Quality of complementary feeding and its effect on nutritional status in preterm infants: a cross-sectional study.

BACKGROUND: The first 2 years of life represent a critical phase for growth and development, with the quality of the diet at this stage having repercussions throughout adulthood. The present study aimed to develop an Index for Measuring the Quality of Complementary Feeding (IMQCF) for infants, as well as to evaluate diet quality and its effects on the nutritional status of preterm infants. METHODS: This cross-sectional study was conducted at a Brazilian University Hospital. The data were extracted by care protocol of outpatient preterm infants at 2 years of corrected age (CA). Dietary data were collected from 24-h recalls. The diet quality was assessed by the IMQCF composed of nine items based on a Brazilian Food Guide for children aged <2 years. Response options were scored 0-100, with scores closer to 100 representing a better quality diet. Association with growth indicators (Z-scores for weight- and length-for-age (WAZ and LAZ) were evaluated via tests of mean difference and multiple linear regression. RESULTS: The median complementary feeding (CF) score was 72.2 (61.1-77.8) A shorter breastfeeding duration or infant formula use and the early introduction of wheat-based foods, ultra-processed foods and cow's milk in the preterm's diet were the main factors interfering in the adequacy of diet. There was an association between the quality of the diet score and WAZ (0.44; 95% confidence interval = 0.03-0.85; P = 0.03). CONCLUSIONS: The introduction of poor quality food in the first 2 years of life interfered with the CF quality of preterm infants and can affect nutritional status at 2 years of CA, possibly in the long term.

Oral fish oil positively influences nutritional-inflammatory risk in patients with haematological malignancies during chemotherapy with an impact on long-term survival: a randomised clinical trial.

BACKGROUND: Studies suggest that the ingestion of fish oil (FO), a source of the omega-3 polyunsaturated fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), can reduce the deleterious side-effects of chemotherapy. The aim of this randomised clinical trial was to evaluate the effect of supplementation with oral FO for 9 weeks on nutritional parameters and inflammatory nutritional risk in patients with haematological malignancies during the beginning of chemotherapy. METHODS: Twenty-two patients with leukaemia or lymphoma were randomised to the unsupplemented group (UG) (n = 13) or supplemented group (SG) (n = 9). SG received 2 g/day of fish oil for 9 weeks. Nutritional status, serum acute-phase proteins and plasma fatty acids were evaluated before (T0) and after (T1) the intervention period. Data were analysed using two models; model 1, comprising data from all patients included in the study, and model 2, comprising data from UG patients with no increase in the proportions of EPA and DHA in plasma and data from SG patients showing an at least 100% increase in plasma EPA and DHA. RESULTS: SG showed an increased plasma proportion of EPA and DHA in both models. In model 2, C-reactive protein (CRP) and CRP/albumin ratio showed larger reductions in the SG. Overall long-term survival in both models (465 days after the start of the chemotherapy) was higher in the group ingesting fish oil (P < 0.05). CONCLUSIONS: These findings indicate an improved nutritional-inflammatory risk and potential effects on long-term survival in patients with haematological malignancies supplemented with FO during the beginning of chemotherapy.

IL-8/IL-17 gene variations and the susceptibility to severe viral bronchiolitis.

Clinical manifestations of acute bronchiolitis (AB) vary from minimal disease to severe respiratory failure. The response to respiratory viral infections is possibly influenced by genetic polymorphisms linked to the regulation of the inflammatory response. In the present study, we investigated whether interleukin-8 (IL-8) and interleukin-17 (IL-17) genetic variants are associated with the severity of AB. A group of Brazilian infants hospitalized with AB and a control group (infants with no or mild AB, without hospitalization) were genotyped for four IL-8/IL-17 variations. For replication, we studied an Argentinean population sample of infants with mild and severe AB. IL-8 polymorphism (rs 2227543) and IL-17 (rs2275913) variants showed significant associations with the severity of AB. The effect of the IL-8 variation could be replicated in the Argentinean sample. This finding suggests that IL-8 variations may influence the severity of AB in young infants. Further genetic association studies in low- or middle-income populations are necessary with the aim of expanding knowledge in this area.

Analysis of the motivation for hematopoietic stem cell donation.

The Italian Bone Marrow Donor Register is the institutional organization for management of unrelated hematopoietic stem cell donors. The law requires only a donor's clinical history, but not a psychosocial profile for registration. We have studied the donor's motivation for enlistment on the donor registry and the medical staff's need for this information to interact correctly with the donor. For this purpose we distributed a questionnaire to new donors at the 20 centers in the Lombardy Region over a period of 1 year. The analysis of the responses revealed a prevalence of extrinsic motivations that would not ensure continued registration for donation. Therefore, it is necessary that the donor be well informed and better educated about all aspects of donation, in order to produce a shift to an intrinsic motivation. This objective can be facilitated via professional training of health workers in communication.

Local anesthesia for cochlear implant surgery: low risks for the patient and few costs for the hospital, a rational alternative.

OBJECTIVES: The aim of this article is to illustrate the possibility of performing a cochlear implant with local anesthesia and sedation, the anesthesic technique and the advantages of that in comparison to a general anesthesia. MATERIAL AND METHODS: We describe two successful surgeries done with local anesthesia, including the neural telemetry and the conditions the patient presented after the surgery, with a very good recovery and no complications during and after the procedure. RESULTS: The results of these two surgeries are described regarding the fast recovery, no symptoms of dizziness and vomiting after the surgeries, discharging from the hospital on the same day, and the immediate post operative period by meaning of complaints from the patient. CONCLUSION: Local anesthesia with sedation for cochlear implant surgery in adults is a very good alternative for lowering the morbidity of the patient, fewer risks, lower costs for the hospital, with a very good control of the surgery.

Transcanal labyrinthectomy in childhood: report of a case.

Vertigo in children is caused by several factors. One such factor is viruses (e.g., mumps, measles, and rubeola) afflicting the inner ear by various mechanisms. In the majority of cases, affected patients improve with clinical therapy and vestibular rehabilitation. We present the case of a child with vertigo as a sequela of mumps virus infection that did not improve with clinical treatment and vestibular rehabilitation. Consequently, the child was submitted to a transcanal labyrinthectomy followed by vestibular rehabilitation, with significant postprocedure improvement of symptoms. We discuss surgical indications, the technique used in this case, and the importance of vestibular rehabilitation in the postoperative period.

Estenose congênita de abertura nasal piriforme: relato de caso / Congenital stenosis of the aperture nasal pyriform: a case report

A estenose congênita de abertura piriforme é causa rara de obstruçäo nasal no recém-nato descrita pela primeira vez em 1989 por BROWN et al relatou 6 casos, seguido por ARLIS et al que relatou outros 6 casos em 1992, totalizando 12 casos descrito na literatura até o momento. Esta anomalia produz sintomas e sinais clínicos de obstruçäo nasal, em recém-nascidos e crianças, similares aos encontrados na atresia coanal bilateral. A tomografia computadorizada confirma o diagnóstico e delimita a anomalia. Descrevemos um caso diagnosticado no Hospital de Clínicas da Universidade Federal do Paraná no ano de 1993, no serviço de otorrinolaringologia, tratado cirurgicamente por acesso sublabial

Abnormal neutrophil chemotaxis in bone marrow transplant patients correlates with impaired 31D8 monoclonal antibody binding.

BACKGROUND: 31D8 monoclonal antibody (mAb) has been shown to bind heterogeneously to human neutrophils, identifying subsets of cells which differ in their functional response to chemotactic stimuli. In this study we used 31D8 mAb to determine whether differences in neutrophil subpopulations might explain the long-lasting decreased chemotaxis observed in bone marrow transplant recipients. METHODS: Thirty patients with self-sustaining hematopoiesis 1 to 5 years bone marrow transplantation (BMT) (15 allogeneic and 15 autologous) performed for acute lymphocytic leukemia (ALL, 10 patients) or acute myelogenous leukemia in complete remission (8 patients), Hodgkin's lymphoma (2 patients), chronic myeloid leukemia (8 patients) and severe aplastic anemia (2 patients) were included in the study. Neutrophil chemotaxis was evaluated using a modified Boyden chamber assay and 31D8 binding was determined by indirect immunofluorescence and cytofluorimetric analysis. RESULTS: Neutrophil chemotaxis was significantly impaired in the BMT group with respect to controls. The chemotactic defect strikingly correlated with autologous BMT and, in particular, with ALL as the pre-existing disease. No differences between patients and controls were observed in the percentage of 31D8 bright and dull neutrophils. However, when mean fluorescence intensity (MFI) was analyzed as a relative measure of 31D8 antigen expression on the overall neutrophil population, a significant decrease was observed in neutrophils from BMT patients with respect to controls. As for chemotaxis, the impairment of 31D8 binding was more evident in autologous BMT and strikingly correlated with ALL as the pre-existing disease regardless of age, sex and time since BMT. Moreover, a significant positive correlation between impaired chemotaxis and decreased 31D8 binding was found in our patients. CONCLUSIONS: These findings suggest that the decreased neutrophil chemotaxis observed in some BMT patients may be due in part to circulating 31D8 dull neutrophils, although the causes for the decreased 31D8 binding and for the quite pronounced neutrophil defect in ALL patients remain unknown.

Nasoangiofibroma juvenil em mulher. / Juvenile angiofibroma of the nose in women

Os autores relatam um caso de nasoangiofibroma juvenil em uma mulher de 16 anos. A literatura revista mostra a raridade do caso e salientam a importancia do exame da cromatina sexual

Angina de Ludwig. / Ludwig's angina

Os autores apresentam dois casos de angina de Ludwig, mostrando realmente que esta patologia nao esta erradicada, exigindo medidas terapeuticas agressivas e imediatas. Paralelamente, mostram uma revisao bibliografica do assunto chamando atencao para a importancia do diagnostico precoce e preciso dessa entidade

Fibrous dysplasia and the temporal bone.

The cause of fibrous dysplasia of the bone is obscure. We reviewed the available literature concerning temporal bone involvement and analyzed temporal bone involvement and analyzed the most common aspects of this fascinating disease, adding three cases of our own. A clinical staging is proposed: stage 1, latent; stage 2, symptomatic; and stage 3, complication. Clinical evolution and follow-up are described and treatment is suggested.