OCEANIA: real-world study of ovarian cancer treatment patterns across multiple lines of therapy in Argentina and Brazil.

Aim: To evaluate real-world data on treatment patterns in Argentina and Brazil in patients with ovarian cancer. Methods: This study evaluated de-identified antineoplastic exposure data from a private healthcare provider in Argentina and health claims database (Orizon) in Brazil from 2010 to 2019 and 2015 to 2020, respectively. Results: Platinum-based chemotherapy was the most common first-line therapy (Argentina: n =311 [87.6%]; Brazil: n = 1142 [79.3%]). The proportion of patients receiving platinum-based chemotherapy declined across both populations from first- to second-line, while use of non-platinum-based, targeted, and hormone therapies increased. Duration of platinum-based treatment and time to next treatment decreased from first- to fourth-line. Conclusion: There is an unmet need for effective therapies that can prolong time to next treatment in ovarian cancer in Argentina and Brazil.

[Box: see text].

[Tuberculosis mortality trends and the correlation with the socio-demographic index in Brazil between 2010 and 2019]. / Tendência da mortalidade por tuberculose e relação com o índice sóciodemográfico no Brasil entre 2005-2019.

The scope of this article is to analyze the trend of the standardized mortality rate (SMR) for tuberculosis and its correlation with the developmental status in Brazil. An ecological time series study was conducted to analyze data of deaths from tuberculosis reported between 2005 and 2019 in all states. Data were extracted from the Mortality Information System, the Brazilian Institute of Geography and Statistics, and the Global Burden of Disease study. The temporal trend was analyzed using Prais-Winsten regression. Spearman's correlation analysis between SMR and Socio-Demographic Index (SDI) was also performed. From 2005 to 2019, 68,879 deaths from tuberculosis were recorded in Brazil. The average mortality rate was 2.3 deaths per 100,000 inhabitants. The decreasing trend of SMR due to tuberculosis was observed in Brazil and in all regions. There was a significant negative correlation between SDI and TMP. TMP due to tuberculosis revealed a decreasing trend in Brazil and in all regions. Most states showed a decreasing trend and none of them had an increasing trend. An inverse relationship was found between developmental status and mortality due to tuberculosis.

O objetivo do artigo é analisar a tendência da taxa de mortalidade padronizada (TMP) por tuberculose e sua correlação com o status de desenvolvimento no Brasil. Estudo ecológico de séries temporais que analisou dados de óbitos por tuberculose notificados entre 2005 e 2019 de todos os estados. Os dados foram extraídos do Sistema de Informação sobre Mortalidade, do Instituto Brasileiro de Geografia e Estatística e do estudo da Carga Global de Doenças. A tendência temporal foi analisada pela regressão de Prais-Winsten. A análise da correlação de Spearman entre a TMP e o índice sociodemográfico (socio-demographic index - SDI) também foi realizada. De 2005 a 2019, foram registrados 68.879 óbitos por tuberculose no Brasil. A taxa média de mortalidade foi de 2,3 óbitos por 100.000 habitantes. A tendência decrescente da TMP por tuberculose foi observada no Brasil e em todas as regiões. Verificou-se correlação negativa significativa entre o SDI e a TMP. A maioria dos estados apresentou tendência decrescente e nenhum deles teve tendência crescente. Uma relação inversa foi verificada entre o SDI e a mortalidade por tuberculose.

Tendência da mortalidade por tuberculose e relação com o índice sóciodemográfico no Brasil entre 2005-2019 / Tuberculosis mortality trends and the correlation with the socio-demographic index in Brazil between 2010 and 2019

Resumo O objetivo do artigo é analisar a tendência da taxa de mortalidade padronizada (TMP) por tuberculose e sua correlação com o status de desenvolvimento no Brasil. Estudo ecológico de séries temporais que analisou dados de óbitos por tuberculose notificados entre 2005 e 2019 de todos os estados. Os dados foram extraídos do Sistema de Informação sobre Mortalidade, do Instituto Brasileiro de Geografia e Estatística e do estudo da Carga Global de Doenças. A tendência temporal foi analisada pela regressão de Prais-Winsten. A análise da correlação de Spearman entre a TMP e o índice sociodemográfico (socio-demographic index - SDI) também foi realizada. De 2005 a 2019, foram registrados 68.879 óbitos por tuberculose no Brasil. A taxa média de mortalidade foi de 2,3 óbitos por 100.000 habitantes. A tendência decrescente da TMP por tuberculose foi observada no Brasil e em todas as regiões. Verificou-se correlação negativa significativa entre o SDI e a TMP. A maioria dos estados apresentou tendência decrescente e nenhum deles teve tendência crescente. Uma relação inversa foi verificada entre o SDI e a mortalidade por tuberculose.

Abstract The scope of this article is to analyze the trend of the standardized mortality rate (SMR) for tuberculosis and its correlation with the developmental status in Brazil. An ecological time series study was conducted to analyze data of deaths from tuberculosis reported between 2005 and 2019 in all states. Data were extracted from the Mortality Information System, the Brazilian Institute of Geography and Statistics, and the Global Burden of Disease study. The temporal trend was analyzed using Prais-Winsten regression. Spearman's correlation analysis between SMR and Socio-Demographic Index (SDI) was also performed. From 2005 to 2019, 68,879 deaths from tuberculosis were recorded in Brazil. The average mortality rate was 2.3 deaths per 100,000 inhabitants. The decreasing trend of SMR due to tuberculosis was observed in Brazil and in all regions. There was a significant negative correlation between SDI and TMP. TMP due to tuberculosis revealed a decreasing trend in Brazil and in all regions. Most states showed a decreasing trend and none of them had an increasing trend. An inverse relationship was found between developmental status and mortality due to tuberculosis.

Rescued Cats Prefer to Scratch Fabrics Commonly Used to Cover Upholstered Furniture.

Preference responses of cats for scratching fabrics commonly used on furniture were evaluated during four consecutive days in three Non-Governmental Organizations (NGOs) that rescue companion animals. Cats were grouped and their choices were registered at a group level (no individual identification). Daily choices for chenille, suede, synthetic leather, or waterproof grosgrain fabrics were evaluated for the cats' groups. A preference for chenille and non-preference for synthetic leather and waterproof grosgrain was found, independent of the NGO. In conclusion, although not using chenille does not assure that cats stop scratching furniture - especially if no other option to scratch is available - synthetic leather and waterproof grosgrain seem to be less attractive fabrics for these animals. Further studies are needed to investigate whether these findings apply to cats in a home scenario, when just one or a few individuals are usually present and only one type of fabric covering furniture is commonly available. Although we did not investigate the effect of providing scratching posts for these animals, we recommend such posts are available in the environment as scratching behavior is important to cats.

Effect of photobiomodulation combined with physical therapy on functional performance in children with myelomeningocele: A protocol randomized clinical blind study.

INTRODUCTION: Myelomeningocele is a severe type of spina bifida, resulting from improper closure of the neural tube. This condition drastically affects the structures of the spinal cord resulting in deficiencies. The combination of these deficiencies results in an overall decrease in mobility and functional participation amongst this population. Physiotherapy plays an essential role in rehabilitating people with MMC. The current literature shows that resources such as photobiomodulation (PBM) may support the rehabilitation of neurological conditions. The aim of the proposed study is to evaluate the effects of photobiomodulation (PBM) combined with physical therapy on functional performance in children with low lumbosacral myelomeningocele. MATERIALS AND METHODS: This is a protocol randomized clinical blind study, that will include 30 individuals of both sexes, aged between 5 to 8 years, diagnosed with low and sacral lumbar myelomeningocele and capable of performing the sit-to-stand task. The participants will be randomly assigned into two treatment groups: PBM + physiotherapeutic exercises and sham PBM + physiotherapeutic exercises. Irradiation will be carried out with light emitting diode (LED) at a wavelength of 850 nm, energy of 25 J per point, 50 seconds per point and a power of 200 mW. The same device will be used in the placebo group but will not emit light. Muscle activity will be assessed using a portable electromyograph (BTS Engineering) and the sit-to-stand task will be performed as a measure of functioning. Electrodes will be positioned on the lateral gastrocnemius, tibialis anterior and rectus femoris muscles. The Pediatric Evaluation of Disability Inventory will be used to assess functional independence. Quality of life will be assessed using the Child Health Questionnaire-Parent Form 50. Changes in participation will be assessed using the Participation and Environment Measure for Children and Youth. The data will be analyzed with the aid of GraphPad PRISM. DISCUSSION: The results of this study can contribute to a better understanding of the effectiveness of PBM on functioning and quality of life in children with myelomeningocele. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04425330.

Evaluation of leaching potential of tebuthiuron using bioindicator plants / Estudo da lixiviação do herbicida tebuthiuron com plantas bioindicadoras

The last destination of most herbicides used in agricultural systems is the soil. This is a dynamic interaction; herbicides can remain in the soil solution or be carried through the soil profile, reaching the water table. The objective of this work was to evaluate the leaching potential of the tebuthiuron herbicide using bioindicator plants grown in an Oxisol of sandy loam texture and in an Entisol of clay texture, after the occurrence of natural rainfall events. A complete randomized experimental design was used, in a 3×8 factorial arrangement, with four replications. The treatments consisted of three accumulated natural rainfall depths (30-40, 60-80, and 100-120 mm) and eight soil profile layers (0-3, 3-6, 6-9, 9-12, 12-15, 15-20, 20-25, and 25-30 cm). Soil samples were collected after the tebuthiuron herbicide application - 750 for clayey soil, and 600 g ha-1 for the sandy loam soil -and the rainfall events. PVC pipes with length of 30 cm and diameter of 15 cm were introduced into the soil profile for sampling. The pipes with soil columns were carefully removed by digging around them, to maintain the soil original integrity during collection and, subsequently, cut longitudinally for sowing the bioindicator species - cucumber (Cucumis sativus L.), and lettuce (Lactuca sativa L.). Then, the phytotoxicity in the bioindicator plants grown in these soils were evaluated at 5, 7, 10, and 12 days after sowing, using a grading scale of 0 to 100%. The mobility of the tebuthiuron herbicide was low in both soils, regardless of the rainfall depth, and the cucumber was the most suitable plant species to use as a bioindicator.(AU)

O solo é o destino final da maioria dos herbicidas utilizados no sistema agrícola e, sendo esta relação dinâmica, eles podem permanecer na solução ou ser carregados no perfil do solo, podendo atingir o lençol freático. O objetivo deste trabalho foi avaliar o potencial de lixiviação do herbicida tebuthiuron por meio de plantas bioindicadoras e após a ocorrência de precipitações pluviométricas naturais, em solos com texturas franco arenoso (Latossolo Vermelho-Amarelo) e argiloso (Neossolo Litólico). O delineamento experimental foi o inteiramente casualizado em um esquema fatorial 3 x 8 com quatro repetições, sendo três níveis de precipitação pluviométrica (30-40, 60-80 e 100-120 mm) e oito de profundidade do perfil do solo (0-3, 3-6, 6-9, 9-12, 12-15, 15-20, 20-25 e 25-30 cm). As coletas das amostras ocorreram após a aplicação do herbicida tebuthiuron nas doses de 750 e 600 g ha-1 para o solo argiloso e arenoso, respectivamente, e posterior acúmulo das precipitações. Para a coleta das amostras foram introduzidas, no perfil do solo, colunas de PVC com 30 cm de altura e 15 cm de diâmetro. As colunas foram retiradas cuidadosamente escavando-se ao seu redor, mantendo a integridade original do solo durante a coleta. Posteriormente, as colunas foram separadas com corte longitudinal, para a semeadura das espécies bioindicadoras pepino (Cucumis sativus L.) e alface (Lactuca sativa L.). Para as avaliações das plantas bioindicadoras nas colunas, adotou-se a escala de notas de 0 a 100% de fitotoxicidade, aos 5, 7, 10 e 12 dias após a semeadura. A mobilidade do herbicida tebuthiuron mostrou-se reduzida em ambos os tipos de solo estudado, independentemente da precipitação pluvial, e as plantas de pepino mostraram-se mais adequadas para serem utilizadas como espécie bioindicadora.(AU)

Herbicides selectivity in pre-budded seedlings of sugarcane / Seletividade de herbicidas em mudas pré-brotadas de cana-de-açúcar

Herbicides are expected to show selectivity towards cultivated plants, i.e., they ought to control weeds without jeopardizing the development and productivity of crops. The objective of this project was to evaluate the selectivity of herbicides applied in pre-planting of three sugar cane cultivars which were planted according to the system of pre-budded seedlings (PBS) under climatic natural conditions, between September and November of 2013. The experiment was set according to a completely random design with four replications. The treatments were distributed according to a factorial scheme of 3 × 8, in which factor A was the cultivar (CTC14, CTC7, and RB966928), and factor B was the herbicide (in g.ha-1): S-metolachlor (2,640), clomazone (1,000), sulfentrazone (800), diclosulam (200), metribuzin (1,920), diuron + hexazione (1,170 + 330), S-metolachlor + sulfentrazone (2,640 + 800), and a no treatment. The visual symptoms of intoxication were evaluated 14, 28, 35, 42, 49, 56, and 63 days after application (DAA), the height and number of tillers 14, 35, 49, 56, and 63 DAA, the dry weight of shoot (DWS), and the dry weight of root (DWR) 63 DAA. Under the conditions of the experiment, the herbicides S-metolachlor, clomazone, metribuzin, diuron + hexazinone, and S-metolachlor + sulfentrazone were selective towards the presprouted sugar-cane plantlets. Diclosulam was the less selective herbicide, followed by sulfentrazone. Cultivar CTC14 was visually the less tolerant to the herbicides diclosulam and sulfentrazone.(AU)

Os herbicidas devem apresentar seletividade às culturas agrícolas, ou seja, controlar as plantas daninhas sem comprometer o desenvolvimento nem a produtividade da cultura. O objetivo deste trabalho foi avaliar a seletividade de herbicidas aplicados em pré-plantio de três cultivares de cana-de-açúcar plantados pelo sistema de mudas pré-brotadas (MPB). O experimento foi desenvolvido na Usina São Martinho, próximo ao município de Pradópolis (SP), sob condições naturais de clima, no período de setembro a novembro de 2013. O delineamento experimental utilizado foi o inteiramente casualizado, com quatro repetições. Os tratamentos foram distribuídos em esquema fatorial (3 × 8), sendo o fator A composto de três cultivares: CTC14, CTC7 e RB966928; e o fator B por sete herbicidas (em g.ha-1): S-metolachlor (2,640); clomazone (1,000); sulfentrazone (800); diclosulam (200); metribuzin (1,920); diuron + hexazinone (1,170 + 330); S-metolachlor + sulfentrazone (2,640 + 800); mais uma testemunha sem aplicação de herbicidas. Foram avaliados os sintomas visuais de fitointoxicação aos 14, 28, 35, 42, 49, 56 e 63 dias após aplicação (DAA), a altura e o número de perfilhos dos cultivares aos 14, 35, 49 e 63 DAA, a massa seca da parte aérea (DWS) e a massa seca do sistema radicular (MSSR) aos 63 DAA. Nas condições em que o experimento foi conduzido, os herbicidas S-metolachlor, clomazone, metribuzin, diuron + hexazinone e S-metolachlor + sulfentrazone foram seletivos às mudas pré-brotadas de cana-de-açúcar. O herbicida diclosulam foi o menos seletivo, seguido do sulfentrazone. O cultivar CTC14 apresentou-se visualmente menos tolerante aos herbicidas diclosulam e sulfentrazone.(AU)

Herbicides selectivity in pre-budded seedlings of sugarcane / Seletividade de herbicidas em mudas pré-brotadas de cana-de-açúcar

Herbicides are expected to show selectivity towards cultivated plants, i.e., they ought to control weeds without jeopardizing the development and productivity of crops. The objective of this project was to evaluate the selectivity of herbicides applied in pre-planting of three sugar cane cultivars which were planted according to the system of pre-budded seedlings (PBS) under climatic natural conditions, between September and November of 2013. The experiment was set according to a completely random design with four replications. The treatments were distributed according to a factorial scheme of 3 × 8, in which factor A was the cultivar (CTC14, CTC7, and RB966928), and factor B was the herbicide (in g.ha-1): S-metolachlor (2,640), clomazone (1,000), sulfentrazone (800), diclosulam (200), metribuzin (1,920), diuron + hexazione (1,170 + 330), S-metolachlor + sulfentrazone (2,640 + 800), and a no treatment. The visual symptoms of intoxication were evaluated 14, 28, 35, 42, 49, 56, and 63 days after application (DAA), the height and number of tillers 14, 35, 49, 56, and 63 DAA, the dry weight of shoot (DWS), and the dry weight of root (DWR) 63 DAA. Under the conditions of the experiment, the herbicides S-metolachlor, clomazone, metribuzin, diuron + hexazinone, and S-metolachlor + sulfentrazone were selective towards the presprouted sugar-cane plantlets. Diclosulam was the less selective herbicide, followed by sulfentrazone. Cultivar CTC14 was visually the less tolerant to the herbicides diclosulam and sulfentrazone.

Os herbicidas devem apresentar seletividade às culturas agrícolas, ou seja, controlar as plantas daninhas sem comprometer o desenvolvimento nem a produtividade da cultura. O objetivo deste trabalho foi avaliar a seletividade de herbicidas aplicados em pré-plantio de três cultivares de cana-de-açúcar plantados pelo sistema de mudas pré-brotadas (MPB). O experimento foi desenvolvido na Usina São Martinho, próximo ao município de Pradópolis (SP), sob condições naturais de clima, no período de setembro a novembro de 2013. O delineamento experimental utilizado foi o inteiramente casualizado, com quatro repetições. Os tratamentos foram distribuídos em esquema fatorial (3 × 8), sendo o fator A composto de três cultivares: CTC14, CTC7 e RB966928; e o fator B por sete herbicidas (em g.ha-1): S-metolachlor (2,640); clomazone (1,000); sulfentrazone (800); diclosulam (200); metribuzin (1,920); diuron + hexazinone (1,170 + 330); S-metolachlor + sulfentrazone (2,640 + 800); mais uma testemunha sem aplicação de herbicidas. Foram avaliados os sintomas visuais de fitointoxicação aos 14, 28, 35, 42, 49, 56 e 63 dias após aplicação (DAA), a altura e o número de perfilhos dos cultivares aos 14, 35, 49 e 63 DAA, a massa seca da parte aérea (DWS) e a massa seca do sistema radicular (MSSR) aos 63 DAA. Nas condições em que o experimento foi conduzido, os herbicidas S-metolachlor, clomazone, metribuzin, diuron + hexazinone e S-metolachlor + sulfentrazone foram seletivos às mudas pré-brotadas de cana-de-açúcar. O herbicida diclosulam foi o menos seletivo, seguido do sulfentrazone. O cultivar CTC14 apresentou-se visualmente menos tolerante aos herbicidas diclosulam e sulfentrazone.

Estado cognitivo de escolares: diagnóstico na escola pública e privada / Children cognitive status: diagnosis in public and private school

Introdução: O teste Mini Mental adaptado para crianças avalia cinco principais áreas cognitivas, a saber: orientação, atenção, concentração, memória e linguagem, e resultados inferiores aos esperados servem para alertar a escola, a família e o pediatra da criança para a necessidade de uma avaliação mais completa. Objetivos: Verificar o diagnóstico para o estado cognitivo de crianças de ambos os sexos, oriundas de uma escola pública e outra privada do município de Itabuna/BA. Métodos: Participaram da pesquisa 73 escolares com idades compreendidas entre 6 e 9 anos. O exame ocorreu a partir de questionário validado para a língua portuguesa e elaborado para este fim específico. As crianças foram avaliadas individualmente e sem a influência de agentes externos. Ao final, todas as respostas foram somadas e o escore obtido foi confrontado com os valores de normalidade atribuídos segundo a idade. Resultados: Ser do sexo feminino e ter baixa escolaridade materna mostraram forte correlação para estado cognitivo deficiente. Houve maior prevalência de estado cognitivo não preservado entre as crianças oriundas de escolas públicas, para ambos os sexos. Os piores níveis de escolaridade materna estiveram presentes nas escolas públicas. A idade mais afetada foi a de 7 anos, independente da origem escolar. Conclusão: Pertencer ao sexo feminino, possuir 7 anos e apresentar baixa escolaridade materna estiveram associados a maior risco para ocorrência de estado cognitivo deficiente. (AU)

Background: The Mini Mental test adapted for children assesses five cognitive key areas, namely: orientation, attention, concentration, memory and language and outputs lower than expected alert the school, the family and the child's pediatrician to the need for more complete evaluation. Objectives: To verify the diagnosis for cognitive status of children of both sexes, coming from a public and a private school in the city of Itabuna/BA. Methods: 73 students 6 to 9 years old participated. The examination took place through a questionnaire validated for the Portuguese language and designed for this specific purpose. Children were assessed individually and without the influence of external agents. At the end, all the answers were summed and the score was compared with normal values assigned according to age. Results: Being female and having low maternal education showed strong correlation to poor cognitive status. There was a higher prevalence of cognitive state not preserved between children from public schools, for both sexes. The worst maternal education levels were present in public schools. The most affected age was 7 years old, regardless of school origin. Conclusion: Being a female, being 7 years old with low maternal education were associated with greater risk for poor cognitive status. (AU)

Ingestão de energia e de nutrientes e baixo peso ao nascer: estudo de coorte com gestantes adolescentes / Energy and nutrient intakes and low birth weight: cohort study with pregnant adolescents

OBJETIVO: Avaliar a ingestão de energia, de macro e de micronutrientes por adolescentes no primeiro e no segundo trimestres de gestação e estimar sua associação com o peso do concepto ao nascer. MÉTODOS: Estudo longitudinal, incluindo 139 gestantes adolescentes atendidas em serviço de pré-natal de maternidade pública, acompanhadas desde o primeiro trimestre gestacional até o puerpério imediato. Aplicou-se um questionário de frequência de consumo alimentar no primeiro e no segundo trimestres de gestação. O peso e a idade gestacional ao nascer dos recém-nascidos foram coletados dos prontuários hospitalares. Foram estimados médias e intervalo de confiança de 95%. O método dos resíduos foi utilizado para ajustar o consumo de nutrientes pelo consumo energético total. Modelos de regressão linear múltipla foram desenvolvidos para identificar os fatores associados ao peso ao nascer. RESULTADOS: O consumo médio de proteínas (p=0,02), lipídeos (p=0,02), ácidos graxos saturados (p=0,02) e monoinsaturados (p=0,05), colesterol (p=0,01), cálcio (p<0,01), potássio (p=0,01) e fósforo (p<0,01) foi mais elevado entre gestantes que tiveram filhos com peso ao nascer acima de 2500g. Idade gestacional ao parto (β=105,8; p<0,01), número de consultas de pré-natal (β=34,1; p=0,04), consumo de ácidos graxos poli-insaturados (β=7,5; p=0,04) e de ômega-3 (β=74,3; p=0,05) e de colesterol (β=0,4; p=0,04) foram variáveis preditoras do peso ao nascer em modelos de regressão linear múltipla. CONCLUSÃO: O perfil lipídico da dieta da mãe foi o principal preditor do peso do concepto ao nascer, e os resultados sugerem que o acompanhamento nutricional deva ser incluído na rotina dos serviços de atenção pré-natal...

OBJECTIVE: This study assessed energy, macronutrient, and micronutrient intakes of adolescents in the first and second trimesters of pregnancy and investigated their association with the infant's birth weight. METHODS: This longitudinal study included 139 pregnant adolescents seen at the prenatal care clinic of a public maternity hospital. They were followed from the first trimester of pregnancy until hospital discharge after delivery. The participants answered a food frequency questionnaire in the first and second trimesters of pregnancy. Birth weight and gestational age were collected from the mothers' hospital records. The means and 95% confidence intervals were calculated. The residual method was used for adjusting nutrient intake according to total energy intake. The factors associated with birth weight were identified by multiple linear regression models. RESULTS: The mothers of infants with birth weight higher than 2500 grams had higher mean intakes of protein (p=0.02), lipids (p=0.02), saturated fatty acids (p=0.02) monounsaturated fatty acids (p=0.05), cholesterol (p=0.01), calcium (p<0.01), potassium (p=0.01), and phosphorus (p<0.01). According to the multiple linear regression models, gestational age at delivery (β=105.8; p<0.01), number of prenatal care visits (β=34.1; p=0.04), intake of polyunsaturated fatty acids (β=7.5; p=0.04), intake of omega-3 fatty acids (β=74.3; p=0.05), and cholesterol intake (β=0.4; p=0.04) were predictors of birth weight. CONCLUSION: The mother's dietary lipid profile was the main predictor of the infant's birth weight and the results suggest that nutritional follow-up should be included in the prenatal care routine...

Vitamin A concentration in mature human milk.

OBJECTIVE: To quantify vitamin A levels in mature milk of 196 nursing women who were treated at the Maternity School of Rio de Janeiro and to evaluate its correlation with sociodemographic variables and degree of nutrition knowledge. METHODS: To quantify retinol concentrations, 10 mL of mature milk were collected by manual expression of one breast, 2 hours after the last feed, in the morning period. Values below 1.05 µmol/L and 2.3 µmol/L were considered inadequate to meet satisfactory intake and to constitute vitamin A liver reserve, respectively. The following variables were also assessed: sex, age, familiar income, maternal education, basic sanitation conditions, number of people in the household, maternal age, prenatal care, and degree of nutrition knowledge. RESULTS: Among the 196 lactating mothers analyzed, the average vitamin A concentration observed in mature milk was 1.76±0.85 µmol/L and prevalence of vitamin A deficiency was observed in 20.5% mothers. There was no significant difference between vitamin A levels in maternal milk and the variables socioeconomic status and nutrition knowledge. Only 38.9% of lactating women presented enough vitamin A concentrations in milk for the infants' liver reserves (2.3 µmol/L). CONCLUSIONS: These findings reveal high prevalence of inadequate vitamin A nutritional status of mothers and infants, consistent with the national prevalence reported in women of childbearing age and Brazilian children, and that the intervention measures to fight this shortage should be extended to all pregnant and postpartum women, regardless of sociodemographic conditions and degree of nutrition knowledge, in order to improve the health of mother and child.

Concentração de vitamina A no leite humano maduro / Vitamin A concentration in mature human milk

OBJETIVO: Quantificar a concentração de vitamina A no leite maduro de nutrizes assistidas em maternidade pública no município do Rio de Janeiro e avaliar a sua relação com variáveis sociodemográficas e grau de conhecimento de nutrição. MÉTODOS: Para a quantificação do retinol, foram coletadas amostras de 10 mL de leite maduro. Os pontos de corte adotados para identificação da deficiência de vitamina A e constituição de reserva hepática foram de < 1,05 µmol/L e > 2,3 µmol/L, respectivamente. Foram avaliadas, ainda, as variáveis: grau de conhecimento de nutrição, sexo, idade, renda familiar, escolaridade, condições de saneamento básico, número de moradores na residência, idade materna e assistência pré-natal. Resultados: Participaram do estudo 196 nutrizes, com concentração média de vitamina A no leite maduro de 1,76±0,85 µmol/L e prevalência de 20,5% de deficiência de vitamina A. Não houve diferença na concentração de vitamina A no leite das nutrizes segundo as variáveis sociodemográficas e conhecimento de nutrição. Apenas 38,9% das nutrizes apresentavam concentração de vitamina A no leite suficiente para constituição de reserva hepática dos lactentes. RESULTADOS: Participaram do estudo 196 nutrizes, com concentração média de vitamina A no leite maduro de 1,76±0,85 µmol/L e prevalência de 20,5% de deficiência de vitamina A. Não houve diferença na concentração de vitamina A no leite das nutrizes segundo as variáveis sociodemográficas e conhecimento de nutrição. Apenas 38,9% das nutrizes apresentavam concentração de vitamina A no leite suficiente para constituição de reserva hepática dos lactentes. CONCLUSÕES: Os achados aqui apresentados revelam alta prevalência de inadequação do estado nutricional de vitamina A materno e do lactente, concordante com a prevalência nacional descrita em mulheres em idade fértil e crianças brasileiras, e que as medidas de intervenção para combate à carência devem ser estendidas a todas as gestantes e puérperas, independentemente das condições sociodemográficas e do grau de conhecimento de nutrição, visando melhorar a saúde do binômio mãe/filho.

OBJECTIVE: To quantify vitamin A levels in mature milk of 196 nursing women who were treated at the Maternity School of Rio de Janeiro and to evaluate its correlation with sociodemographic variables and degree of nutrition knowledge. METHODS: To quantify retinol concentrations, 10 mL of mature milk were collected by manual expression of one breast, 2 hours after the last feed, in the morning period. Values below 1.05 µmol/L and 2.3 µmol/L were considered inadequate to meet satisfactory intake and to constitute vitamin A liver reserve, respectively. The following variables were also assessed: sex, age, familiar income, maternal education, basic sanitation conditions, number of people in the household, maternal age, prenatal care, and degree of nutrition knowledge. RESULTS: Among the 196 lactating mothers analyzed, the average vitamin A concentration observed in mature milk was 1.76±0.85 µmol/L and prevalence of vitamin A deficiency was observed in 20.5% mothers. There was no significant difference between vitamin A levels in maternal milk and the variables socioeconomic status and nutrition knowledge. Only 38.9% of lactating women presented enough vitamin A concentrations in milk for the infants' liver reserves (2.3 µmol/L). CONCLUSIONS: These findings reveal high prevalence of inadequate vitamin A nutritional status of mothers and infants, consistent with the national prevalence reported in women of childbearing age and Brazilian children, and that the intervention measures to fight this shortage should be extended to all pregnant and postpartum women, regardless of sociodemographic conditions and degree of nutrition knowledge, in order to improve the health of mother and child.

The growth of Monoraphidium sp. and Scenedesmus sp. cells in the presence of thorium.

Toxicity of thorium by Monoraphidium sp. and Scenedesmus sp. was studied. Microalgal cultures were inoculated in ASM-1 medium in presence and absence of thorium. Its effect was monitored by direct counting on Fuchs-Rosenthal chamber and with software. The toxicity of thorium over the species was observed for concentrations over 50.0 mg/L. After 30 days, Monoraphidium cells decreased their concentration from 4.23 × 10(6) to 4.27 × 10(5) and 8.57 × 10(5) cells/mL, in the presence of 50.0 and 100.0 mg/L of thorium, respectively. Scenedesmus sp. cells were more resistant to thorium: for an initial cell concentration of 7.65 × 10(4) cells/mL it was observed a change to 5.25 × 10(5) and 5.12 × 10(5) cells/mL, in the presence of thorium at 50.0 and 100.0 mg/L, respectively. This is an indication that low concentrations of the radionuclide favored the growth, and that Scenedesmus cells are more resistant to thorium than Monoraphidium cells. The software used for comparison with direct count method proved to be useful for the improvement of accuracy of the results obtained, a decrease in the uncertainty and allowed recording of the data. The presence of thorium suggests that low concentrations have a positive effect on the growth, due to the presence of the nitrate, indicating its potential for ecotoxicological studies.

Sobrepeso e obesidade pré-gestacionais: prevalência e desfechos associados à gestação / Pregestational overweight and obesity: prevalence and outcome associated with pregnancy

OBJETIVO: Descrever o resultado obstétrico de mulheres com sobrepeso/obesidade atendidas no serviço de pré-natal de uma maternidade pública no Rio de Janeiro. MÉTODOS: Estudo do tipo descritivo transversal, tendo sido incluídas 433 puérperas (³20 anos, sem enfermidades crônicas) e seus respectivos recém-nascidos atendidos em maternidade pública do Rio de Janeiro. As informações foram coletadas em prontuários e por meio de entrevistas. As características maternas e dos recém-nascidos avaliadas foram agrupadas em maternas (hábitos sociais, antropométricas, da assistência pré-natal, clínicas e obstétricas) e dos recém-nascidos (condições ao nascer). A avaliação da razão de chance entre as categorias de estado nutricional os desfechos gestacionais se deu por meio da odds ratio (OR), com intervalos de confiança (IC) de 95 por cento. RESULTADOS: A prevalência de sobrepeso/obesidade nesta casuística foi de 24,5 por cento (n=106). Observou-se uma associação entre ganho de peso inadequado e a frequência de sobrepeso/obesidade (OR 2,7; IC95 por cento 1,5-4,9; p<0,05). As mulheres com sobrepeso/obesidade apresentaram maior risco para pré-eclâmpsia (OR 3,3; IC95 por cento 1,1-9,9; p=0,03). Quanto às condições ao nascimento, verificou-se peso médio ao nascer de 3291,3 g (±455,2), sendo as taxas de baixo peso de 4,7 por cento (n=5) e macrossomia de 2,8 por cento (n=3). CONCLUSÕES: Observou-se uma prevalência alarmante de inadequação do estado nutricional pré e gestacional, que pode associar-se ao maior risco de morbimortalidade perinatal. Com isso, sugere-se a necessidade de monitoramento nutricional dessas gestantes.

PURPOSE: To describe the obstetric outcome of women with overweight/obesity treated at the prenatal care clinic of a public maternity hospital in Rio de Janeiro. METHODS: A descriptive cross-sectional study which investigated 433 women (³20 years-old, without any chronic diseases) and their newborns treated at public hospitals in Rio de Janeiro. Information was collected from medical records and through interviews. The characteristics of mothers and newborns evaluated were divided into maternal (social habits, anthropometric measurements and clinical, obstetric, and prenatal care) and newborn groups (birth conditions). Data regarding the categories of nutritional status were analyzed using the odds ratio (OR) and 95 percent confidence interval (CI). RESULTS: The prevalence of overweight/obesity in this sample was 24.5 percent (n=106). There was an association between inadequate weight gain and the prevalence of overweight/obesity (OR 2.7, 95 percentCI 1.5-4.9, p<0.05). Overweight/obese women had an increased risk for preeclampsia (OR 3.3, 95 percentCI 1.1--9.9, p=0.03). Regarding birth conditions, mean birth weight was 3291.3 g (±455.2), with rates of low birth weight of 4.7 percent (n=5) and rates of macrosomia of 2.8 percent (n=3). CONCLUSIONS: There was an alarming prevalence of inadequate nutritional status before and during pregnancy, which may be associated with increased risk of perinatal morbidity and mortality. This suggests the need for nutritional monitoring of these pregnant women.

[Pregestational overweight and obesity: prevalence and outcome associated with pregnancy]. / Sobrepeso e obesidade pré-gestacionais: prevalência e desfechos associados à gestação.

PURPOSE: To describe the obstetric outcome of women with overweight/obesity treated at the prenatal care clinic of a public maternity hospital in Rio de Janeiro. METHODS: A descriptive cross-sectional study which investigated 433 women (≥20 years-old, without any chronic diseases) and their newborns treated at public hospitals in Rio de Janeiro. Information was collected from medical records and through interviews. The characteristics of mothers and newborns evaluated were divided into maternal (social habits, anthropometric measurements and clinical, obstetric, and prenatal care) and newborn groups (birth conditions). Data regarding the categories of nutritional status were analyzed using the odds ratio (OR) and 95% confidence interval (CI). RESULTS: The prevalence of overweight/obesity in this sample was 24.5% (n=106). There was an association between inadequate weight gain and the prevalence of overweight/obesity (OR 2.7, 95%CI 1.5-4.9, p<0.05). Overweight/obese women had an increased risk for preeclampsia (OR 3.3, 95%CI 1.1--9.9, p=0.03). Regarding birth conditions, mean birth weight was 3291.3 g (±455.2), with rates of low birth weight of 4.7% (n=5) and rates of macrosomia of 2.8% (n=3). CONCLUSIONS: There was an alarming prevalence of inadequate nutritional status before and during pregnancy, which may be associated with increased risk of perinatal morbidity and mortality. This suggests the need for nutritional monitoring of these pregnant women.

Exfoliative cytology of the oral mucosa: comparison of two collection methods.

This study compared the sampling efficacy of a cytobrush and metal spatula for exfoliative cytology of the oral mucosa. Thirty students with no detectable oral alterations upon clinical examination were submitted to exfoliative cytology of the lateral border of the tongue, using a metal spatula on the left side and a cytobrush on the right side. The smears were stained using the Papanicolaou technique and evaluated for cellularity, cell type, cell distribution, homogeneity, and cellular distortion, as well as the presence of mucus, inflammatory infiltrate, and hemorrhage. A statistical test (Z-test) with a 95% confidence interval (CI) showed a significant difference between the metal spatula and cytobrush in terms of cellularity (p = 0.02) and homogeneity (p = 0.01). No difference between the two methods was observed regarding cell type (p = 0.4, Z-test) or cell distribution for the 95% confidence interval (p = 0.2, Fisher's test). Cell distortion and the presence of mucus were observed in five cases that used the metal spatula and in two cases that used the cytobrush. No hemorrhage or inflammatory infiltrate was detected in any of the slides. Based on the results of this study, the cytobrush produced qualitatively better smears in terms of cellularity and homogeneity compared to the metal spatula.

Revisão da literatura sobre recomendações de utilização de edulcorantes em gestantes portadoras de diabetes mellitus / Literature Review about recommendations of use of sweeteners in pregnant women with diabetes mellitus

Trata-se de uma revisão narrativa do conhecimento disponível na literatura sobre a recomendação de edulcorantes nos casos de diabetes na gestação, com consulta às seguintes bases de dados: Medline, Lilacs e PubMed, tendo como base os períodos de 1978 a 2009. Os edulcorantes são classificados em nutritivos e não-nutritivos. Atualmente, o aspartame é alvo de várias críticas, porém a American Diabetes Association (ADA), revisando as evidências científicas acerca da inocuidade do aspartame, declara que o edulcorante não é carcinogênico e não está associado a desordens neurológicas. Quanto à sacarina, alguns autores recomendam restrição do consumo desta por gestantes, devido à falta de informações conclusivas sobre possíveis efeitos no desenvolvimento fetal, além das poucas evidências sobre seu efeito transplacentário e transmamário. A ADA não recomenda o uso do esteviosidio como edulcorante. Os edulcorantes não-calóricos atualmente aprovados para uso pela população em geral, incluindo as gestantes são: aspartame, acesulfame-K, sacarina, sucralose e neotame. Na orientação dietética, deve-se considerar a quantidade permitida por dia e esclarecer à cliente sobre a importância de controlar a dose utilizada, além de revisar periodicamente os tipos de edulcorantes presentes nos adoçantes e produtos dietéticos disponíveis no mercado.

The present narrative review article accounts for the available knowledge about the recommended use of sweeteners in cases of gestational diabetes, according to the Medline, Lilacs and PubMed databases from 1978 to 2009. Sweeteners are classified as nutritive and non-nutritive. Currently, aspartame is being strongly criticised despite the American Diabetes Association (ADA) having stated that it is not carcinogenic nor associated with neurological disorders. As for saccharin, some authors recommend a restricted intake by pregnant women due to the lack of conclusive information about its possible effects on fetal development, and to the little evidence of its transplacental and transmammary effects. The ADA does not recommend the use of stevioside as a sweetener. The approved low-calorie sweeteners for all population, including pregnant women, are aspartame, acesulfame-K, saccharin, sucralose and neotame. During diet orientation, the allowed daily intake should be considered, the importance of controlling the dose should be explained to the patient, and the sweeteners used in diet products available in the market should be frequently revised.

Repercussões da equoterapia nas relações socioafetivas da criança com atraso de desenvolvimento por prematuridade

A pesquisa tem como objeto de estudo famílias com crianças com atraso de desenvolvimento neuropsicomotor devido à prematuridade e que estão em atendimento interdisciplinar em equoterapia, abordagem terapêutica que tem como recurso primordial o cavalo e seu ambiente. Ela foi realizada com duas crianças do Núcleo de Equoterapia do Caxangá Golf & Country Club, suas respectivas famílias e profissionais que acompanham as crianças na equoterapia. Os instrumentos utilizados constaram de observação das crianças nas sessões; entrevista com terapeutas da instituição, com os pais e, quando necessário, outros “cuidadores”. Foi constatada a importância do vínculo da criança com o animal para sua maior participação na terapia e para o investimento familiar, e como este interfere positivamente no andamento da terapia; a importância da interação entre a criança, a equipe e outros praticantes no processo de socialização; a adequação dos estímulos do ambiente equoterápico pela equipe interdisciplinar, bem como as trocas entre ela e a família; o conhecimento da história da criança para compreensão de seu comportamento e eventos familiares; a importância do feedback da criança quanto ao seu desenvolvimento para o sistema familiar permanecer investindo e acreditando. Percebeu-se melhora da criança no aspecto socioafetivo, facilitando e sendo facilitado pelas relações familiares. Portanto, através da pesquisa puderam ser compreendidas as repercussões da equoterapia, bem como seus elementos intervenientes no desenvolvimento socioafetivo da criança com retardo neuropsicomotor por prematuridade (AU)