A importância da alimentação e nutrição para indivíduos com enxaqueca / La importancia de la alimentación y nutrición para personas con jaqueca / The importance of food and nutrition for people with chronic migraines

Introdução: As cefaleias são consideradas um importante problema de saúde pública e estima-se que são a segunda queixa mais comum de dor, sendo a enxaqueca uma das mais presentes. O tratamento da enxaqueca pode ser sintomático ou profilático, a fim de reduzir os sintomas em períodos de crise e evitar que novas crises se instalem, destacando a importância da adoção de hábitos saudáveis e uma alimentação equilibrada. Objetivo: O objetivo deste estudo foi realizar uma revisão integrativa da literatura, destacando os principais achados sobre a importância da alimentação e nutrição para indivíduos acometidos pela enxaqueca. Metodologia: foi realizado um levantamento de estudos nas bases de dados: Biblioteca Virtual em Saúde (BVS); Medline, LILACS, SciELO e Google Acadêmico, além de ter sido considerada a lista de referências dos trabalhos consultados, utilizando a estratégia PECO, onde P (population) indica a população, a letra E (exposure) exposição, C (comparison) comparação e a letra O (outcome) se refere aos desfechos esperados, assim gerou a pergunta norteadora do estudo: "Qual é a importância da alimentação e nutrição para indivíduos com enxaqueca?". Resultados: Foram selecionados 15 estudos para a produção do presente trabalho e foi realizada uma síntese descritiva dos resultados obtidos da relação e influência de hábitos alimentares com a enxaqueca. Conclusões: Conclui-se que os hábitos alimentares e a nutrição adequada têm grande influência e importância para indivíduos com enxaqueca, pois dessa forma, podem reduzir os sintomas apresentados e crises, já que as substâncias presentes nos alimentos estão relacionadas com o início e intensificação das crises (AU).

Introduction: Headaches are considered an important public health problem and are estimated to be the second most common pain complaint, with migraines being one of the most common. Migraine treatment is symptomatic and prophylactic to reduce symptoms when an attack starts and prevent new ones from forming, highlighting the importance of adopting healthy habits and a balanced diet. Objective: The purpose of this study was to carry out an integrative review of the literature in order to highlight the main findings on the influence of eating habits and the importance of nutrition for migraine patients. Methodology:A survey study was performed in the following databases: Virtual Health Library (VHL); Medline, LILACS, SciELO, and Google Scholar, in addition to considering the reference list of the consulted works. The PECO P (population) E (exposure) C (comparison) O (outcome) strategy was used, which generated the guiding question of the study: 'How important is food and nutrition for people with chronic migraines?'. Results:A total of 15 studies were selected to analyze in this work and a descriptive synthesis of the results was performed on the relationship and influence of eating habits of people with chronic migraines. Conclusions:It was concluded that eating habits and adequate nutrition have great influence and importance for migraine patients, as they are one of the main culprits of triggering and intensifying attacks (AU).

Introducción: Las cefaleas son consideradas un importante problema de salud pública y se estima que son la segunda queja más común de dolor, siendo la jaqueca una de las más frecuentes. El tratamiento de la jaqueca puede ser sintomático o profiláctico, con el fin de reducir los síntomas en periodos de crisis y evitar que nuevas ocurran, destacando la importancia de una adopción de hábitos saludables y una alimentación equilibrada. Objetivo: El objetivo de este estudio fue realizar una revisión integrativa de la literatura, destacando los principales hallazgos sobre la importancia de la alimentación y nutrición en personas afectadas por la jaqueca. Metodología: Fue realizada una investigación de los estudios en las bases de dados: Biblioteca Virtual en Salud (BVS); Medline, LILACS, SciELO y Google Académico, además de considerar la lista de referencias de los trabajos consultados, utilizando la estrategia PECO, donde P (population) indica la población, la letra E (exposure) exposición, C (comparison) comparación y la letra O (outcome) se refiere a los resultados esperados, así fue generada la pregunta guía del estudio: "¿Cuál es la importancia de la alimentación y nutrición para las personas con jaqueca?" Resultados: Fueron seccionados 15 estudios para la producción del presente trabajo y fue realizada una síntesis descriptiva de los resultados obtenidos de la relación e influencia de los hábitos alimentarios con la jaqueca. Conclusiones: Se concluye que los hábitos alimentarios y la nutrición adecuada tienen gran influencia e importancia para las personas conjaqueca, pues de esta forma, pueden reducir los síntomas presentados y crisis, ya que las sustancias presentes en los alimentos están relacionadas con el inicio e intensificación de las crisis (AU).

Relacionamentos afetivo-sexuais de mulheres encarceradas em presídios mistos brasileiros / Affective-sexual relationships of incarcerated women in brazilian mixed prisons / Relaciones afectivo-sexuales de mujeres encarceladas en prisiones mixtas brasileñas

Este artigo pretende discutir os relacionamentos afetivo-sexuais de mulheres aprisionadas a partir de seis estudos de caso com reclusas em um presídio misto brasileiro de pequeno porte. Utilizaram-se como instrumentos entrevistas semiestruturadas, analisadas a partir da criminologia crítica feminista e da teoria do apego de John Bowlby. Os relacionamentos afetivo-sexuais da vida adulta foram compreendidos a partir das vivências da infância, marcadas pela insatisfação de suas necessidades afetivas, violências múltiplas, rompimentos de vínculos afetivos e desejo de constituição de uma família entendida como tradicional. Na prisão, enfrentam limitações para o contato, rompimentos e, algumas vezes, o fortalecimento dos relacionamentos. Em todos os casos analisados, aspiram reiterar a função do ser mulher por meio da constituição de uma família para a obtenção do reconhecimento enquanto sujeito. Evidenciou-se a necessidade de questionamento das normativas sociais de gênero, das restrições ao contato impostas nas prisões e da atual política de encarceramento brasileira.(AU)

This study aims to discuss imprisoned women's affective and sexual relationships based on six case studies with female prisoners in a small Brazilian mixed prison. The instruments used were semi-structured interviews, analyzed according to critical feminist criminology and attachment theory, by John Bowlby. The affective-sexual relationships in adulthood were understood based on childhood experiences, marked by the lack of satisfaction of their affective needs, multiple violence, disruption of affective bonds, and the desire of constituting what is deemed as a traditional family. In prison, they face contact limitations, breakups and, sometimes, strengthening of the relationships. In all the cases analyzed, they aspire to reiterate the function of being a woman by establishing a family to obtain recognition as a subject. This research made apparent the need for questioning social gender normativities, restrictions on contact imposed within prisons, and current Brazilian incarceration policy.(AU)

Este artículo tiene como objetivo discutir sobre las relaciones afectivo-sexuales de las mujeres encarceladas en base a seis estudios de caso con prisioneras en una pequeña prisión mixta de Brasil. Se utilizaron como instrumentos entrevistas semiestructuradas, analizadas con base en la criminología feminista crítica y la teoría del apego, por John Bowlby. Las relaciones afectivo-sexuales en la edad adulta pueden entenderse a partir de las experiencias infantiles, marcadas por la insatisfacción de sus necesidades afectivas, la violencia múltiple, la ruptura de los lazos afectivos y el deseo de formar una familia entendida como tradicional. En prisión, enfrentan limitaciones en el contacto, rupturas y, a veces, el fortalecimiento de las relaciones. En todos los casos analizados, aspiran a reiterar la función de ser mujer mediante el establecimiento de una familia para obtener el reconocimiento como sujeto. La necesidad de cuestionar las normas sociales de género, las restricciones al contacto impuestas en las cárceles y la actual política de encarcelamiento brasileña se hicieron evidentes.(AU)

Dietary methionine as a strategy to improve innate immunity in rainbow trout (Oncorhynchus mykiss) juveniles.

Methionine ability to enhance fish immune status and inflammatory response by the modulation of methionine-related pathways has been verified in several fish species. However, no attention has been given to the role of methionine as an immune-modulatory additive in rainbow trout (Oncorhynchus mykiss). Hence, this study was designed to evaluate the effect of short-term feeding a diet supplemented with dl-methionine on the rainbow trout immune status. For this purpose, two diets were formulated: a control (CTRL) diet including the AA profile required to meet the ideal pattern estimated for rainbow trout; and an experimental diet (MET) identical to the CTRL but supplemented with dl-methionine two fold above its requirement level. After 2 and 4 weeks, fish haematological profile, peripheral cell populations, plasma and skin mucus humoral immune parameters as well as head-kidney gene expression were analysed. Results showed that methionine was able to improve peripheral neutrophil numbers after 4 weeks of feeding while reducing the expression of pro-inflammatory genes (i.e. IL1ß and IL8). Also, indications of fish physiological ability to regulate polyamine biosynthesis were found by the reduced expression of the spermine synthase enzyme (SMS). Together, these results point to some level of enhancement of the cellular-related innate immune status by dietary dl-methionine supplementation after a short-term feeding period, which could be used as a prophylactic strategy for rainbow trout health management.

Urban gardening and neglected and underutilized species in Salvador, Bahia, Brazil.

BACKGROUND: Urban agriculture has been evidenced as a food production and environmental sustainability strategy, although it faces many obstacles in Latin American countries. Additionally, in urban areas, low consumption of fruit and greenery is noticeable, along with loss in food diversity, including the neglected and underutilized species (NUS), which involve potential to strengthen local food systems. For this reason, this work has sought to map urban gardens in the city of Salvador, Bahia, Brazil, characterizing their gardeners, and to systematize information regarding food produced and the use of NUS. METHODS: The municipality's urban gardens were mapped and data was collected from the gardeners. The study included two steps: (i) garden localization; (ii) on-site visits for interviews with gardeners and verification of cultivated food, destination of production, availability, and use of NUS. RESULTS: Eighteen active food gardens were located, seventeen of which participated in the study: eight (8) communal (UCG) and nine (9) private (UPG). Respondents were on average 55.76 years old, mostly (52.9%) male, working at UPG (88.9%). Women predominated in the UCG (87.5%), with higher levels of education. For 52.9% of the interviewees, the garden was their main source of income. Food produced at the urban gardens was consumed by 82.4% of the gardeners and their families. In 70.6% of the gardens, production was also sold, while 47.1% donated. During the survey, 59 NUS were found and 76.5% of respondents reported consuming 19 of the species. NUS leaves, fruits, and seeds were found to be eaten raw, boiled, or sautéed in various preparations, especially Coleus amboinicus Lour. (76.5%), Eryngium foetidum L. (35.3%), Talinum fruticosum (L.) Juss., and Pereskia aculeata Mill (both 29.4%). Occurrence and utilization of NUS did not present significant associations with the gardens or gardeners (p > 0.05). CONCLUSIONS: Salvador urban gardens, even in small numbers and without government support, have produced affordable food for the local population, preserved food diversity, and the tradition of NUS cultivation and use. Thus, urban gardens are reaffirmed as relevant spaces that should be included in public policies in order to promote food and nutritional security, biodiversity, and urban environmental sustainability.

Fetal lipomyelomeningocele: A closed neural tube defect diagnosed at second-trimester ultrasound examination.

Fetal lipomyelomeningocele was suspected during the second-trimester ultrasound and confirmed by magnetic resonance imaging. The pregnancy took its course and a term neonate was delivered. At 2 years of age lipomyelomeningocele surgical removal was performed. The patient is now 4 years old and, despite neurogenic bladder, is a healthy boy with normal psychomotor development for his age. This case illustrates the favorable prognosis of this entity and the importance of prompt diagnosis and multidisciplinary counseling.

Avaliação da contaminação por bromato em pães do tipo francês / Analysis on the occurrence of bromate contamination in French type bread

O setor de panificação no Brasil tem realizado esforços para acompanhar as tendências de um mercadoexigente e competitivo, e uma das alternativas tem sido os agentes oxidantes. O bromato de potássio(KBrO3) é um agente oxidante que fortalece as cadeias de glúten. Apesar de benefícios tecnológicose econômicos, sua toxicidade como aditivo alimentar tem sido demonstrada. No Brasil o emprego doKBrO3 é proibido em qualquer quantidade nas farinhas e nos produtos de panificação. Foram investigadasamostras de pão Francês provenientes de 25 pontos comerciais, que foram analisadas em triplicatas,totalizando-se 75 ensaios. A determinação de bromatos foi realizada em duas etapas: primeiramente pelaprova de triagem utilizando-se o método analítico qualitativo, para identificar amostras positivas paraagentes oxidantes e, posteriormente, a determinação de BrO3- usando o reativo fucsina-bissulfito. Em todasas amostras foram detectados agentes oxidantes. Na análise confirmatória de bromato, foi identificadaa presença deste aditivo em amostras de seis estabelecimentos dos 25 analisados, correspondendo àfrequência de 24 % nas amostras examinadas. Este estudo mostra que apesar da proibição do emprego deKBrO3 em produtos de panificação, há ainda o uso deste componente pelos estabelecimentos comerciais,e isto representa risco à saúde da população...

Prevalência e preditores de embolia pulmonar em pacientes com insuficiência cardíaca agudamente descompensada / Prevalence and predictors of pulmonary embolism in patients with acutely decompensated heart failure

FUNDAMENTO: Não existe descrição da prevalência de Embolia Pulmonar (EP) em pacientes internados por quadro clássico de Insuficiência Cardíaca descompensada (IC). OBJETIVO: Em pacientes internados por IC, (1) descrever a prevalência de EP, e (2) avaliar a acurácia diagnóstica dos Escores de Wells e de Genebra. MÉTODOS: Pacientes internados primariamente por IC realizaram sistematicamente cintilografia pulmonar de ventilação/perfusão, sendo EP definida por laudo de alta probabilidade. Para fins de interpretação, definimos baixa probabilidade clínica de EP como prevalência < 5 por cento, de acordo com dados da literatura. No cálculo do tamanho amostral, 49 pacientes seriam necessários para fornecer um intervalo de confiança 95 por cento com ± 10 por cento de precisão, estimando uma prevalência a priori de 15 por cento. RESULTADOS: Em 51 pacientes estudados, seis apresentaram cintilografia de alta probabilidade, resultando em prevalência de 12 por cento (95 por cento IC = 5 por cento - 23 por cento). Os Escores de Wells e de Genebra apresentaram área abaixo da curva ROC de 0,53 (95 por cento IC = 0,27 - 0,80; p = 0,80) e 0,43 (95 por cento IC = 0,13 - 0,73; p = 0,56), respectivamente, indicando ausência de acurácia para o diagnóstico de EP. Alternativamente, variáveis relacionadas à IC mostraram tendência a associação com EP e um modelo exploratório formado por esse tipo de variável apresentou acurácia diagnóstica para EP (ROC = 0,81; 95 por cento IC = 0,66 - 0,96; p = 0,01). CONCLUSÃO: (1) A despeito da ausência de suspeita primária, pacientes internados com IC possuem probabilidade clínica intermediária de EP concomitante; (2) Os escores usualmente utilizados para estimar a probabilidade clínica de EP não se aplicam à população com IC e futuros modelos preditores devem contemplar variáveis relacionadas a esta síndrome.

BACKGROUND: The prevalence of pulmonary embolism (PE) has not been reported in patients hospitalized due to classical findings of decompensated heart failure (HF). OBJECTIVE: To describe the prevalence of PE and to assess the diagnostic accuracy of the Wells and Geneva scores in patients hospitalized due to HF. METHODS: Patients hospitalized primarily due to HF underwent systematic ventilation-perfusion lung scan, and PE was defined by a result of high probability. Aiming at interpreting, low clinical probability of PE was defined as prevalence < 5 percent, according to the literature. When calculating the sample size, 49 patients were required to provide a 95 percent confidence interval with ±10 percent accuracy, estimating an a priori prevalence of 15 percent. RESULTS: Of 51 patients studied, six had a high probability of PE on lung scan, resulting in 12 percent prevalence (95 percent CI = 5 percent - 23 percent). The Wells and Geneva scores had an area under the ROC curve of 0.53 (95 percent CI = 0.27 - 0.80; p = 0.80) and 0.43 (95 percent CI = 0.13 - 0.73; p = 0.56), respectively, indicating lack of accuracy for the diagnosis of PE. Alternatively, variables related to HF showed a tendency towards association with PE, and an exploratory model formed by that type of variable showed diagnostic accuracy for PE (ROC = 0.81; 95 percent CI = 0.66 - 0.96; p = 0.01). CONCLUSION: (1) Despite the lack of primary suspicion, patients admitted with HF have intermediate clinical probability of concomitant PE; (2) the scores usually used to estimate the clinical probability of PE do not apply to the population with HF, and future predictive models should consider variables related to that syndrome.

Prevalence and predictors of pulmonary embolism in patients with acutely decompensated heart failure.

BACKGROUND: The prevalence of pulmonary embolism (PE) has not been reported in patients hospitalized due to classical findings of decompensated heart failure (HF). OBJECTIVE: To describe the prevalence of PE and to assess the diagnostic accuracy of the Wells and Geneva scores in patients hospitalized due to HF. METHODS: Patients hospitalized primarily due to HF underwent systematic ventilation-perfusion lung scan, and PE was defined by a result of high probability. Aiming at interpreting, low clinical probability of PE was defined as prevalence < 5%, according to the literature. When calculating the sample size, 49 patients were required to provide a 95% confidence interval with ±10% accuracy, estimating an a priori prevalence of 15%. RESULTS: Of 51 patients studied, six had a high probability of PE on lung scan, resulting in 12% prevalence (95% CI = 5% - 23%). The Wells and Geneva scores had an area under the ROC curve of 0.53 (95% CI = 0.27 - 0.80; p = 0.80) and 0.43 (95% CI = 0.13 - 0.73; p = 0.56), respectively, indicating lack of accuracy for the diagnosis of PE. Alternatively, variables related to HF showed a tendency towards association with PE, and an exploratory model formed by that type of variable showed diagnostic accuracy for PE (ROC = 0.81; 95% CI = 0.66 - 0.96; p = 0.01). CONCLUSION: (1) Despite the lack of primary suspicion, patients admitted with HF have intermediate clinical probability of concomitant PE; (2) the scores usually used to estimate the clinical probability of PE do not apply to the population with HF, and future predictive models should consider variables related to that syndrome.

Phenotypic expression in the first case of complete trisomy 12: combination of prenatal ultrasound and necropsic examination.

The authors report the first case of a complete trisomy 12 detected antenatally at 16 weeks of gestation. The ultrasonographic features (craniofacial abnormalities) correlated well with postmortem findings. The absence of the hypophysis gland, olfactory pathways and both adrenal glands, as well as developmental anomalies of the central nervous system, were additional findings at autopsy. The recognition of complete trisomy 12 phenotype can be helpful in the pre- and postnatal diagnosis of future similar cases and parental counseling.

História dos índios no Brasil / History of indians in Brazil

História dos Índios no Brasil é um esforço inédito de divulgação dos conhecimentos mais atuais sobre a história dos índios, com forte destaque para a população indígena da Amazônia. A coletânea oferece ao grande público a oportunidade de ter acesso às principais questões ligadas à presença dos povos indígenas no Brasil, como, por exemplo, as novas teorias sobre a origem do homem americano. Apresentado de forma extremamente bem cuidada, com 611 páginas encadernadas em capa dura, História dos Índios no Brasil dá grande importância à iconografia, trazendo documentos pouco conhecidos e inéditos, além de mapas ilustrativos e vinhetas alusivas à cultura material dos povos indígenas destacados nos estudos. É uma obra de referência única, indispensável, afinada com a nova política educacional do país, que valoriza a pluralidade cultural como o mais importante patrimônio do Brasil.

[Sonographic measurement of cervical length and prediction of spontaneous preterm delivery: how useful is it?]. / Avaliação ecográfica do colo uterino e rastreio de parto pré-termo: método útil ou ainda controverso?

Preterm delivery is a major concern in Maternal-Fetal Medicine. The sonographic measurement of the cervix is a reproducible and safe method to assess cervical length. Many authors have shown the benefits of cervical assessment in the screening of pregnant women at risk of preterm labor. Although screening could be useful in women at high-risk for preterm spontaneous labor, in a low-risk population the accuracy of the method is limited. An important issue is the usefulness of cervical cerclage to prevent preterm birth when a short cervix is detected by ultrasonography. In this review, the authors present new evidence of recent literature reporting sonographic measurement of cervical length and prediction of spontaneous preterm birth.

Non-viable cervico-isthmic pregnancy: the importance of an accurate sonographic diagnosis to preserve fertility.

BACKGROUND: Cervico-isthmic pregnancy is a rare occurrence and until the use of current ultrasonographic techniques was associated with a disastrous outcome for women desiring to maintain their fertility. CASE REPORT: A 39-year-old woman was diagnosed at 12 weeks of amenorrhoea with an intra-uterine non-viable pregnancy and a low implantation of the gestational sac. Medical management of this situation with a regimen of intravaginal misoprostol was unsuccessful. At introduction of a cervical expander severe vaginal bleeding ensued, leading to an emergency curettage followed by a life-saving hysterectomy. Pathologic examination confirmed the peroperative impression of an isthmic implantation of the gestational sac. CONCLUSION: Early ultrasonographic diagnosis is essential to make conservative management of cervico-isthmic pregnancy possible.

[Clinical impact of ultrasonography between the 10th and the 13th week of pregnancy]. / Impacto clínico da ecografia entre as 10 e as 13 semanas de gravidez.

The authors aimed to assess the impact of a routine ultrasound examination performed between 10 and 13 weeks of pregnancy. During a thirty month period, 778 ultrasound examinations between 10 and 13 weeks of pregnancy were performed, in women referred to our hospital. Transvaginal ultrasound was systematically adopted and the parameters obtained were introduced in a computerized data base. Biographic data, first day of menses (whenever possible), menstrual cycle characteristics, eventual use of hormonal contraception in the three months before last menses, antecedents of chromosomal abnormalities, number of foetuses and chorionicity, foetal vitality, crown-rump length, nuchal translucency and foetal heart rate were registered in all examinations. The median gestational age at the time of examination was 12.5 weeks (9-14.3). The median of maternal age was 29 years (14-44), maternal age prevalence higher or equal to 35 years was 17%. Fifty two per cent of women had usually regular menstrual cycles and 11% ignored last menses. In 74% of cases discrepancy between amenorrhea and ultrasound derived gestational age was inferior to one week and in 19% superior. The median of nuchal translucency was 1.4 mm (0.5-10), 7% of all cases had a nuchal translucency higher or equal to 2.5 mm. If maternal age criteria had been decisive for diagnostic invasive procedures, they would have been made in 135 cases. Considering nuchal translucency value combined with maternal age, it should have been done in 63 cases. In our series, invasive testing was performed in 31 (5%) cases. Eight women with fetuses with abnormal karyotypes decided for termination of pregnancy. The importance of ultrasound examination between 10 and 13 weeks seems unquestionable, allowing the correction of gestational age, multiple pregnancy characterisation and chromosomal abnormalities screening.

Populações tradicionais e a Convenção da Diversidade Biológica / Populações tradicionais e a Convenção da Diversidade Biológica

Os conhecimentos e o papel de populações tradicionais com relação a seus recursos genéticos são hoje reconhecidos na Convenção da Diversidade Biológica (CDB). O acordo TRIPS e a CDB estão levando o Brasil e muitos outros países signatários a mudarem sua legislação sobre direitos intelectuais e sobre o acesso a recursos genéticos e conhecimentos. Diante disso, colocam-se alternativas que são discutidas neste artigo. Deve-se estender o sistema de direitos de propriedade intelectual às populações tradicionais? Ou melhor, devem-se manter o seu saber no domínio público mas assegurando-lhes participação em eventuais benefícios comerciais derivados de seus conhecimentos? E qual a natureza desse saber local?.

The convention for Biological Diversity (CDB) has acknowledged the importance of traditional knowledge and stewardship of genetic ressources. The TRIPS agreement and the CBD are leading Brazil and other countries to change their legislation on intellectual rights and on access to genetic ressources and associated knowledge. Should one then extend the intellectual property system to cover local and indigenous knowledge? Or should one rather maintain it in the public domain and assure that local people participate in the possible benefits of commercial products derived from it? And then, what is the nature of local knowledge?.