donations stratified by gender and age were randomly titrated to identify the best source of products for apheresis and exsanguinous transfusion. METHODS: Samples from 603 blood donors were tested by ABO antibody titration using the conventional tube technique at room temperature. ABO antibody levels higher than 64 were considered high. After correction for gender, statistical analyses were performed using the Fisher exact and Kruskal-Wallis tests. RESULTS: Most donors in the blood bank were male (65.7 percent). ABO antibody titers ranged from 1 to 2048. The estimations of prevalence for the titers were: anti-A,B < 128 = 86.9 percent and > 128 = 2.16 percent; Anti-A > 128 = 9.29 percent and anti-B > 128 = 4.81 percent. Low mean titers for both anti-A and anti-B antibodies were found in over 50-year-old men (p-value = 0.040). High anti-B antibody levels were found in young women (p-value = 0.002). CONCLUSION: This study confirms that over 50-year-old O group men should be selected as blood donors in non-identical ABO transfusion situations. Also, titration of ABO antibodies in blood banks will increase safety in non-identical ABO transfusions.

Crianças pré-escolares e suas concepções de família / Preschool children and their family conceptions / Niños de edad preescolar y sus concepciones de la familia

Para compreender o desenvolvimento e a diversidade da família contemporânea, faz-se necessário conhecer as concepções de família na perspectiva de crianças pré-escolares. Participaram deste estudo 33 crianças com idades de três, quatro e cinco anos: 15 do Grupo A (ambos os genitores com ocupação remunerada) e 18 do Grupo B (apenas o pai com ocupação remunerada). Os participantes foram entrevistados sobre suas concepções de família e referiram-se à composição familiar, à coabitação e ao cumprimento das funções de provedora, cuidadora e socializadora. As crianças consideraram como parte da composição da família: o núcleo familiar, membros da família extensa, padrinhos, amigos e animais de estimação. Porém, houve maior ênfase à função socializadora no Grupo B do que no Grupo A e as definições foram mais abstratas e complexas entre crianças de cinco anos. Os dados indicam que as concepções das crianças sobre os atuais modos de vida das famílias precisam ser investigadas em uma perspectiva longitudinal e transcultural.

To understand the development and diversity of the contemporary family, it is necessary to understand children's family conceptions. Thirty-three preschool children participated in the study (aged 3, 4, and 5 years old): 15 composed the Group A (both parents had a paid job), and 18 composed the Group B (only the father had a paid job). They were inquired about their conceptions of family and mentioned the following aspects: family composition, cohabitation, and the roles of provider, caregiver and socializing agent. Children included the nuclear family, extended family members, godparents, friends and pets in the composition of the family. However, the Group B emphasized the socializing function of the family more than the Group A. Moreover, children at aged 5 also provided more abstract and complex definitions than the other ones. The data indicates that children's conceptions on current family lifestyles need to be investigated in a longitudinal and cross-cultural perspective.

Para comprender el desarrollo y la diversidad de la familia contemporánea, es necesario conocer las concepciones de los niños. En esta investigación participaron 33 niños de edad preescolar (3, 4 y 5 años), 15 en el Grupo A (ambos genitores tenían ocupación remunerada) y 18 en el grupo B (sólo el padre tenía ocupación remunerada). Los niños fueran entrevistados sobre sus concepciones de la familia, se refirieron a la composición familiar, la convivencia y el desempeño de las funciones de proveedor, cuidador y socializador. Los niños incluyeron en la composición de la familia tanto miembros de la familia nuclear, como de la familia amplia, padrinos, amigos y mascotas. Los resultados indican que en el grupo B se daba mayor énfasis a la función de socialización que en el Grupo A. También las concepciones fueron más abstractas y complejas en los niños de 5 años. Los datos indican la necesidad de investigar las concepciones de los niños sobre los actuales modos de vida de la familia desde una perspectiva longitudinal y trans-cultural.