Estado nutricional de crianças do baixo Amazonas: concordância entre três critérios de classificação

Introduction: The knowledge of adequate methods to monitor growth and nutritional status during childhood and adolescence makes possible an early diagnosis of possible problems, such as malnutrition, overweight or obesity in adult life.  Objective: To determine the agreement between three methods of nutritional assessment status of children 2 to 6 years old from Lower Amazonas region, Brazil. Methods: Exploratory, epidemiological, and cross-sectional school-based study conducted in 2014 with children of Child Education in the city of Parintins. We assessed the nutritional status, body mass index, according to three criteria: Conde and Monteiro, Cole et al, and World Health Organization (WHO). We used the Kappa coefficient to investigate the agreement between three criteria. Results: Participants were 1.387 children (714 boys) with a mean age of 5 years. The boys had a higher prevalence of overweight than girls by the WHO classification, but higher proportion of girls with low weight, according to the national criteria. The best levels of agreement were for females and national protocol showed good agreement with the international use of protocols, highlighting proposed by the WHO. Conclusion: We concluded that there was agreement among the criteria for assessing the nutritional status of children in the Lower Amazonas.Introdução: A avaliação do estado nutricional é fundamental na infância, pois a desnutrição, o sobrepeso e a obesidade são estágios indicativos de desequilíbrios que podem influenciar o adequado desenvolvimento infantil e interferir nos processos de saúde/doença. Objetivo: Determinar a concordância entre três métodos de avaliação do estado nutricional de crianças de 2 a 6 anos de idade da região do Baixo Amazonas, Brasil. Método: Estudo exploratório, epidemiológico com desenho transversal de base escolar realizado em 2014 com crianças do Ensino Infantil da cidade de Parintins. Foi avaliado o estado nutricional, pelo índice de massa corporal, segundo três critérios de avaliação: Conde e Monteiro, Cole et al. e Organização Mundial da Saúde (OMS). Aplicaram-se testes descritivos e de associação para análise do comportamento das variáveis e o coeficiente de Kappa para investigar a concordância dos resultados entre os três critérios.Resultados: Participaram da pesquisa 1.387 crianças (714 meninos) com idade média de 5 anos. Os meninos apresentaram maior prevalência de sobrepeso em relação às meninas pela classificação da OMS, em contrapartida maior proporção de meninas com baixo peso, segundo o critério nacional. Os melhores níveis de concordância foram para o sexo feminino e o protocolo nacional apresentou satisfatória concordância com os protocolos de uso internacional, com destaque para o proposto pela OMS. Conclusão: Desse modo, conclui-se que houve concordância entre os critérios de avaliação do estado nutricional em crianças do Baixo Amazonas.  

Ingestive behavior and thermoregulation in sheep fed forage cactus silage undergoing intermittent water supply

This study aimed to assess the effect of using forage cactus silage in the diet of sheep under intermittent water supply on its ingestive behavior and thermoregulation. We used in the experiment thirty-six intact male sheep of undefined genotype with an initial average weight of 19.8 ± 2.1 kg and age of approximately six months. The experimental design was a randomized block design in a 3 × 3 factorial scheme composed of three levels of forage cactus silage in the diet (0, 21, and 42%), three water supply periods (0, 24, and 48 hours), and four replications. For the ingestive behavior, observations were carried out every 5 minutes for 2 periods of 24 hours. Thermoregulatory responses were taken at 7:00 and 15:00 h on days other than those intended for ingestive behavior tests. Intermittent water supply did not affect any of the studied variables (P > 0.05). The use of forage cactus silage significantly influenced the ingestive behavior of animals (P < 0.05). Sheep fed forage cactus silage in the diet presented an average feeding efficiency of 255.77 g DM h?1 and an average rumination efficiency of 102.16 g DM h?1, while animals fed control diet showed values of 198.63 and 78.45 g DM h?1, respectively. Urinary frequency increased according to the levels of forage cactus silage in the diet, with 23.60 urination per day in animals fed diets with 42% of forage cactus silage and 10.83 urination per day in animals fed control diet. However, the search for water reduced, with averages of 2.73 and 0.54 per day for animals fed 0 and 42% forage cactus silage, respectively. The use of forage cactus silage also increased thermoregulatory responses of sheep, with an average respiratory rate of 103.35 mov. min?1 and heart rate of 140.08 mov. min?1 in the warmest period of the day (in the afternoon). Thus, sheep fed forage cactus silage increases its feeding and rumination efficiencies, decreases its search for water, and increases its thermoregulatory responses. The intermittent water supply within 48 hours does not influence the ingestive behavior and thermoregulation of confined sheep

Final results from the PERUSE study of first-line pertuzumab plus trastuzumab plus a taxane for HER2-positive locally recurrent or metastatic breast cancer, with a multivariable approach to guide prognostication

Background: The phase III CLinical Evaluation Of Pertuzumab And TRAstuzumab (CLEOPATRA) trial established the combination of pertuzumab, trastuzumab and docetaxel as standard first-line therapy for human epidermal growth factor receptor 2 (HER2)-positive locally recurrent/metastatic breast cancer (LR/mBC). The multicentre single-arm PERtUzumab global SafEty (PERUSE) study assessed the safety and efficacy of pertuzumab and trastuzumab combined with investigator-selected taxane in this setting. Patients and methods: Eligible patients with inoperable HER2-positive LR/mBC and no prior systemic therapy for LR/mBC (except endocrine therapy) received docetaxel, paclitaxel or nab-paclitaxel with trastuzumab and pertuzumab until disease progression or unacceptable toxicity. The primary endpoint was safety. Secondary endpoints included progression-free survival (PFS) and overall survival (OS). Prespecified subgroup analyses included subgroups according to taxane, hormone receptor (HR) status and prior trastuzumab. Exploratory univariable analyses identified potential prognostic factors; those that remained significant in multivariable analysis were used to analyse PFS and OS in subgroups with all, some or none of these factors. Results: Of 1436 treated patients, 588 (41%) initially received paclitaxel and 918 (64%) had HR-positive disease. The most common grade 653 adverse events were neutropenia (10%, mainly with docetaxel) and diarrhoea (8%). At the final analysis (median follow-up: 5.7 years), median PFS was 20.7 [95% confidence interval (CI) 18.9-23.1] months overall and was similar irrespective of HR status or taxane. Median OS was 65.3 (95% CI 60.9-70.9) months overall. OS was similar regardless of taxane backbone but was more favourable in patients with HR-positive than HR-negative LR/mBC. In exploratory analyses, trastuzumab-pretreated patients with visceral disease had the shortest median PFS (13.1 months) and OS (46.3 months). Conclusions: Mature results from PERUSE show a safety and efficacy profile consistent with results from CLEOPATRA and median OS exceeding 5 years. Results suggest that paclitaxel is a valid alternative to docetaxel as backbone chemotherapy. Exploratory analyses suggest risk factors that could guide future trial design

Effect of different levels of concentrate and inclusion of protected fat in the diet on the productive performance and thermoregulation of sheep.

Esse trabalho foi realizado com o intuito de levantar informações sobre a relação entre o nível dos alimentos: volumoso e concentrado sobre o desempenho produtivo e a termorregulação de ovinos, bem como averiguar se a utilização de gordura protegida na alimentação desses animais tem efeito positivo tanto sobre seu desempenho como sobre o seu bem estar. Assim foi feita uma revisão de literatura sobre o tema com base em estudos de vários autores para que se pudesse confrontar tais informações. Foram abordadas informações, em sua maioria, de artigos publicados nos últimos cinco anos, que retratam a importância da utilização do nível adequado de alimento concentrado, bem como da inclusão de gordura protegida na dieta de ruminantes. A partir do que foi observado, verificou-se que o nível de concentrado quando elevado pode comprometer a termorregulação de ruminantes em ambiente de estresse calórico e que a inclusão de gordura protegida pode em alguns casos melhorar o desempenho produtivo desses animais.This work was conducted in order to gather information about the relationship between the level of concentrate, the production performance and thermoregulation of sheep, as well as to establish whether the use of protected fat in the diet of these animals has a positive effect both on their performance and on their welfare. So we made a literature review on the topic based on studies of several authors so that they could confront such information. We approached information, mostly of articles published in the last five years, portraying the importance of using the appropriate level of concentrate, as well as the inclusion of protected fat in the diet of ruminants. From the results obtained, it was found that when the concentrate level high can impair Thermoregulation in ruminant environment and heat stress that inclusion of fat protected may in some cases improve the productive performance of these animals

VIOLÊNCIA ENTRE TORCIDAS ORGANIZADAS NO FUTEBOL

No futebol, esporte que é admirado pela população brasileira como forma de prazer, alegria, ousadia e felicidade, local de grandes atrações como o rei do futebol, Edson Arantes do Nascimento ou simplesmente Pelé, cria-se um cenário que diferentemente de todos os benefícios dessa maestria futebolística, começa a se tornar palco de violência entre torcedores que ao invés de demonstrarem amor à camisa, efetuam atitudes agressivas e inadequadas as quais sujam esse desporto coletivo. O objetivo desse estudo foi identificar as principais causas da violência entre torcidas organizadas nos estádios de futebol. Trata-se de uma revisão sistemática de literatura, de caráter descritivo e qualitativo. Utilizando como base de dados o Google Acadêmico e uma combinação de palavras-chave, foi realizada uma síntese dos principais estudos relacionados a temática em questão para posterior análise. A partir dos termos de busca foram encontrados 250 estudos, destes 29 estavam relacionados a temática e foram selecionados para leitura na íntegra. Após análise, apenas 5 trabalhos atenderam aos critérios e foram incluídos nos resultados. Foi possível constatar que entre as principais causas da violência entre torcidas organizadas no futebol, encontra-se o uso exagerado de bebidas alcoólicas, fanatismo, influência dos árbitros e atitudes antidesportistas, e que tais fatores podem ocasionar acidentes graves, como agressões física e até mesmo a fatalidade de alguns torcedores. Assim sendo, notou-se que a utilização do Juizado Especial Criminal nos estádios de futebol, podem ajudar a minimizar esse tipo de violência

Cactus Pear Silage to Mitigate the Effects of an Intermittent Water Supply for Feedlot Lambs: Intake, Digestibility, Water Balance and Growth Performance

The aim of this study was to evaluate the intake, digestibility, water balance and growth performance of lambs receiving diets containing cactus silage under an intermittent water supply. Thirty-six male, uncastrated Santa Inês lambs with an initial weight of 19.8 ± 2.1 kg and age of 6 months were distributed in a 3 × 3 factorial arrangement, with three proportions of cactus pear in the diets (0 (control diet containing Tifton hay), 21% and 42% of dry matter) and three periods of intermittent water supply (0, 24 and 48 h), with four repetitions. Lambs that received diets non-isonitrogenous with cactus silage showed higher intakes of dry matter (p p p p p = 0.005), water intake via food (p p p p p = 0.001). When using 42% forage cactus silage in place of Tifton hay and water offered at 48 h intervals, intake, digestibility, and performance of feedlot lambs were improved

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)