Functional disability of adult individuals with spinal cord injury and its association with socio-demographic characteristics

The aim was to investigate the Functional Disability degree in adults with spinal cord injury and its association with socio-demographic characteristics. The Barthel Index was used and 75 subjects answered a questionnaire with socio-demographic variables. The Chi-Square, Cronbach's Alpha and Fisher tests were used in the analysis. The mean age was 42.23 years. Cronbach's Alpha for the Barthel Index was 0.807. The activities that were more difficult to perform were Climbing and Descending Stairs (92%) and Walking (82.7%). The mean Barthel Index score was 64 points. The tests of association demonstrated values with p>0.05. Even though this population demonstrated a low degree of dependency and no association was identified between the socio-demographic variables and Functional Disability, the study contributes to nursing care for individuals with spinal cord injury, considering the limitations the condition imposes on their self-care.El objetivo fue investigar el grado de Incapacidad Funcional de adultos con lesión medular y su asociación con las características socio-demográficas. Se utilizó el Índice de Barthel y un cuestionario con variables socio-demográficas. Participaron 75 sujetos. Se efectuaron las pruebas: Chi-cuadrado, Cronbach y Fisher. El promedio de edad fue de 43,23 años. El Alfa de Cronbach para el Índice de Barthel fue de 0,807. Las actividades en las cuales se verificó mayor dificultad de realización fueron Subir y Bajar escaleras (92%) y Deambular (82,7%). La mediana del Índice de Barthel fue de 64 puntos. Las pruebas de asociación presentaron valores de p>0,05. A pesar de que la población presenta un grado leve de dependencia y no se identificaron asociaciones entre las variables socio-demográficas y la Incapacidad Funcional, se considera que el estudio contribuye para la asistencia de enfermería, debido a algunas limitaciones que la lesión medular impone en el auto-cuidado.Objetivou-se investigar o grau de incapacidade funcional de adultos com lesão medular e a sua associação com as características sociodemográficas. Utilizaram-se o índice de Barthel e um questionário com variáveis sociodemográficas. Participaram 75 sujeitos. Efetuaram-se os teste qui-quadrado, Cronbach e Fisher. A média de idade foi de 43,23 anos. O alfa de Cronbach para o índice de Barthel foi de 0,807. As atividades nas quais se verificou maior dificuldade de realização foram subir e descer escadas (92%) e deambular (82,7%). O escore médio do índice de Barthel foi de 64 pontos. Os testes de associação apresentaram valores de p>0,05. Apesar de a população apresentar grau leve de dependência e não se identificar associação entre as variáveis sociodemográficas e a incapacidade funcional, considera-se que o estudo contribui para a assistência de enfermagem, por possibilitar reflexões na busca de se amenizar algumas limitações que a lesão medular impõe ao autocuidado

Understanding the clinical spectrum of complicated Plasmodium vivax malaria: a systematic review on the contributions of the Brazilian literature

The resurgence of the malaria eradication agenda and the increasing number of severe manifestation reports has contributed to a renewed interested in the Plasmodium vivax infection. It is the most geographically widespread parasite causing human malaria, with around 2.85 billion people living under risk of infection. The Brazilian Amazon region reports more than 50% of the malaria cases in Latin America and since 1990 there is a marked predominance of this species, responsible for 85% of cases in 2009. However, only a few complicated cases of P. vivax have been reported from this region. A systematic review of the Brazilian indexed and non-indexed literature on complicated cases of vivax malaria was performed including published articles, masters' dissertations, doctoral theses and national congresses' abstracts. The following information was retrieved: patient characteristics (demographic, presence of co-morbidities and, whenever possible, associated genetic disorders); description of each major clinical manifestation. As a result, 27 articles, 28 abstracts from scientific events' annals and 13 theses/dissertations were found, only after 1987. Most of the reported information was described in small case series and case reports of patients from all the Amazonian states, and also in travellers from Brazilian non-endemic areas. The more relevant clinical complications were anaemia, thrombocytopaenia, jaundice and acute respiratory distress syndrome, present in all age groups, in addition to other more rare clinical pictures. Complications in pregnant women were also reported. Acute and chronic co-morbidities were frequent, however death was occasional. Clinical atypical cases of malaria are more frequent than published in the indexed literature, probably due to a publication bias. In the Brazilian Amazon (considered to be a low to moderate intensity area of transmission), clinical data are in accordance with the recent findings of severity described in diverse P. vivax endemic areas (especially anaemia in Southeast Asia), however in this region both children and adults are affected. Finally, gaps of knowledge and areas for future research are opportunely pointed out

Performance and egg quality of laying hens fed diets containing aflatoxin, fumonisin and adsorbent

The effects of aflatoxin and fumonisin and their combination on egg production and quality, as well as the efficacy of a mycotoxin adsorbent in reducing or eliminating these effects in commercial layers. A number of 168 layers with initial age of 37 weeks were submitted to an experimental period of 56 days. A completely randomized experimental design in a 3x2+1 factorial arrangement was applied (3 treatments with mycotoxins: aflatoxin (AF), fumonisin (FU), or aflatoxin + fumonisin (AF+FU); 2 treatments with or without adsorbent; and a control group that was fed no mycotoxins, nor adsorbent), totaling 7 treatments with 6 replicated of 4 birds/cage. The dietary inclusion levels were 1ppm AF, 25ppm FU, and 2 kg adsorbent/ton feed. Birds fed AF presented the lowest percentage of lay (p=0.0594). Egg mass was the lowest (p<0.05) in the AF+FU treatment (49.49g). The treatment with AF resulted in higher eggshell thickness and strength (p<0.05) than the FU treatment and the control group. The inclusion of the adsorbent in the AF contaminated feed reduced eggshell strength, which returned to levels similar to those of the control group. The observed changes indicate that aflatoxin is toxic at a concentration of 1ppm, and that the effects of fumonisin were less evident as a function of the low dose applied. The inclusion of the glucan (2kg/ton) effectively reverted some of the toxic effects of aflatoxin and, at lower extension, those of fumonisin, when these mycotoxins were invidually added to commercial layer feeds

Acolhimento e características maternas associados à oferta de líquidos a lactentes

OBJECTIVE: To identify the maternal characteristics and welcoming actions towards mothers of infants aged less than six months associated with early liquid offer. METHODS: Cross-sectional study performed in 2007, with a representative sample of mothers of infants aged less than six months (n=1,057), users of Primary Health Care (PHC) Units, in the city of Rio de Janeiro, Southeastern Brazil. A multivariate logistic regression model was used to estimate the association between explanatory variables and liquid offer, with weighing and design effect and controlled for infant age. RESULTS: Of all mothers, 32% did not receive the welcoming card in the maternity hospital, 47% did not receive guidance on breastfeeding at their first visit to the PHC unit after childbirth and 55% reported they had offered liquids to their infants. Women without at least six months of previous breastfeeding experience were more likely to offer liquids than those with such experience (OR=1.57; 95% CI: 1.16;2.13). Mothers who had not received guidance on breastfeeding at their first visit to the UBS after childbirth were 58% more likely to offer liquids than those who had received it. Liquid offer was positively associated with adolescence among women with a partner (OR=2.17; 95% CI: 1.10;4.30) and negatively associated with adolescence among those without a partner (OR=0.31; 95% CI: 0.11;0.85). Among women with less than eight years of education, those who had not received guidance on breastfeeding after childbirth were 1.8 times more likely to offer liquids than others who had received it. CONCLUSIONS: Age, marital status and previous breastfeeding experience are maternal characteristics associated with liquid offer to infants aged less than six months. Receiving early guidance on breastfeeding could reduce liquid offer to infants.OBJETIVO: Identificar características maternas y acciones de acogimiento en las madres de niños menores de seis meses asociadas a la oferta precoz de líquidos. MÉTODOS: Estudio transversal realizado en 2007 con muestra representativa de madres de niños menores de seis meses (n=1.057) usuarias de unidades básicas de salud en la ciudad de Rio de Janeiro, Sureste de Brasil. Para estimar la asociación entre las variables explicativas y la oferta de líquidos se utilizó un modelo de regresión logística multivariada con ponderación, efecto de diseño y controlado por la edad del niño. RESULTADOS: De las madres, 32% no recibieron la tarjeta de acogimiento en la maternidad, 47% no recibieron orientación sobre amamantamiento en la primera ida a la USB posterior al parto y 55% relataron la oferta de líquidos a los lactantes. Mujeres sin experiencia anterior en amamantar por al menos seis meses presentaron oportunidad de oferta de líquidos mayor que aquellas con experiencia (OR=1,57;IC 95%:1,16;2.13). Las que no recibieron orientación sobre amamantamiento en la primera ida a la unidades de salud posterior al parto tuvieron oportunidad 58% mayor de ofrecer líquidos que aquellas que recibieron orientación. La oferta de líquidos se mostró positivamente asociada con la adolescencia entre mujeres con compañero (OR=2,17; IC 95%: 1,10;4,30) y negativamente asociada con la adolescencia entre aquellas sin compañero (OR=0,31; IC 95%: 0,11;0,85). Entre mujeres con menos de ocho años de estudio, las que no recibieron orientación sobre amamantamiento posterior al nacimiento del niño presentaron oportunidad de oferta de líquidos 1,8 veces mayor que aquellas que recibieron orientación. CONCLUSIONES: Edad, situación conyugal y experiencia anterior en amamantar son características maternas asociadas a la oferta de líquidos para niños menores de seis meses. El recibimiento de orientación precoz sobre amamantamiento materno puede reducir el ofrecimiento de líquidos a los lactantes.OBJETIVO: Identificar características maternas e ações de acolhimento às mães de crianças menores de seis meses associadas à oferta precoce de líquidos. MÉTODOS: Estudo transversal realizado em 2007 com amostra representativa de mães de crianças menores de seis meses (n = 1.057) usuárias de unidades básicas de saúde (UBS) na cidade do Rio de Janeiro, RJ. Para estimar a associação entre as variáveis explicativas e a oferta de líquidos utilizou-se um modelo de regressão logística multivariado com ponderação, efeito de desenho e controlado pela idade da criança. RESULTADOS: Das mães, 32% não recebeu o cartão de acolhimento na maternidade, 47% não recebeu orientação sobre amamentação na primeira ida à UBS após o parto e 55% relatou a oferta de líquidos aos lactentes. Mulheres sem experiência pregressa em amamentar por pelo menos seis meses apresentaram chance de oferta de líquidos maior que aquelas com experiência (OR = 1,57; IC 95%: 1,16;2,13). As que não receberam orientação sobre amamentação na primeira ida à UBS após o parto tiveram chance 58% maior de oferecer líquidos que aquelas que receberam orientação. A oferta de líquidos mostrou-se positivamente associada com a adolescência entre mulheres com companheiro (OR = 2,17; IC 95%: 1,10;4,30) e negativamente associada com a adolescência entre aquelas sem companheiro (OR = 0,31; IC95%: 0,11;0,85). Entre mulheres com menos de oito anos de estudo, as que não receberam orientação sobre amamentação após o nascimento da criança apresentaram chance de oferta de líquidos 1,8 vez maior que aquelas que receberam orientação. CONCLUSÕES: Idade, situação conjugal e experiência pregressa em amamentar são características maternas associadas à oferta de líquidos para crianças menores de seis meses. O recebimento de orientação precoce sobre aleitamento materno pode reduzir o oferecimento de líquidos aos lactentes

High risk pregnancies and factors associated with neonatal death

OBJETIVO Identificar os fatores associados à mortalidade neonatal intra-hospitalar com base nas características individuais de gestantes de risco, do parto e do recém-nascido. MÉTODO Estudo epidemiológico do tipo transversal, realizado com crianças nascidas vivas de partos hospitalares de mulheres acompanhadas pelo ambulatório de alto risco de um hospital filantrópico de Maringá, Paraná, Brasil, no período de setembro de 2012 a setembro de 2013. RESULTADOS Fizeram parte da pesquisa 688 mulheres. O coeficiente de mortalidade neonatal foi de 17,7 óbitos/1.000 nascidos vivos, sendo sua maioria no período neonatal precoce. Trabalho de parto prematuro, malformação fetal e gestação múltipla foram as intercorrências associadas ao óbito neonatal. Recém-nascidos prematuros, com muito baixo peso ao nascer e Índice de Apgar menor que sete no quinto minuto de vida apresentaram risco elevado de morte. CONCLUSÃO A identificação de fatores de risco pode auxiliar no planejamento de ações para consolidação da rede perinatal. Programas específicos devem ser incentivados em outros países, na busca de resultados perinatais expressivos, como a redução da mortalidade neonatal.OBJECTIVE To identify the factors associated with intra-hospital neonatal mortality based on the individual characteristics of at-risk pregnant mothers, delivery and newborns. METHOD This was a cross-sectional epidemiological study of live newborns delivered by women attended at the high-risk outpatient unit of a philanthropic hospital in Maringá, Paraná, Brazil between September 2012 and September 2013. RESULTS Six hundred and eighty-eight women participated in the study. The neonatal mortality coefficient found was 17.7/1,000 live births, most in the early neonatal phase. Premature labor, fetal malformation and multiple gestations were associated with neonatal death. Premature, very low birth weight newborns and those with an Apgar score of less than seven, five minutes after birth were at high risk of death. CONCLUSION Identifying risk factors can help plan actions to consolidate the perinatal network. Specific programs should be incentivized in other countries, in the search for significant perinatal results such as reducing neonatal mortality.OBJETIVO Identificar los factores asociados con la mortalidad neonatal intrahospitalaria con base en las características individuales de gestantes de riesgo, del parto y del recién nacido. MÉTODO Estudio epidemiológico del tipo transversal, realizado con niños nacidos vivos de partos hospitalarios de mujeres seguidas en el ambulatorio de alto riesgo de un hospital filantrópico de Maringá, Paraná, Brasil, en el período de septiembre de 2012 a septiembre de 2013. RESULTADOS Hicieron parte de la investigación 688 mujeres. El coeficiente de mortalidad neonatal fue de 7,7 defunciones/1.000 nacidos vivos, siendo su mayoría en el período neonatal precoz. Trabajo de parto prematuro, malformación fetal y gestación múltiple fueron los sucesos asociados con la defunción neonatal. Recién nacidos prematuros, con muy bajo peso al nacer e Índice de Apgar menor que siete el quinto minuto de vida presentaron riesgo elevado de muerte. CONCLUSIÓN La identificación de factores de riesgo puede auxiliar la planificación de acciones para consolidación de la red perinatal. Se deben incentivar programas específicos en otros países, en la búsqueda por resultados perinatales considerables, como la reducción de la mortalidad neonatal