Contributions in the field of Public Health for decision-making in health

Brazil has made a wide development and contribution in the field of Public Health. These contributions have maximized public health decision-making, which is a factor of great importance for the maintenance of health of a given population, either in the prevention of disease, as is the case of immunizations or with actions in Health Promotion, improving the quality of life of the affected population. Thus, the Journal of Human Growth and Development has contributed enormously to the dissemination of knowledge, not only in Brazil but also in the world making a major effort with its publications in English which is the preferred language of the modern scientific world. It was evidenced the importance of research in the investigation of better ways to obtain the public health of a given community, bringing discussion of themes that involve aspects of human growth and development such as nutritional aspects, sexuality, motor development, covering situations and diseases as obesity, cerebral palsy, dyslexia and violence. The Journal of Human Growth and Development has maintained the tradition of approaching the different aspects that involve clinical practice for people and for Public Health.  Brazil has made a wide development and contribution in the field of Public Health. These contributions have maximized public health decision-making, which is a factor of great importance for the maintenance of health of a given population, either in the prevention of disease, as is the case of immunizations or with actions in Health Promotion, improving the quality of life of the affected population. Thus, the Journal of Human Growth and Development has contributed enormously to the dissemination of knowledge, not only in Brazil but also in the world making a major effort with its publications in English which is the preferred language of the modern scientific world. It was evidenced the importance of research in the investigation of better ways to obtain the public health of a given community, bringing discussion of themes that involve aspects of human growth and development such as nutritional aspects, sexuality, motor development, covering situations and diseases as obesity, cerebral palsy, dyslexia and violence. The Journal of Human Growth and Development has maintained the tradition of approaching the different aspects that involve clinical practice for people and for Public Health.

FACTORS RELATED TO MOTOR DEVELOPMENTAL DELAY OF NEWBORNS

Introduction: Studies on the association between motor developmental delay and events observed during the neonatal period are performed after discharge. In such cases, the associations found may be interfered by factors occurring between discharge from the NICU and evaluation. Evaluate newborns before hospital discharge can prevent these effects.The purpose of this study is to identify factors related to motor developmental delay of newborns when being discharged from Neonatal Intensive Care Unit. The method chosen to carry out this investigation was a prospective cohort, populationbased and analytic-descriptive study, and 178 newborns were assessed through the Test of Infant Motor Performance. Binomial logistic regression has been developed for analyzing the associated factors. Among the results obtained, 58.4% of them were premature, 56.2% were low weight newborns and 59.0% were male. The participants were selected among those with the following characteristics: Birth Weight (BW) 2304.3 g, Gestational Age (GA) 35.33 weeks. Morbidity occurred in 23.6% of the participants and 34.8% showed changes in the motor performance (64.7% in the ones below 1501g and 27.8% in the ones above 1500g). Upon completion of the TIMP, it was possible to conclude that the factors associated with motor developmental delay in the binomial logistic regression were prematurity, seizures, being female

PACING OPPORTUNITIES AT HOME AND SKILL OF CHILDREN WITH POTENTIAL CHANGES IN FUNCTIONAL DEVELOPMENT

Introduction: the multifactorial nature of motor development is reinforced by the combination of biological and environmental risk factors, which intensify the chances of impaired motor development. Objectives: to verify the relationship between functional mobility skills of children with risk factors and motor stimulus opportunities in their home environment. Methods: transversal study conducted with 112 patients aged 18-42 months from follow-up services. Motor stimulus opportunities were evaluated by the Affordance in the Home Environment for Motor Development (AHEMD-SR) and Functional mobility skills by the Pediatric Evaluation Disability Inventory (PEDI). Student t test and multiple linear regression analysis were carried out. Results: predominance of good performance of functional mobility skills and “average level” of environmental stimulus opportunities were observed. There was no significant association between HFM-PEDI and AHEMD-SR. The results showed significant association only between HFM-PEDI and presence of health problems (p = 0.004). Children with health problems had lower mean PEDI normative score. Multiple linear regression analysis showed significant result for health problems in the interaction among environment, control variables and HFM-PEDI (p = 0.003). Conclusion: there was no association between functional mobility skills of children with risk factors and motor stimulus opportunities in their home environment. On the other hand, children with some health problem showed lower performance in functional mobility skills

Microbial Ecosystem Analysis in Root Canal Infections Refractory to Endodontic Treatment

Introduction To combine Multiple Displacement Amplification (MDA) and checkerboard DNA–DNA hybridization to qualitatively and quantitatively evaluate the microbiota present in infections refractory to endodontic treatment. Methods The subjects of this study were 40 patients presenting periapical lesions refractory to endodontic treatment. Samples were taken by scraping or filing root canal walls with a #10 K-type hand file. Sample DNA was amplified by MDA, and the levels of 107 bacterial taxa were analyzed by checkerboard DNA–DNA hybridization. The taxa were divided into three distinct microbial populations, depending on their mean proportion in samples (% DNA probe counts ± SEM), as follows: dominant (≥3.0%), sub-dominant (\u3e1.6 to 3.0%) and residual (≤1.6%) populations. The significance of differences was determined using the Mann-Whitney test. Results The taxa present with the highest mean proportions (constituting the dominant population) were Corynebacterium diphtheriae (8.03±0.98), Porphyromonas gingivalis (5.42±2.09), Streptococcus sobrinus (5.33±0.69), and Stenotrophomonas maltophilia (4.72±1.73). Among the sub-dominant population were Eubacterium saphenum (3.85±1.06), Helicobacter pylori (3.16±0.62), Dialister pneumosintes (3.12±1.1), Clostridium difficile (2.74±0.41), Enterobacter agglomerans (2.64±0.54), Salmonella enterica (2.51±0.52), Mobiluncus mulieris (2.44±0.6), and Klebsiella oxytoca (2.32±0.66). In the population of bacteria present at the lowest mean proportions (the residual population), Bacteroides ureolyticus (0.04±0.01), Haemophilus influenzae (0.04±0.02), and Prevotella oris (0.01±0.01) were found at the lowest mean proportions. Enterococcus faecalis was detected in the residual population (0.52±0.26). Conclusion The microbial climax community in teeth refractory to endodontic treatment not only harbor medically important species, but also contains distinct microbial consortia present with different population levels

Síndrome de Torsades de Pointes: análise de casos: Torsades de Pointes Syndrome: case analysis

A Síndrome de Torsades de Pointes (TdP) é uma taquiarritmia ventricular polimórfica de pacientes com um intervalo QT longo congênito ou induzido por fármacos, cujo eletrocardiograma possui aspecto de “torção das pontas” e os sinais e sintomas característicos são síncope, palpitação ou mesmo evolução para fibrilação ventricular e morte súbita. O sexo mais frequentemente acometido é o feminino, o diagnóstico se baseia no eletrocardiograma e o tratamento preconizado é o sulfato de magnésio (MgSO4) intravenoso, a correção dos distúrbios eletrolíticos, principalmente a hipocalemia e o tratamento da causa base, na TdP farmacoinduzida. O objetivo do estudo é analisar os casos de Síndrome de Torsades de Pointes em pacientes com alterações do intervalo QT no eletrocardiograma. Trata-se de uma revisão bibliográfica integrativa, do tipo quantitativa, que utilizou as plataformas do PubMed, SciELO e Cochrane Library como bases de dados para seleção dos artigos, todos na língua inglesa. Foram utilizadas literaturas publicadas com recorte temporal de 2017 a 2022. De acordo com as literaturas analisadas, conclui-se que a TdP é uma taquiarritmia ventricular polimórfica com um mau prognóstico se não tratada precocemente com o MgSO4 intravenoso e, por ter diversas etiologias, é primordial que o diagnóstico preciso seja estabelecido de forma rápida, devido ao alto índice de mortalidade. Pacientes portadores da síndrome do QT longo congênita, bradicardia sinusal e bloqueio atrioventricular de 1º grau possuem predisposição para o desenvolvimento de TdP. Observa-se escassez na literatura a respeito das formas adequadas de prevenção da TdP, já que muitos pacientes que participam das triagens, muitas das vezes inefetivas, adquirem a síndrome após o uso de drogas que a predispõem, com prolongamento do intervalo QT, ou não sabem que possuem uma SQTL pré-existente, obrigatória para o desenvolvimento da TdP

Diretriz da Sociedade Brasileira de Cardiologia sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas

This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.  Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities.   Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.  The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.  The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.     Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou. A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica. Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas. A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica. A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.    Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.&nbsp

Catálogo Taxonômico da Fauna do Brasil: setting the baseline knowledge on the animal diversity in Brazil

The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others

Relato de caso de colestase neonatal ocasionada por Toxoplasma gondii

The congenital infection by Toxoplasma gondii is a potentially serious condition, which is possible to prevent and to treat. We describe a case of perinatal death occurred by congenital infection by Toxoplasma gondii agent, whose main symptom was a severe neonatal cholestasis in a patient born in the maternity of a Public Hospital in the city of Juiz de Fora, MG. The mother did not accomplish prenatal exams. The Pathology identified the T. gondii (macroscopic and microscopic studies), and there were cysts of T. gondii in the brain, heart, lungs, liver, and spleen, with intense intra hepatic impairment. It is essential to guarantee that all the women have access to the prenatal and recognize the need to do it precociously and adequately. Moreover, it is essential that the professionals of the health area be attentive for the precocious recognition of possible cases and the institution of the adequate treatment, reducing the mortality and if possible minimizing the sequels occurrence.A infecção congênita pelo Toxoplasma gondii é uma condição potencialmente grave, prevenível e tratável. Será descrito um caso de óbito perinatal ocorrido por infecção congênita pelo agente T. gondii, cuja sintomatologia principal foi uma grave colestase neonatal, em um paciente nascido na Maternidade de um Hospital Público, na cidade de Juiz de Fora – MG. A mãe não realizou pré-natal. O T. gondii foi identificado por anatomia patológica (macroscopia e microscopia), com presença de cistos de T. gondii no cérebro, coração, pulmões, fígado, e baço, com intenso comprometimento intra-hepático. É essencial garantir que todas as mulheres tenham acesso ao pré-natal e reconheçam a necessidade de fazê-lo precocemente e adequadamente. Além disso, é imprescindível que os profissionais da área de saúde estejam atentos para o reconhecimento precoce de possíveis casos e a instituição do tratamento adequado, reduzindo a mortalidade e se possível minimizando a ocorrência de seqüelas

ESTUDO DA PREVALÊNCIA DE MORBIDADES E COMPLICAÇÕES NEONATAIS SEGUNDO O PESO AO NASCIMENTO E A IDADE GESTACIONAL EM LACTENTES DE UM SERVIÇO DE FOLLOW-UP.

Objective: To estimate of neonatal morbidity and complications according to the birth weight, the gestational age (GA) and classification of the weight / GA in users of a service of Follow-up. Methods: This study was cross-sectional, retrospective, and descriptive-analytic.229 medical register infants that were analyzed divided according to the GA and birth weight. The Qui-square test was used to compare the groups and the significance level considered was α = 0.05. Results: There was a high frequency of births weighing below 1.500 g and GA less than 33 weeks. Among the most frequent morbidities, it was highlighted the occurrence of sepsis (94.9%), respiratory complications (79%), jaundice (69.9%) and anemia (34.5%). Most participants had more than five complications (91.2%) and more than half (61.8%) remained in the Neonatal Intensive Care Unit- NICU for more than 20 days. There were statistically significant differences regarding the frequency of the majority of complications, and morbidity in relation to the GA, the weight and classification of weight/GA, with highest prevalence in the GA less than 29 weeks and weight less than 1.000g groups. Final considerations: The birth weight, the gestational age (GA) and classification of the weight / GA have significant influence in the neonatal morbidity and complications. The reduction of births with GA less than 29 weeks and weight less than 1.000g should be the main focus of prevention policies on child health, since they can have a substantially impact on improving the quality of life and population’s health by reducing the occurrence of diseases at short and long term, as well as the need for specialized services.Objetivo: Estimar a prevalência de morbidades e complicações neonatais segundo o peso ao nascimento, idade gestacional (IG) e relação Peso/IG em usuários de um serviço de Follow-up. Material e Métodos: Este estudo foi do tipo transversal, retrospectivo, analítico descritivo. Foram analisados os prontuários de 229 lactentes, divididos de acordo com a IG e peso ao nascimento. Para análise estatística, foi utilizado o teste Qui-quadrado, sendo considerado o nível de significância α = 0,05. Resultados: Foi encontrada alta frequência de nascidos com peso abaixo de 1500 gramas e IG abaixo de 33 semanas. Dentre as alterações mais frequentes, destacam-se a sepse (94.9%), as alterações respiratórias (79%), a icterícia (69.9%) e a anemia (34.5%). A maioria dos participantes apresentou mais de cinco intercorrências (91.2%) e mais da metade (61.8%) permaneceu em Unidade de Terapia Intensiva Neonatal- UTIN por mais de 20 dias. Houve associação estatisticamente significativa em relação à frequência da maioria de complicações e morbidades com a IG, o peso e a classificação da relação Peso/IG, sendo significativamente mais prevalentes nos grupos de prematuros extremos e de extremo baixo peso. Considerações finais: O peso, a IG e a relação Peso/IG influenciam significativamente a prevalência de morbidades e complicações neonatais. A redução dos nascimentos com IG abaixo de 29 semanas e peso abaixo de 1.000 g deveria ser o foco central de políticas de prevenção em saúde da criança, uma vez que pode impactar ,substancialmente, na melhoria da qualidade de vida e saúde da população, diminuindo a ocorrência de morbidades a médio e longo prazo e a necessidade de utilização de serviços especializados