Evaluation of Pain Prevalence in Children Who Experienced Perinatal Hypoxia-Ischemia Events: Characteristics and Associations With Sociodemographic Factors.

INTRODUCTION: Pain in children who suffer from hypoxia-ischemia (HI) events is still not widely studied. Hypoxia-ischemia is characterized by the momentary or permanent cessation of blood flow and, consequently, of oxygen supply, becoming the main cause of encephalopathy in children. Hyperalgesia was identified in animals undergoing prenatal hypoxia-ischemia by researchers from the Universidade do Estado do Rio de Janeiro (UERJ). Premature and asphyxiated newborns have been admitted to the neonatal intensive care unit (NICU) of Pedro Ernesto University Hospital (HUPE) in Brazil and are monitored by the Outpatient Follow-up of High-Risk Newborns Project (SARAR), but no pain assessment was performed. OBJECTIVE: To assess pain in children born in high-risk situations, such as prematurity and perinatal asphyxia, with higher chances of perinatal HI, discharged from the NICU/HUPE, and followed by SARAR. METHODOLOGY: The study was approved by the HUPE Research Ethics Committee. The epidemiological, descriptive, cross-sectional study started in 2021 and finished in 2023, with the application of the pain assessment tool or instrument adapted from the Lübeck Pain-Screening Questionnaire to the caregivers and with the collection of growth and development data. The population consisted of asphyxiated infants born with a gestational age greater than 35 weeks and submitted to the Therapeutic Hypothermia protocol and premature infants discharged from the NICU between two (gestational age 1 (GA1)) and 12 years old. For most of them, pain prevalence was assessed according to its frequency and intensity, as were sociodemographic variables of the child and mother, neural alterations, and the Children's Developmental Scale (DENVER II). The percentage differences between the evaluated factors and the presence of pain were performed using Fisher's exact test and medians using the non-parametric Wilcoxon rank-sum test, both appropriate for the small sample of children. Significance levels of 10% were considered for trends and 5% for statistically significant differences. RESULTS: Of the 86 children included in our search, 26 (30%) were born with a gestational age greater than 35 weeks and diagnosed with perinatal asphyxia (hereinafter referred to as the asphyxiation group), and 60 (70%) were premature. Pain was reported by 22 (25%) children, of whom 54.4% reported moderate or severe pain. The head and abdomen were the most reported sites (36%). Differences were observed in the percentage distribution of pain between asphyxiates and premature infants (11% vs. 32%; p-value 0.061 on the Fisher test) and between females and males (34% vs. 17%; p-value 0.085 on the Fisher test). Black and Brown children had higher median pain scale values than White children (p-value < 0.027, Wilcoxon rank sum test). CONCLUSION: There is a higher prevalence of pain in girls, in the head, in premature infants, and greater intensity among Black and Brown children. Therefore, knowing the pain profile can help improve their quality of life by offering treatments.

Association between type of feeding at discharge from the hospital and nutritional status of very low birth weight preterm infants.

The ideal feeding for premature babies has been the source of extensive debate. The aim of this study was to assess the association between type of feeding at discharge and the nutritional status of very low birth weight infants. This was a retrospective cohort of preterm babies with birth weight ≤1500 g, born between January 2006 and December 2013. The infants were divided into 3 groups according to type of feeding at discharge: exclusive breast milk (group 1), mixed feeding (group 2) and exclusive artificial formula (group 3). Frequencies of each group were calculated, as well as mean Z-score differences in weight, length and head circumference. Six hundred and forty-nine newborns were included. The mean weight of groups 1, 2, and 3 was 1338.7, 1104.0, and 1254.7 g, respectively, and their mean gestational age was 31.9, 30, and 31.2 weeks, respectively. The Z-score differences (means±SD) for groups 1, 2, and 3 were: -0.84±0.68, -1.02±0.75, and -0.86±0.71 for weight, -0.21±1.23, -0.52±1.64 and -0.08±1.34 for head circumference, and -1.10±1.18, -1.54±1.37, and -0.97±1.21 for length. A significant difference was observed between groups 2 and 3 in the adjusted Z-score model for length, with no significant differences in anthropometric measurements for the other comparative analyses. Because of its many advantages, breastfeeding should be stimulated within neonatal units since nutritional status was not influenced by the different types of feeding.

Association between type of feeding at discharge from the hospital and nutritional status of very low birth weight preterm infants

The ideal feeding for premature babies has been the source of extensive debate. The aim of this study was to assess the association between type of feeding at discharge and the nutritional status of very low birth weight infants. This was a retrospective cohort of preterm babies with birth weight ≤1500 g, born between January 2006 and December 2013. The infants were divided into 3 groups according to type of feeding at discharge: exclusive breast milk (group 1), mixed feeding (group 2) and exclusive artificial formula (group 3). Frequencies of each group were calculated, as well as mean Z-score differences in weight, length and head circumference. Six hundred and forty-nine newborns were included. The mean weight of groups 1, 2, and 3 was 1338.7, 1104.0, and 1254.7 g, respectively, and their mean gestational age was 31.9, 30, and 31.2 weeks, respectively. The Z-score differences (means±SD) for groups 1, 2, and 3 were: −0.84±0.68, −1.02±0.75, and −0.86±0.71 for weight, −0.21±1.23, −0.52±1.64 and −0.08±1.34 for head circumference, and −1.10±1.18, −1.54±1.37, and −0.97±1.21 for length. A significant difference was observed between groups 2 and 3 in the adjusted Z-score model for length, with no significant differences in anthropometric measurements for the other comparative analyses. Because of its many advantages, breastfeeding should be stimulated within neonatal units since nutritional status was not influenced by the different types of feeding.

Morphological and proteomic characterization of midgut of the malaria vector Anopheles albimanus at early time after a blood feeding.

The midgut of anopheline mosquito is the entry of Plasmodium, the causative agent of malaria.When the mosquito feeds on parasite infected host, Plasmodium parasites reach the midgut and must confront digestive enzymes, the innate immune response and go across the peritrophic matrix (PM), a thick extracellular sheath secreted by the mosquito midgut epithelial cells. Then, to continue its development, the parasite must reach the salivary glands to achieve transmission to a vertebrate host. We report here the morphological and biochemical descriptions of the midgut changes after a blood meal in Anopheles albimanus. Before blood feeding, midgut epithelial cells contained numerous electrondense vesicles distributed in the central to apical side. These vesicles were secreted to the luminal side of the midgut after a blood meal. At early times after blood ingest, the PM is formed near microvilli as a granulous amorphous material and after it consolidates forming a highly organized fibrillar structure, constituted by layers of electrondense and electronlucent regions. Proteomic comparative analysis of sugar and blood fed midguts showed several molecules that modify their abundance after blood intake; these include innate immunity, cytoskeletal, stress response, signaling, and digestive, detoxifying and metabolism enzymes. Biological significance In the midgut of mosquitoes during bloodfeeding, many simultaneous processes occur, including digestion, innate immune activities, cytoskeleton modifications, construction of a peritrophic matrix and hormone production, between others. Mechanical forces are very intense during bloodfeeding and epithelial and muscular cells must resist the stress, modifying the actin cytoskeleton and coordinating intracellular responses by signaling. Microorganisms present in midgut contents reproduce and interact with epithelial cells triggering innate immune response. When infectious agents are present in the blood meal they must traverse the peritrophic matrix, an envelope formed from secretion products of epithelial cells, and evade the immune system in order to reach the epithelium and continue their journey towards salivary glands, in preparation for the transmission to the new hosts. During all these processes, proteins of mosquitoes are modified in order to deal with mechanical and biological challenges, and the aim of this work is to study these changes.

[Prebiotic inulin/oligofructose in Yacón root (Smallanthus sonchifolius), phytochemistry and standardization as basis for clinical and pre-clinical research]. / Prebiótico Inulina/Oligofructosa en la raíz del Yacón (Smallanthus Sonchifolius),Fitoquímica y Estandarización como base de estudios preclínicos y clínicos.

INTRODUCTION: Experiments have demonstrated that the association between inulin and oligofructose can prevent colitis by modifying the intestinal microflora by acting as a prebiotic. It has also been found that this association is naturally present in the roots of the Yacón root (Smallanthus sonchifolius) making phytochemical and standardization studies well worth pursuing. These studies could contribute to the safe use of improved strains of Yacón, to significant savings in health resources, and to promoting additional clinical and pre-clinical research. So far, studies have been made on organically cultivated Yacón in the coast, on varieties adapted from those cultivated in the Andes. The aim is to promote consumption of Yacón in the sectors of society that need it most. OBJECTIVE: To determine the general chemical composition of the Yacón tuberous root cultivated in the coast by means of a phytochemical screening, as well as standardizing its inulin content in order to contribute knowledge on its conditions of use. METHODS: The roots harvested in the Lima Botanical Garden of the National Health Institute were used to prepare aqueous extracts through decoction and juice for the phytochemical screening with conventional reagents. The aqueous extracts were standardized for insulin content by using a fructose standard method and a validated analytical technique. The samples were read in a TU-1810S Split Beam UV-VIS spectrophotometer. RESULTS: The trials confirmed the presence of phenolic compounds, flavonoids, alkaloids, steroids, glycosides and carbohydrates. The standardization found values of 7,8% inulin in the hydrolyzed extract and of 7, 01% in the non-hydrolyzed extract. CONCLUSIONS: The extracts of the Yacón roots were screened and standardized Ander known cultivation conditions. The possibilities of its use are being considered due to its prebiotic properties. These properties are considered useful in treating certain types of colitis by stimulating the growth of the Lactobacillus and Bifidobacterium microflora. Saving of health resources would be possible and further clinical and pre-clinical research would be encouraged.

Prebiótico inulina/oligofructosa en la raíz del Yacón (Smallanthus Sonchifolius), fitoquímica y estandarización como base de estudios preclínicos y clínicos / Prebiotic insulin/oligofructose in Yacón root (Smallanthus sonchifolius), phytochemistry and standarization as basis for clinical and pre-clinical research

Introducción: Se ha demostrado experimentalmente que la asociación inulina más oligofructosa puede prevenir la colitis al modificar la microflora, actuando como un prebiótico. También se ha encontrado que tal asociación de inulina más oligofructuosa se encuentra en las raíces de Yacón (Smallanthus sonchifolius). Ello, amerita su estudio fotoquímico como su estandarización, con el fin de contribuir a su consumo con seguridad y calidad, a los ahorros en recursos de salud y promover adicionales trabajos preclínicos y clínicos. El estudio se realizó sobre la especie cultivada orgánicamente en la Costa, adaptada de la que crece en los Andes, para propiciar su consumo económico en sectores de la sociedad que lo requieran. Objetivos: Determinar la composición química general de las raíces tuberosas de Yacón cultivado en la Costa, mediante tamizaje fotoquímico. Además, la estandarización de su contenido de inulina para contribuir al conocimiento de las condiciones en su empleo. Métodos: Con las raíces cosechadas en el Jardín Botánico del Instituto Nacional de Salud en Lima, se prepararon extractos acuosos por decocción y zumo para el tamizaje fotoquímico con reactivos convencionales. Se estandarizaron los extractos acuosos por su contenido de inulina, empleando un estándar de fructuosa y técnica analítica validada. Las muestras fueron leídas en un Espectrofotómetro UV-VIS, Modelo TU-1810S Split Beam. Resultados: Los ensayos confirmaron la presencia de compuestos fenólicos, flanovoides, alcaloides, esteroides, glicósidos y carbohidratos. La estandarización encontró valores de 7.8 por ciento de inulina en el extracto hidrolizado y de 7.01 por ciento en el sin hidrolizar. Conclusiones: Se tamizaron y...

Introduction: Experiments have demonstrated that the association between inulin and oligofructose can prevent colitis by modifying the intestinal microflora by acting as a prebiotic. It has also been found that this association is naturally present in the roots of the Yacón root (Smallanthus Sonchifolius making phytochemical an standarization studies well worth pursuing. These studies could contribute to the safe use of improved strains of Yacón, to significant savings in health resources, and to promoting additional clinical and pre-clinical research, so far, studies have been made on organically cultivated Yacón in the coast, on varieties adapted from those cultivated in the Andes. The aim is to promote consumption of Yacón in the sectors of society that need it most. Objective: To determinate the general chemical composition of the Yacón tuberous root cultivated in the coast by means of a phytochemical screening, as well as standardizing its inulin content in order to contribute knowledge on its conditions of use. Methods: The roots harvested in the Lima Botanical Garden of the National Health Institute were used to prepare aqueous extracts through decoction and juice for the phytochemical screening with conventional reagents. The aqueous extracts were standardized for inulin content by using a fructose standard method and a validated analytical technique. The samples were read in a TU-1810S Split Beam UV-VIS spectrophotometer. Results: The trials confirmed the presence of phenolic compounds, flavonoids, alkaloids. Steroids, glycosides and carbohydrates. The standardization found values of 7.8 percentage inulin in the hydrolyzed extract and of 7.01 percentage in the non-hydrolyzed...

Prominent ears--Pitanguy's island technique: long-term results.

Through the analysis of 300 cases of prominent ears operated by Pitanguy's technique with a follow-up of 1-15 years we observed the preservation of the aesthetic aspect as well as the cephaloauricular angle. We call attention to its easy performance and almost no incidence of early or late complications.

Clinical evaluation and surgical treatment of hemangiomata.

We report on the histologic and anatomopathologic aspects of cutaneous hemangiomas, stressing the involutive and noninvolutive aspects of these malformations. We analyze its clinical evolution, approaching the propedeutic and therapeutic methods, and present a detailed commentary on the conservative methodology of a series of 473 consecutive patients, encompassing a follow-up of 1 to 18 years.