A medida da atividade da fosfatase alcalina na deteccao da doenca ossea-metabolica da prematuridade e sua relacao com a dieta do recem-nascido prematuro de muito baixo peso

A observação de que os RNPMBPN alimentados com leite materno ou fórmula láctea não específica para prematuros estão em risco de desenvolvimento de deficiência osteomineral estimulou-nos ao desenvolvimento desse estudo. Nosso objetivo~ foi o de verificar se a adição de Cálcio e Fósforo a dieta oferecida aos RNPMBPN interfere na concentração da F A, levando em conta seu envolvimento no metabolismo ósseo. Foram selecionados 71 neonatos prematuros com PN inferior a 1500g de IO de inferior a 35 semanas divididos em 2 grupos. No OI os neonatos (n 37) receberam leite-matemo ou fórmula para lactentes a termo acrescido de sais de Ca e P; e no 02 (n 34)~ os neonatos receberam apenas leite matemo ou a mesma fórmula. Paralelamente~ selecionou-se um terceiro grupo de neonatos a termo AIO alimentados com LM ou fórmula. Ao ingressar no estudo não houve diferenças significativas entre os grupos G I e 02 com relação ao PN, PCN~ CN~ Sexo e IG. Os dois grupos receberam o mesmo volume de alimentação e taxas calóricoprotéicas semelhantes. Os RNPMBPN foram acompanhados com dosagens séricas quinzenais de Ca., P e FA ate atingirem 2000g. Não houve diferença significativa na média do Ca sérico nos G I e G2, mas em relação ao grupo 3 - a média do Ca sérico foi significativamente mmor do que nos outros 2 grupos. Encontrou-se resultados semelhantes com relação ao P sérico. A média da. concentração da. FA entre Gl e G2 diferiu significativamente a partir da. quarta semana de vida. A comparação das médias da concentração da. F~ nas diversas idades, entre Gl e G3 não mostra diferença significativa; no entanto, há significância. entre as médias de G2 e G3. Em sete neonatos de G2 - que alcançaram a concentração da F A 5 vezes o limite superior considerado como normal iniciou-se a. suplementação de Ca e P. Em todos houve a. diminuição da. concentração da. F A, com diferença estatisticamente significativa considerando-se o grupo. Concluímos que a medida da concentração da FA é um método útil e eficiente para a monitorização da. DOMP nos neonatos. Podemos concluir també~ que o leite humano eJou as fórmulas lácteas não especificas para RNPMBPN são inadequadas para. a sua alimentação, tendo em vista. o deficiente aporte de Ca e P, sendo necessária., a suplementação desses sais na. tentativa. de prevenir a DOMP.The observation 1hat 1he VLBW infants fed wi1h breast-milk or with a not specified cow milk-based formula for prematures suffer any risk of developping osteomineral deficiency encouraged us to work on this subject Our aim was to prove whether the addition of Calcium and Phosphor to the diet offered,to VLBW infants interferes in the concentration o f AP (phosphatase Alkaline ), taking into accowtt its envolvement in 1he bone metabolism. Seventy one (71) premature newbom with BW ~ 1500 gr and GA ~ 35 weeks were selected and divided into two groups. In G 1 the fullterm newbom (n ± 37) received breast miik or a cow milk-based formula enriched by CA (calcium) and P (phosphorus) salts; and in G2 (n=34) the newbom received only breast milk or the same formula At 1he same time a third group of newborn was selected and fed, apropriate for the gesta:tional age, wi1h breast milk or formula In 1he begirming of this study there were no significant di:fferences between Gl and G2 with relation to PN, PCN, CN, sex and gestational age. The two groups received same volume of nourishment and with similar caloric-proteic rates. The VLBW infants were accompanied by weekly serial doses of CA, P and AP tmtil reaching 2. 000 gr. No significa.tive difference in the average of CA serial in G 1 and G2 appeared, but in rela.tion to G3 the seral CA average was considerably higher than in the other 2 groups. Similar results were found with relation to P (phosphorus) serial. The concentration average o f AP between G 1 and G2 differed considerably from the fourth week of life on. The comparison o f the AP concentration-average does not show significative difference; however, there is a sigficance between the average of G2 and 03. To seven newbom of G2, who reached a FA concentration 5 times higher than the superior Iimit considered normal, an addition of CA and P was given. In ali of them there was a descresse of the FA concentration with a significant statistically proved di.fference considering the group. W e concluded that the FA concentration rate is a useful and efficient method for the monitorization of the MBDP (Metabolic Bone Disease) of newbom. We may also conclude that human milk andlor non specific milk formula for VLBW infants are inadequate for their nourishment, due to the defficient amount of CA and P, a suplementation of these salts being therefore necessary in order to prevent Metabolic Bone Disease of Prematurity (MBDP)

Estatura e maturac¸ão sexual em meninas com artrite idiopática juvenil

Objective: To evaluate height, sexual maturation, and the difference between final and expected height in girls with juvenile idiopathic arthritis and no glucocorticoid treatment for at least six months, as compared to a group of healthy girls. Methods: This cross-sectional study involved 44 girls with juvenile idiopathic arthritis, diagnosed according to the International League of Associations for Rheumatology criteria, and 59 healthy controls aged between 8 and 18 (incomplete) years with no comorbid chronic diseases. Demographic data were collected from all participants, and disease and treatment variables were compiled for the patient group. Anthropometric measurements were converted into Z-scores based on World Health Organization standards. Sexual maturation was classified according to Tanner stages. Results: Body mass index and height Z-scores were lower in girls with juvenile idiopathic arthritis as compared to control participants. These values differed significantly in Tanner stage II. Three (6.8%) girls with juvenile idiopathic arthritis had height-for-age Z-scores <−2 (short stature). Girls with polyarticular juvenile idiopathic arthritis and higher cumulative glucocorticoid doses were significantly more likely to present with short stature. The percentage of prepubertal girls in the juvenile idiopathic arthritis group was significantly higher than that observed in the control group, (p = 0.012). Age of menarche, adult height, and the difference between actual and expected height did not differ between groups. Conclusion: These findings suggest that even six months after the suspension of glucocorticoid treatment, children with polyarticular/systemic juvenile idiopathic arthritis subtypes are still susceptible to low height and delayed puberty.Objetivo: Avaliar a estatura, maturac¸ão sexual e a diferenc¸a entre a estatura final e a esperada em meninas com artrite idiopática juvenil (AIJ) sem tratamento com glicocorticoides por pelo menos seis meses, em comparac¸ão com um grupo de meninas saudáveis. Métodos: Este estudo transversal avaliou 44 meninas com artrite idiopática juvenil, diagnosticadas de acordo com os critérios da International League of Associations for Rheumatology e 59 controles saudáveis, entre oito e 18 anos (incompletos) sem comorbidades por doenc¸as crônicas. Os dados demográficos foram coletados de todos os participantes e as variáveis de doenc¸a e tratamento foram compiladas para o grupo de pacientes. As medidas antropométricas foram convertidas em escores-z com base nos padrões da Organizac¸ão Mundial da Saúde. A maturac¸ão sexual foi classificada de acordo com os estágios de Tanner. Resultados: Índice de massa corporal e escores-z de estatura foram menores em meninas com artrite idiopática juvenil em comparac¸ão com os participantes-controle. Esses valores diferiram significativamente no estágio II de Tanner. Três (6,8%) meninas com artrite idiopática juvenil tinham escores-z de estatura para idade < -2 (baixa estatura). Meninas com artrite idiopática juvenil poliarticular e doses cumulativas de glicocorticoides foram significativamente mais propensas a apresentar baixa estatura. A porcentagem de meninas pré-púberes no grupo artrite idiopática juvenil foi significativamente maior do que a observada no grupo controle (p = 0,012). A idade da menarca, a estatura adulta e a diferenc¸a entre a estatura real e a esperada não diferiram entre os grupos. Conclusão: Esses achados sugerem que, mesmo após seis meses da suspensão do tratamento com glicocorticoides, as crianc¸as com os subtipos poliarticular/sistêmico de AIJ ainda são suscetíveis a baixa estatura e atraso na puberdade

Self-reported psychosocial factors among In Vitro Fertilization patients interviewed alone or with the partner

"Published online: 07 Nov 2015"The purpose of this study was to compare the sociodemographic and psychosocial characteristics reported by female in vitro fertilization (IVF) patients interviewed alone or with the partner in heterosexual couples. During 12 months (2011-2012), all patients undergoing IVF or intracytoplasmic sperm injection at one public reproductive medicine unit, in Portugal, were interviewed on the day of the diagnosis of pregnancy, being recruited 221 women interviewed with the partner and 92 interviewed alone. Interviewers collected data on sociodemographic and obstetric characteristics; and anxiety, depression, social support and partner relationship were collected by self-administered questionnaires. χ(2) test was used to assess the independent association between the categorical variables and being interviewed alone or with the partner. For continuous variables, mean or median differences were compared by the t-test or the Mann-Whitney test, according to data distribution. No statistically significant differences were found in the self-reporting of depression, anxiety, social support and partner relationship or in sociodemographic and obstetric characteristics between women interviewed alone or with the partner. Although women interviewed alone were older and more frequently had children than women interviewed with the partner, no significant associations were observed. Thus, having a male partner present in the research setting during a self-administered questionnaire seems not to influence women's responses to psychosocial measures. Other outcomes and settings need to be evaluated to support evidence-based guidelines for research on infertility.The authors gratefully acknowledge the funding from FEDER by the Operational Programme Factors of Competitiveness – COMPETE and the national funding from the Foundation for Science and Technology – FCT (Portuguese Ministry of Education and Science) (FCOMP-01-0124-FEDER-014453), and the grants IF/00956/2013 (to SS), IF/00829/2013 (to HM), SFRH/BPD/103562/2014 (to EA) and SFRH/BD/75807/2011 (to CS).The authors thank the staff of the reproductive medicine unit for the collaboration and support, and all the patients who participated. The authors gratefully acknowledge the funding from FEDER by the Operational Programme Factors of Competitiveness – COMPETE and the national funding from the Foundation for Science and Technology – FCT (Portuguese Ministry of Education and Science) (FCOMP-01-0124-FEDER-014453), and the grants IF/00956/2013 (to SS), IF/00829/2013 (to HM), SFRH/BPD/103562/2014 (to EA) and SFRH/BD/75807/2011 (to CS)

HOME VISITING IN THE FAMILY HEALTH STRATEGY: ITS PERCEPTION AMONG NURSES

A visita domiciliar é, atualmente, um instrumento essencial para a prática das ações no nível primário de assistência a saúde, em especial, na Estratégia Saúde da Família. Trata-se de um estudo descritivo e exploratório, de abordagem qualitativa, cujo objetivo foi identificar e analisar a percepção de enfermeiros acerca da visita domiciliar. Para a análise dos dados utilizou-se a técnica da Análise Temática. Foram identificadas duas unidades temáticas: A visita domiciliar como possibilidade de criação de vínculo e A visita domiciliar como possibilidade de uma assistência integral. Assim, a visita domiciliar como instrumento do processo de trabalho em saúde, em especial, na Atenção Primária à Saúde, se constitui num elemento facilitador para o acesso por parte dos usuários aos serviços públicos de saúde e se apresenta como uma forma integral de assistir, em que as reais necessidades de cada indivíduo/família podem ser identificadas

Empreendedorismo Cultural no Território do Sisal: Estratégias de Qualificação Voltadas Para Mestres Artesãos

O presente trabalho tem como intuito apresentar um projeto de intervenção que tem como propósito capacitar artesãos-mestres, aprendizes e sucessores através de práticas educativas de valorização da identidade cultural regional e fomento à cultura empreendedora mediante a apresentação da tecnologia social de Economuseus. Busca-se que tais atores sociais se apropriem de seus processos criativos e produtivos como empreendedores culturais. O projeto é idealizado para abranger cinco (05) municípios localizados no semiárido baiano, especificamente no Território de Identidade conhecido como Território do Sisal, sendo eles: Barrocas, Conceição do Coité, Ichu, Lamarão e Valente. O projeto foi desenvolvido no Curso de Graduação Tecnológica em Gestão Pública e Gestão Social do Programa de Desenvolvimento e Gestão Social da Universidade Federal da Bahi

Environmental risk assessment in a contaminated estuary: an integrated weight of evidence approach as a decision support tool

Environmental risk assessment of complex ecosystems such as estuaries is a challenge, where innovative and integrated approaches are needed. The present work aimed at developing an innovative integrative methodology to evaluate in an impacted estuary (the Sado, in Portugal, was taken as case study), the adverse effects onto both ecosystem and human health. For the purpose, new standardized lines of evidence based on multiple quantitative data were integrated into a weight of evidence according to a best expert judgment approach. The best professional judgment for a weight of evidence approach in the present study was based on the following lines of evidence: i) human contamination pathways; ii) human health effects: chronic disease; iii) human health effects: reproductive health; iv) human health effects: health care; v) human exposure through consumption of local agriculture produce; vi) exposure to contaminated of water wells and agriculture soils; vii) contamination of the estuarine sedimentary environment (metal and organic contaminants); viii) effects on benthic organisms with commercial value; and ix) genotoxic potential of sediments. Each line of evidence was then ordinally ranked by levels of ecological or human health risk, according to a tabular decision matrix and expert judgment. Fifteen experts scored two fishing areas of the Sado estuary and a control estuarine area, in a scale of increasing environmental risk and management actions to be taken. The integrated assessment allowed concluding that the estuary should not be regarded as impacted by a specific toxicant, such as metals and organic compounds hitherto measured, but by the cumulative risk of a complex mixture of contaminants. The proven adverse effects on species with commercial value may be used to witness the environmental quality of the estuarine ecosystem. This method argues in favor of expert judgment and qualitative assessment as a decision support tool to the integrative management of estuaries. Namely it allows communicating environmental risk and proposing mitigation measures to local authorities and population under a holistic perspective as an alternative to narrow single line of evidence approaches, which is mandatory to understand cause and effect relationships in complex areas like estuaries.info:eu-repo/semantics/publishedVersio