Ketogenic diet in pharmacoresistant epilepsies: a clinical nutritional assessment.

BACKGROUND: Epilepsies are among the most prevalent chronic neurological diseases, usually beginning in childhood. About 30% of children with epilepsies develop seizures that are difficult to control with medication. Recurrent epileptic seizures hinder diet intake, impairing the nutritional status. Although non-pharmacological interventions (e.g., ketogenic diet therapy) can improve epileptic seizure frequency, few studies analyzed their impact on the nutritional status of children and adolescents with epilepsies. OBJECTIVE: The aim was to evaluate the effects of a ketogenic diet on the nutritional status and clinical course of patients with pharmacoresistant epilepsies. METHODS: This cross-sectional study included patients under 18 years of age followed up at the Ketogenic Diet Ambulatory Clinic of the Instituto de Medicina Integral Prof. Fernando Figueira between December 2015 and December 2021. Socioeconomic, clinical, nutritional, and laboratory data were collected from medical records at different time points during the ketogenic diet. RESULTS: The sample comprised 49 patients aged between 5 months and 17 years (median = 4.4 years), mostly male (62.1%), and from Recife and the metropolitan region (51%). Underweight patients (BMI-for-age) improved their nutritional status in six months. However, patients who were normal weight and overweight maintained their nutritional status. Dyslipidemia was a common and short-term adverse effect. Moreover, the treatment decreased epileptic seizure frequency and antiseizure medication intake. CONCLUSION: The ketogenic diet prevented malnutrition from worsening and reduced epileptic seizures and antiseizure medication intake.

ANTECEDENTES: A epilepsia, uma das doenças neurológicas crônicas mais prevalentes, tem geralmente início na infância. Cerca de 30% das crianças com epilepsia desenvolvem crises de difícil controle medicamentoso. As crises epilépticas recorrentes dificultam a ingestão alimentar, prejudicando o estado nutricional. Intervenções não farmacológicas, como a terapia com dieta cetogênica, podem melhorar a frequência das crises epilépticas, mas existem poucos estudos sobre a repercussão no estado nutricional da criança/adolescente. OBJETIVO: Avaliar o efeito da terapia cetogênica sobre o estado nutricional e a evolução clínica da epilepsia fármaco-resistente. MéTODOS: Estudo tipo corte transversal envolvendo menores de 18 anos acompanhados no Ambulatório de Dieta Cetogênica do Instituto de Medicina Integral Prof. Fernando Figueira entre dezembro de 2015 e dezembro de 2021. Dados socioeconômicos, clínicos, nutricionais e laboratoriais foram coletados nos prontuários dos pacientes em vários momentos da terapia cetogênica. RESULTADOS: A amostra foi composta por 49 pacientes com idades entre cinco meses e 17 anos (mediana = 4,4 anos), a maioria do sexo masculino (62,1%) e procedentes de Recife e região metropolitana (51%). Pacientes com baixo peso (de acordo com o IMC para idade) melhoraram seu estado nutricional em seis meses. No entanto, os pacientes com peso adequado e com sobrepeso mantiveram seu estado nutricional. A dislipidemia foi um efeito adverso frequente e de curta duração. Além disso, o tratamento reduziu a frequência de crises epilépticas e a dose de fármacos anticrises. CONCLUSãO: A dieta cetogênica preveniu o agravamento da desnutrição e reduziu as crises epilépticas e a dosagem de fármacos anticrises.

Ketogenic diet in pharmacoresistant epilepsies: a clinical nutritional assessment / Dieta cetogênica na epilepsia fármaco-resistente: avaliação clínica-nutricional

Abstract Background Epilepsies are among the most prevalent chronic neurological diseases, usually beginning in childhood. About 30% of children with epilepsies develop seizures that are difficult to control with medication. Recurrent epileptic seizures hinder diet intake, impairing the nutritional status. Although non-pharmacological interventions (e.g., ketogenic diet therapy) can improve epileptic seizure frequency, few studies analyzed their impact on the nutritional status of children and adolescents with epilepsies. Objective The aim was to evaluate the effects of a ketogenic diet on the nutritional status and clinical course of patients with pharmacoresistant epilepsies. Methods This cross-sectional study included patients under 18 years of age followed up at the Ketogenic Diet Ambulatory Clinic of the Instituto de Medicina Integral Prof. Fernando Figueira between December 2015 and December 2021. Socioeconomic, clinical, nutritional, and laboratory data were collected from medical records at different time points during the ketogenic diet. Results The sample comprised 49 patients aged between 5 months and 17 years (median = 4.4 years), mostly male (62.1%), and from Recife and the metropolitan region (51%). Underweight patients (BMI-for-age) improved their nutritional status in six months. However, patients who were normal weight and overweight maintained their nutritional status. Dyslipidemia was a common and short-term adverse effect. Moreover, the treatment decreased epileptic seizure frequency and antiseizure medication intake. Conclusion The ketogenic diet prevented malnutrition from worsening and reduced epileptic seizures and antiseizure medication intake.

Resumo Antecedentes A epilepsia, uma das doenças neurológicas crônicas mais prevalentes, tem geralmente início na infância. Cerca de 30% das crianças com epilepsia desenvolvem crises de difícil controle medicamentoso. As crises epilépticas recorrentes dificultam a ingestão alimentar, prejudicando o estado nutricional. Intervenções não farmacológicas, como a terapia com dieta cetogênica, podem melhorar a frequência das crises epilépticas, mas existem poucos estudos sobre a repercussão no estado nutricional da criança/adolescente. Objetivo Avaliar o efeito da terapia cetogênica sobre o estado nutricional e a evolução clínica da epilepsia fármaco-resistente. Métodos Estudo tipo corte transversal envolvendo menores de 18 anos acompanhados no Ambulatório de Dieta Cetogênica do Instituto de Medicina Integral Prof. Fernando Figueira entre dezembro de 2015 e dezembro de 2021. Dados socioeconômicos, clínicos, nutricionais e laboratoriais foram coletados nos prontuários dos pacientes em vários momentos da terapia cetogênica. Resultados A amostra foi composta por 49 pacientes com idades entre cinco meses e 17 anos (mediana = 4,4 anos), a maioria do sexo masculino (62,1%) e procedentes de Recife e região metropolitana (51%). Pacientes com baixo peso (de acordo com o IMC para idade) melhoraram seu estado nutricional em seis meses. No entanto, os pacientes com peso adequado e com sobrepeso mantiveram seu estado nutricional. A dislipidemia foi um efeito adverso frequente e de curta duração. Além disso, o tratamento reduziu a frequência de crises epilépticas e a dose de fármacos anticrises. Conclusão A dieta cetogênica preveniu o agravamento da desnutrição e reduziu as crises epilépticas e a dosagem de fármacos anticrises.

Sociohistorical Analysis of Normative Standards of Masculinity in the Pandemic of COVID-19: Impacts on Men's Health/Mental Health.

Objective: This study aims to analyze sociohistorically how the normative patterns of hegemonic masculinity produced impacts on men's health/mental health in the context of the COVID-19 pandemic. Methods: A qualitative study from a socio-historical perspective was conducted with 50 men based on an online survey. A semistructured form was applied. The data were analyzed by the Collective Subject Discourse method, interpreted in the light of the context of epidemic disease and hegemonic masculinity. Results: The experience of the pandemic exposed the normative patterns of masculinities from the consummation of acts representative of the pandemic context, which incited men to deny the existence of COVID-19 disease and to delay the understanding and adoption of measures to protect and control COVID-19. As a repercussion, men presented conflicts in the regulation of emotions; presented emotional suppression; were more reactive; felt threatened regarding the loss of the role of family provider, virility; and revealed a sense of invulnerability, added to the weakening of self-care. Conclusion: The discourse revealed that the men's behaviors are consistent with the characteristics of hegemonic masculinity, but express signs of recognition that this behavior causes harm to themselves and their health.

Nursing care for bed bath in patients with COVID-19: an integrative review / Cuidados de enfermería para baños en cama en pacientes con COVID-19: revisión integrativa / Cuidados de enfermagem para banho no leito em pacientes com Covid-19: revisão integrativa

ABSTRACT Objective: to identify the main nursing care procedures for performing bed bath in patients with COVID-19. Method: an integrative literature review. Five stages were followed for this research: research question elaboration (identification of the problem), search of studies in literature, study assessment, data analysis, and presentation of review. To search for primary studies, the VHL and SciELO databases were selected. Results: initially, 55 publications were found. After reading and analyzing the abstracts, the sample consisted of 15 studies. Conclusion: patients with the new coronavirus have specific care to perform a bed bath, oral, intimate and skin hygiene. It is important that professionals use adequate personal protective equipment, perform humanized care, continuously observing patients' vital signs to avoid occurrence of adverse events, promoting patient safety.

RESUMEN Objetivo: identificar los principales procedimientos asistenciales de enfermería para realizar un baño en cama en pacientes con COVID-19. Método: revisión integradora de la literatura. Se siguieron cinco etapas para esta investigación: elaboración de la pregunta de investigación (identificación del problema), búsqueda de estudios en la literatura, evaluación de estudios, análisis de datos y presentación de la revisión. Para la búsqueda de estudios primarios, se seleccionaron las bases de datos BVS y SciELO. Resultados: inicialmente se encontraron 55 publicaciones. Después de leer y analizar los resúmenes, la muestra estuvo formada por 15 estudios. Conclusión: los pacientes con el nuevo coronavirus tienen cuidados específicos para realizar un baño en la cama, higiene bucal, íntima y cutánea. Es importante que los profesionales utilicen equipos de protección personal adecuados, realicen cuidados humanizados, observando continuamente los signos vitales de los pacientes para evitar la ocurrencia de eventos adversos, promoviendo la seguridad del paciente.

RESUMO Objetivo: identificar os principais cuidados de enfermagem para a realização do banho no leito em pacientes com COVID-19. Método: revisão integrativa da literatura. Percorreram-se cinco etapas para esta pesquisa: elaboração da questão de pesquisa (identificação do problema), busca dos estudos na literatura, avaliação dos estudos, análise dos dados e apresentação da revisão. Para a busca dos estudos primários, selecionaram-se as bases de dados BVS e SciELO. Resultados: inicialmente, foram encontradas 55 publicações. Após leitura e análise dos resumos, a amostra foi composta por 15 estudos. Conclusão: pacientes com o novo coronavírus têm cuidados específicos para a realização do banho no leito, higiene bucal, íntima e com a pele. É importante que os profissionais utilizem Equipamento de Proteção Individual adequado, executem um cuidado humanizado, observando, continuamente, os sinais vitais dos pacientes para evitar a ocorrência de eventos adversos, promovendo a segurança do paciente.

Nursing care for bed bath in patients with COVID-19: an integrative review.

OBJECTIVE: to identify the main nursing care procedures for performing bed bath in patients with COVID-19. METHOD: an integrative literature review. Five stages were followed for this research: research question elaboration (identification of the problem), search of studies in literature, study assessment, data analysis, and presentation of review. To search for primary studies, the VHL and SciELO databases were selected. RESULTS: initially, 55 publications were found. After reading and analyzing the abstracts, the sample consisted of 15 studies. CONCLUSION: patients with the new coronavirus have specific care to perform a bed bath, oral, intimate and skin hygiene. It is important that professionals use adequate personal protective equipment, perform humanized care, continuously observing patients' vital signs to avoid occurrence of adverse events, promoting patient safety.

Comparison of weight estimation methods in hospitalized Brazilian children and adolescents / Comparación de métodos de estimación del peso en niños y adolescentes brasileños hospitalizados

NTRODUCTION: in emergencies or in situations involving critically ill patients, an accurate calculation of body weight is essential to ensure adequate medical care. Generally, simple techniques are used to determine weight. AIM: to evaluate the weight estimation methods Advanced Paediatric Life Support (APLS) Update, Luscombe and Owens, Best Guess, and the Broselow tape, comparing measured weight with the weight estimated by each method in hospitalized Brazilian children and adolescents. METHODS: an observational study in which anthropometric data were collected from patients of 0-14 years of age between August 2016 and January 2017. The paired t-test was used to compare the patients' measured weight with their estimated weight. The accuracy of each method was analyzed using Bland-Altman plots and Lin's concordance correlation coefficient. RESULTS: the sample consisted of 446 patients. Most of the patients were male (58.1%), of 1-5 years of age (43%) and well nourished (85%). For those under 12 months of age, the APLS Update and Best Guess methods performed best, with the difference in means of measured weight and estimated weight being 0.4 kg (p = 0.183) and -0.2 kg (p = 0.140), respectively. In the 1-5 years of age group only the APLS Update yielded satisfactory results (0.2 kg; p = 0.200). The best agreement with measured weight, according to the Bland-Altman plots and Lin's coefficient, was found for the Broselow tape (CC = 0.96). CONCLUSION: of the estimation methods evaluated the Broselow tape was the most accurate one. Further studies are required to adapt this method for use in the Brazilian population, thus ensuring its appropriate application in this country

INTRODUCCIÓN: en las emergencias o en las situaciones que involucran a pacientes críticamente enfermos, el cálculo preciso del peso corporal es esencial para garantizar una atención médica adecuada. En general se utilizan técnicas simples para determinar el peso. OBJETIVO: evaluar los métodos de estimación del peso Advanced Paediatric Life Support (APLS) Update, Luscombe y Owens, Best Guess y la cinta Broselow, comparando el peso medido con el peso estimado por cada método en los pacientes hospitalizados. MÉTODOS: estudio observacional en el que se recopilaron datos antropométricos de pacientes de 0 a 14 años de edad entre agosto de 2016 y enero de 2017. Se utilizó la prueba t pareada para comparar el peso medido de los pacientes con su peso estimado. La precisión de cada método se analizó mediante gráficos de Bland-Altman y el coeficiente de correlación de concordancia de Lin. RESULTADOS: la muestra estuvo constituida por 446 pacientes. La mayoría eran varones (58,1 %) de 1 a 5 años (43 %) y bien nutridos (85 %). Para los menores de 12 meses de edad, los métodos APLS Update y Best Guess obtuvieron los mejores resultados, siendo la diferencia entre las medias de peso medido y peso estimado de 0,4 kg (p = 0,183) y -0,2 kg (p = 0,140), respectivamente. En el grupo de 1 a 5 años, solo el método APLS Update arrojó resultados satisfactorios (0,2 kg; p = 0,200). El mejor acuerdo con el peso medido, según las gráficas de Bland-Altman y el coeficiente de Lin, se encontró al utilizar la cinta Broselow (CC = 0,96). CONCLUSIÓN: de los métodos de estimación evaluados, la cinta Broselow fue la más precisa. Se requieren estudios adicionales para adaptar este método para su uso en la población brasileña

Natural food for domestic animals: A national and international technological review.

People's concern with the health of their animals has grown as the concern with their own health. The phenomenon known as humanization of animals has contributed to the emergence of this awareness about the care that animal owners need to have in relation with food, thus creating a new market nourishment, of natural and healthy foods. With revenues of US$ 91 billion in 2018, the pet food market is seen as a valuable market with great growth prospects for years to come. Nutrition is one of the most important parameters for the maintenance of animal health. Paying close attention to this new trend, the pet industry has been launching and betting on new products that work for the improvement of the quality of life of domestic animals. The present work carries out a national and international technological review on natural food, interesting components and their benefits in pet food, definitions, food market and their trends.

Conhecimento de enfermeiros sobre promoção da saúde na unidade de terapia intensiva / Nurses' knowledge about health promotion in the intensive therapy unit / Conocimiento de los enfermeros sobre promoción de la salud en unidad de cuidados intensivos

Objetivo: Avaliar os conhecimentos de enfermeiros intensivistas sobre a promoção da saúde em Unidade de Terapia Intensiva. Métodos: Estudo descritivo, exploratório, retrospectivo, com abordagem quantitativa, realizado em um Hospital de ensino localizado na cidade de Teresina PI. A coleta de dados ocorreu no período de janeiro a fevereiro de 2015. A análise dos dados ocorreu por meio do software Microsoft Office Excel 2007 para a obtenção de frequência, média e percentual. Resultados: Ainda há muito a avançar para alcançar o desenvolvimento da promoção da saúde no contexto hospitalar, particularmente, no contexto da Unidade de Terapia Intensiva, sobretudo, porque as práticas de saúde instituídas no cuidado ao cliente são centradas hegemonicamente nos aspectos físicos da doença e não é adotada de forma unânime pelos enfermeiros. Conclusão: Os enfermeiros entenderam a importância da promoção da saúde para evitar complicações no estado de saúde dos clientes que assistem

Objective: To evaluate the knowledge of intensive care nurses on health promotion in the Intensive Care Unit. Methods: This is a descriptive, exploratory, retrospective study with a quantitative approach performed at a teaching hospital located in the city of Teresina-PI. The data collection took place from January to February 2015. Data analysis was performed using Microsoft Office Excel 2007 software to obtain frequency, average and percentage. Results: There is still much to be done in order to achieve the development of health promotion in the hospital context, particularly in the context of the Intensive Care Unit, mainly because the health practices instituted in client care are hegemonically focused on the physical aspects of the disease and is not unanimously adopted by nurses. Conclusion: Nurses understood the importance of health promotion to avoid complications in the health status of the clients they attend

Objetivo: Evaluar los conocimientos de enfermeros intensivos en la promoción de la salud en Unidad de Terapia Intensiva. Métodos: Estudio descriptivo, exploratorio, retrospectivo, con abordaje cuantitativo, realizado en un Hospital de enseñanza ubicado en la ciudad de Teresina-PI. La recolección de datos ocurrió en el período de enero a febrero de 2015. El análisis de los datos ocurrió a través del software Microsoft Office Excel 2007 para la obtención de frecuencia, media y porcentual. Resultados: Todavía hay mucho que avanzar para alcanzar el desarrollo de la promoción de la salud en el contexto hospitalario, particularmente, en el contexto de la Unidad de Terapia Intensiva, sobre todo, porque las prácticas de salud instituidas en el cuidado al cliente se centran hegemónicamente en los aspectos físicos de la enfermedad y no es adoptada de forma unánime por los enfermeros. Conclusión: Los enfermeros entendieron la importancia de la promoción de la salud para evitar complicaciones en el estado de salud de los clientes que asisten

Effects of photobiostimulation in the treatment of post-herpetic neuralgia: a case report / Efeitos da fotobioestimulação no tratamento da neuralgia pós-herpética: relato de caso

Abstract Objectives: to describe the effect of photobiomodulation therapy in the treatment of post-herpetic neuralgia in the elderly. Case report: a female patient, 61 years old, 56 kg, 1.67cm tall, sought treatment at the Laser Therapy Center of the Universidade do Vale do Paraíba, in the city of São José dos Campos, São Paulo, Brazil, on October 27, 2015. She had been diagnosed with herpes zoster on September 4, 2015 with complaints of intermittent neuralgia in the long thoracic nerve path and spikes of intense pain (level 10, according to the analogue pain scale). Photobiomodulation was performed with low intensity laser spot irradiations at 20 points around the herpesvirus nerve, with a distance of 2cm between each point. Irradiation was performed at each point after 20 seconds, with 3J/cm2 per point and total energy of 60 J. At the end of the treatment the pain level was 0 and the patient exhibited a normal sleep pattern (8 hours of sleep). Conclusions: Photobiomodulation treated painful discomfort, improved the quality of life of the patient and proved to be an effective, safe and promising treatment, with significant potential to become the therapy of choice in such cases. AU

Resumo Objetivo: Descrever o efeito da fotobiomodulação no tratamento de neuralgia pós-herpética em idosa. Relato de caso: Paciente do gênero feminino, 61 anos, 56kg, 1,67cm de altura, procurou o Centro de Laserterapia da Universidade do Vale do Paraíba, na cidade de São José dos Campos, SP, Brasil, no dia 27 de outubro de 2015. Diagnosticada com herpes zoster em 4 de setembro de 2015 com queixas de neuralgia intermitente no trajeto do nervo torácico longo e picos de dor intensa (nível 10, segundo escala analógica de dor). A fotobiomodulação foi realizada com irradiações pontuais do laser de baixa intensidade em 20 pontos ao redor do nervo acometido pelo herpesvírus, com uma distância de 2 cm de cada ponto. A irradiação foi realizada com o tempo de 20 segundos em cada ponto, ou seja, 3J/cm2 por ponto e energia total de 60 J. Sendo ao final do tratamento o nível de dor 0 e o padrão de sono normal (oito horas de sono). Conclusão: A fotobiomodulação tratou o desconforto álgico, melhorou a qualidade de vida da paciente e mostrou-se, por meio de suas vantagens, ser um tratamento efetivo, seguro e promissor, com grande potencial de se tornar a terapia de escolha em tais casos. AU

Thermographic and anthropometric assessment of electrical stimulation on localized body fat / Avaliação termográfica e antropométrica da eletrolipólise na adiposidade localizada

Abstract Introduction: Adiposity is defined as the accumulation of energy reserves within the adipose tissue at specific body sites. Low-frequency electrical stimulation elicits lipolysis. When applied by insertion of needles into the dermis-hypodermis junction, it leads to a modification of the interstitial space, favoring metabolic changes and lipolysis. Objective: To investigate the effects of electrical stimulation on body fat localized to the abdomen and flanks. Methods: Randomized, controlled clinical trial consisted of two groups of women with body fat localized to the abdomen and flanks. The intervention group (IG) was made up of 9 women (± 24,77 years) who received ten sessions of electrical stimulation, whereas the control group (CG) was made up of 7 women (± 21,8 years) who did not receive electrical stimulation. Perimetric, adipometric and thermographic data were collected before and after the intervention. Data were analyzed using the Shapiro-Wilk test, t test, one-way ANOVA. The significance level was set at p < 0,05. Results: There were statistically significant differences between the intervention and control groups in the assessment immediately following intervention (IG: 33.08 ± 1.00; CG: 30.83 ± 1.5; p = 0.002), 15 minutes following intervention (IG: 33.05 ± 0.48; CG: 30.40± 1.24; p < 0.0001) and at the endpoint (IG: 32.22 ± 14.20; CG: 30.53 ± 1.34; p=0.005) for the thermographic data. For the anthropometric variables, there were no statistically significant differences before and after treatment. Conclusion: Electrical stimulation evokes a significant increase in the temperature of the subcutaneous tissue.

Resumo Introdução: Adiposidade é o acúmulo de reservas energéticas no tecido adiposo, em regiões específicas. A estimulação elétrica de baixa frequência como geradora da lipólise, quando aplicada com agulhas inseridas na junção derme-hipoderme, gera modificação do meio intersticial, favorecendo as trocas metabólicas e a lipólise. Objetivo: Investigar o efeito da eletrolipólise na adiposidade localizada em região abdominal e de flancos. Métodos: Ensaio clínico controlado e randomizado constituído de dois grupos: grupo intervenção GI, constituído de 9 mulheres (± 24,77 anos) com adiposidade localizada nas regiões abdominal e de flancos, que realizaram dez sessões de eletrolipólise; e o grupo controle GC, constituído de 7 mulheres (± 21,8 anos) que não realizaram as sessões de eletrolipólise. Prévia e posteriormente à intervenção foram coletados a perimetria, a adipometria e a análise termográfica. Para análise dos dados foram utilizados os testes Shapiro-Wilk, teste T, teste One-Way ANOVA; considerou-se nível de significância de p < 0,05. Resultados: Para os dados termográficos, observou-se diferença estatística entre os grupos intervenção e controle na reavaliação imediata (GI: 33,08 ± 1,00; GC: 30,83 ± 1,5; p = 0,002), reavaliação após 15 minutos de aplicação da técnica (GI: 33,05 ± 0,48; GC: 30,40±1,24; p < 0,0001) e na reavaliação final (GI:32,22 ± 14,20; GC: 30,53 ± 1,34; p=0,005). Para as variáveis antropométricas, não houve resultado significativo antes e após o tratamento. Conclusão: A eletrolipólise promove incremento significativo na temperatura do tecido subcutâneo.

Comparação da termografia cutânea após aplicação da massagem modeladora, endermoterapia e eletrolipólise / Comparison of skin thermography after application of massage, endermotheraphy and electrolipolysis

Introdução: massagem modeladora, endermoterapia e eletrolipólise agem na superfície cutânea estimulando o aumento da temperatura, a qual pode ser avaliada pela termografia cutânea. Objetivo: comparar as variações na temperatura cutânea superficial da região abdominal, a curto prazo, após massagem modeladora, endermoterapia e eletrolipólise. Metodologia: trinta mulheres foram aleatorizadas para os grupos: massagem modeladora, endermoterapia e eletrolipólise, realizados na região abdominal, uma única vez. Foi realizada avaliação termográfica antes (primeira avaliação), imediatamente após (segunda avaliação) e 20 minutos após a aplicação das técnicas (terceira avaliação). Para análise dos dados utilizou-se ANOVA e Teste T. Resultados: observou-se aumento significativo da temperatura após a massagem modeladora (p<0,0001), endermoterapia (p<0,0001) e eletrolipólise (p<0,0001). Massagem modeladora e endermoterapia apresentaram aumento de temperatura significativo em relação a eletrolipólise. Conclusões: conclui-se que as técnicas são capazes de gerar aumento significativo na temperatura cutânea a curto prazo, com maior aumento da temperatura para massagem modeladora e endermoterapia.

Introduction: massage, dermotherapy and electrolipolysis act in stimulating the skin surface temperature increase, which can be assessed by skin thermography. Objective: To compare the variations in the surface skin temperature of the abdomenal region, in the short term, after massage, dermotherapy and electrolipolysis. Methodology: Thirty women were randomized to groups: massage, dermotherapy and electrolipolysis, performed in the abdominal region, once. Thermographic evaluation was performed before (first assessment), immediately after (second evaluation) and 20 minutes after application of techniques (third assessment). For data analysis we used ANOVA and T test. Results: there was significant rise in temperature after the massage (p<0.0001), dermotherapy (p<0.0001) and electrolipolysis (p<0.0001). Massage and dermotherapy showed significant temperature rise in relation to electrolipolysis. Conclusions: the techniques are capable of generating significant increase in the skin temperature in short term, there was a greater increase in temperature for massage and dermotherapy.

Refeeding syndrome: clinical and nutritional relevance.

INTRODUCTION: Feedback syndrome is characterized clinically by neurological alterations, respiratory symptoms, arrhythmias and heart failure few days after refeeding. It happens due to severe electrolyte changes, such as hypophosphatemia, hypomagnesemia and hypokalemia associated with metabolic abnormalities that may occur as a result of nutritional support (oral, enteral or parenteral) in severely malnourished patients. OBJECTIVE: To evaluate its causes and the preventive dietary measures aiming to reduce the morbimortality. METHODS: Was conducted literature review in SciELO, LILACS, Medline / PUBMED, Cochrane Library and government websites in Portuguese, English and Spanish. The survey was about the last 15 years, selecting the headings: refeeding syndrome, malnutrition, hypophosphatemia, hypokalemia, hypomagnesemia. CONCLUSION: The monitoring of metabolic parameters and electrolyte levels before starting nutritional support and periodically during feeding should be based on protocols and the duration of therapy. Patients at high risk and other metabolic complications should be followed closely, and depletion of minerals and electrolytes should be replaced before starting the diet. A multidisciplinary team of nutrition therapy can guide and educate other health professionals in prevention, diagnosis and treatment of the syndrome.

Qual é a importância clínica e nutricional da síndrome de realimentação? / Refeeding syndrome: clinical and nutritional relevance

INTRODUÇÃO: A síndrome de realimentação caracteriza-se por alterações neurológicas, sintomas respiratórios, arritmias e falência cardíacas, poucos dias após a realimentação. Ocorre em consequência do suporte nutricional (oral, enteral ou parenteral) em pacientes severamente desnutridos. OBJETIVO: Avaliar de suas causas e a aplicação das medidas dietéticas profiláticas apropriadas visando a prevenção e diminuição da morbimortalidade desta condição. MÉTODOS: Foi realizado levantamento bibliográfico na SciELO, LILACS, Medline/Pubmed, Biblioteca Cochrane e sites governamentais nos idiomas português, inglês e espanhol. Os levantamentos foram sobre os últimos 15 anos, selecionando os descritores: síndrome de realimentação, desnutrição, hipofosfatemia, hipocalemia, hipomagnesemia. CONCLUSÃO: O acompanhamento de parâmetros metabólicos e de níveis de eletrólitos antes do início do suporte nutricional e periodicamente durante a alimentação deve ser baseado em protocolos, no estado da doença subjacente e na duração da terapia. Equipe multidisciplinar de terapia nutricional pode orientar e educar outros profissionais de saúde na prevenção, diagnóstico e tratamento dessa síndrome.

INTRODUCTION: Feedback syndrome is characterized clinically by neurological alterations, respiratory symptoms, arrhythmias and heart failure few days after refeeding. It happens due to severe electrolyte changes, such as hypophosphatemia, hypomagnesemia and hypokalemia associated with metabolic abnormalities that may occur as a result of nutritional support (oral, enteral or parenteral) in severely malnourished patients. OBJETIVE: To evaluate its causes and the preventive dietary measures aiming to reduce the morbimortality. METHODS: Was conducted literature review in SciELO, LILACS, Medline / Pubmed, Cochrane Library and government websites in Portuguese, English and Spanish. The survey was about the last 15 years, selecting the headings: refeeding syndrome, malnutrition, hypophosphatemia, hypokalemia, hypomagnesemia. CONCLUSION: The monitoring of metabolic parameters and electrolyte levels before starting nutritional support and periodically during feeding should be based on protocols and the duration of therapy. Patients at high risk and other metabolic complications should be followed closely, and depletion of minerals and electrolytes should be replaced before starting the diet. A multidisciplinary team of nutrition therapy can guide and educate other health professionals in prevention, diagnosis and treatment of the syndrome.

The tropics and the rise of the British Empire: Mungo Park's perspective on Africa in the late eighteenth century. / Os trópicos na rota do Império britânico: a visão de Mungo Park sobre a África em fins do século XVIII.

The young Scottish physician Mungo Park, aged 23, arrived in Africa in 1795 with a mission as specific as it was complex in those bygone days, namely to travel the entire length of the River Niger. In 1799, the story of this journey was published in a book that sold 1500 copies in the first month alone, with two further editions published that same year, as well as the translation of the work into French and German the following year. In this article, the narrative of Mungo Park is examined by taking due consideration of the relationship between the tropics, science and travel in the early days of British expansionism into the heart of Africa.

Os trópicos na rota do Império britânico: a visão de Mungo Park sobre a África em fins do século XVIII / The tropics and the rise of the British Empire: Mungo Park's perspective on Africa in the late eighteenth century

O jovem médico escocês Mungo Park chegou à África em 1795, aos 23 anos, com uma missão tão específica quanto complexa naqueles tempos: percorrer o curso do rio Níger. Em 1799, o relato dessa jornada veio a público em uma publicação que vendeu 1.500 cópias em apenas um mês, estimulando o aparecimento de mais duas edições da obra no mesmo ano e sua tradução para o francês e o alemão no ano seguinte. Neste artigo, examina-se a narrativa de Mungo Park considerando-se as relações entre trópico, ciência e viagem nos primeiros tempos do expansionismo inglês sobre o interior da África.

The young Scottish physician Mungo Park, aged 23, arrived in Africa in 1795 with a mission as specific as it was complex in those bygone days, namely to travel the entire length of the River Niger. In 1799, the story of this journey was published in a book that sold 1500 copies in the first month alone, with two further editions published that same year, as well as the translation of the work into French and German the following year. In this article, the narrative of Mungo Park is examined by taking due consideration of the relationship between the tropics, science and travel in the early days of British expansionism into the heart of Africa.

[Medicine, science and power: relations between France, Germany and Brazil in the period 1919-1942]. / Medicina, ciência e poder: as relações entre França, Alemanha e Brasil no período de 1919 a 1942.

This research note proposes hypotheses and frameworks for the study of the dynamics of the German and French medical and scientific movement aimed at Latin America, and Brazil in particular, between 1919 and 1942. It also seeks to comprehend to what extent the efforts at intellectual cooperation and the concomitant flow of ideas, institutional models, common research agendas, and action strategies aimed at expanding the Franco-Germanic field of influence in this part of the American continent, were put into practice.