Factors associated with prolonged non-nutritive sucking habits in two cohorts of Brazilian children

Abstract Background Non-nutritive sucking habits (NNSH) are very common during childhood. However, if these habits were maintained for 36 months of age or more, they are considered to be prolonged (PNNSH) and can cause occlusal, physiological and esthetic changes. There is controversy about their prevalence and whether perinatal, social, demographic and health characteristics influence their onset and duration. So, the objectives of this study are to estimate the prevalence of PNNSH and to evaluate perinatal, early life and school age factors associated with their occurrence in children. Methods A sample of 1,463 children aged 7–11 years born in Ribeirão Preto (RP-1994) and São Luís (SL-1997/98), Brazil, was reevaluated at school age in 2004/05. Birth weight, gestational age and perinatal variables were obtained at birth. Type of feeding, occurrence and duration of finger and pacifier sucking were recorded retrospectively at school age. PNNSH were defined when persisted for 36 months of age or more. Crude and adjusted prevalence ratios (PR) were estimated by Poisson regression (alpha = 5%). Results Prevalence of PNNSH was higher in RP (47.6%) than in SL (20.2%) – (p < 0.001). Perinatal variables were not associated to PNNSH, whilst female sex (PR = 1.27 in RP; PR = 1.47 in SL) and bottle feeding for 24 months or more (PR = 2.24 in RP; PR = 2.49 in SL) were risk factors in both locations. Breast feeding for 12 months or more (PR = 0.53 in RP; PR = 0.31 in SL) was associated with lower prevalence of PNNSH in both places. In SL, children whose mothers lived in consensual union (PR = 1.62) and worked outside the home (PR = 1.51) showed higher prevalence of PNNSH compared to their counterparts. Conclusions Prevalence of PNNSH was high especially in RP and was not associated with perinatal variables. In both cities there was an association between female sex, shorter breast-feeding duration, longer bottle feeding duration and higher prevalence of PNNSH.http://deepblue.lib.umich.edu/bitstream/2027.42/109521/1/12889_2013_Article_6874.pd

Molecular Electrostatic Potential and Chemometric Techniques as Tools to Design Bioactive Compounds

In this chapter, firstly, we briefly review aspects of the approximation of quantum chemistry, molecular electrostatic potential (MEP), and chemometrics techniques, which are accredited as important tools in the development of chemical science and are frequently used in the study and design of bioactive compounds. Ultimately, we use MEP and pattern recognition (PR) techniques as tools to design nitrofuran compounds with biological activity against Trypanosoma cruzi (T. cruzi). PR models (PCA, HCA, KNN, SDA, and SIMCA) were constructed and demonstrated that 23 nitrofurans can be classified into two classes or groups: more active and less active according to their degrees of activity against T. cruzi. Properties such as charge on the N atom of the nitro group (QN1); the difference between the highest occupied molecular orbital (HOMO) energy and the lowest unoccupied molecular orbital (LUMO) energy (GAP energy); molecular representation of structure based on electron diffraction code of signal 5, unweighted (Mor05u); and Moriguchi water–octanol partition coefficient (MlogP) are responsible for the classification into more active and less active studied nitrofurans. It is interesting to notice that these properties represent three distinct classes of interactions between the nitrofurans and the biological receptor: electronic (QN1 and GAP energy), steric (Mor05u), and hydrophobic (MlogP). The results of the application of PR models on the validation set evidenced two nitrofuran compounds (compounds 25 and 30) as more promising for synthesis and biological assays, which in the future can be used to validate our PR models

Perinatal and early life factors associated with symptoms of depression in Brazilian children

Background: Few studies have been conducted on the association between perinatal and early life factors with childhood depression and results are conflicting. Our aim was to estimate the prevalence and perinatal and early life factors associated with symptoms of depression in children aged 7 to 11 years from two Brazilian birth cohorts. Methods: The study was conducted on 1444 children whose data were collected at birth and at school age, in 1994 and 2004/2005 in Ribeirao Preto, where they were aged 10-11 years and in 1997/98 and 2005/06 in Sao Luis, where children were aged 7-9 years. Depressive symptoms were investigated with the Child Depression Inventory (CDI), categorized as yes (score &gt;= 20) and no (score &lt; 20). Adjusted and non-adjusted prevalence ratios (PR) were estimated by Poisson regression with robust estimation of the standard errors. Results: The prevalence of depressive symptoms was 3.9% (95% CI = 2.5-5.4) in Ribeirao Preto and 13.7% (95% CI = 11.0-16.4) in Sao Luis. In the adjusted analysis, in Ribeirao Preto, low birth weight (PR = 3.98; 95% CI = 1.72-9.23), skilled and semi-skilled manual occupation (PR = 5.30; 95% CI = 1.14-24.76) and unskilled manual occupation and unemployment (PR = 6.65; 95% CI = 1.16-38.03) of the household head were risk factors for depressive symptoms. In Sao Luis, maternal schooling of 0-4 years (PR = 2.39; 95% CI = 1.31-4.34) and of 5 to 8 years (PR = 1.80; 95% CI = 1.08-3.01), and paternal age &lt; 20 years (PR = 1.92; 95% CI = 1.02-3.61), were independent risk factors for depressive symptoms. Conclusions: The prevalence of depressive symptoms was much higher in the less developed city, Sao Luis, than in the more developed city, Ribeirao Preto, and than those reported in several international studies. Low socioeconomic level was associated with depressive symptoms in both cohorts. Low paternal age was a risk factor for depressive symptoms in the less developed city, Sao Luis, whereas low birth weight was a risk factor for depressive symptoms in the more developed city, Ribeirao Preto.CNPq (Conselho Nacional de Desenvolvimento Cientifico e Tecnologico - Brazilian National Research Council) [523474/96-2, 520664/98-1]FAPEMA (Fundacao de Amparo a Pesquisa e ao Desenvolvimento Cientifico e Tecnologico do Maranhao)FAPESP (Fundacao de Amparo a Pesquisa do Estado de Sao Paulo - Sao Paulo Research Foundation) [93/0525-0, 97/09517-1, 00/0908-7

CUSTOS DIRETOS COM FERIDAS CRÔNICAS EM SERVIÇO AMBULATORIAL DE UMA UNIVERSIDADE PÚBLICA NO NORDESTE BRASILEIRO

Objetivo: Avaliar custos diretos com feridas crônicas de pessoas atendidas no ambulatório de enfermagem em estomaterapia de uma universidade pública no nordeste brasileiro. Método: Estudo documental, transversal, coleta de dados sobre materiais para tratamento das feridas, maio a junho de 2020 em 22 prontuários, analisadas pelo JASP (frequências absolutas, relativas, média, desvio padrão e regressão multivariada). Resultados: Maior frequência para mulheres 12(54,5%), 45 a 79 anos, idade média de 59,3, 7(31,81%) possuíam úlceras venosas, tratamentos de maiores custos: laserterapia e hidrofibra com prata. Variável desfecho (R$384,787 reais) e as variáveis independentes (R$ 121,598 cm2 para área da lesão, R$11.864 para número de atendimentos e R$ 1,727 para número de feridas). Análise multivariada, custo total apresentou correlação com o número de atendimentos. Conclusão: Frente à avaliação econômica, observou-se predomínio de custo com feridas crônicas em idosos, laserterapia e o uso de penso as intervenções impactantes do custo direto

Nascidos vivos com hemangioma e linfangioma no Brasil: estudo epidemiológico.

Introduction: Hemangiomas and lymphangiomas represent congenital vascular conditions affecting the circulatory and lymphatic systems, respectively. Hemangiomas consist of abnormal blood vessels, while lymphangiomas are composed of altered lymphatic vessels. Both conditions are typically identified in newborns or young children, though they can manifest at any age. Methodology: This study constitutes a descriptive epidemiological analysis focused on investigating cases of hemangioma and lymphangioma in live births in Brazil. Data collection will be conducted through the Live Birth Information System (SINASC) during the period from 2017 to 2021. Results: In the Northern region, 25 cases were recorded, representing 4.86% of the total live births with hemangioma and lymphangioma in the sample. In the Northeast region, this proportion is slightly higher, with 76 cases, accounting for 14.79% of the total. The Southeast holds the highest proportion, with 316 cases, representing a significant 61.48% of the sample. In the Southern region, 69 cases were recorded, comprising 13.42% of the total. Finally, in the Central-West region, 28 cases were counted, representing 5.45% of the sample. Conclusion: This meticulous analysis of variables related to live births with these conditions provides valuable insights that go beyond mere numerical understanding. The relevance of this profile is evident when considering various aspects.Introdução: Hemangiomas e linfangiomas representam condições vasculares congênitas que afetam o sistema circulatório e linfático, respectivamente. Os hemangiomas são formados por vasos sanguíneos anormais, enquanto os linfangiomas são compostos por vasos linfáticos alterados. Ambas as condições são geralmente identificadas em recém-nascidos ou crianças pequenas, embora possam se manifestar em qualquer idade. Metodologia: Esta pesquisa configura uma análise epidemiológica descritiva voltada para a investigação de casos de hemangioma e linfangioma em nascidos vivos no Brasil. A coleta de dados será conduzida por meio do Sistema de Informações sobre Nascidos Vivos (SINASC) no período compreendido entre 2017 e 2021. Resultado: Na região Norte, foram registrados 25 casos, representando 4,86% do total de nascidos vivos com hemangioma e linfangioma na amostra. Já na região Nordeste, essa proporção é um pouco maior, com 76 casos, correspondendo a 14,79% do total. O Sudeste detém a maior proporção, com 316 casos, representando expressivos 61,48% da amostra. Na região Sul, foram registrados 69 casos, compreendendo 13,42% do total. Por fim, na região Centro-Oeste, foram contabilizados 28 casos, representando 5,45% da amostra. Conclusão: Essa análise minuciosa das variáveis relacionadas a nascidos vivos com essas condições proporciona insights valiosos que transcendem a simples compreensão numérica. A relevância desse perfil é evidente ao considerar vários aspectos

Comparison of major depression diagnostic classification probability using the SCID, CIDI, and MINI diagnostic interviews among women in pregnancy or postpartum: An individual participant data meta‐analysis

OBJECTIVES: A previous individual participant data meta-analysis (IPDMA) identified differences in major depression classification rates between different diagnostic interviews, controlling for depressive symptoms on the basis of the Patient Health Questionnaire-9. We aimed to determine whether similar results would be seen in a different population, using studies that administered the Edinburgh Postnatal Depression Scale (EPDS) in pregnancy or postpartum. METHODS: Data accrued for an EPDS diagnostic accuracy IPDMA were analysed. Binomial generalised linear mixed models were fit to compare depression classification odds for the Mini International Neuropsychiatric Interview (MINI), Composite International Diagnostic Interview (CIDI), and Structured Clinical Interview for DSM (SCID), controlling for EPDS scores and participant characteristics. RESULTS: Among fully structured interviews, the MINI (15 studies, 2,532 participants, 342 major depression cases) classified depression more often than the CIDI (3 studies, 2,948 participants, 194 major depression cases; adjusted odds ratio [aOR] = 3.72, 95% confidence interval [CI] [1.21, 11.43]). Compared with the semistructured SCID (28 studies, 7,403 participants, 1,027 major depression cases), odds with the CIDI (interaction aOR = 0.88, 95% CI [0.85, 0.92]) and MINI (interaction aOR = 0.95, 95% CI [0.92, 0.99]) increased less as EPDS scores increased. CONCLUSION: Different interviews may not classify major depression equivalently

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure &lt;= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake