Counselling sessions increased duration of exclusive breastfeeding: a randomized clinical trial with adolescent mothers and grandmothers

Background: Considering that adolescent mothers may be more vulnerable to discontinuing exclusive breastfeeding (EBF) before 6 months and that their mothers may exert a negative influence on this practice, this study was conducted with the objective of evaluating the efficacy of breastfeeding counselling for adolescent mothers and their mothers in increasing EBF duration. Methods: A clinical trial was performed in 323 adolescent mothers with newborns and their mothers randomized in four groups: (1) not living with mother, without intervention; (2) not living with mother, with intervention; (3) living with mother, without intervention, (4) living with mother, with intervention. The intervention consisted of five counselling sessions directed to mother and grandmother, in the maternity hospital and on follow-up. Information about feeding practices during the newborn’s first six months of life was collected monthly by telephone. Intervention’s efficacy was measured through Cox regression and comparison of exclusive breastfeeding medians and survival curves for the different groups. Results: The intervention increased the duration of EBF by67 days for the group which included grandmothers (HR = 0.64; CI 95% = 0.46-0.90) and 46 days for the group which did not include grandmothers (HR = 0.52; CI 95% = 0.36-0.76). Conclusions: Counselling sessions in the first four months of children’s lives proved to be effective in increasing EBF duration among adolescent mothers

Changes in intestinal motility and in the myenteric plexus in a rat model of intestinal ischemia-reperfusion

Background/Purpose: Early histologic changes induced by intestinal ischemia-reperfusion injury (IIRI) have been extensively studied using animal models. However, information regarding late effects On intestinal motility is lacking. The aim of this study was to investigate the late effects of IIRI on myenteric plexus histology and intestinal motility. Materials and Methods: Thirty-two postweaning male mice weighing between 58 and 103 g were divided randomly into 4 groups: Control (unoperated), Sham (celiotomy), 30-minute ischemia (celiotomy and superior mesenteric artery ischemia for 30 minutes), and 45-minute ischemia (celiotomy and superior mesenteric artery ischemia for 45 minutes). Postoperative intestinal motility was assessed by weighing total fecal output for 24 hours on the 3rd, 7th, 14th, and 21st day after surgery. Segments of duodenum, jejunum, and ileum were examined at light microscopy for changes in the myenteric plexus. Results: Three weeks after IIRI, the ganglion cells from the myenteric plexus appeared in light microscopy, spongy or foamy, containing many vacuoles in their cytoplasm. The neuronal nucleus became irregular, with degenerative signs. These alterations did not occur among animals from the control or sham groups. Although the animals of the 45-minute ischemia group showed a significant drop in fecal output in the 21st postoperative day, this appeared to have no effect on weight gain. Conclusions: The results suggest that intestinal ischemia-reperfusion causes late neuronal damage. These changes resulted in alterations of intestinal motility, which, within the conditions of the present study, had no repercussion on general weight gain. (c) 2007 Elsevier Inc. All rights reserved.4261062106

Chronic liver abnormalities in sickle cell disease: A clinicopathological study in 70 living patients

Background and Aim: The present study aimed to evaluate the incidence and etiology of chronic liver abnormalities in 70 living patients with sickle cell disease from the Hematology and Hemotherapy Center of the State University of Campinas. Methods: Clinical and laboratory investigations, including liver function tests, serological tests for viral hepatitis and abdominal ultrasound, were performed in all patients. Additionally, liver biopsies were taken from 20 patients. Results: Sixty-seven (96%) patients had some liver abnormality; these included abnormal liver function tests, viral hepatitis, liver ultrasonographic changes or cholelithiasis. The sickling process was the only explanation for the abnormal liver function tests or liver ultrasonographic changes in 24% of these patients. One or more defined reasons, including viral hepatitis, cholelithiasis, clinical hemosiderosis, alcoholism or diabetes, justified the liver abnormalities in 76% of the patients. Nineteen of the 20 liver biopsies presented some degree of vascular lesion; other histological findings were associated with hemosiderosis, viral hepatitis or cholestasis. Conclusions: In patients with sickle cell dis-ease, chronic liver abnormalities are frequent and seem to be a multifactorial phenomenon, depending on overlapping factors such as cholelithiasis, viral damage, iron overload and also the primary disease itself.Copyright (C) 2007 S. Karger AG, Basel.118312913

Passiflora edulis peel intake and ulcerative colitis: Approaches for prevention and treatment

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Inflammatory bowel disease is a chronic relapsing disease that affects millions of people worldwide; its pathogenesis is influenced by genetic, environmental, microbiological, and immunological factors. The aim of this study was to evaluate the effects of short- and long-term Passiflora edulis peel intake on the antioxidant status, microbiota, and short-chain fatty acids formation in rats with 2,4,6-trinitrobenzenesulphonic acid-induced colitis using two "in vivo" experiments: chronic (prevention) and acute (treatment). The colitis damage score was determined using macroscopic and microscopic analyses. In addition, the antioxidant activity in serum and other tissues (liver and colon) was evaluated. Bifidobacteria, lactobacilli, aerobic bacteria and enterobacteria, and the amount of short-chain fatty acids (acetic, butyric, and propionic acids) in cecum content were counted. Differences in the colon damage scores were observed; P. edulis peel intake improved serum antioxidant status. In the treatment protocol, decreased colon lipid peroxidation, a decreased number of aerobic bacteria and enterobacteria, and an improvement in acetic and butyric acid levels in the feces were observed. An improvement in the bifidobacteria and lactobacilli was observed in the prevention protocol. These results suggested that P. edulis peel can modulate microbiota and could be used as source of fiber and polyphenols in the prevention of oxidative stress through the improvement of serum and tissue antioxidant status.2395542551Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)FAPESP [2010/16752-3, 2010-10131-7

Percepções do fonoaudiólogo recém-formado quanto a sua formação, intenção profissional e atualização de conhecimentos Perceptions of newly graduated Speech and Language Pathologists regarding their academic formation, professional goals and knowledge update

OBJETIVO: Investigar as percepções do fonoaudiólogo recém-formado do estado do Rio de Janeiro quanto a sua formação, intenção profissional e busca por atualização de conhecimento. MÉTODOS: Participaram fonoaudiólogos graduados em cursos de formação no estado do Rio de Janeiro, nos anos 2005 e 2006. Foi aplicado um questionário constituído por dez perguntas fechadas, elaboradas para esta pesquisa e previamente verificadas por projeto piloto. Os dados foram submetidos a análise estatística com cruzamento de variáveis. RESULTADOS: Observou-se que a maioria dos fonoaudiólogos considerou-se atendida em suas expectativas e segura dos conhecimentos adquiridos (p<0,001). Esses profissionais pretendem atuar principalmente em clínicas (89%) e continuar se atualizando por meio de cursos de especialização (70%). A área de Linguagem foi considerada a que melhor subsidiou sua formação (68%), enquanto que Saúde Coletiva foi a que menos atendeu às expectativas (72%), com diferenças estatisticamente significativas. A indústria (70%) foi o local de trabalho considerado de acesso mais difícil ao fonoaudiólogo (p<0,05). CONCLUSÃO: Os fonoaudiólogos do estado do Rio de Janeiro graduados em 2005 e 2006 consideraram-se atendidos em suas expectativas quanto à formação, especialmente no que se refere à área de Linguagem, e apontaram maior interesse por atuação em clínica. Quanto à busca por atualização de conhecimento, a especialização foi o curso que despertou maior interesse.<br>PURPOSE: To investigate the perceptions of newly graduated Speech and Language Pathologists (SLP) from the state of Rio de Janeiro regarding their academic formation, professional goals and search for knowledge updates. METHODS: SLPs graduated from universities located at the state of Rio de Janeiro during the years of 2005 and 2006 participated in the study. A questionnaire with ten closed questions, developed for the present study and validated through a pilot study, was applied. Data were statistically analyzed comparing different variables. RESULTS: It was observed that the majority of the SLPs interviewed considered that their expectations were met and felt safe about the knowledge acquired (p<0.001). These professionals wish to act mostly in clinics (89%), and intend to continue their studies through lato sensu programs (70%). Language was considered the area in which they received the best support during their training (68%), while Public Health was the area in which they considered to have received less support (72%), and this difference was statistically significant. Industry was considered the most difficult workplace to be accessed by SLPs (p<0,05). CONCLUSION: Newly graduated SLPs from the state of Rio de Janeiro considered to have met their expectations regarding their formation, especially in the Language area, and showed more interest for the clinical setting. Lato sensu programs were the most attractive to the population studied for updating their knowledge