Middle Childhood Adverse Psychomotor Outcomes from Malaria in Pregnancy: A Study using the Denver Developmental Screening Test-II

Objective: to evaluate changes in the development of premature children aged 5 to 6 years, born to mothers with malaria during pregnancy and to compare them to a control group of premature children born to mothers who did not have malaria during pregnancy. Methods: cross-sectional and analytical study. The Denver test-II was applied to 20 children in the study group and 20 children in the control group. Results: in the group of premature children of mothers with malaria during pregnancy, the vast majority showed abnormal performance with more significant changes in the activities of the language sector "define seven words", "say two compound words", "understand four prepositions" and "account five blocks”, “knows three adjectives”. In the fine-adaptive motor sector, the activities "draw people with six parts", "copy disassembled square", "copy +" and in the gross motor sector "swing your foot for six seconds", "swing your foot for five seconds", "swing the foot for four seconds", "rocks the foot for three seconds", were the most important developmental changes. In the control group, the performance of suspected delay or possible abnormality was more concentrated in the gross motor sector. Conclusions: children from 5 to 6 years of age, born prematurely to mothers with malaria during pregnancy, 80% had suspected abnormal performance, a result much higher than the group of children born prematurely to mothers without malaria. These results strongly suggest that malaria disease during pregnancy alters fetal development, producing developmental sequelae that can be detected even at 5 to 6 years of age. In addition, the results support the use of the Denver test-II as a simple screening method for the assessment of delays in child development, covering broad motor coordination (coarse), fine motor coordination (adaptive), language and personal-social adaptation. This test has been used to identify children who are at risk of developing problems and to monitor the child longitudinally

EFEITO DE DIFERENTES DOSES DE CLOPROSTENOL SÓDICO NO PERÍODO PÓS-PARTO DE VACAS DE CORTE

O restabelecimento da atividade reprodutiva pós-parto é dependente de dois processos fisiológicos, a involução uterina e o restabelecimento da atividade luteal cíclica. Problemas ou atrasos na involução uterina podem afetar diretamente a atividade ovariana pós-parto. As prostaglandinas F2a (PGF2a) exercem uma importante função no processo de involução uterina. Entretanto, a utilização dos análogos sintéticos da PGF2a para estimular involução uterina em bovinos tem sido pequena. O objetivo deste estudo foi avaliar o efeito de duas doses de uma mistura racêmica de cloprostenol (D+L-Cloprostenol), aplicadas no pós-parto imediato, sobre o desempenho reprodutivo de vacas mestiças de corte. Vacas de corte com parto normal foram divididas aleatoriamente em três grupos: G1(n=144), grupo controle; G2 (n=145), 0.530mg de D+L-Cloprostenol, aplicados IM de três a cinco dias após o parto, e G3 (n=145), 1.060 mg de D+L-Cloprostenol, no mesmo protocolo de G2. Foram analisados os serviços por concepção (c2), dias do parto à primeira inseminação e período de serviço. Não foram observadas diferenças no número de serviços por concepção nos três grupos (P>0.05). A média de dias do parto à primeira inseminação foi de 88,77 + 23,64ª; 77,59 + 26,95b e 76,22 + 26,28b, e o intervalo parto-concepção foi de 97.34±26.54ª; 86,38 + 28,81b; 85,23 + 30,12b, para os grupos 1, 2 e 3, respectivamente (P<0.05). O tratamento, independente da dose de cloprostenol, antecipou o reinicio da atividade reprodutiva em mais de 10 dias. A aplicação de cloprostenol sódico no pós-parto pode melhorar a eficiência reprodutiva de vacas de corte. Não existem diferenças entre as duas doses comparadas. PALAVRAS-CHAVE: bovino; involução uterina; prostaglandinas

2 nd Brazilian Consensus on Chagas Disease, 2015

Abstract Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

TRANSVERSALIDADE DE GENERO NO PROJETO MENINAS VELOZES

International audienc