Vitamin D Status in Children With High-risk Neuroblastoma.

BACKGROUND: Vitamin D deficiency has become a matter of concern in pediatric cancer patients. A relationship between neuroblastoma and Vitamin D signaling pathways has been revealed with interest in the antiproliferative and antiinvasive properties of vitamin D. Our aim is to describe the prevalence of Vitamin D deficiency among children with high-risk neuroblastoma (HR-NB) and to explore its association with disease status. MATERIALS AND METHODS: In all, 182 patients with HR-NB were managed at our center from 2017 to 2021. Serum 25(OH)D levels were tested at the first blood analysis performed and correlated with clinical data and disease status. RESULTS: One hundred forty-eight (81.4%) had low 25(OH)D levels (48.4% categorized as deficiency (25(OH)D below 20 ng/mL) and 33.0% as insufficiency (25(OH)D 20 to 30 ng/mL). Median Vitamin D level was 20.2 ng/mL. Vitamin D levels were not associated with race or sex. Although malnourished patients had lower median 25(OH)D levels(11.1 ng/mL), no statistical association was observed with Vitamin D deficiency. There was no association between Vitamin D levels and disease status. An inverse correlation was found between age and vitamin D levels ( P =0.0040). CONCLUSION: A concerning high prevalence of low Vitamin D levels affects more than two-thirds of patients with HR-NB in our cohort, regardless of the disease status at the time of evaluation. Older children are at a higher risk for deficient levels of vitamin D.

Cytotoxic and mutagenic effects of the food additive tartrazine on eukaryotic cells.

BACKGROUND: Among the food additives used in the food industry, food dyes are considered the most toxic. For instance, tartrazine (TRZ) is a food colorant commercially available with conflicting data regarding its cytotoxic, genotoxic, and mutagenic effects. Therefore, this study aimed to evaluate the cytotoxic and mutagenic potential of TRZ using different eukaryotic cells (in vitro). METHODS: This study employed 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT), brine shrimp lethality, Allium cepa and Saccharomyces cerevisiae tests. Different concentrations of TRZ and different exposure times were used in this study. RESULTS: The results demonstrate that TRZ induced a concentration-dependent toxic effect on the test systems. It also exerted cytotoxicity in fibroblasts and human gastric cells. In addition, TRZ showed mutagenic effects on the A. cepa test system. However, its toxicogenic effects may not relate to the oxidizing activity, which was confirmed by the S. cerevisiae test model. CONCLUSION: Taken together, TRZ exerted toxicogenic effects on the test systems. Therefore, it may be harmful to health, especially its prolonged use may trigger carcinogenesis.

Endocrine Late Effects in Childhood Cancer Survivors.

Childhood cancer management has improved considerably over the years, leading to a significant improvement in survival of up to 80%. However, childhood cancer survivors are at the highest risk of developing sequelae resulting from treatment, with endocrine complications being frequently observed among survivors. Multiple predisposing factors for endocrine sequelae have been identified, including age at diagnosis, treatment received, radiation, tumor type, and genetic polymorphisms, which could explain the individual predisposition to develop drug toxicity. Novel agents targeting tumor growth and immune checkpoint inhibitors have recently become the cornerstone for the treatment of different cancers, triggering a myriad of immune-related endocrinopathies. Endocrine sequelae of cancer therapy will have an impact on not only childhood but also on the survival and quality of life of these highly complex patients. Therefore, lifelong monitoring of childhood cancer survivors at risk of endocrine diseases is paramount. Encouraging oncologists and endocrinologists to develop new follow-up and early detection guidelines that minimize sequelae among these patients has become a priority, promoting integration between pediatric and adult units since many sequelae may manifest only after years to decades of follow-up.

Antimicrobial Stewardship Improvement in Pediatric Intensive Care Units in Spain-What Have We Learned?

Antibiotic misuse in pediatric intensive care units (PICUs) can lead to increased antimicrobial resistance, antibiotic-triggered side effects, hospital costs, and mortality. We performed a multicenter, prospective study, analyzing critically ill pediatric patients (≥1 month to ≤18 years) admitted to 26 Spanish PICUs over a 3-month period each year (1 April−30 June) from 2014−2019. To make comparisons and evaluate the influence of AMS programs on antibiotic use in PICUs, the analysis was divided into two periods: 2014−2016 and 2017−2019 (once 84% of the units had incorporated an AMS program). A total of 11,260 pediatric patients were included. Total antibiotic prescriptions numbered 15,448 and, overall, 8354 patients (74.2%) received at least one antibiotic. Comparing the two periods, an increase was detected in the number of days without antibiotics in patients who received them divided by the number of days in PICUs, for community-acquired infections (p < 0.001) and healthcare-associated infections (HAIs) acquired in PICUs (p < 0.001). Antibiotics were empirical in 7720 infections (85.6%), with an increase in appropriate antibiotic indications during the second period (p < 0.001). The main indication for antibiotic adjustment was de-escalation, increasing in the second period (p = 0.045). Despite the high rate of antibiotic use in PICUs, our results showed a significant increase in appropriate antibiotic use and adjustment following the implementation of AMS programs.

Encefalitis centroeuropea. Descripción del primer caso importado en España en un paciente pediátrico / Tick-borne encephalitis. Description of the first imported case in Spain in a paediatric patient

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Aspectos epidemiológicos da Leishmaniose Visceral Humana no estado do Piauí, Brasil (2007-2017) / Epidemiological aspects of Human Visceral Leishmaniasis in the state of Piauí, Brazil (2007- 2017) / Aspectos epidemiológicos de la Leishmaniasis Visceral Humana en el estado do Piauí, Brasil (2007-2017)

Justificativa e Objetivos: A leishmaniose visceral apresenta considerável expansão em centros urbanos no Piauí, e a sua ocorrência é marcada por sucessivos registros de surtos. O objetivo deste estudo foi analisar os casos notificados de Leishmaniose Visceral Humana no Piauí, entre os anos de 2007 e 2017. Métodos: Os dados sobre os números de casos e variáveis, como a distribuição no tempo, no espaço e algumas características das pessoas atingidas, óbitos e diagnóstico, foram através do Sistema de Informação de Agravos de Notificação (SINANDatasus). Resultados: Foram notificados 2.447 casos, com 2.265 casos autóctones (92,56%), e o diagnóstico laboratorial conclusivo foi realizado em 86,6% dos casos. O ano de 2014 foi o ano com maior registro (283 casos) e maior coeficiente de letalidade anual de 14,1%. Ao todo, 183 municípios (81,7%) apresentaram casos positivos em residentes. Na capital, Teresina, ocorreu o maior número de casos em residentes (734 casos, 30%) e foi o município que mais notificou em todo o estado (1.859 casos, 75,97%). Os mais acometidos foram indivíduos do sexo masculino (66,30%) e faixa etária menor que 10 anos (43,44%). Em relação à escolaridade, a classificação "não se aplica" foi mais prevalente (39,84%), assim como a raça/cor parda (88,27%) e a zona residencial urbana (67,63%). Conclusão: A realização destas análises fornece informações sobre a situação epidemiológica da leishmaniose visceral no Piauí em uma série histórica de 2007 a 2017, como a distribuição espacial dos casos, municípios com maiores incidências, a dificuldade de acesso ao diagnóstico, grupos sociais mais acometidos e óbitos, podendo auxiliar no direcionamento das ações para o controle da doença no estado.(AU)

Background and Objectives: Visceral leishmaniasis presents considerable expansion in urban centers in the state of Piauí and its occurrence is marked by successive records of outbreaks. To analyze the reported cases of Human Visceral Leishmaniasis in Piauí, between 2007 and 2017. Methods: The data about the number of cases and variables such as distribution in time, space and some characteristics of the affected people, deaths and diagnosis were obtained from Notifiable Diseases Information System (SINAN-Datasus) Results: 2,447 cases were reported, of which 2,265 autochthonous cases (92.56%). The conclusive diagnosis was made in 86.6% of the cases. The year with the highest record (283 cases) was 2014, also the annual lethality rate was 14.1%. Positive cases were registered in residents of 183 municipalities (81.7%). The capital Teresina presents the highest number of cases in residents (734.30%) and notification (1,859, 75.97%). Males (66.30%) were the most affected and individuals under 10 years old (43.44%). Regarding education, the classification "does not apply" (39.84%) was the most prevalent, as well as brown race/color (88.27%) and the urban residential area (67.63%). Conclusion: Epidemiological assay provides knowledge about the real epidemiological situation in the state of Piauí, such as profile characterization, frequency of cases occurrence, assisting in actions for control and eradication of the disease in the state.(AU)

Justificación y Objetivos: La Leishmaniasis visceral presenta una expansión considerable en los centros urbanos de Piauí, y su aparición está marcada por sucesivos registros de brotes. Analizar los casos reportados de Leishmaniasis Visceral Humana en Piauí, entre los años 2007 a 2017. Métodos: Datos sobre el número de casos y variables como distribución en tiempo, espacio y algunas características de las personas afectadas, defunciones y diagnóstico fueron obtenido mediante el Sistema de Información de Enfermedades Notificables (SINAN-Datasus). Resultados: Fueron notificados 2.447 casos, con 2.265 casos autóctonos (92,56%). El diagnóstico de laboratorio concluyente se realizó en el 86,6% de los casos. 2014 fue el año con el récord más alto (283 casos) y la tasa de letalidad anual del 14,1%. 183 municipios (81,7%) presentó casos positivos en residentes. La capital Teresina tuvo el mayor número de casos en residentes (734 casos, 30%) y fue el municipio que más reportó en todo el estado (1.859 casos, 75,97%). Los más afectados pertenecían al sexo masculino (66,30%) y los menores de 10 años (43,44%). En cuanto a la educación, la clasificación "no aplica" fue más prevalente (39,84%) y la zona residencial urbana (67,63%). Conclusión: La realización de estos análisis aporta conocimiento sobre la situación epidemiológica en Piauí en una serie histórica de 2007 a 2017, como la caracterización de los casos, las fallas en los registros y la frecuencia de ocurrencia de los casos, ayudando a orientar las acciones para el control en el estado.(AU)

Triatomine bugs (Hemiptera, Reduviidae, Triatominae) in the Domiciles of the Guaribas Valley Territory, in Northeastern Brazil.

INTRODUCTION: Triatomine bugs are hematophagous insects that are extremely important in public health because they are natural vectors of Trypanosoma cruzi, the causative agent of Chagas disease. In this study, we aimed to assess the occurrence of triatomine species and the natural T. cruzi infection in the Guaribas Valley territory, an endemic region for Chagas disease in northeastern Brazil. METHODS: Insects were actively captured from July 2017 to October 2019 in the intra- and peridomiciles of 16 municipalities of the Guaribas Valley territory, in the southeast area of Piauí state. Triatomine species were identified following a taxonomic key, and natural infection was investigated through insects' fresh feces exams. RESULTS: A total of 430 triatomines were collected, including 211 nymphs and 219 adults. Of all collected specimens, 39 (9.1%) were from the intradomiciles and 391 (90.9%) from peridomiciles. Nine species, including two subspecies, could be identified: Triatoma brasiliensis brasiliensis, T. brasiliensis macromelasoma, T. pseudomaculata, T. sordida, T. juazeirensis, T. melanocephala, Panstrongylus lutzi, Rhodnius domesticus, R. nasutus, and R. robustus. T. brasiliensis were the most frequently collected bugs, representing 72% of all the identified insects. None of the examined invertebrates presented flagellate forms of T. cruzi. CONCLUSIONS: This is the first report of T. b. macromelasoma and T. juazeirensis in the Guaribas Valley territory. The persistence of triatomine species in the domiciles in an endemic area for Chagas disease emphasizes the relevance of entomological surveillance and vector control measures in the studied area.

Formas parasitárias encontradas em hortaliças comercializadas em feira livre de Picos, Piauí: a importância do processo de sanitização / Parasites found in the vegetables sold in open fairs in Picos, Piauí: the importance of sanitation process

O consumo diário de vegetais fornece inúmeros benefícios para a saúde do ser humano, no entanto têm sido um dos alimentos mais relacionados a surtos de toxinfecção alimentar em nível mundial. O objetivo deste estudo foi avaliar a presença de estruturas parasitárias em hortaliças comercializadas na feira livre do município de Picos, Piauí antes e após a utilização de hipoclorito de sódio como sanitizante. Foram analisadas 160 amostras, sendo 40 de alfaces-crespa (Lactuca sativa L.), 40 amostras de acelga (Beta vulgaris var. cicla L.), 40 amostras de coentro (Coriandrum sativum L.) e 40 amostras de cebolinha (Allium fistulosum L.), todas oriundas de plantio convencional. Para a busca parasitária, utilizou-se o método de sedimentação espontânea (Hoffmann). Os resultados mostraram que 75% das amostras, após lavagem com água destilada, estavam contaminadas por alguma estrutura parasitária, incluindo casos de múltipla contaminação. Os parasitos que prevaleceram nas amostras foram Ancilostomídeo (ovo e larva), Ascaris lumbricoides (ovo), Entamoeba histolytica (cisto), Taenia sp. (ovo) e Trichuris trichiura (ovo e larva). Após a sanitização das amostras, houve a redução da carga parasitária, o que torna indispensável esse processo. Esses dados demonstram a situação higiênico-sanitária precária das hortaliças comercializadas na feira livre e a necessidade da realização de campanhas de educação em saúde para produtores, comerciantes e consumidores de hortaliças da região. Essas medidas proporcionam melhora na qualidade das hortaliças e segurança para quem as consome.

Daily intake of vegetables provides numerous benefits to human health, yet they have been one of the foods most related to food poisoning outbreaks worldwide. The aim of this study was to evaluate the presence of parasitic structures in vegetables sold in the open fairs in Picos – Piauí, before and after the use of 2% sodium hypochlorite as a sanitizer. One hundred and sixty samples were analyzed: 40 of lettuce (Lactuca sativa L.), 40 samples of Swiss chard (Beta vulgaris var. cicla L.), 40 samples of coriander (Coriandrum sativum L.) and 40 samples of chives (Allium fistulosum L.), all from conventional planting. For parasitic search, the spontaneous sedimentation method (Hoffmann) was used. All samples examined were contaminated by some parasitic structure and had multiple contamination. The predominant parasites were hookworm (egg and larva), Ascaris lumbricoides (egg), Entamoeba histolytica (cyst), Taenia sp. (egg) and Trichuris trichiura (egg and larva). The samples were sanitized, and the process reduced the parasite load by more than half. It is important to carry out health education campaigns for producers, traders and consumers of vegetables in the region and a strict supervision of the hygienic-sanitary quality of these foods, measures that provide improvement in the quality of vegetables and safety for those who consume them.

Formas parasitárias encontradas em hortaliças comercializadas em feira livre de Picos, Piauí: A importância do processo de sanitização / PARASITES FOUND IN THE VEGETABLES SOLD IN OPEN FAIRS IN PICOS, PIAUÍ: THE IMPORTANCE OF SANITATION PROCESS

O consumo diário de vegetais fornece inúmeros benefícios para a saúde do ser humano, no entanto têm sido um dos alimentos mais relacionados a surtos de toxinfecção alimentar em nível mundial. O objetivo deste estudo foi avaliar a presença de estruturas parasitárias em hortaliças comercializadas na feira livre do município de Picos, Piauí antes e após a utilização de hipoclorito de sódio como sanitizante. Foram analisadas 160 amostras, sendo 40 de alfaces-crespa (Lactuca sativa L.), 40 amostras de acelga (Beta vulgaris var. cicla L.), 40 amostras de coentro (Coriandrum sativum L.) e 40 amostras de cebolinha (Allium fistulosum L.), todas oriundas de plantio convencional. Para a busca parasitária, utilizou-se o método de sedimentação espontânea (Hoffmann). Os resultados mostraram que 75% das amostras, após lavagem com água destilada, estavam contaminadas por alguma estrutura parasitária, incluindo casos de múltipla contaminação. Os parasitos que prevaleceram nas amostras foram Ancilostomídeo (ovo e larva), Ascaris lumbricoides (ovo), Entamoeba histolytica (cisto), Taenia sp. (ovo) e Trichuris trichiura (ovo e larva). Após a sanitização das amostras, houve a redução da carga parasitária, o que torna indispensável esse processo. Esses dados demonstram a situação higiênico-sanitária precária das hortaliças comercializadas na feira livre e a necessidade da realização de campanhas de educação em saúde para produtores, comerciantes e consumidores de hortaliças da região. Essas medidas proporcionam melhora na qualidade das hortaliças e segurança para quem as consome

Daily intake of vegetables provides numerous benefits to human health, yet they have been one of the foods most related to food poisoning outbreaks worldwide. The aim of this study was to evaluate the presence of parasitic structures in vegetables sold in the open fairs in Picos ­ Piauí, before and after the use of 2% sodium hypochlorite as a sanitizer. One hundred and sixty samples were analyzed: 40 of lettuce (Lactuca sativa L.), 40 samples of Swiss chard (Beta vulgaris var. cicla L.), 40 samples of coriander (Coriandrum sativum L.) and 40 samples of chives (Allium fistulosum L.), all from conventional planting. For parasitic search, the spontaneous sedimentation method (Hoffmann) was used. All samples examined were contaminated by some parasitic structure and had multiple contamination. The predominant parasites were hookworm (egg and larva), Ascaris lumbricoides (egg), Entamoeba histolytica (cyst), Taenia sp. (egg) and Trichuris trichiura (egg and larva). The samples were sanitized, and the process reduced the parasite load by more than half. It is important to carry out health education campaigns for producers, traders and consumers of vegetables in the region and a strict supervision of the hygienic-sanitary quality of these foods, measures that provide improvement in the quality of vegetables and safety for those who consume them

SOCIOECONOMIC IMPACT OF MOTORCYCLE ACCIDENT VICTIMS IN THE EMERGENCY ROOM OF A HOSPITAL (PART 2).

OBJECTIVE: To evaluate the socioeconomic impact of motorcycle accidents of a metropolis with one million inhabitants treated by a university hospital in 2017. To study hospital cost and time of victims, evaluate definite and incapacitating sequelae, and analyze patient's insertion in the labor market six months after the accident. METHODS: Retrospective study of 62 victims of motorcycle accidents treated in the emergency room and referred for surgical procedure in a university hospital. Data were collected from medical records and answers via telephone six months after the trauma. RESULTS: Injuries related to motorcycle accident resulted in high hospital costs. Average loss per patient was R$ 17,555. Of those who answered the functional impact questionnaire, 64% were on paid leave by INSS and 84% presented partial or permanent physical disabilities after the accident. Only 9 people (36%) received any kind of financial benefit from public authorities. CONCLUSION: High costs are directly related to hospitalization time and surgical needs. Most victims needed financial help and had their social lives aggravated. Investments in motorcyclists' awareness of traffic laws and use of safety equipment are needed, as well as in road infrastructure. Level of evidence II, Prognostic studies.

OBJETIVO: Avaliar o impacto socioeconômico de acidentes motociclísticos de uma metrópole com mais de um milhão de habitantes atendidos, no ano de 2017, em um hospital universitário. Estudar custo e tempo de internação hospitalar das vítimas, avaliar sequelas definitivas e incapacitantes e analisar a inserção no mercado de trabalho seis meses depois do acidente. MÉTODOS: Estudo retrospectivo de 62 pacientes vítimas de acidentes motociclísticos, atendidos na urgência e emergência, levados para procedimento cirúrgico de um hospital universitário. Coleta de dados através do levantamento de prontuários e contato telefônico seis meses após o trauma. RESULTADOS: Lesões relacionadas às vítimas implicaram elevados custos hospitalares. Prejuízo médio por paciente foi de R$ 17.555. Dos que responderam ao questionário do impacto funcional, 64% ficaram afastados da atividade laboral pelo INSS e 84% apresentaram incapacidades físicas parciais ou permanentes após o acidente. Apenas 9 (36%) receberam algum tipo de benefício financeiro do governo. CONCLUSÃO: Elevados custos estão diretamente relacionados ao tempo de internação e necessidades cirúrgicas. A maioria das vítimas necessitou de auxílio financeiro e teve sua vida social prejudicada. Investimentos em conscientização dos motociclistas, para que conduzissem respeitando as leis de trânsito e utilizando equipamentos de segurança, e na infraestrutura das rodovias são necessários. Nível de evidência II, Estudo prognóstico.

Socioeconomic impact of motorcycle accident victims in the emergency room of a hospital (part 2) / Impacto socioeconômico em vítimas de acidente de moto na emergência de um hospital (parte 2)

ABSTRACT Objective: To evaluate the socioeconomic impact of motorcycle accidents of a metropolis with one million inhabitants treated by a university hospital in 2017. To study hospital cost and time of victims, evaluate definite and incapacitating sequelae, and analyze patient's insertion in the labor market six months after the accident. Methods: Retrospective study of 62 victims of motorcycle accidents treated in the emergency room and referred for surgical procedure in a university hospital. Data were collected from medical records and answers via telephone six months after the trauma. Results: Injuries related to motorcycle accident resulted in high hospital costs. Average loss per patient was R$ 17,555. Of those who answered the functional impact questionnaire, 64% were on paid leave by INSS and 84% presented partial or permanent physical disabilities after the accident. Only 9 people (36%) received any kind of financial benefit from public authorities. Conclusion: High costs are directly related to hospitalization time and surgical needs. Most victims needed financial help and had their social lives aggravated. Investments in motorcyclists' awareness of traffic laws and use of safety equipment are needed, as well as in road infrastructure. Level of evidence II, Prognostic studies.

RESUMO Objetivo: Avaliar o impacto socioeconômico de acidentes motociclísticos de uma metrópole com mais de um milhão de habitantes atendidos, no ano de 2017, em um hospital universitário. Estudar custo e tempo de internação hospitalar das vítimas, avaliar sequelas definitivas e incapacitantes e analisar a inserção no mercado de trabalho seis meses depois do acidente. Métodos: Estudo retrospectivo de 62 pacientes vítimas de acidentes motociclísticos, atendidos na urgência e emergência, levados para procedimento cirúrgico de um hospital universitário. Coleta de dados através do levantamento de prontuários e contato telefônico seis meses após o trauma. Resultados: Lesões relacionadas às vítimas implicaram elevados custos hospitalares. Prejuízo médio por paciente foi de R$ 17.555. Dos que responderam ao questionário do impacto funcional, 64% ficaram afastados da atividade laboral pelo INSS e 84% apresentaram incapacidades físicas parciais ou permanentes após o acidente. Apenas 9 (36%) receberam algum tipo de benefício financeiro do governo. Conclusão: Elevados custos estão diretamente relacionados ao tempo de internação e necessidades cirúrgicas. A maioria das vítimas necessitou de auxílio financeiro e teve sua vida social prejudicada. Investimentos em conscientização dos motociclistas, para que conduzissem respeitando as leis de trânsito e utilizando equipamentos de segurança, e na infraestrutura das rodovias são necessários. Nível de evidência II, Estudo prognóstico.

EPIDEMIOLOGICAL PROFILE OF MOTORCYCLE ACCIDENT VICTIMS IN UNIVERSITY HOSPITAL.

OBJECTIVE: To evaluate the epidemiological profile of motorcycle accident victims in a metropolis with more than one million inhabitants attended in a university hospital of reference in 2017. METHODS: a retrospective study through the analysis of medical records of 105 motorcycle accident victims in Campinas (SP) attended in a university hospital of reference and who needed surgical procedure in 2017. RESULTS: 87 patients (82.9%) were men. Multiple fractures were observed in 61 patients (58.1%) and polytrauma was found in 14 patients (13.3%). Tibial fracture was the most frequent, present in 65 cases (61.9%). Exposed fractures occurred in 68 patients (64.7%). Among the polytrauma victims, the most frequent injury was traumatic brain injury (TBI), present in seven patients (6.6%). The mean age was 29.8 years (range 6-63 years). The average length of hospital stay was 14 days (1-87). CONCLUSION: It is essential to investigate and evaluate the victims' epidemiological profile, as well as the resulting injuries, in order to provide adequate support for the implementation of measures aimed at primary prevention and awareness of the most affected groups. Level of Evidence II, Prognostic studies - Investigating the effect of a patient characteristic on the outcome of disease.

OBJETIVO: Avaliar o perfil epidemiológico das vítimas de acidentes motociclísticos ocorridos em uma metrópole com mais de 1 milhão de habitantes atendidas em um hospital universitário de referência no ano de 2017. MÉTODOS: Estudo retrospectivo através da análise de prontuários de 105 vítimas de acidentes motociclísticos ocorridos em Campinas, SP, Brasil, no ano de 2017 atendidas em um hospital universitário de referência que necessitaram de procedimento cirúrgico. RESULTADOS: Oitenta e sete pacientes (82,9%) eram do sexo masculino. Foram verificadas polifraturas em 61 pacientes (58,1%) e politraumatismo em quatorze (13,3%). A fratura de tíbia foi a mais frequente, presente em 65 casos (61,9%). Fraturas expostas ocorreram em 68 pacientes (64,7%). Entre as vítimas de politraumatismo, a lesão mais recorrente foi o traumatismo cranioencefálico (TCE), presente em sete pacientes (6,6%). A média de idade foi 29,8 anos (variando de 6-63 anos). O tempo de internação médio foi 14 dias (1-87). CONCLUSÃO: É fundamental investigar e avaliar o perfil epidemiológico das vítimas, assim como os agravos resultantes, de modo a propiciar subsídio adequado para implementação de medidas de prevenção primária e conscientização, especialmente direcionadas para os grupos mais acometidos. Nível de Evidência II, Estudos prognósticos - Investigação do efeito de característica de um paciente sobre o desfecho da doença.

Epidemiological profile of motorcycle accident victims in university hospital / Perfil epidemiológico de vítimas de acidentes de moto em hospital universitário

ABSTRACT Objective: To evaluate the epidemiological profile of motorcycle accident victims in a metropolis with more than one million inhabitants attended in a university hospital of reference in 2017. Methods: a retrospective study through the analysis of medical records of 105 motorcycle accident victims in Campinas (SP) attended in a university hospital of reference and who needed surgical procedure in 2017. Results: 87 patients (82.9%) were men. Multiple fractures were observed in 61 patients (58.1%) and polytrauma was found in 14 patients (13.3%). Tibial fracture was the most frequent, present in 65 cases (61.9%). Exposed fractures occurred in 68 patients (64.7%). Among the polytrauma victims, the most frequent injury was traumatic brain injury (TBI), present in seven patients (6.6%). The mean age was 29.8 years (range 6-63 years). The average length of hospital stay was 14 days (1-87). Conclusion: It is essential to investigate and evaluate the victims' epidemiological profile, as well as the resulting injuries, in order to provide adequate support for the implementation of measures aimed at primary prevention and awareness of the most affected groups. Level of Evidence II, Prognostic studies - Investigating the effect of a patient characteristic on the outcome of disease.

RESUMO Objetivo: Avaliar o perfil epidemiológico das vítimas de acidentes motociclísticos ocorridos em uma metrópole com mais de 1 milhão de habitantes atendidas em um hospital universitário de referência no ano de 2017. Métodos: Estudo retrospectivo através da análise de prontuários de 105 vítimas de acidentes motociclísticos ocorridos em Campinas, SP, Brasil, no ano de 2017 atendidas em um hospital universitário de referência que necessitaram de procedimento cirúrgico. Resultados: Oitenta e sete pacientes (82,9%) eram do sexo masculino. Foram verificadas polifraturas em 61 pacientes (58,1%) e politraumatismo em quatorze (13,3%). A fratura de tíbia foi a mais frequente, presente em 65 casos (61,9%). Fraturas expostas ocorreram em 68 pacientes (64,7%). Entre as vítimas de politraumatismo, a lesão mais recorrente foi o traumatismo cranioencefálico (TCE), presente em sete pacientes (6,6%). A média de idade foi 29,8 anos (variando de 6-63 anos). O tempo de internação médio foi 14 dias (1-87). Conclusão: É fundamental investigar e avaliar o perfil epidemiológico das vítimas, assim como os agravos resultantes, de modo a propiciar subsídio adequado para implementação de medidas de prevenção primária e conscientização, especialmente direcionadas para os grupos mais acometidos. Nível de Evidência II, Estudos prognósticos - Investigação do efeito de característica de um paciente sobre o desfecho da doença.

Triatomine bugs (Hemiptera, Reduviidae, Triatominae) in the Domiciles of the Guaribas Valley Territory, in Northeastern Brazil

Abstract INTRODUCTION Triatomine bugs are hematophagous insects that are extremely important in public health because they are natural vectors of Trypanosoma cruzi, the causative agent of Chagas disease. In this study, we aimed to assess the occurrence of triatomine species and the natural T. cruzi infection in the Guaribas Valley territory, an endemic region for Chagas disease in northeastern Brazil. METHODS Insects were actively captured from July 2017 to October 2019 in the intra- and peridomiciles of 16 municipalities of the Guaribas Valley territory, in the southeast area of Piauí state. Triatomine species were identified following a taxonomic key, and natural infection was investigated through insects' fresh feces exams. RESULTS A total of 430 triatomines were collected, including 211 nymphs and 219 adults. Of all collected specimens, 39 (9.1%) were from the intradomiciles and 391 (90.9%) from peridomiciles. Nine species, including two subspecies, could be identified: Triatoma brasiliensis brasiliensis, T. brasiliensis macromelasoma, T. pseudomaculata, T. sordida, T. juazeirensis, T. melanocephala, Panstrongylus lutzi, Rhodnius domesticus, R. nasutus, and R. robustus. T. brasiliensis were the most frequently collected bugs, representing 72% of all the identified insects. None of the examined invertebrates presented flagellate forms of T. cruzi. CONCLUSIONS: This is the first report of T. b. macromelasoma and T. juazeirensis in the Guaribas Valley territory. The persistence of triatomine species in the domiciles in an endemic area for Chagas disease emphasizes the relevance of entomological surveillance and vector control measures in the studied area.

Freshwater mollusks from three reservoirs of Piauí, northeastern Brazil / Moluscos límnicos de três reservatórios do Piauí, nordeste do Brasil

Abstract: The pronounced dry season determines the characteristics of the semiarid region of Brazil. Numerous small reservoirs are built to overcome this condition, accumulating multiple uses and causing important changes in the landscape and the local biota. Considering the limited amount of information about the malacofauna of reservoirs, mainly in the Northeast region of the country, this inventory provides a list of mollusks from three important reservoirs located in the city of São Julião, state of Piauí. The collections were carried out monthly between May/2017 and April/2018, sampling a total of 11,149 mollusks, corresponding to the species Melanoides tuberculata (Müller, 1774) (n = 9,724), Biomphalaria straminea (Dunker, 1848) (n = 1,361) and Pomacea lineata (Spix, 1827) (n = 64). The richness of mollusks from the three reservoirs was low, similar to those described in studies conducted in other regions of Northeast Brazil. There was a significant difference in the abundance of M. tuberculata and B. straminea among the studied reservoirs. These environments are not connected and are installed in urban and rural areas, presenting different ecological conditions. The relationship between the human population and the reservoirs, associated with the lack of sanitation, increases the risks of spreading waterborne diseases besides the development of environmental imbalance by the introduction of exotic species.

Resumo: O período de seca pronunciado marca a região semiárida brasileira. Para superação dessa condição inúmeros reservatórios de pequeno porte são construídos, acumulando múltiplos usos e causando alterações importantes na paisagem e na biota local. Considerando as poucas informações sobre a malacofauna de reservatórios, principalmente na região nordeste do país, este trabalho apresenta o inventário das espécies de moluscos provenientes de três importantes reservatórios localizados no município de São Julião, estado do Piauí. As coletas foram realizadas mensalmente entre os meses de maio/2017 e abril/2018. Foi amostrado um total de 11.149 moluscos, correspondentes as espécies Melanoides tuberculata (Müller, 1774) (n=9,724), Biomphalaria straminea (Dunker, 1848) (n=1,361) e Pomacea lineata (Spix, 1827) (n=64). A riqueza de moluscos amostrados nos três reservatórios foi baixa, não diferindo daquelas descritas em estudos realizados em outras regiões do Nordeste do Brasil. Houve diferença significativa na abundância de M. tuberculata e B. straminea entre os reservatórios estudados os quais não são conectados e encontram-se instalados em áreas urbana e rurais, com condições ambientais distintas. A relação entre a população humana da região e os reservatórios, juntamente com a falta de saneamento representam riscos à propagação de doenças transmitidas pela água e desequilíbrio ambiental pela introdução de espécies exóticas.

Adherencia a la dieta mediterránea en población universitaria colombiana / Mediterranean diet adherence in Colombian university population

Objetivo: Medir la adherencia a la dieta mediterránea de universitarios de dos ciudades de Colombia pertenecientes a la región andina y costa caribe de Colombia, y su relación con los estratos socioeconómicos. Materiales y métodos: Se aplicó el cuestionario KIDMED a un total de 795 estudiantes de universidades privadas de la ciudad de Bogotá, y de ciudad de Montería. Resultados y discusión: Los resultados mostraron que sólo el 9,3% de los participantes tenían una dieta acorde a la dieta mediterránea en la ciudad de Bogotá, 29,3% en la ciudad de Montería. La mayoría de los participantes mostraron tener una dieta media con posibilidad a mejorar a lo estipulado por este modelo alimenticio, en ambas ciudades con porcentajes de 60,3% y 63% respectivamente. El otro 30,3% de la población de la ciudad de Bogotá, y 7,7% de la ciudad Montería, mostró tener una dieta de muy baja calidad. Se identifican diferencias entre los estratos socioeconómicos y géneros de los participantes en ambas ciudades. Conclusiones: La adherencia a la dieta mediterránea de los jóvenes universitarios parece estar relacionada no sólo con el estrato socioeconómico, sino también por los hábitos alimenticios

Objective: The aim of this stydy was to estimate the level of Mediterranean diet in two groups of university students, of two different cities of Colombia, and the relation to their socioeconomic status. Materials and methods: The KIDMED Questionnaire was administered to 795 students of a private university in Bogotá, and Monteria, Colombia. Results and Discussion: Showed that only 9,3% of the participants had an optimum adherence to the Mediterranean diet in Bogotá, and 29,3% in Monteria. Most of the participants showed to had a medium adherence to improve to Mediterranean diet in both cities, 60,3% in Bogotá and 63% in Monteria. The other 30,3% of the participants of Bogota and 7,7% of Monteria students, showed a poor adherence. Differences between the socioeconomic status and gender, in relation with the Mediterranean diet was identified.Conclusion: Therefore, it is concluded that the university student's Mediterranean diet adherence may be related not only to socioeconomic factors, but also to nutrition habits

Tendinopatias do pé e tornozelo / Foot and ankle tendinopathies

Objetivo Avaliar a etiologia das tendinopatias e as diferentes técnicas cirúrgicas utilizadas na reparação dos tendões calcâneos, tibial posterior, tibial anterior, fi bular curto e fi bular longo e apresentar os resultados clínico-funcionais, grau de satisfação dos pacientes e as complicações pós-cirúrgicas. Métodos Estudo retrospectivo de 88 pacientes com lesões degenerativas ou agudas dos tendões calcâneo, tibial anterior, tibial posterior, fi bular curto e fi bular longo, entre o período de 2005 a 2017. Resultados Dos 88 pacientes analisados, 50 eram do sexo masculino e 38 do sexo feminino, com idade média de 49 anos. A frequência de lesão foi de 54% para o membro direito, 40% para o membro esquerdo e 6% para ambos os pés. O mecanismo de ruptura predominante foi o degenerativo, em 56% dos pacientes. A maioria dos indivíduos (49%) apresentou lesões no tendão calcâneo e a técnica cirúrgica com a utilização do tendão semitendíneo foi empregada na maioria dos casos (41%). Os resultados clínicos funcionais obtidos pelo Questionário da American Orthopaedic Foot and Ankle Society no pós-operatório, após um tempo médio de 18 meses, foram de 87 pontos (variando de 65 a 92). Houve complicação na área receptora em apenas 5 pacientes. Conclusão O reparo cirúrgico das tendinopatias mostrou-se extremamente efetivo na reabilitação funcional dos pacientes, com uma baixa taxa de complicações e elevado grau de satisfação dos pacientes.

Objective To evaluate the etiology of tendinopathies and the different surgical techniques used to repair the calcaneus, posterior tibial, anterior tibial, long fibular and short fibular tendons and present the clinical-functional results, the degree of patient satisfaction and postoperative complications. Methods A retrospective study of 88 patients with degenerative or acute lesions of the calcaneus, anterior tibial, posterior tibial, short fibular and long fibular tendons between 2005 and 2017. Results Of the 88 patients analyzed, 50 were males and 38 female, with a mean age of 49 years. The lesion frequency was 54% for the right limb, 40% for the left limb and 6% for both feet. The predominant mechanism of rupture was degenerative in 56% of the patients. Most of the individuals (49%) presented lesions in the calcaneus tendon and the semitendinosus tendon surgical technique was used in most cases (41%). The functional clinical results obtained by the American Orthopedic Foot & Ankle Society Questionnaire postoperative questionnaire after an average time of 18 months, were 87 points (ranging from 65 to 92). Recipient area complications were reported in only 5 patients. Conclusion Tendinopathy surgery proved to be extremely effective in the functional rehabilitation of patients, with a low rate of complications and a high degree of patient satisfaction.