BABY-LED WEANING, AN OVERVIEW OF THE NEW APPROACH TO FOOD INTRODUCTION: INTEGRATIVE LITERATURE REVIEW.

OBJECTIVE: To analyze the scientific literature on Baby-Led Weaning with an integrative literature review to identify risks and benefits. DATA SOURCE: The databases used were: National Library of Medicine (MEDLINE), Latin American and Caribbean Literature in Health Sciences (LILACS - Literatura Latino-Americana e do Caribe em Ciências da Saúde), US National Library of Medicine (PubMed), and Virtual Health Library (BVS - Biblioteca Virtual em Saúde) in December 2017. The inclusion criteria established were publications in English with the descriptor "baby-led weaning" in the heading, abstract, or keywords, classified as original articles, of primary nature, and available online and in full. We excluded review articles, editorials, letters to the editor, critical commentaries, and books on the subject, as well as articles not available in full and duplicates. DATA SUMMARY: We identified 106 articles, of which 17 met the selection criteria. The Baby-Led Weaning method was significantly associated with the baby's satiety, the start of complementary feeding, and adequacy of weight gain. On the other hand, choking and the intake of micronutrients were negatively associated, however with no statistical differences. CONCLUSIONS: Despite the benefits found, the risks still deserve attention and should be investigated with longitudinal randomized controlled studies to ensure the safety of the method when practiced exclusively.

Baby-led weaning, an overview of the new approach to food introduction: integrative literature review / Baby-led weaning, panorama da nova abordagem sobre introdução alimentar: revisão integrativa de literatura

ABSTRACT Objective: To analyze the scientific literature on Baby-Led Weaning with an integrative literature review to identify risks and benefits. Data source: The databases used were: National Library of Medicine (MEDLINE), Latin American and Caribbean Literature in Health Sciences (LILACS - Literatura Latino-Americana e do Caribe em Ciências da Saúde), US National Library of Medicine (PubMed), and Virtual Health Library (BVS - Biblioteca Virtual em Saúde) in December 2017. The inclusion criteria established were publications in English with the descriptor "baby-led weaning" in the heading, abstract, or keywords, classified as original articles, of primary nature, and available online and in full. We excluded review articles, editorials, letters to the editor, critical commentaries, and books on the subject, as well as articles not available in full and duplicates. Data summary: We identified 106 articles, of which 17 met the selection criteria. The Baby-Led Weaning method was significantly associated with the baby's satiety, the start of complementary feeding, and adequacy of weight gain. On the other hand, choking and the intake of micronutrients were negatively associated, however with no statistical differences. Conclusions: Despite the benefits found, the risks still deserve attention and should be investigated with longitudinal randomized controlled studies to ensure the safety of the method when practiced exclusively.

RESUMO Objetivo: Analisar a literatura científica referente ao desmame guiado pelo bebê (Baby-Led Weaning) por meio de revisão integrativa de literatura a fim de identificar riscos e benefícios. Fonte de dados: As bases de dados utilizadas foram: National Library of Medicine (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), US National Library of Medicine (PubMed) e Biblioteca Virtual em Saúde (BVS); e a busca foi realizada em dezembro de 2017. Os critérios de inclusão estabelecidos foram publicações em inglês com o descritor "baby-led weaning" no título, resumo ou palavras-chave em artigos classificados como originais de natureza primária, disponibilizados online e na íntegra. Excluíram-se artigos de revisão, editoriais, cartas ao editor, comentários críticos e livros abordando o assunto, assim como artigos não disponíveis na íntegra e duplicatas. Síntese dos dados: Identificaram-se 106 artigos, dos quais 17 faziam parte do critério de seleção. O método Baby-Led Weaning teve associação significativa com a saciedade do bebê, início da alimentação complementar e adequação de ganho de peso. Já o engasgo e a ingestão de micronutrientes foram associados negativamente, contudo sem diferenças estatísticas. Conclusões: Apesar dos benefícios apontados, os riscos ainda merecem atenção por meio de pesquisas longitudinais controladas e randomizadas para fornecer mais segurança para a sua prática de forma exclusiva.

Impact of screening and monitoring of capillary blood glucose in the detection of hyperglycemia and hypoglycemia in non-critical inpatients / Impacto do rastreamento e monitoramento de glicemia capilar na detecção de hiperglicemia e hipoglicemia em pacientes não graves internados

Objective: To evaluate the impact of screening hyper and hypoglycemia measured by capillary glycemia and standard monitorization of hyperglycemic patients hospitalized in regular care units of Hospital Israelita Albert Einstein. Methods: The capillary glycemia was measured by the Precision PCx (Abbott) glucosimeter, using the PrecisionWeb (Abbott) software. The detection of hyper and hypoglycemia during the months of May/June were compared to those of March/April in 2009 and to the frequency of the diagnosis of diabetes in 2007. Results: There was an increase in the glycemia screening from 27.7 to 77.5% of hospitalized patients (p < 0.001), of hyperglycemia detection (from 9.3 to 12.2%; p < 0.001) and of hypoglycemia (from 1.5 to 3.3%; p < 0.001) during the months of May/June 2009. According to this action 14 patients for each additional case of hyperglycemia and 26 cases for each case of hypoglycemia were identified. The detection of hyperglycemia was significantly higher (p < 0.001) than the frequency of registered diagnosis related do diabetes in the year of 2007. Conclusions: the adoption of an institutional program of glycemia monitorization improves the detection of hyper and hypoglycemia and glycemia control in hospitalized patients in regular care units.

Objetivo: Analisar o impacto do rastreamento de hiper e hipoglicemia mensurada por glicemia capilar e da monitorização padronizada em pacientes hiperglicêmicos internados em unidades não graves do Hospital Israelita Albert Einstein. Métodos: A glicemia capilar foi mensurada com glucosímetro Precision PCx (Abbott), rastreada com software PrecisionWeb (Abbott). A detecção de hiper e hipoglicemia no bimestre Maio/Junho foi comparada ao bimestre Março/Abril de 2009 e ainda quanto à frequência de diagnósticos relacionados ao diabetes no ano de 2007. Resultados: Houve um aumento do rastreamento de glicemia de 27,7 para 77,5% dos pacientes internados (p < 0,001), na detecção de hiperglicemia (de 9,3 para 12,2%; p < 0,001) e de hipoglicemia (de 1,5 para 3,3%; p < 0,001) no bimestre Maio-Junho de 2009. Com essa iniciativa, foram rastreados 14 pacientes para cada caso adicional de hiperglicemia e 26 pacientes para cada caso de hipoglicemia. A detecção de hiperglicemia foi significantemente maior (p < 0,001) que a frequência de registros de diagnósticos relacionados ao diabetes no ano de 2007. Conclusões: a adoção de um programa institucional de monitoramento de glicemia melhora a detecção de hiper e hipoglicemia e o controle de glicemia em pacientes internados em unidades não graves.

Impact of screening and monitoring of capillary blood glucose in the detection of hyperglycemia and hypoglycemia in non-critical inpatients.

OBJECTIVE: To evaluate the impact of screening hyper and hypoglycemia measured by capillary glycemia and standard monitorization of hyperglycemic patients hospitalized in regular care units of Hospital Israelita Albert Einstein. METHODS: The capillary glycemia was measured by the Precision PCx (Abbott) glucosimeter, using the PrecisionWeb (Abbott) software. The detection of hyper and hypoglycemia during the months of May/June were compared to those of March/April in 2009 and to the frequency of the diagnosis of diabetes in 2007. RESULTS: There was an increase in the glycemia screening from 27.7 to 77.5% of hospitalized patients (p < 0.001), of hyperglycemia detection (from 9.3 to 12.2%; p < 0.001) and of hypoglycemia (from 1.5 to 3.3%; p < 0.001) during the months of May/June 2009. According to this action 14 patients for each additional case of hyperglycemia and 26 cases for each case of hypoglycemia were identified. The detection of hyperglycemia was significantly higher (p < 0.001) than the frequency of registered diagnosis related do diabetes in the year of 2007. CONCLUSIONS: the adoption of an institutional program of glycemia monitorization improves the detection of hyper and hypoglycemia and glycemia control in hospitalized patients in regular care units.

Tooth movement activates the central amygdala and the lateral hypothalamus by the magnitude of the force applied.

OBJECTIVE: To determine if the magnitude of the force used to induce incisor tooth movement promotes distinct activation in cells in the central amygdala (CEA) and lateral hypothalamus (LH) of rats. Also, the effect of morphine on Fos immunoreactivity (Fos-IR) was investigated in these nuclei. MATERIALS AND METHODS: Adult male rats were anesthetized and divided into six groups: only anesthetized (control), without orthodontic appliance (OA), OA but without force, OA activated with 30g or 70g, OA with 70g in animals pretreated with morphine (2 mg/kg, intraperitoneal). Three hours after the onset of the experiment the rats were reanesthetized and perfused with 4% paraformaldehyde. The brains were removed and fixed, and sections containing CEA and LH were processed for Fos protein immunohistochemistry. RESULTS: The results show that in the control group, the intramuscular injection of a ketamine/ xylazine mixture did not induce Fos-IR cells in the CEA or in the LH. Again, the without force group showed a little Fos-IR. However, in the 70g group the Fos-IR was the biggest observed (P < .05, Tukey) in the CEA and LH compared with the other groups. In the 30g group, the Fos-IR did not differ from the control group, the without OA group, and the without force group. Furthermore, pretreatment with morphine in the 70g group reduced Fos-IR in these regions. CONCLUSIONS: Tooth movement promotes Fos-IR in the CEA and LH according to the magnitude of the force applied.

A importância da avaliação postural no paciente com disfunção da articulação temporomandibular / The importance of the postural evaluation in patients with temporomandibular joint dysfunction

O equilíbrio do corpo bem como os movimentos da cabeça são originados pelo posicionamento do crânio sobre a região cervical determinando assim a postura do indivíduo. Estando a articulação temporomandibular (ATM) diretamente relacionada com a região cervical e escapular através de um sistema neuromuscular comum, alterações posturais da coluna cervical podem acarretar em distúrbios na ATM e vice-versa. O número crescente de pacientes com disfunção da articulação temporomandibular (DTM) que apresentavam alterações posturais levou ao desenvolvimento de estudos que procuram demonstrar suas relações. Este trabalho propôs-se realizar uma revisão de literatura que demonstre a relação entre má postura e DTM. Salienta ainda a necessidade de uma equipe multidisciplinar, formada pelo médico ortopedista, o cirurgião dentista e o fisioterapeuta, para realizarem juntos o diagnóstico e o tratamento de tais alterações.

A utilização da toxina botulínica tipo A na dor e disfunção temporomandibular / Using type A botulinum toxin in pain and temporomandibular joint dysfunction

A terapia atual para a disfunção da articulação temporomandibular não é totalmente efetiva. Com o intuito de se solucionar este problema, a toxina botulínica tipo A foi introduzida como o mais novo método terapêutico para pacientes que sofrem desta doença. Este trabalho irá discutir as indicações, contra-indicações, técnica de aplicação e possíveis efeitos colaterais desta droga