Relationship between polyvictimization and overweight among adolescents from São Paulo city, Brazil.

This study is to identify victimization patterns and analyze the association between the experience of polyvictimization and overweight or obesity among adolescent girls and boys. The sample consisted of 2680 Brazilian ninth-graders enrolled in public and private schools, taken from the São Paulo Project for the social development of children and adolescents (SP-PROSO). Victimization was explored in two ways: (i) as per Finkelhor and (ii) by latent class analysis (LCA). The interest outcomes were overweight and obesity. Multinomial logistic regression models were used to study the relationship between victimization and overweight or obesity, controlling for confounders. LCA grouped boys and girls adolescents into three classes. These classes received the same labels, but the patterns differed between sexes. Class 1 was characterized by fewer types of victimization suffered and lower endorsement values in the analyzed items and was named bullying and indirect victimization (♀: 42.7%, n = 546; ♂: 21.6%, n = 293). Class 2 included more victimization types than Class 1 and less than Class 3. This class was labeled family violence and peer victimization (♀: 29.1%, n = 356; ♂: 47.9%, n = 652). Class 3 was named high polyvictimization (♀: 28.2%, n = 345; ♂: 30.5%, n = 418). According to Finkelhor, polyvictimization was not associated with overweight or obesity in both sexes. Only the class of high polyvictimization was associated with being overweight (ORadj: 1.60, 95%CI: 1.01-2.54) in girls. In this study, polyvictimization was associated with being overweight only among adolescent girls. Longitudinal studies in different contexts and populations are needed to understand this relationship.

Soil class map of the Rio Jardim watershed in Central Brazil at 30 meter spatial resolution based on proximal and remote sensed data and MESMA method.

Geospatial soil information is critical for agricultural policy formulation and decision making, land-use suitability analysis, sustainable soil management, environmental assessment, and other research topics that are of vital importance to agriculture and economy. Proximal and Remote sensing technologies enables us to collect, process, and analyze spectral data and to retrieve, synthesize, visualize valuable geospatial information for multidisciplinary uses. We obtained the soil class map provided in this article by processing and analyzing proximal and remote sensed data from soil samples collected in toposequences based on pedomorphogeological relashionships. The soils were classified up to the second categorical level (suborder) of the Brazilian Soil Classification System (SiBCS), as well as in the World Reference Base (WRB) and United States Soil Taxonomy (ST) systems. The raster map has 30 m resolution and its accuracy is 73% (Kappa coefficient of 0.73). The soil legend represents a soil class followed by its topsoil color.

Differential arsenic binding in the sediments of two sites in Chile's lower Loa River basin.

Fluvial sediments from two lower Loa River basin sites in northern Chile were compared in order to probe the effects of vegetation and organic matter (OM) on As accumulation in fluvial environments. The two sites were the Sloman dam, which lacks macrophytes and has a low OM content (2.4%) in sediments, and the Quillagua Oasis, which is 23 km downstream from the Sloman site and has a higher OM (6.2%) in sediments and abundant aquatic plant life. The Quillagua site had preferential As enrichment with a co-occurrence pattern that differed from that of the Sloman site, which had a lower As concentration (1528 vs. 262 mg/kg d.w., respectively). At the Quillagua site, As concentration was strongly correlated with Mn and OM (r = 0.91 and 0.85, respectively); while at the Sloman site, As concentration in sediments was significantly correlated with Ca and Sr (r = 0.63 and 0.54, respectively). Sequential extraction analyses showed that the Sloman site had higher percentage of easily exchangeable As within the surface sediment (12%, 45 mg/kg d.w.) compared with the Quillagua site (3%, 40 mg/kg d.w.). These contrasting results suggest that both vegetation and OM control the immobilization and accumulation of As in the arid Loa River basin.

Is myocardial performance index an independent echocardiographic marker of death in children with idiopathic dilated cardiomyopathy?

BACKGROUND: Myocardial performance index (MPI) was reported as a parameter of ventricular systolic and diastolic function, as well as a useful tool to predict the outcome in patients with ventricular dysfunction. HYPOTHESIS: To compare MPI with classical echocardiographic parameters as an independent marker of death in children with idiopathic dilated cardiomyopathy (IDCM). METHODS: Fifty-five children (13 deaths) underwent 104 echocardiograms from January 1996 to May 2005. Right ventricle (RV) MPI and left ventricle (LV) MPI, and 9 classical echocardiographic parameters (left atrium [LA]/body surface area [BSA], distance between mitral E point and ventricular septum, LV mass/body surface area, RV shortening fraction, LV end-systolic and end-diastolic dimensions/body surface area, LV ejection fraction, fiber circumferential shortening velocity, and mitral deceleration time) were compared. Statistical analysis was performed by chi-square, Pearson's correlation and Student t-test, Kaplan-Meier method, Cox's method, and receiver operating curve (ROC). Statistical significance was considered with alpha<0.05 and p=0.80]. RESULTS: Univariate analysis showed that all studied parameters were markers of death. There was a high correlation between RVMPI and LVMPI (r=0.847]-p=0.0001]); therefore, to avoid bias, RVMPI was discharged from multivariate analysis. In the deceased group, moderate/severe mitral regurgitation was frequent (76.9%; confidence interval [CI[ 95%=46.2%- 94.9%) and it was considered in multivariate analysis. In Cox's multivariate analysis, LVMPI was the only independent marker of death (p=0.0213]). The ideal cut-off was 0.63 with 92.3% sensitivity, 66.7% specificity, and fitted ROC area=0.918]. CONCLUSIONS: In children with IDCM, LVMPI is an independent marker of death.

[Health psychology: a key to understand therapeutic adherence]. / Psicología de la salud: una clave para comprender el fenómeno de la adherencia terapéutica.

The lack of compliance with treatment is a public health problem that affects the patient's quality of life, avoids an objective assessment of therapeutic effectiveness and may even cause death. Non compliance can be considered an one-dimensional problem that only depends of patients's responsibility. However, Health Psychology has generated theoretical models that allow the prediction and understanding of therapeutic compliance. It also expands the responsibility to other agents involved in the therapeutic process, specifically health care providers and health systems.

Outcome factors of idiopathic dilated cardiomyopathy in children - a long-term follow-up review.

BACKGROUND: Idiopathic dilated cardiomyopathy in children has a high rate of mortality. Cardiac transplantation is the treatment of choice in those who fail to respond to therapeutics. Several studies have been carried out to determine unfavourable prognoses, and to provide an early indication for cardiac transplantation. Nevertheless, no consensus has been reached on the matter. OBJECTIVE: To propose predictors of death in children with idiopathic dilated cardiomyopathy. METHODS: We reviewed data extending over 22 years from 142 consecutive children with idiopathic dilated cardiomyopathy, of whom 36 died. The criteria for inclusion were the presence of congestive heart failure or cardiomegaly in a routine chest X-ray, confirmed by enlargement and hypo kinesis of the left ventricle in the echocardiogram. We included asymptomatic children in functional class I. Based on Cox's analysis of clinical and laboratory data, we sought any predictors of death. RESULTS: In univariate analysis, the predictors were functional class IV at presentation (p equal to 0.0001), dyspnoea (p equal to 0.0096), and reduced pedal pulses (p equal to 0.0413). In chest X-ray, they were maximal cardiothoracic ratio (p equal to 0.0001) and pulmonary congestion (p equal to 0.0072). In the electrocardiogram, right atrium overload (p equal to 0.0118), ventricular arrhythmias (p equal to 0.0148) and heart rate (p equal to 0.027). In the echocardiogram, mitral regurgitation of grade 3 to 4 (p equal to 0.002), the left atrial to aortic ratio (p equal to 0.0001), and left ventricle ejection fraction (p equal to 0.0266). In multivariate analysis, the independent predictors were maximum cardiothoracic ratio (p equal to 0.0001), left ventricle ejection fraction (p equal to 0.0013), mitral regurgitation of grade 3 or 4 (p equal to 0.0017), functional class IV at presentation (p equal to 0.0028), and ventricular arrhythmias (p equal to 0.0253). CONCLUSION: Children, who have these predictors of death should be considered for early heart transplantation when no improvement is observed in clinical treatment.

Laminin affects polymerization, depolymerization and neurotoxicity of Abeta peptide.

Amyloid deposition in Alzheimer fibrils forms neurotoxic senile plaques in a process that may be modulated by associated proteins. In this work we demonstrate the ability of laminin-1 and laminin-2 to inhibit fibril formation and toxicity on cultured rat hippocampal neurons. We confirm that the laminin-1-derived peptide YFQRYLI inhibits efficiently both fibril formation and neurotoxicity and show that the IKVAV peptide inhibits amyloid neurotoxicity despite its slight inhibition of fibril formation. On other hand, laminin-1 induces disaggregation of preformed fibrils in vitro, characterized as a progressive disassembly of fibrils into protofibrils and further clearance of these latter species, leading to a continual inhibition of amyloid neurotoxicity.

T-cell-mediated immune responses in patients with cutaneous or mucosal leishmaniasis: long-term evaluation after therapy.

T-cell immune responses in patients with cutaneous leishmaniasis (CL) and mucosal leishmaniasis (ML) were studied during the active disease, at the end of therapy, and 1 to 17 years posttherapy (long-term follow-up). Lymphocyte proliferative responses, phenotypic characterization of CD4(+) and CD8(+) Leishmania-reactive T cells, and cytokine production were assayed. Patients with active ML and CL showed higher proportions of CD4(+) than CD8(+) T cells. In CL, the healing process was associated with a decrease of CD4(+) and an increase of CD8(+), leading to similar CD4(+) and CD8(+) proportions. This pattern was only seen in ML after long-term therapy. Long-term follow-up of patients with CL showed a positive CD4(+)/CD8(+) ratio as observed during the active disease, although the percentages of these T cell subsets were significantly lower. Patients with CL did not show significant differences between gamma interferon (IFN-gamma) and interleukin-5 (IL-5) production during the period of study. Patients with active ML presented higher IFN-gamma and IL-5 levels compared to patients with active CL. IL-4 was only detected during active disease. Patients long term after cure from ML showed increasing production of IFN-gamma, significant decrease of IL-5, and no IL-4 production. Two apparently beneficial immunological parameters were detected in tegumentary leishmaniasis: (i) decreasing proportions of CD4(+) Leishmania-reactive T cells in the absence of IL-4 production associated with cure of CL and ML and (ii) decreasing levels of IL-5 long after cure, better detected in patients with ML. The observed T-cell responses maintained for a long period in healed patients could be relevant for immunoprotection against reinfection and used as a parameter for determining the prognosis of patients and selecting future vaccine preparations.

Cirugía estático-activa para el pie plano flácido en niños y adolescentes de 10 a 14 años / Static active surgery for flaccid flat foot in children and adolescent from 10 to 14 years

El pie plano flácido en el niño, también llamado aplanamiento de la bóveda plantar persiste muchas veces después de los 10 años y en ocasiones se hace permanente. La respuesta al tratamiento conservador a base de soporte y zapato adecuado no es la que esperamos, tenemos fracasos a pesar que iniciamos tratamiento a edad temprana. Los padres preocupados, no únicamente por la apariencia plana del pie, sino por el dolor, cansancio, dificultad para la marcha, alteraciones en su postura y desgaste anormal del calzado, ante está situación, buscarán otras opciones, y nosotros por nuestra parte, tenemos la necesidad de ofrecer resultados que garanticen el bienestar del paciente. Por otra parte, si insistimos en que continúe usando arreglos ortopédicos se puede perder al paciente, ya que otro médico le ofrecerá otra alternativa como la quirúrgica, quizá con los resultados que el padre desea

Consideraciones coloproctológicas en la tercera edad / Colo-proctological considerations in elderly

Se describen los métodos de estudio de las enfermedades del colón, recto y ano en geriatría, destacándose la importancia de la historia clínica, la evaluación de los signos y síntomas así como el uso apropiado de las técnicas de exámen

Helmintos parasitos de peixes das usinas hidreléticas da Eletrosul (Brasil). II: Reservatórios de Salto Osório e de Salto Santiago, Bacia do Rio Iguaçu / Helminth parasites of fishes from the hydroelectric power station of \"Eletrosul-(Brazil). II: -Salto Osório\" and \"Salto Santiago\" reservoirs, Iguaçu River basin

Na Usina Hidrelátrica Salto Osório foram examinados 88 peixes, dos quais 24 (27,3%) encontravam-se parasitados por oito espécies de nematóides: Capillaria sp., formas imaturas de Contracoecum sp., Procamallanus peraccuratus Pinto et al., 1976, Procamallanus petterae Kohn & Fernandes, 1988, Raphidascaris sp., Spirocamallanus intermedius Pinto et al., 1974, Spirocamallanus pintoi Kohn & Fernandes, 1988 e Spirocamallanus sp., além de uma forma imatura de cestóide. Na Usina Hidrelétrica de Salto Santiago, dos 83 peixes examinados, 32 (38,5%) apresentaram-se parasitados por três espécies de nematóides: Contracoecum sp. (forma larvar), Procamallanus peraccuratus e Raphydascaris sp., e uma especie de cestóide (forma larvar)