Scientific Output by Latin American Women in Pediatric Surgical Sciences Over the Past 11 Years: A Bibliometric and Visual Analysis.

INTRODUCTION: This academic article discusses the historical underrepresentation of female in science, with a focus on Latin America. It highlights the importance of both technical and non-technical skills in the medical-surgical field, particularly the role of research skills. The study aims to quantify and characterize the scientific output of Latin American female researchers over the past decade, providing insights into the challenges and opportunities in low and middle-income countries. MATERIAL AND METHODS: A retrospective cross-sectional bibliometric study was conducted in 2023, focusing on pediatric surgical science journals in Scopus and PubMed. It assessed Latin American female participation, journal details, and interaction networks, using SPSS and Gephi software. The period analyzed was from January 2012 to December 2022. RESULTS: Between 2012 and 2022, 727 articles with Latin authorship in pediatric surgery were analyzed across 304 journals. Of these, 63.69% had female co-authors. The majority were original articles (53.13%), with contributions from Brazil, Mexico, and Chile. Notable journals included the Journal of Pediatric Surgery and Child's Nervous System. Keywords like Laparoscopy and Cardiac surgery were common. A growth trend in female Latin American publications was observed, despite temporary declines. CONCLUSIONS: This study highlights a growing trend in Latin American females' scientific contributions to pediatric surgery from 2012 to 2022, although a gender gap persists. The research mainly consists of primary data studies, with a focus on Brazil and Mexico from public institutions. The Journal of Pediatric Surgery featured prominently, and common topics included Laparoscopy, Cardiac surgery, Liver transplant, Congenital heart defects, and COVID-19. LEVEL OF EVIDENCE: IV.

Incorporating biodiversity responses to land use change scenarios for preventing emerging zoonotic diseases in areas of unknown host-pathogen interactions.

The need to reconcile food production, the safeguarding of nature, and the protection of public health is imperative in a world of continuing global change, particularly in the context of risks of emerging zoonotic disease (EZD). In this paper, we explored potential land use strategies to reduce EZD risks using a landscape approach. We focused on strategies for cases where the dynamics of pathogen transmission among species were poorly known and the ideas of "land-use induced spillover" and "landscape immunity" could be used very broadly. We first modeled three different land-use change scenarios in a region of transition between the Cerrado and the Atlantic Forest biodiversity hotspots. The land-use strategies used to build our scenarios reflected different proportions of native vegetation cover, as a proxy of habitat availability. We then evaluated the effects of the proportion of native vegetation cover on the occupancy probability of a group of mammal species and analyzed how the different land-use scenarios might affect the distribution of species in the landscape and thus the risk of EZD. We demonstrate that these approaches can help identify potential future EZD risks, and can thus be used as decision-making tools by stakeholders, with direct implications for improving both environmental and socio-economic outcomes.

Fractal methods applied to the seminiferous lumen images can quantify testicular changes induced by heat stress.

Male infertility affects many couples around the world and can be related to environmental factors such as exposure to high temperatures. Even so, automated methods evaluating the seminiferous tubules to detect testicular damage are still scarce. In search of new approaches to automation in the microscopic analysis of the testis; the present study used the fractal dimension, lacunarity, multifractality and quantitative morphometry to quantify changes in microphotographs of the seminiferous lumen in testicles reversibly damaged by heat stress (43 °C, 12 min). The parameters fractal dimension, lacunarity, multifractality (Dq and α), perimeter, feret and circularity were able to detect changes in the seminiferous lumen at 7, 15 and 30 days after the testicular damage. These methods also detected the recovery of spermatogenesis at 60 days after heat stress. Area, f(α), centroid X and Y, roundness, rectangle height and width were unable to detect changes caused by heat stress. In conclusion, computer assisted methods applied to the seminiferous lumen images can be a useful new viewpoint to analyze microscopic changes in the testicles, a fast low-cost tool to assist in the automated quantification of testicular damage.

Adesão dos profissionais de saúde à utilização da lista de verificação de segurança cirúrgica: Contributo de um programa formativo / Adherence of health professionals to the use of the surgical safety checklist: Contribution of a training program

A lista de verificação de segurança cirúrgica (LVSC) foi desenvolvida pela Organização Mundial de Saúde para reforçar práticas de segurança, melhorar a comunicação e o trabalho em equipa nos cuidados perioperatórios, reduzir a mortalidade e as complicações cirúrgicas evitáveis. Apesar das mais-valias descritas na evidência científica, persistem lacunas na adesão à LVSC. Uma das estratégias usadas para melhorar a sensibilização e adesão dos profissionais à LVSC tem sido a formação. É objetivo deste estudo avaliar a influência de um programa formativo na adesão dos profissionais de saúde à utilização da LVSC. O estudo englobou a implementação de um programa de formação, para os profissionais de saúde do bloco operatório e procurou sensibilizar para a importância da utilização da LVSC na segurança do doente. Trata-se de um estudo longitudinal, que recorre a uma metodologia de abordagem mista. Na colheita de dados, utilizaram-se dados documentais e questionários que permitem caracterizar a amostra, avaliar a perceção dos profissionais de saúde sobre o contributo da utilização da LVSC para a segurança do doente, questionar os fatores dificultadores e facilitadores na utilização da LVSC e explorar propostas de estratégias de melhoria para utilização da LVSC. O processo de colheita de dados decorreu em dois momentos distintos, ?antes? e ?após? o programa formativo. Os dados quantitativos foram tratados segundo estatística descritiva e inferencial e os dados qualitativos foram sujeitos a uma análise de conteúdo. A amostra do estudo foi constituída por enfermeiros, cirurgiões e anestesistas, que trabalham num serviço de bloco operatório. O programa formativo criou oportunidade para a sensibilização, discussão, esclarecimento de dúvidas e adoção de melhorias. Apesar de nas avaliações, ?antes? e ?após? formação, não se observarem diferenças estatisticamente significativas na perceção dos profissionais sobre a importância da utilização da LVSC para a segurança do doente, a taxa de adesão à utilização da LVSC subiu de 24,0% para 75,4%. Este trabalho potenciou a sensibilização dos profissionais de saúde do bloco operatório no que concerne à segurança cirúrgica, contributo da LVSC para a segurança do doente e na adoção de estratégias facilitadoras da sua utilização.

Valeriana officinalis Counteracts Rotenone Effects on Spreading Depression in the Rat Brain in vivo and Protects Against Rotenone Cytotoxicity Toward Rat Glioma C6 Cells in vitro.

Astrocytes can protect neurons against oxidative stress and excitability-dependent disorders, such as epilepsy. Valeriana officinalis has been used as anticonvulsant and can exert an antioxidant effect, which may underlie its opposing action against the toxic effects of the pesticide rotenone. We investigated the V. officinalis /rotenone interaction in the cortical spreading depression (CSD), a phenomenon that depends upon brain excitability (in vivo model). In addition, we analyzed the protective action of V. officinalis against the cytotoxic effects of rotenone in cultures of rat C6 glioma cells (in vitro model). For the CSD study, Wistar rats received either V. officinalis (250 mg/kg/day via gavage for 15 days; n = 8) or 10 mg/kg/day rotenone via subcutaneous injections for 7 days (n = 7), or they received both substances (n = 5). Two control groups received either saline (vehicle for V. officinalis; n = 8) or 1% Tween-80 aqueous solution (vehicle for rotenone; n = 9). After treatment, CSD was recorded for 4 h. The rotenone- and V. officinalis-treated groups presented, respectively, with lower (2.96 ± 0.14 mm/min), and higher CSD propagation velocity (3.81 ± 0.10 mm/min) when compared with the controls (Tween-80, 3.37 ± 0.06 mm/min and saline, 3.35 ± 0.08 mm/min; p < 0.05). The rotenone plus V. officinalis-treated group displayed a CSD velocity (3.38 ± 0.07 mm/min) that was similar to controls. In line with these results, in vitro experiments on rat glioma C6 cells revealed a protective effect (MTT assay) of V. officinalis against rotenone-induced cytotoxicity. These results suggest the therapeutic potential of V. officinalis for treating neurological diseases involving redox imbalance and astrocyte dysfunction.

[Congenital Heart Disease Prevalence in Portugal in 2015: Data from the National Register of Congenital Anomalies]. / Prevalência de Cardiopatias Congénitas em Portugal em 2015: Dados do Registo Nacional de Anomalias Congénitas.

INTRODUCTION: The prevalence at birth of congenital heart disease in Portugal is 8.3/1000 births; undetected critical congenital heart disease may result in adverse outcomes for the fetus/newborn infant. This study describes the reported cases of congenital heart disease in Portugal in 2015 regarding antenatal diagnosis, cardiac defect, and presence of other congenital anomalies/chromosomal abnormalities. These indicators are compared in live births and medical pregnancy terminations. Additionally, postnatal deaths were characterized. MATERIAL AND METHODS: Congenital heart disease data derived from the 2015 Portuguese National Registry of Congenital Birth Defects were analyzed. The prevalence rates per 1000 births were assessed by the chi-square test of independence. RESULTS: The prevalence of congenital heart disease in this study was 5/1000 live-births (339 live-births, 20% with critical defects). The most common defects were ventricular septal defect (38%), atrial septal defect (15%), aortic coarctation (7%), tetralogy of Fallot (7%) and pulmonary stenosis (5%). One third of the live births had antenatal diagnosis of congenital heart disease. In the live-births with critical congenital heart disease, 54% had antenatal diagnosis and 14% were diagnosed at birth. There were records of 84 pregnancy terminations; 49% had critical defects, 75% had non-cardiac congenital anomalies and 40% had chromosomal abnormalities. There were 15 postnatal deaths recorded (3.4% mortality rate), associated with prematurity/low birthweight, critical congenital heart disease, other non-cardiac congenital anomalies and chromosomal abnormalities. DISCUSSION: The data analysis revealed a prevalence of congenital heart disease in this study of 5/1000 births (inferior to other international studies), with a distribution per type of anomaly similar to that reported in previously published work. There were significant regional differences that need further studying. CONCLUSION: These results are paramount to characterize the Portuguese scenario and improve Healthcare planning. It is important to improve reporting in the Portuguese National Registry of Congenital Birth Defects.

Introdução: A prevalência de cardiopatias congénitas em Portugal é de 8,3/1000 nascimentos; cardiopatias congénitas críticas não detectadas podem resultar em graves consequências para o feto/recém-nascido. O objectivo deste trabalho é descrever os casos de cardiopatia congénita reportados em Portugal em 2015 quanto ao diagnóstico pré-natal, patologia cardíaca e à presença de outras malformações congénitas ou anomalias cromossómicas. Estas características são comparadas nos subgrupos dos nados-vivos e de interrupção médica da gravidez. Por último, caracterizam-se os óbitos.Material e Métodos: Os dados de cardiopatias congénitas reportadas ao Registo Nacional de Anomalias Congénitas em 2015 foram analisados, e calculadas as taxas de prevalência por 1000 nascimentos, comparadas utilizando teste de independência do quiquadrado.Resultados: A prevalência de cardiopatias congénitas neste estudo foi de 5/1000, (339 nados-vivos, 20% com cardiopatias congénitas críticas). As cardiopatias mais frequentes foram as seguintes: comunicação interventricular (38%), comunicação interauricular (15%), coartação da aorta (7%), tetralogia de Fallot (7%) e estenose pulmonar (5%). Um terço dos nados-vivos teve diagnostico pré-natal de cardiopatia. Dos nados-vivos com cardiopatias congénitas críticas, 54% teve diagnostico pré-natal e 14% foi diagnosticado ao nascer. Foram identificados 84 registos de interrupção médica da gravidez; 49% apresentava cardiopatias congénitas críticas, 75% outras malformações associadas, e 40% cromossomopatias. Foram registados 15 óbitos (3,4% de mortalidade) associados a prematuridade e/ou baixo-peso ao nascer, cardiopatias congénitas críticas, outras malformações e anomalias cromossómicas.Discussão: A prevalência de cardiopatias congénitas neste estudo (5/1000 nascimentos) foi inferior ao descrito noutros estudos internacionais, não obstante uma distribuição por tipo de anomalia semelhante ao previamente reportado. Observaram-se assimetrias regionais significativas que necessitam de mais investigação.Conclusão: Este estudo é relevante para melhor conhecimento da realidade nacional e organização dos Cuidados de Saúde. É importante uma maior adesão ao Registo Nacional de Anomalias Congénitas.

Programa de intervenção comunitária: "A outra face do cuidar" / Community intervention program: "The other face of caring" / Programa de intervención comunitaria: "La otra cara de la atención"

Introdução: O cuidador informal (CI) presta cuidados a pessoas dependentes, não sendo recompensado economicamente. São inúmeros os fatores de estresse inerentes à tarefa de cuidar, com consequente desgaste físico e emocional. Estudos indicam que as abordagens que englobam a realização de atividade física apresentam um impacto positivo na diminuição da depressão, estresse, raiva e sobrecarga apresentados pelo CI. Objetivo: Reduzir a sobrecarga do CI, com vista à capacitação da tarefa de cuidar, pela aquisição de ferramentas na gestão da sobrecarga. Métodos: De uma listagem de 90 utentes com a codificação "demência" e 50 com "atraso mental" realizou-se o diagnóstico de situação através da aplicação da escala de Zarit que avalia a sobrecarga dos CI. Destes, 13 mostraram interesse em participar na intervenção, que consistiu em sessões de educação para a saúde, sessões de yoga e dinamização de um grupo de apoio. Foi avaliado o grau de sobrecarga dos participantes e a sua satisfação. Resultados: Os CI eram maioritariamente mulheres (92%), com idade média de 62 anos. Foram realizadas 100% das sessões previstas, com 23% de desistência dos participantes. A sobrecarga moderada a severa ou severa diminuiu de 92.3% para 60% no final da intervenção. Todos os CI classificaram o projeto como "bom" ou "muito bom". Discussão: O projeto cumpriu a planificação inicial, tendo-se verificado uma diminuição do grau de sobrecarga do CI como evidenciado em outros estudos. Destaca-se como limitação a dificuldade do CI na realização de outras atividades além de cuidar do seu dependente. Conclusão: A intervenção teve um impacto positivo nos CI, tendo cumprido os objetivos inicialmente propostos. A equipa de saúde deu continuidade a este projeto através de uma parceria com uma cooperativa de solidariedade social local.

Introduction: The informal caregiver (IC) provides assistance to disabled people without any financial gratification. Many stress factors are associated with the task of taking care of others, leading to physical and emotional deterioration. Studies indicate that approaches involving physical activity have a positive impact on the reduction of depression, stress, anger and overload presented by the IC. Objective: To reduce IC overload with a view to enabling the task of caring by acquiring tools for overload management. Methods: The data collection of ICs overload was made using Zarit scale from a previous database of 90 patients classified as "dementia" and 50 as "mental retardation". 13 IC's express their interest to be part of the project. The intervention consisted in health education sessions; yoga classes; establishment of a support group. The participant's degree of overload and their satisfaction were assessed. Results: IC were mainly women (92%), with average age of 62 years. All scheduled sessions took place, with 23% participants withdrawing. Moderate to severe or severe overload level reduced from 92.3% to 60% at the end of the intervention and all participants classified the project as "good" or "very good". Discussion: The project fulfilled the initial planning. Decrease of the IC overload was noted as evidenced in other studies. The limitation is the difficulty of IC in performing other activities besides then taking care of its dependent. Conclusions: The intervention had a positive impact in the ICs and the main goals were achieved. The health team continued this project through a partnership with a local social solidarity cooperative.

Introducción: El cuidador informal (CI) presta cuidados a las personas dependientes, no siendo recompensado económicamente. Son innumerables los factores de estrés inherentes a la tarea de cuidar, con consiguiente desgaste físico y emocional. Los estudios indican que los enfoques que incluyen la actividad física tienen un impacto positivo en la reducción de la depresión, el estrés, la ira y la sobrecarga que presenta el CI. Objetivo: Reducir la sobrecarga del CI, con miras a la capacitación de la tarea de cuidar y la adquisición de herramientas en la gestión de la sobrecarga. Métodos: De una lista de 90 pacientes con la clasificación "demencia" y 50 con "retraso mental" se realizó el diagnóstico de sobrecarga del CI, aplicándose la escala de Zarit. De ellos, 13 mostraron interés en participar en la intervención, que consistió en sesiones de educación para la salud, sesiones de yoga y dinamización de un Grupo de Apoyo. Se evaluó el grado de sobrecarga de los participantes y su satisfacción. Resultados: Los CI fueron en su mayoría mujeres (92%), con una edad promedio de 62 años. El 100% de las sesiones se llevaron a cabo, y el 23% de los participantes se rindieron. La sobrecarga moderada a severa o severa disminuyó del 92,3% al 60% al final de la intervención. Todos los CIs calificaron el proyecto como "bueno" o "muy bueno". Discusión: El proyecto cumplió la planificación inicial, habiéndose comprobado una disminución del grado de sobrecarga del CI como lo demuestran otros estudios. Se destaca como limitación la dificultad del CI en la realización de otras actividades además de cuidar de su dependiente. Conclusión: La intervención tuvo un impacto positivo en los CI, habiendo cumplido los objetivos inicialmente propuestos. El equipo de salud continuó este proyecto a través de una asociación con una cooperativa de solidaridad social local.

Project INSIDE: towards autonomous semi-unstructured human-robot social interaction in autism therapy.

This paper describes the INSIDE system, a networked robot system designed to allow the use of mobile robots as active players in the therapy of children with autism spectrum disorders (ASD). While a significant volume of work has explored the impact of robots in ASD therapy, most such work comprises remotely operated robots and/or well-structured interaction dynamics. In contrast, the INSIDE system allows for complex, semi-unstructured interaction in ASD therapy while featuring a fully autonomous robot. In this paper we describe the hardware and software infrastructure that supports such rich form of interaction, as well as the design methodology that guided the development of the INSIDE system. We also present some results on the use of our system both in pilot and in a long-term study comprising multiple therapy sessions with children at Hospital Garcia de Orta, in Portugal, highlighting the robustness and autonomy of the system as a whole.

[The Experience of a Protocol for the Management of Pediatric Minor Head Injury: A Three Years Longitudinal Study]. / A Experiência duma Norma de Atuação no Traumatismo Crânio-Encefálico Ligeiro em Idade Pediátrica: Estudo Longitudinal de Três Anos.

INTRODUCTION: Head injury is common in children, with mostly being minor and not resulting in intracranial injury. Computerized tomography head scan is the preferred exam, but implies exposure to radiation; the indications for computerized tomography head scan in minor injuries are not consensual. An expectant approach is a good option in most cases. The aim was to compare the patients hospitalized and subjected to computerized tomography head scan with patients hospitalized but not subjected to computerized tomography head scan in order to assess the safety of our institution's practice protocol. MATERIAL AND METHODS: Analytical longitudinal retrospective study, during three years, including patients younger than 15 years of age with minor head injury, admitted for in hospital surveillance through a paediatric emergency room. We defined two study groups: group A (hospitalized with computerized tomography head scan) and group B (hospitalized without computerized tomography head scan). RESULTS: Study sample consisting of 206 patients: 81 (39%) group A and 125 (61%) group B. Symptoms, including vomiting, were more frequent in group B (91% and 61% vs 75% and 35%, p < 0.05); large scalp hematoma and palpable fracture in group A (11% and 12% vs 0%, p < 0.05). We performed computerized tomography head scan in 39% of the study patients (children with red flags in the physical examination or unfavourable course during hospitalization); 43% had traumatic brain injury (29 patients had fracture, 18 patients had intracranial injury). Three patients underwent neurosurgery. We did not register deaths, readmissions or neurologic sequelae. DISCUSSION: Significant intracranial injury was infrequent. The hospitalization and surveillance of children and adolescents with symptomatic minor head injury, without red flags in the physical examination, did not seem to result in additional risks. CONCLUSION: The careful selection of patients for computerized tomography head scan enabled a decrease in the number of these exams and the exposure to ionizing radiation.

Introdução: Os traumatismos crânio-encefálicos são frequentes em Pediatria, habitualmente ligeiros e sem lesões intracranianas. A tomografia computorizada crânio-encefálica é o exame de eleição, implicando radiação ionizante, não existindo consenso nas indicações nos traumatismos crânio-encefálicos ligeiros. Uma atitude expectante é uma opção adequada na maioria dos casos. Os autores pretenderam comparar os doentes internados e submetidos a tomografia computorizada crânio-encefálica com os doentes internados sem tomografia computorizada crânio-encefálica, inferindo a segurança da norma de atuação em vigor na nossa instituição. Material e Métodos: Estudo analítico longitudinal retrospetivo, durante três anos, de doentes com menos de 15 anos admitidos na Urgência Pediátrica e internados por traumatismos crânio-encefálicos ligeiros. Amostra organizada num grupo A (internados com tomografia computorizada crânio-encefálica) e num grupo B (internados sem tomografia computorizada crânio-encefálica). Resultados: Amostra de estudo constituída por 206 doentes: 81 (39%) grupo A e 125 (61%) grupo B. Sintomas, nomeadamente vómitos, foram mais frequentes no grupo B (91% e 61% vs 75% e 35%, p < 0,05); hematoma epicraniano volumoso e afundamento ósseo no grupo A (11% e 12% vs 0%, p < 0,05). Realizou-se tomografia computorizada crânio-encefálica em 39% dos doentes estudados (crianças com sinais de alarme à observação ou evolução não favorável durante o internamento); 43% tinham alterações (29 doentes apresentavam fratura, 18 doentes apresentavam lesões intracranianas). Três doentes foram submetidos a neurocirurgia. Não registámos óbitos, reinternamentos ou sequelas neurológicas. Discussão: As lesões intracranianas clinicamente significativas foram pouco frequentes. A atitude preconizada de vigilância hospitalar das crianças e adolescentes com traumatismos crânio-encefálicos ligeiros sintomáticos, sem alterações significativas ao exame objetivo, não pareceu ter implicado riscos acrescidos. Conclusão: A utilização criteriosa da tomografia computorizada crânio-encefálica permitiu reduzir o número de exames e a exposição a radiação ionizante.

Properties of biochar derived from wood and high-nutrient biomasses with the aim of agronomic and environmental benefits.

Biochar production and use are part of the modern agenda to recycle wastes, and to retain nutrients, pollutants, and heavy metals in the soil and to offset some greenhouse gas emissions. Biochars from wood (eucalyptus sawdust, pine bark), sugarcane bagasse, and substances rich in nutrients (coffee husk, chicken manure) produced at 350, 450 and 750°C were characterized to identify agronomic and environmental benefits, which may enhance soil quality. Biochars derived from wood and sugarcane have greater potential for improving C storage in tropical soils due to a higher aromatic character, high C concentration, low H/C ratio, and FTIR spectra features as compared to nutrient-rich biochars. The high ash content associated with alkaline chemical species such as KHCO3 and CaCO3, verified by XRD analysis, made chicken manure and coffee husk biochars potential liming agents for remediating acidic soils. High Ca and K contents in chicken manure and coffee husk biomass can significantly replace conventional sources of K (mostly imported in Brazil) and Ca, suggesting a high agronomic value for these biochars. High-ash biochars, such as chicken manure and coffee husk, produced at low-temperatures (350 and 450°C) exhibited high CEC values, which can be considered as a potential applicable material to increase nutrient retention in soil. Therefore, the agronomic value of the biochars in this study is predominantly regulated by the nutrient richness of the biomass, but an increase in pyrolysis temperature to 750°C can strongly decrease the adsorptive capacities of chicken manure and coffee husk biochars. A diagram of the agronomic potential and environmental benefits is presented, along with some guidelines to relate biochar properties with potential agronomic and environmental uses. Based on biochar properties, research needs are identified and directions for future trials are delineated.

[Acute gastroenteritis by Cambylobacter spp: a retrospective study of a paediatric emergency department]. / Gastroenterite Aguda por Campylobacter Spp: Casuística de uma Urgência Pediátrica.

INTRODUCTION: Infection by Cambylobacter occurs worldwide and represents the main cause of acute bacterial gastroenteritis within the European Union. AIMS: Determine the prevalence of Campylobacter in stool cultures from patients with gastroenteritis and study their microbiological, epidemiological, clinical, and therapeutic profiles, as well as associated complications. MATERIAL AND METHODS: Review of clinical files of patients presenting to the paediatric emergency department of a general district hospital over a 30 month period with an acute gastroenteritis and a Campylobacter isolated in a stool specimen. RESULTS: Out of 216 stool cultures, 98 (45%) were positive. We identified Campylobacter in 49 (50%) cases; 30 (61%) were female. Median age was 23 months. Fourteen patients were under one year of age, 25 between one and five years old and 10 patients were over five years old. Watery diarrhea was identified in 5 (10%) patients, bloody diarrhea in 44 (90%) and mucosanguineous in 14 (29%), while 23 (47%) had fever, 14 (29%) complained of abdominal pain and 11 (22%) presented with vomiting. One patient was septic. Five patients were admitted as inpatients. Eight patients were treated with azithromycin. DISCUSSION: This is the largest published national series on gastroenteritis by Campylobacter in children and the first in the south region. Campylobacter was the main bacteria isolated. Infection was self-resolving in the majority of cases. Nevertheless, severe forms of this infection should be considered. Increased resistance to quinolones is worrisome. CONCLUSION: Judicious use of stool cultures allows etiological identification of bacterial gastroenteritis. The increase in Campylobacter cases reinforces the need for better control of hygiene measures in handling food products.

Introdução: A infeção por Campylobacter é a principal causa de gastroenterite aguda bacteriana pediátrica na União Europeia.Objetivos: Conhecer a prevalência de isolamento deste agente nas crianças admitidas na urgência com gastroenterite aguda que realizaram coprocultura, caracterizando a microbiologia, epidemiologia, clínica, terapêutica e complicações associadas.Material e Métodos: Casuística por consulta dos processos dos doentes admitidos na Urgência Pediátrica dum hospital distrital, durante 30 meses, com o diagnóstico de gastroenterite aguda e isolamento em coprocultura de Campylobacter.Resultados: Das 216 coproculturas efetuadas, 98 (45%) foram positivas. Identificámos Campylobacter spp. em 49 (50%) doentes. Destes, 30 (61%) eram do género feminino. A mediana de idades foi 23 meses. Catorze doentes tinham idade inferior a um ano, 25 entre um e cinco anos e 10 idade superior a cinco anos. Verificámos diarreia aquosa em cinco (10%) doentes, diarreia com sangue em 44 (90%), sangue e muco em 14 (29%), febre em 23 (47%), dor abdominal em 14 (29%) e vómitos em 11 (22%). Registámos um caso de sépsis. Internámos cinco doentes. Oito doentes foram medicados com azitromicina.Discussão: Esta é a maior casuística nacional publicada de gastroenterite aguda a Campylobacter em idade pediátrica e a primeira no sul do país. Campylobacter foi a principal bactéria identificada, associada maioritariamente a doença auto-limitada. Contudo, há a considerar formas de infeção graves. O aumento da resistência às quinolonas é preocupante.Conclusão: A utilização criteriosa da coprocultura permite a identificação etiológica na gastrenterite aguda bacteriana. O crescente aumento dos casos de Campylobacter diagnosticados reforça a necessidade de maior controlo das medidas de higiene na manipulação dos alimentos.

Babassu nut residues: potential for bioenergy use in the North and Northeast of Brazil.

Babassu is considered the largest native oil resource worldwide and occurs naturally in Brazil. The purpose of this study was to evaluate the potential of babassu nut residues (epicarp, mesocarp and endocarp) for bioenergy use, especially for direct combustion and charcoal production. The material was collected in the rural area of the municipality of Sítio Novo do Tocantins, in the state of Tocantins, Brazil. Analyses were performed considering jointly the three layers that make up the babassu nut shell. The following chemical characterizations were performed: molecular (lignin, total extractives and holocellulose), elemental (C, H, N, S and O), immediate (fixed carbon, volatiles and ash), energy (higher heating value and lower heating value), physical (basic density and energy density) and thermal (thermogravimetry and differential thermal analysis), besides the morphological characterization by scanning electron microscopy. Babassu nut residues showed a high bioenergy potential, mainly due to their high energy density. The use of this biomass as a bioenergy source can be highly feasible, given their chemical and thermal characteristics, combined with a low ash content. Babassu nut shell showed a high basic density and a suitable lignin content for the sustainable production of bioenergy and charcoal, capable of replacing coke in Brazilian steel plants.

Primary cardiac leiomyoma of the ventricular septum: a rare form of pediatric intracardiac tumor.

A case of ventricular septal tumor diagnosed in 7-month-old boy is reported. An echocardiogram was performed for investigation of a heart murmur in an otherwise healthy infant. He remained asymptomatic, and the tumor had a very slow growth. When the boy was 9 years old, partial surgical excision was performed for right ventricular outflow tract obstruction. Histology showed a primary cardiac leiomyoma. To the authors' knowledge, a primary cardiac leiomyoma of the ventricular septum has not been reported previously.

Sleep deprivation and accidental fall risk in children.

OBJECTIVES: To look for an association between sleep deprivation and risk of accidental falls (AF) in children. METHODS: A questionnaire was applied to two groups of children aged 1-14 years, encompassing children observed in an emergency room for AF (G1) and children attending health care visits (HV) (G2). Collected data included demographic characteristics, medical history, previous week's sleep pattern (PWSP), sleep duration and sleep pattern in the preceding 24 h, mechanism of fall, and injury severity. EXCLUSION CRITERIA: acute or chronic disease or exposure to drugs interfering with sleep. Statistical analyses included Fisher's exact test, Pearson Chi-square, Fisher-Freeman-Halton test, T and Mann-Whitney tests for independent samples, and multivariate logistic regression (α=5%). RESULTS: We obtained 1756 questionnaires in G1 and 277 in G2. Of those, 834 in G1 and 267 in G2 were analyzed. We found an increased risk of AF in boys (OR 1.6; 95% CI 1.2-2.4). After controlling for age, gender, summer holidays, parental education and profession, lack of naps and PWSP were associated with increased risk (OR 2.1; 95% CI 1.3-3.3 and OR 2.7; 95% CI 1.2-6.1). In 3-5 year-old children there was an association between AF and a shorter than usual sleep duration in the previous 24 h (p=0.02). CONCLUSIONS: To our knowledge, our study is the largest so far to assess the association between sleep deprivation and childhood injury. It evidences a protective effect of naps in children. Sleep duration of less than 8 h increases risk of AF. Pre-schoolers may be particularly susceptible to sleep deprivation.