Peso materno em gestantes de baixo risco na atenção pré-natal

Objectives: To evaluate the nutritional status of low-risk pregnant women during prenatal, characterize the sociodemographic profile and quantify the patients with inadequate weight. Methods: Observational, prospective in low-risk pregnant women in Aracaju health centers, Sergipe, from March to June 2014. The evaluation followed the nutritional standards recommended by the Ministry of Health (MOH) and was conducted in three consultations consecutive, where the body mass index (BMI) was calculated by the researcher. Socioeconomic and gestational data of the patients were placed on a special form. Statistical analysis was performed using the EPI-INFO software, made distribution tables of frequencies and performed association testing variables. Results: 188 pregnant women were selected, of these 150 were eligible. The average age was 26 years, with standard deviation of 6.53. The average pre-pregnancy weight was 56.3 kg (± 20.8), average weights in the first, second and third reviews were 65.17 kg (± 12.8), 67.56 kg (± 12.9 ) and 69.97 kg (± 12.6), respectively. The pregnant woman’s card filling was incomplete in 63% of cases. In the pre-pregnancy period, 14% were malnourished and 14% obese. A significant association between BMI identified in the consultations and the inadequacy of pre-pregnancy BMI (p <0.01). Conclusions: Most of the women had BMI changed during the evaluations. Prenatal card filling proved inadequate, but there was no association with BMI during pregnancy. The factor related to pregnancy BMI change was the pre-pregnancy BMI inappropriate

A medida socioeducativa de internação sob uma lente foucaultiana

A partir de uma revisão bibliográfica, procura-se analisar as práticas das medidas socioeducativas pelos parâmetros do Estatuto da Criança e do Adolescente (ECA), tendo como suporte teórico as ideias foucaultianas. Nota-se que nestas instituições há um processo de negação da singularidade do jovem e de sua dinâmica familiar, que tem levado à cristalização de identificações estereotipadas pelo adolescente. Além disso, é discutido como as relações de poder no cenário jurídico reproduzem uma lógica punitiva e coercitiva no tratamento do jovem. De modo geral, a pesquisa possibilitou localizar diversas violações de direitos, na medida em que se evidenciam contradições acentuadas entre a lei e a prática e a utilização de verdades engessadas como forma de dominação.

Leiomioma uterino - repercussões clínicas e manejo cirúrgico: Uterine leiomyoma - clinical repercussions and surgical management

O leiomioma uterino (LU) é um tumor benigno que tem origem em uma única célula tronco que compõem o miométrio uterino. Essa afecção se manifesta por tumores benignos, que são os mais incidentes do aparelho reprodutor feminino, podendo variar de 20 a 50%. Vale ressaltar os principais fatores de risco, sendo eles: idade avançada, nuliparidade, obesidade, estado pré-menopausa, hipertensão, história familiar e obesidade. A origem fisiopatológica e do desenvolvimento do leiomioma ainda não foram totalmente descobertas, ainda que potenciais genéticos e mecanismos moleculares têm sido exaustivamente debatidos na literatura científica. Dentre as hipóteses do mecanismo patológico dessa doença, a principal delas está ligada às mutações do gene MED12. Em relação às manifestações clínicas, muitas pacientes com LU são assintomáticas, contudo, uma parcela significativa dessa população, por volta de 30%, pode apresentar sintomas, como metrorragia, dificuldade miccional ou fecal. Sabendo que a clínica do LU é variada, exames de imagem como a ultrassonografia são imprescindíveis para a confirmação do diagnóstico, sendo a ultrassonografia transabdominal e a transvaginal as mais utilizadas e classificadas segundo a Federação Internacional de Ginecologia e Obstetrícia. Na perspectiva terapêutica, a histerectomia persiste sendo o único tratamento cirúrgico definitivo para leiomiomas sintomáticos, desde que a mulher já esteja com sua prole definida e que não se oponha à retirada do útero. Tal método propedêutico apresenta resultados favoráveis quando se trata de menor tempo de operação e menor dor pós-operatória em 24 horas

Protocol for evaluating the in vitro effect of violet light-emitting diodes (LEDs) 410 nm ± 10 nm on yeast cultures

BACKGROUND: Candida spp and Malassezia spp cause superficial infections that may be resistant to conventional treatments. Violet light-emitting diodes (LEDs) therapy is a therapeutic alternative. PURPOSE: To describe the protocol for evaluating the antifungal effect of violet LEDs 410 nm ± 10 nm on Candida spp and Malassezia spp in vitro. PROTOCOL: LEDs 410 nm ± 10 nm are applied to a fungal suspension at fluences of 61.13 J/cm2, 91.70 J/cm2, and 183.39 J/cm2. The isolates are cultured for 48 to 72 hours. Colony forming units (CFUs) are quantified by visual counting and percent culture plate occupancy by digital analysis. Morphology is assessed by light microscopy and Gram staining, and yeast metabolism/function by transmission electron microscopy, assessment of reactive oxygen species, and DNA fragmentation. DATA ANALYSIS: the percentage of LEDs inhibition is calculated considering the growth of the negative control condition and the percentage of plate occupancy by yeasts by dividing the number of pixels classified as colonies by the total number of pixels on the plate. The morphological and functional aspects are described for the intervention and negative control. The ANOVA test is used to compare the mean percentages of growth inhibition and plate occupancy between the three fluences of LEDs 410 nm ± 10 nm and the negative control. ESTIMATED RESULTS: We intend to determine the antifungal effect of the different fluences of LEDs 410 nm ± 10 nm on Candida spp and Malassezia spp. The evaluation of other fungal species by this protocol should be investigated

Profile of Central and Effector Memory T Cells in the Progression of Chronic Human Chagas Disease

Chagas disease is a parasitic infection caused by protozoan Trypanosoma cruzi that affects approximately 11 million people in Latin America. The involvement of the host's immune response on the development of severe forms of Chagas disease has not been fully elucidated. Studies on the immune response against T. cruzi infection show that the immunoregulatory mechanisms are necessary to prevent the deleterious effect of excessive immune response stimulation and consequently the fatal outcome of the disease. A recall response against parasite antigens observed in in vitro peripheral blood cell culture clearly demonstrates that memory response is generated during infection. Memory T cells are heterogeneous and differ in both the ability to migrate and exert their effector function. This heterogeneity is reflected in the definition of central (TCM) and effector memory (TEM) T cells. Our results suggest that a balance between regulatory and effectors T cells may be important for the progression and development of the disease. Furthermore, the high percentage of central memory CD4+ T cells in indeterminate patients after stimulation suggests that these cells may modulate host's inflammatory response by controlling cell migration to tissues and their effector role during chronic phase of the disease

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe