Cross-cultural adaptation and reliability analysis of the Brazilian version of Pediatric Balance Scale (PBS)

BACKGROUND: The Pediatric Balance Scale (PBS) was developed from a modified version of the Berg Balance Scale aiming to obtain a balance scale more appropriate for the child population. OBJECTIVES: To adapt the PBS into Brazilian-Portuguese and to evaluate the intra and inter-rater reliability of the Brazilian-Portuguese version of PBS. METHODS: To perform the cross-cultural adaptation of the American version of PBS four translators were involved, who have performed two translations and their respective back-translations. Then, a review by a multidisciplinary committee and a subsequent an assessment of the equivalence of meaning between the back-translations and the original English scale were performed by 3 and 30 healthcare professionals respectively. The intra-rater reliability of the final version of the Brazilian-Portuguese PBS was evaluated using a test-retest design with one-week interval. The Brazilian-Portuguese version of the PBS was tested twice on the same day by two different raters to test the inter-rater reliability. The inter-rater reliability, which was measured from a video of the volunteers performance, was evaluated by comparing the score given by five raters independently. Reliability was evaluated by Intraclass Correlation Coefficient (ICC). Fifteen volunteers (11±2.7 years) diagnosed with Cerebral Palsy (CP) classified at level I and II on the Gross Motor Function Classification System (GMFCS) were assessed. RESULTS: The reliability of the PBS total score for both intra-rater (ICC=0.85) and inter-rater (ICC=0.91) was excellent. The inter-rater reliability (measured from the video) for the total score was also classified as excellent (ICC=0.98). CONCLUSION: The results showed adequate reliability for the PBS for pediatric population with CP diagnostic classified at level I and II on the GMFCS.CONTEXTUALIZAÇÃO: A Pediatric Balance Scale (PBS) foi desenvolvida a partir de uma modificação da Escala de Equilíbrio de Berg (EEB), visando obter uma escala de equilíbrio mais apropriada para a população infantil. OBJETIVOS: Adaptar para o português-Brasil e avaliar a confiabilidade intra-avaliador e interavaliadores/observadores da versão brasileira da PBS. MÉTODOS: Para a adaptação cultural da versão americana da PBS, foram envolvidos quatro tradutores que realizaram duas traduções e respectivas retrotraduções, uma revisão por um comitê multidisciplinar e uma avaliação subsequente da equivalência de significado entre as retrotraduções e o original (respectivamente três e 30 profissionais da área de saúde). A confiabilidade intra-avaliador da escala final em Português - Escala de Equilíbrio Pediátrica (EEP) - foi avaliada comparando-se duas avaliações repetidas pelo mesmo avaliador com o intervalo de uma semana. A confiabilidade interavaliadores foi testada comparando-se as avaliações de dois avaliadores diferentes que realizaram o teste no mesmo dia. A confiabilidade interobservadores, a partir do vídeo do desempenho dos voluntários, foi avaliada por meio da comparação da pontuação dada independentemente por cinco observadores. A confiabilidade foi avaliada por meio do Coeficiente de Correlação Intraclasse (CCI). Foram avaliados 15 voluntários (11±2,7 anos) com diagnóstico de Paralisia Cerebral (PC), classificados nos níveis I e II do Sistema de Classificação da Função Motora Grossa (GMFCS). RESULTADOS: A confiabilidade para o escore total da EEP foi excelente tanto para o teste intra-avaliador (CCI=0,85) como para o interavaliadores (CCI=0.91). A confiabilidade interobservadores (a partir do vídeo) para o escore total foi excelente (CCI=0,98). CONCLUSÃO: Os resultados mostraram confiabilidade adequada para a EEP para a população pediátrica com diagnóstico de PC classificada nos níveis I e II do GMFCS.Universidade do Estado de Santa Catarina Postgraduate Program in Physical TherapyUniversidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Genetic characterization of some neoponera (Hymenoptera: Formicidae) populations within the foetida species complex

The foetida species complex comprises 13 Neotropical species in the ant genus Neoponera Emery (1901). Neoponera villosa Fabricius (1804) , Neoponera inversa Smith (1858), Neoponera bactronica Fernandes, Oliveira & Delabie (2013), and Neoponera curvinodis (Forel, 1899) have had an ambiguous taxonomic status for more than two decades. In southern Bahia, Brazil, these four species are frequently found in sympatry. Here we used Bayesian Inference and maximum likelihood analyses of COI and 16S mtDNA sequence data and conventional cytogenetic data together with observations on morphology to characterize sympatric populations of N. villosa, N. inversa, N. bactronica, and N. curvinodis. Our results showed marked differences in the karyotype of these ants. Both N. curvinodis and N. inversa have chromosome number of 2n = 30. Their chromosome composition, however, is distinct, which indicates that N. curvinodis is more closely related to N. bactronica. These four species clustered into three distinct groups. The close relationship between N. bactronica and N. curvinodis deserves further investigation since it has not been fully resolved here. Our results confirm that N. inversa, N. villosa, N. bactronica + N. curvinodis indeed represent four distinct taxa within the foetida species complex

The potential therapeutic use of cord blood in autologous transplants or in special patients: a review and update

Umbilical Cord Blood is a rich source of hematopoietic stem cells widely used as a substitute of bone marrow (BM) in transplants. Cells from umbilical cord blood present advantages over BM cells, mainly as they are younger and a have higher proliferative rate. Besides hematopoietic stem cells, umbilical cord blood contains endothelial and mesenchymal progenitor cells, suggesting their possible application in cell therapy protocols for different tissues. In this paper, we discuss the importance of autologous umbilical cord blood storage and the research on stem cell transplantation for degenerative diseases.O sangue de cordão umbilical e placentário (SCUP) é uma rica fonte de células-tronco (CT) hematopoéticas e é amplamente utilizado como substituto da medula óssea em casos de transplante. As células do SCUP possuem vantagens sobre as células da medula óssea (MO), principalmente por serem mais jovens e apresentarem maior taxa proliferativa. Além dos progenitores hematopoéticos, o sangue de cordão umbilical contém progenitores endoteliais e mesenquimais, sugerindo sua possível aplicação nos novos protocolos de terapia celular para diferentes tecidos. Na presente revisão, discutimos a importância do armazenamento do sangue de cordão umbilical autólogo e as pesquisas desenvolvidas para a sua aplicação em doenças degenerativas.Cryopraxis Criobiologia LtdaUniversidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM)Instituto de Traumato-ortopediaSanta Casa de São PauloHospital Samaritano de São PauloUFRJ HUCFFHospital Central do ExércitoUFRJ IPPMGUFRJCollege of Medicine Department of Neurosurgery Center of Excellence for Aging & Brain RepairUNIFESP, EPMSciEL

Identification of Piecemeal Degranulation and Vesicular Transport of MBP-1 in Liver-Infiltrating Mouse Eosinophils During Acute Experimental Schistosoma mansoni Infection

Eosinophils have been long associated with helminthic infections, although their functions in these diseases remain unclear. During schistosomiasis caused by the trematode Schistosoma mansoni, eosinophils are specifically recruited and migrate to sites of granulomatous responses where they degranulate. However, little is known about the mechanisms of eosinophil secretion during this disease. Here, we investigated the degranulation patterns, including the cellular mechanisms of major basic protein-1 (MBP-1) release, from inflammatory eosinophils in a mouse model of S. mansoni infection (acute phase). Fragments of the liver, a major target organ of this disease, were processed for histologic analyses (whole slide imaging), conventional transmission electron microscopy (TEM), and immunonanogold EM using a pre-embedding approach for precise localization of major basic protein 1 (MBP-1), a typical cationic protein stored pre-synthesized in eosinophil secretory (specific) granules. A well-characterized granulomatous inflammatory response with a high number of infiltrating eosinophils surrounding S. mansoni eggs was observed in the livers of infected mice. Moreover, significant elevations in the levels of plasma Th2 cytokines (IL-4, IL-13, and IL-10) and serum enzymes (alanine aminotransferase and aspartate aminotransferase) reflecting altered liver function were detected in response to the infection. TEM quantitative analyses revealed that while 19.1% of eosinophils were intact, most of them showed distinct degranulation processes: cytolysis (13.0%), classical and/or compound exocytosis identified by granule fusions (1.5%), and mainly piecemeal degranulation (PMD) (66.4%), which is mediated by vesicular trafficking. Immunonanogold EM showed a consistent labeling for MBP-1 associated with secretory granules. Most MBP-1-positive granules had PMD features (79.0 ± 4.8%). MBP-1 was also present extracellularly and on vesicles distributed in the cytoplasm and attached to/surrounding the surface of emptying granules. Our data demonstrated that liver-infiltrating mouse eosinophils are able to degranulate through different secretory processes during acute experimental S. mansoni infections with PMD being the predominant mechanism of eosinophil secretion. This means that a selective secretion of MBP-1 is occurring. Moreover, our study demonstrates, for the first time, a vesicular trafficking of MBP-1 within mouse eosinophils elicited by a helminth infection. Vesicle-mediated secretion of MBP-1 may be relevant for the rapid release of small concentrations of MBP-1 under cell activation

Occupational exposure of workers to pesticides: Toxicogenetics and susceptibility gene polymorphisms

Farm workers are often exposed to pesticides, which are products belonging to a specific chemical group that affects the health of agricultural workers and is mostly recognized as genotoxic and carcinogenic. The exposure of workers from Piauí, Brazil, to these hazardous chemicals was assessed and cytogenetic alterations were evaluated using the buccal micronucleus assay, hematological and lipid parameters, butyrylcholinesterase (BChE) activity and genetic polymorphisms of enzymes involved in the metabolism of pesticides, such as PON1, as well as of the DNA repair system (OGG1, XRCC1 and XRCC4). Two groups of farm workers exposed to different types of pesticides were evaluated and compared to matched non-exposed control groups. A significant increase was observed in the frequencies of micronuclei, kariorrhexis, karyolysis and binucleated cells in the exposed groups (n = 100) compared to controls (n = 100). No differences were detected regarding the hematological parameters, lipid profile and BChE activity. No significant difference was observed either regarding DNA damage or nuclear fragmentation when specific metabolizing and DNA repair genotypes were investigated in the exposed groups

Morte digna da criança: percepção de enfermeiros de uma unidade de oncologia

O objetivo deste estudo foi identificar o significado e as intervenções de enfermeiros que atuam em oncologia pediátrica na promoção de morte digna da criança. Utilizaram-se como referencial teórico e metodológico o interacionismo simbólico e a pesquisa de narrativa. Os dados foram coletados junto a oito enfermeiros de uma unidade de oncologia pediátrica de um hospital público de São Paulo, por meio de entrevistas semiestruturadas. A análise dos dados permitiu a identificação de cinco categorias: sentir-se sem autonomia para a tomada de decisão; cuidar da família; oferecer conforto físico; valorizar o cuidado humanizado e aprender a lidar com a morte e o morrer. Este estudo contribui para ampliar a compreensão do processo de cuidar e permite avançar na postulação de um quadro teórico que contemple a integração de saberes e ações que constituem uma assistência integral, transcendendo o atendimento de necessidades apenas clínicas e biológicas

Dietary factors associated with metabolic syndrome in Brazilian adults

<p>Abstract</p> <p>Background</p> <p>Metabolic Syndrome (MS) is defined as the association of numerous factors that increase cardiovascular risk and diet is one of the main factors related to increase the MS in the population. This study aimed to evaluate the association of diet on the presence of MS in an adult population sample.</p> <p>Methodology</p> <p>305 adults were clinically screened to participate in a lifestyle modification program. Anthropometric assessments included waist circumference (WC), body fat and calculated BMI (kg/m²) and muscle-mass index (MMI kg/m²). Dietary intake was estimated by 24 h dietary recall. Fasting blood was used for biochemical analysis. MS was diagnosed using NCEP-ATPIII (2001) criteria with adaptation for glucose (≥ 100 mg/dL). Logistic regression (Odds ratio) was performed in order to determine the odds ratio for developing MS according to dietary intake.</p> <p>Results</p> <p>An adequate intake of fruits, OR = 0.52 (CI:0.28-0.98), and an intake of more than 8 different items in the diet (variety), OR = 0.31 (CI:0.12-0.79) showed to be a protective factor against a diagnosis of MS. Saturated fat intake greater than 10% of total caloric value represented a risk for MS diagnosis, OR = 2.0 (1.04-3.84).</p> <p>Conclusion</p> <p>Regarding the dietary aspect, a risk factor for MS was higher intake of saturated fat, and protective factors were high diet variety and adequate fruit intake.</p