AIDS: VINTE QUATRO ANOS DE LUTA.

Se trata de un estudio exploratorio bibliográfico, de naturaleza cualitativa, cuyo objeto es la trayectoria del sida en el mundo y en Brasil. Los objetivos son rescatar las informaciones sobre el VIH/SIDA, en el período del 1980 a 2004, y presentar aspectos referentes al histórico, patología, diagnosis, tratamiento, cuidado y a la epidemiología. Como abordaje teórico metodológico utilizamos el programa nacional de EST’S/sida, documentos, artículos, el desarrollo del estudio registrado en el Directorio de los Grupos de Investigación del CNPq (Consejo Nacional de Desarrollo Científico y Tecnológico) y en el NUPHEBRAS (Núcleo de Investigación de la Enfermería Brasileña) “Dos décadas de VIH/SIDA”, y otras investigaciones ya hechas y estudios que presentasen histórico desde el surgimiento hasta la situación actual en el mundo y en Brasil; el principio de la infección (instalación), las maneras de transmisión y las medicinas disponibles, de entre otras actualizaciones y datos epidemiológicos. Sin pretensión de agotar el tema intentamos mejorar el cuidado de Enfermería haciéndolo más holístico. Constatamos que después de dos décadas, el Sida continúa siendo un síndrome con una carga clasista, con estigma y desafíos, pues la ciencia avanza, pero este síndrome continúa sin curación. Concluimos que la enfermería, así como todas las profesiones de salud, debe estar siempre bien informada, actualizada y atenta a fin de pasar a su cliente y familia toda la información necesaria con respecto a lo que desea, previniendo con esto los casos de abandono, no comprensión correcta de su cuadro clínico, no adherencia medicamentosa de entre otras muchas situaciones. Por ello se hace necesario también, desarrollar una comunicación efectiva con el cliente, reflexionando y construyendo posibles estrategias para mejorar el tratamiento y el cuidado de Enfermería.Trata-se de um estudo exploratório bibliográfico, de natureza qualitativa, cujo objeto é a trajetória da aids no mundo e no Brasil. Os objetivos são resgatar as informações sobre o HIV/ AIDS, no período de 1980 A 2004, e apresentar aspectos referentes ao histórico, patologia, diagnóstico, tratamento, cuidado e epidemiologia Como abordagem teórico metodológica utilizamos o programa nacional de DST/Aids, documentos, artigos, o desenvolvimento do estudo registrado no Diretório dos Grupos de Pesquisa do CNPq e no NUPHERBRAS “Duas Décadas de HIV/AIDS”, outras pesquisas já realizadas e estudos que apresentassem histórico desde o surgimento até a situação atual no mundo e no Brasil; o inicio da infecção (instalação), os modos de transmissão e os medicamentos disponíveis, dentre outras atualizações e dados epidemiológicos. Sem pretensão de exaurir o tema intentamos aprimorar o cuidado de Enfermagem tornando-o mais holístico. Constatamos que apesar de duas décadas a aids continua sendo uma síndrome com uma bagagem preconceituosa, com estigma e desafios, uma vez que a ciência avança, mas essa síndrome continua sem cura. Concluímos que a Enfermagem, bem como todas as profissões de saúde, deve estar sempre bem informada, atualizada e atenta a fim de passar para seu cliente e família toda informação necessária a respeito do que ele deseja, evitando com isso casos de abandono, não compreensão correta de seu quadro clinico, não adesão medicamentosa dentre outras muitas situações. Para tal faz-se necessário, também, desenvolver uma comunicação efetiva com o cliente, refletindo e construindo possíveis estratégias para melhorar o tratamento e o cuidado de Enfermagem

Production of ethanol from mesquite ( Prosopis juliflora (SW) D.C.) pods mash by Zymomonas mobilis and Saccharomyces cerevisiae

This study aimed to assess the use of mesquite pods hydrated mash as biomass for the growth of Saccharomyces cerevisiae UFEPEDA-1012 and Zymomonas mobilis UFEPEDA-205 and for ethanol production using a submerged fermentation. A 23 factorial design was used to analyze the effects of the type of microorganism, time of fermentation and condition of cultivation on the ethanol production in mesquite pods mash (30 g 100 mL-1). From the obtained results the hydrated mesquite pods mash presented as a good substrate for the growth of S. cerevisiae and Z. mobilis in comparison to the standard media. The effect that most affected the ethanol production was the type of microorganism. The highest ethanol concentration (141.1 gL-1) was found when Z. mobilis was cultivated in mesquite pods mash under static condition for 36 hrs. Ethanol production by S. cerevisiae was higher (44.32 gL-1) after 18 hrs of fermentation under static condition. According to these results, the mesquite pods could be known as an alternative substrate to be used for biotechnological purposes, mainly for ethanol production

Incidence and risk factors for hyperglycemia in pregnancy among nulliparous women : a Brazilian multicenter cohort study

Objective To assess the incidence and risk factors for hyperglycemia in pregnancy in a cohort of Brazilian nulliparous pregnant women. Materials and methods This is a secondary analysis of a multicenter cohort study that enrolled 1,008 nulliparous pregnant women at 19–21 weeks. Exclusion criteria included chronic exposure to corticosteroids and previous diabetes. Bivariate and multivariate analyses by Poisson regression were used to identify associated factors. Results The incidence of hyperglycemia in pregnancy was 14.9% (150/1,008), and 94.7% of these cases were gestational diabetes mellitus (142/150). Significant associated factors included a family history of diabetes mellitus, maternal overweight or obesity at enrollment, and previous maternal conditions (polycystic ovarian syndrome, thyroid dysfunctions and hypertensive disorders). A BMI ≥ 26.3Kg/m2 (RRadj 1.87 [1.66–2.10]) and a family history of diabetes mellitus (RRadj 1.71 [1.37–2.15]) at enrollment were independent risk factors for HIP. Conclusions A family history of diabetes mellitus and overweight or obesity (until 19–21 weeks of gestation) may be used as selective markers for HIP in Brazilian nulliparous women. Given the scarcity of results in nulliparous women, our findings may contribute to determine the optimal diagnostic approach in populations of similar socioeconomic characteristics

Incidence and risk factors for Preeclampsia in a cohort of healthy nulliparous pregnant women: a nested case-control study

The objective of this study is to determine the incidence, socio-demographic and clinical risk factors for preeclampsia and associated maternal and perinatal adverse outcomes. This is a nested case-control derived from the multicentre cohort study Preterm SAMBA, in five different centres in Brazil, with nulliparous healthy pregnant women. Clinical data were prospectively collected, and risk factors were assessed comparatively between PE cases and controls using risk ratio (RR) (95% CI) plus multivariate analysis. Complete data were available for 1,165 participants. The incidence of preeclampsia was 7.5%. Body mass index determined at the first medical visit and diastolic blood pressure over 75 mmHg at 20 weeks of gestation were independently associated with the occurrence of preeclampsia. Women with preeclampsia sustained a higher incidence of adverse maternal outcomes, including C-section (3.5 fold), preterm birth below 34 weeks of gestation (3.9 fold) and hospital stay longer than 5 days (5.8 fold) than controls. They also had worse perinatal outcomes, including lower birthweight (a mean 379 g lower), small for gestational age babies (RR 2.45 [1.52-3.95]), 5-minute Apgar score less than 7 (RR 2.11 [1.03-4.29]), NICU admission (RR 3.34 [1.61-6.9]) and Neonatal Near Miss (3.65 [1.78-7.49]). Weight gain rate per week, obesity and diastolic blood pressure equal to or higher than 75 mmHg at 20 weeks of gestation were shown to be associated with preeclampsia. Preeclampsia also led to a higher number of C-sections and prolonged hospital admission, in addition to worse neonatal outcomes9CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQ401636/2013-5Bill and Melinda Gates FoundationGates Foundation [OPP1107597]; CNPqNational Council for Scientific and Technological Development (CNPq) [401636/2013-5

Planning, Implementing, and Running a Multicentre Preterm Birth Study with Biobank Resources in Brazil: The Preterm SAMBA Study

Background. Our aim was to describe the steps in planning, implementing, and running a multicentre cohort study of maternal and perinatal health using a high-quality biobank comprised of maternal serum, plasma, and hair samples collected from five sites in Brazil. The Preterm SAMBA study, conducted by the Brazilian Network for Studies on Reproductive and Perinatal Health, was an innovative approach used to identify women at higher risk for preterm birth. It is also of great importance in the study of other maternal and perinatal complications in the context of Brazil, which is a middle-income country. Methods. We described phases of planning, implementing, and running the Preterm SAMBA study, a multicentre Brazilian cohort study of low-risk nulliparous pregnant women, to validate a set of metabolite biomarkers for preterm birth identified in an external cohort. Procedures and strategies used to plan, implement, and maintain this multicentre preterm birth study are described in detail. Barriers and experience cited in the current narrative are not usually discussed in the scientific literature or published study protocols. Results. Several barriers and strategies were identified in different phases of the Preterm SAMBA study at different levels of the study framework (steering committee; coordinating and local centres). Strategies implemented and resources used in the study are a legacy of the Brazilian Network, aimed at training collaborators in such complex settings. Conclusion. The Brazilian Network for Studies on Reproductive and Perinatal Health has gained some experience in conducting a multicentre cohort study using a resourceful biobank which may be helpful to other research groups and maternal/perinatal health networks that plan on employing a similar approach to a similar background.201

Use of metabolomics for the identification and validation of clinical biomarkers for preterm birth:Preterm SAMBA

Made available in DSpace on 2018-12-11T17:29:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-08-08Background: Spontaneous preterm birth is a complex syndrome with multiple pathways interactions determining its occurrence, including genetic, immunological, physiologic, biochemical and environmental factors. Despite great worldwide efforts in preterm birth prevention, there are no recent effective therapeutic strategies able to decrease spontaneous preterm birth rates or their consequent neonatal morbidity/mortality. The Preterm SAMBA study will associate metabolomics technologies to identify clinical and metabolite predictors for preterm birth. These innovative and unbiased techniques might be a strategic key to advance spontaneous preterm birth prediction. Methods/design: Preterm SAMBA study consists of a discovery phase to identify biophysical and untargeted metabolomics from blood and hair samples associated with preterm birth, plus a validation phase to evaluate the performance of the predictive modelling. The first phase, a case-control study, will randomly select 100 women who had a spontaneous preterm birth (before 37 weeks) and 100 women who had term birth in the Cork Ireland and Auckland New Zealand cohorts within the SCOPE study, an international consortium aimed to identify potential metabolomic predictors using biophysical data and blood samples collected at 20 weeks of gestation. The validation phase will recruit 1150 Brazilian pregnant women from five participant centres and will collect blood and hair samples at 20 weeks of gestation to evaluate the performance of the algorithm model (sensitivity, specificity, predictive values and likelihood ratios) in predicting spontaneous preterm birth (before 34 weeks, with a secondary analysis of delivery before 37 weeks). Discussion: The Preterm SAMBA study intends to step forward on preterm birth prediction using metabolomics techniques, and accurate protocols for sample collection among multi-ethnic populations. The use of metabolomics in medical science research is innovative and promises to provide solutions for disorders with multiple complex underlying determinants such as spontaneous preterm birth.University of Campinas (UNICAMP) School of Medical Sciences Department of Obstetrics and Gynecology, R. Alexander Fleming, 101University of Auckland Gravida: National Centre for Growth and Development Liggins InstituteUniversity College Cork Irish Centre for Fetal and Neonatal Translational Research (INFANT) Department of Obstetrics and GynaecologyUniversity of Auckland South Auckland Clinical School Faculty of Medical and Health SciencesUniversity of Auckland School of Biological SciencesUniversity of Campinas (UNICAMP) LNBio-Brazilian Biosciences National Laboratory and School of Medical SciencesSchool of Medical Sciences University of CampinasLNBioSchool of Medicine of Botucatu UNESPSchool of Medicine Federal University of Rio Grande do SulSchool of Medicine Federal University of PernambucoSchool of Medicine Federal University of CearáKing's College London and King's Health PartnersMaternal and Fetal Health Research Centre University of ManchesterUniversity of LeedsUniversity of AdelaideSchool of Medicine of Botucatu UNES

Perinatal outcomes from preterm and early term births in a multicenter cohort of low risk nulliparous women

Preterm birth is the major contributor for neonatal and under-fve years mortality rates and also accounts for a short- and long-term adverse consequences up to adulthood. Perinatal outcomes may vary according to lots of factors as preterm subtype, late prematurity, which account for the vast majority of cases, country and population characteristics. An under-recognition of the perinatal outcomes and its associated factors might have underpowered strategies to provide adequate care and prevent its occurrence. We aim to estimate the frequency of maternal and perinatal outcomes in women with diferent categories of preterm and term births, factors associated with poorer perinatal outcomes and related management interventions. A multicentre prospective cohort in fve maternities in Brazil between 2015 and 2018. Nulliparous low-risk women with singletons were included. Comprehensive data were collected during three antenatal visits (at 19–21weeks, 27–29 weeks and 37–39 weeks). Maternal and perinatal outcomes were also collected according to maternal and neonatal medical records. Women who had spontaneous (sPTB) and provider-initiated (pi-PTB) preterm birth were compared to those who had term birth. Also, late preterm birth (after 34 weeks), and early term (37–38 weeks) were compared to full term birth (39–40 weeks). Bivariate analysis estimated risk ratios for maternal and adverse outcomes. Finally, a multivariate analysis was conducted to address factors independently associated with any adverse perinatal outcome (APO). In total, 1,165 women had outcome data available, from which 6.7% had sPTB, 4.0% had pi-PTB and 89.3% had a term birth. sPTB and pi-PTb were associated with poorer perinatal outcomes, as well as late sPTB, late pi-PTB and early term neonates. pi-PTB (RRadj 8.12, 95% CI [2.54–25.93], p-value 0.007), maternal weight gain between 20 and 27 weeks <p10 (RRadj 2.04, 95% CI [1.23–3.38], p-value 0.018) and participants from the Northeast centres (RRadj 2.35, 95% CI [1.11–4.95], p-value 0.034) were independently associated with APO. According to our fndings, Brazil would beneft from strategies to more accurately identify women at higher risk for PTB, to promote evidenced-based decision in preterm and early term providerinitiated deliveries, and to prevent perinatal adverse outcomes

AIDS: vinte quatro anos de luta

Se trata de un estudio exploratorio bibliográfico, de naturaleza cualitativa, cuyo objeto es la trayectoria del sida en el mundo y en Brasil. Los objetivos son rescatar las informaciones sobre el VIH/SIDA, en el período del 1980 a 2004, y presentar aspectos referentes al histórico, patología, diagnosis, tratamiento, cuidado y a la epidemiología. Como abordaje teórico metodológico utilizamos el programa nacional de EST’S/sida, documentos, artículos, el desarrollo del estudio registrado en el Directorio de los Grupos de Investigación del CNPq (Consejo Nacional de Desarrollo Científico y Tecnológico) y en el NUPHEBRAS (Núcleo de Investigación de la Enfermería Brasileña) “Dos décadas de VIH/SIDA”, y otras investigaciones ya hechas y estudios que presentasen histórico desde el surgimiento hasta la situación actual en el mundo y en Brasil; el principio de la infección (instalación), las maneras de transmisión y las medicinas disponibles, de entre otras actualizaciones y datos epidemiológicos. Sin pretensión de agotar el tema intentamos mejorar el cuidado de Enfermería haciéndolo más holístico. Constatamos que después de dos décadas, el Sida continúa siendo un síndrome con una carga clasista, con estigma y desafíos, pues la ciencia avanza, pero este síndrome continúa sin curación. Concluimos que la enfermería, así como todas las profesiones de salud, debe estar siempre bien informada, actualizada y atenta a fin de pasar a su cliente y familia toda la información necesaria con respecto a lo que desea, previniendo con esto los casos de abandono, no comprensión correcta de su cuadro clínico, no adherencia medicamentosa de entre otras muchas situaciones. Por ello se hace necesario también, desarrollar una comunicación efectiva con el cliente, reflexionando y construyendo posibles estrategias para mejorar el tratamiento y el cuidado de Enfermería.Trata-se de um estudo exploratório bibliográfico, de natureza qualitativa, cujo objeto é a trajetória da aids no mundo e no Brasil. Os objetivos são resgatar as informações sobre o HIV/AIDS, no período de 1980 A 2004, e apresentar aspectos referentes ao histórico, patologia, diagnóstico, tratamento, cuidado e epidemiologia Como abordagem teórico metodológica utilizamos o programa nacional de DST/Aids, documentos, artigos, o desenvolvimento do estudo registrado no Diretório dos Grupos de Pesquisa do CNPq e no NUPHERBRAS “Duas Décadas de HIV/AIDS”, outras pesquisas já realizadas e estudos que apresentassem histórico desde o surgimento até a situação atual no mundo e no Brasil; o inicio da infecção (instalação), os modos de transmissão e os medicamentos disponíveis, dentre outras atualizações e dados epidemiológicos. Sem pretensão de exaurir o tema intentamos aprimorar o cuidado de Enfermagem tornando-o mais holístico. Constatamos que apesar de duas décadas a aids continua sendo uma síndrome com uma bagagem preconceituosa, com estigma e desafios, uma vez que a ciência avança, mas essa síndrome continua sem cura. Concluímos que a Enfermagem, bem como todas as profissões de saúde, deve estar sempre bem informada, atualizada e atenta a fim de passar para seu cliente e família toda informação necessária a respeito do que ele deseja, evitando com isso casos de abandono, não compreensão correta de seu quadro clinico, não adesão medicamentosa dentre outras muitas situações. Para tal faz-se necessário, também, desenvolver uma comunicação efetiva com o cliente, refletindo e construindo possíveis estratégias para melhorar o tratamento e o cuidado de Enfermagem