Nutritional status of children and adolescents at diagnosis of hematological and solid malignancies

Objective: To assess the nutritional status of child and adolescent patients with cancer at diagnosis. Methods: A total of 1154 patients were included and divided into two groups: solid and hematological malignancies. The parameters used for nutritional assessment were weight, height, triceps skinfold thickness, mid-upper arm circumference, arm muscle circumference, body mass index and percentage weight loss. Results: At diagnosis, below adequate body mass index was observed by anthropometric analysis in 10.85% of the patients – 12.2% in the solid tumor group and 9.52% in the hematologic group. The average weight loss adjusted for a period of 7 days was −2.82% in the hematologic group and −2.9% in the solid tumor group. Conclusions: The prevalence of malnutrition is higher among patients with malignancies than in the general population, even though no difference was observed between the two groups.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

O DESEMPENHO AMBIENTAL DE COMPANHIAS BRASILEIRAS: UMA ANÁLISE DAS COMPANHIAS DO ISE

The aim of this study was to analyze the environmental performance of companies listed on the ISE between 2011 to 2013 Therefore, it was necessary to measure environmental performance, which was made possible based on the questionnaire ISE. Of the 40 companies that on average, comprise the ISE annually, this study included twelve which the overall survey sample. Data were analyzed descriptively and the results indicate that the level of the DA of the surveyed companies have shown an increasing trend, which may be explained by the Stakeholder Theory. This research also indicates how important the association between the activity performed by firms and their behavior towards the environment. The fact that companies have a social and environmental certifications character does not influence considerably in their environmental performance. However, when analyzing the size, we arrive at interesting results which indicated that most smaller companies have improved their environmental performance unlike larger. Given these findings it is understood that this research contributes to academia, corporations and society in general, it provides empirical evidence of the potential of stakeholder theory to explain the Brazilian reality in regard to aspects of CSR.O objetivo desse estudo foi analisar o desempenho ambiental de companhias listadas no ISE no período de 2011 a 2013. Para tanto, foi necessário mensurar desempenho ambiental, o qual foi viabilizado com base no questionário ISE. Das 40 empresas que, em média, compõem o ISE anualmente, esse estudo contou com doze, as quais comporam a amostra geral da pesquisa. Os dados foram analisados descritivamente e os resultados apontam que o nível do DA das empresas pesquisadas tem apresentado uma tendência crescente, podendo ser explicado pela Teoria do Stakeholder. Essa investigação também sinaliza como importante a associação entre a atividade desenvolvida pelas empresas e seu comportamento com relação ao meio ambiente. O fato das empresas possuírem certificações de caráter socioambiental não influi consideravelmente no seu desempenho ambiental. Porém, ao analisar o porte, chega-se a resultados interessantes que apontam que a maioria das empresas de menor porte melhoraram seu desempenho ambiental ao contrário das de maior porte. Diante desses achados entende-se que essa pesquisa contribui para academia, as corporações e a sociedade em geral, pois fornece evidências empíricas do potencial da teoria do stakeholder em explicar a realidade brasileira no que tange a aspectos de RSC

Atenção farmacêutica: uma abordagem sobre a resistência antimicrobiana e o uso inadequado na vida cotidiana / Pharmaceutical attention: an approach to antimicrobial resistance and improper use in everyday life

Introdução: A resistência antimicrobiana (RAM) é um problema de saúde pública global com consequências econômicas e de saúde significativas. A maioria do relatório recente do Sistema de Vigilância do Uso e Resistência Antimicrobiana Global (GLASS), da OMS, revela que o número preocupante de infecções bacterianas humanas é cada vez mais resistente aos antibióticos disponíveis para tratá-las e com taxas de resistência mais altas. O uso excessivo de antibióticos é um dos principais fatores que alimentam a RAM e dados indicam rápido aumento no consumo de antibióticos em LMICs, enquanto as taxas de consumo de antibióticos em muitos países de alta renda permanecem estáveis ou em declínio. No entanto, saneamento e higiene precários podem estar desempenhando um papel ainda maior promovendo RAM. Objetivos: O presente estudo foi realizado com o objetivo de analisar como o uso inadequados dos antibióticos podem levar a problemas bem sérios com a resistência bacteriana e como o cuidado com a higiene, tomada das precauções acabam por diminuir a propagação dessas bactérias. Metodologia: é uma pesquisa básica, que objetiva gerar conhecimentos novos e úteis para o avanço da ciência. Seus objetivos são exploratórios, cuja finalidade é a de proporcionar mais informações sobre o assunto que foi investigado, possibilitando sua definição e seu delineamento. Quanto a sua abordagem, é uma pesquisa qualitativa, que descreve, interpreta e compara os fatos sem considerar os seus aspectos numéricos em termos de regras matemáticas e estatísticas. Do ponto de vista dos procedimentos técnicos, é uma pesquisa bibliográfica, na qual, sua base é a análise de material já publicado. Conclusão: Há uma necessidade urgente de programas educacionais para farmacêuticos e campanhas educacionais de saúde para aumentar a conscientização entre ao público sobre a resistência bacteriana resultante dessa prática em além dos custos e efeitos adversos associados a antibióticos prescritos. Concomitantemente, mais estudos são necessários para compreender os riscos do aumento no consumo de antibióticos e estratégias imediatas são necessárias devido à mortalidade entre os milhões de pessoas que morrem de infecções resistentes aos antimicrobianos anualmente

Mammary Gland Ultrasound Evaluation of Jersey Cattle Breed

Background: Ultrasound allows the udder evaluation of lactating cattle, through parameters such as the area of the cistern of the mammary gland and teat, and can reveal structures with different echogenicity, indicating injuries as mastitis, edema, hematoma, abscess, atrophy and fibrosis in the mammary gland parenchyma. The aim of this study was to observe the clinical, morphometric and sonographic assessment of the mammary gland of Jersey cows, evaluating the correlation of this exam and the production of milk.Materials, Methods & Results: Nine Jersey breed cows, aged 3 to 9 years, in a variable order of first to seventh lactation were evaluated. Animals were submitted to general and specific clinical examination of the mammary gland. For the evaluation, inspection and palpation of the gland cistern and teat cistern, measuring with tape measure the udder circumference and width and height of each mammary quarter was held, and length measurements of the four teats individually using a caliper. By palpation the mammary gland parenchyma was classified as nothing worthy of note and fibrosis. After this evaluation, the mammary glands were evaluated using ultrasound, analyzing biometrics and echotexture in order to detect and/or confirm possible changes identified in prior palpation. The diameter of the gland and teat cistern were measured, and the echogenicity of each region and each mammary quarter, checking the homogeneity of the parenchyma, evaluating the possible presence of nodules, scarring or acute injuries. The average milk production was 15.57 ± 5.4 L. There was no correlation between milk production, measured biometric data of the mammary gland and clinical and ultrasonographic changes (P > 0.05). On palpation exam, a few number of animals had soft to normal consistency in mammary glands (2/9), the occurrence of fibrosis was observed, but could only be detected by ultrasonography (4/9).Discussion: Using the ultrasound examination is possible to access more accurately the morphology of the udder of lactating animals, examining and measuring the area of the cistern of the mammary gland and teat, the thickness of the wall and ceiling interface. Several studies correlate the morphology of these parameters with resistance to mastitis. The imaging aids to differentiate the teats according to animal age, milk production, lactation number, size, as well as a predisposition to mastitis. In healthy animals, the boundary between the gland cistern and teat cistern is marked by the presence of large anechoic structures. Changes in the teats of a gland with mastitis are mild inflammation, proliferation of tissues and mucosal lesions. No significant correlation between the morphology, physical examination and ultrasound changes of the mammary gland and milk production was observed. Possibly this was due to the limited number of experimental animals, and there is a wide variation in age and clinical profiles, as already observed in other studies that cows with high and wide rear udders tend to have higher milk production. In some cases ultrasound allows observe formation of gas, bruising, edema, abscess, atrophy, fibrosis, fistulae and intraluminal obstructions and parenchymal echogenicity changes during infection cases. In normal ultrasound examination, the parenchyma of the mammary gland must be homogeneous with high echogenicity and anechoic alveolus. Atresic and fibrosis are hyperechoic and lose the typical echogenicity of the udder. Thus, it is emphasized that ultrasound is a complementary method in the evaluation of the mammary gland, since it identifies not noticeable injuries on physical examination that may affect milk production

Grupo operativo:: prática educativa como expressão para o autocuidado em diabetes mellitus tipo 2

O objetivo é compreender a visão dos usuários com Diabetes Mellitus tipo 2 sobre a sua participação nos grupos operativos e a repercussão dessa nas práticas de autocuidado . Trata- se de uma pesquisa qualitativa do tipo descritivo-exploratório realizada em três unidades básicas de saúde do distrito sanitário Leste de Belo Horizonte e envolveu a participação de 18 usuários em 2011. As falas dos usuários foram analisadas com base na Análise de Conteúdo, sendo identificadas as categorias: Troca de experiência, Educação para o autocuidado, Avaliação da participação dos usuários nos grupos operativos, Sentimentos e Vínculos entre profissional e usuário. Percebeu-se que os grupos operativos proporcionaram a construção do conhecimento através da escuta, reflexão e problematização da realidade do usuário onde identificaram a importância do saber sobre a dieta, tratamento e atividade física. Observamos que as ações de saúde implementadas através dos grupos operativos estimulam os usuários a refletirem sobre seu estilo de vida, caracterizando-se como um instrumento de educação em saúde sob uma perspectiva de promoção, prevenção e controle

Economic feasibility of diets containing different nitrogen sources as a function of weight gain in Saanen breed goats / Viabilidade Econômica de dietas contendo diferentes fontes de nitrogênio em função do ganho de peso de caprinos da raça Saanen

The use of a low cost protein input results in improvements in animal zootechnical indices. The aim of this study was to evaluate the cost of diets containing different nitrogen sources as a function of weight gain in Saanen goats. Eighteen 150-day-old Saanen goats were randomly divided into two groups: control group (CG) and urea group (UG). At the beginning of the experiment and every 7 days, before feeding, the animals were weighed on a mechanical platform scale to obtain live weight over a period of 121 days. The prices of the dietary ingredients were obtained from the local market of Seropédica - RJ, from April to June 2019. For statistical analysis, the GraphPad PRISM 5® software was used. The use of soybean meal or urea in the diet did not influence animal performance in relation to daily weight gain. The difference in values may not appear to be attractive, but the amount of urea used in ruminant diets is much smaller when compared to the amount of soybean meal, which reflects in the final diet price, making urea make a source more viable for the producer

Gastroesophageal Foreign Bodies in Dogs - Endoscopy and Surgical Removal

Background: Gastroesophageal foreign bodies (GFD) are commonly diagnosed in dogs and are considered an endoscopic emergency that, although not resulting in serious clinical sequelae or mortality, can compromise the health and well-being of the patient. The use of the digestive endoscopy for the diagnosis and treatment of GFD can be a valuable and viable alternative. There are cases of GFD in dogs for which the indicated treatment is surgery, which can be performed using minimally invasive or conventional techniques, associated or not with flexible endoscopy. The objective of this work is to describe 16 cases of GFD removal in dogs demonstrating the efficiency of upper digestive endoscopy. Cases: Of the 16 GFD cases, 63% (10/16) were male and 37% (6/16) female. Most aged under 1 year (63%), puppies (5/16) and juveniles (5/16). The patient with the lowest body weight was a miniature pinscher weighing 0.8 kg (Case 14) and the heaviest was an American Pit Bull Terrier weighing 28 kg (Case 11), the mean body weight of patients diagnosed with GFD was 10.2 ± 6.7 kg. Small and medium breeds were more affected, 44.7% (7/16) and 44.7% (7/16), respectively, and large breeds (Golden Retrievier and Bull Terrier), from cases 1 and 4, the least affected, 12.6% (2/16) of the cases. The 16 patients underwent a 12 h food fast and a 4 h water fast, as gastrointestinal emptying in these cases of GFD can be influenced by these foreign bodies. All underwent general inhalation anesthesia with monitoring of physiological parameters (temperature, heart rate, respiratory rate, oxygen saturation and blood pressure) before, during and after EGD, being positioned in left lateral decubitus. The 16 canine patients with suspected GFD underwent EGD for diagnostic confirmation and removal of foreign bodies. Five esophageal FB were diagnosed, 31% (5/16), and 11 gastric FB, 69% (11/16). The most frequently diagnosed foreign bodies were bone and tissue, 37.5% (6/16) and 31% (5/16). Other foreign bodies were materials such as plastics, metals, rubber, foam and stone. Of the 16 cases of GFD, EGD efficiently treated 88% (14/16) without the need for hospitalization, with only supportive treatment for the remission of complications caused by the presence of foreign bodies in the gastroesophageal tract. The main complications related to the presence of GFD were esophagitis in 25% (4/16) of cases, gastritis in 38% (6/16) and both alterations in 13% (2/16). Discussion: In this work, we can observe that more than a third of the clinical cases of treated dogs were diagnosed with GFD, demonstrating that these cases are common in the veterinary clinic. Most of these animals were males less than 1 year old. The improvement of learning in this category can lead these animals to exacerbated oral exploration of new objects. Most FBs were found in the stomach because they were of adequate size, consistency and shape for their passage through the esophagus, whereas esophageal FBs were all bone fragments of rigid consistency with diameters and sizes larger than the esophageal lumen. The interval between the ingestion of the object and the veterinary care can be decisive for the removal of the FB in the esophagus or stomach. Most gastric FBs removed were fabrics and plastics, flexible objects that can pass through the esophageal lumen more easily. Removal of GFD by endoscopy was performed with a high success rate, with only 2 cases being resolved by esophagostomy and gastrotomy. Flexible endoscopy proved to be an efficient technique for removing treated GFD, which can help remove FB during esophagotomy and be associated with rigid endoscopy. Patients recovered quickly and without complications, but it is important to emphasize that inadequate maneuvers and conducts can determine other outcomes. The use of endoscopy for GFD removal needs to be more popularized, as it can ensure better results for dogs treated with GFD. Keywords: digestive tract, endoscopic extraction, flexible endoscopy, ingested object, rigid endoscopy

Tetraciclinas e glicilciclinas: uma visão geral

Tetracyclines exhibits activity to a broad range of Gram-negative and Gram-positive bacteria and this fact allied to the low toxicity, low cost, and the advantage of administration by oral route led to their indiscriminate use, which caused the appearance of bacterial resistance to these agents, wich has restricted its clinical utility, though new applications have emerged. On the other hand, the glycylcyclines, semi-synthetic products are similar to tetracyclines, which are active against many bacteria resistant to tetracycline and other classes of antibiotics. The purpose of this paper is to give an overview of this important class of antibiotics focusing on its coordination chemistry and possible applications

Percepções sobre a importância da educação interprofissional na formação dos profissionais de saúde: relato de experiência de um grupo do PET–Saúde/Interprofissionalidade

O processo de educação interprofissional em saúde acontece quando duas ou mais profissões trabalham em conjunto, aprendendo entre si, com a outra e sobre a outra. Com o intuito de desenvolver o trabalho colaborativo e almejando melhorias na qualidade da assistência em saúde, especialmente no que tange ao contexto do Sistema Único de Saúde (SUS), o Programa de Educação para o Trabalho em Saúde (PET-Saúde), articulado com instituições de ensino superior e instituições públicas de saúde, prepara e forma profissionais com a atenção voltada para o trabalho coletivo em serviços do SUS. Para que isso de fato aconteça, leva-se em consideração a realidade e necessidade de saúde de uma dada regiãoonde esses profissionais vão atuar diretamente, bem como, uma sólida formação metodológica prévia sobre o assunto. Este relato de experiência demonstra a contribuição do PET-Saúde na formação de estudantes de diversas áreas da saúde daUniversidade Estadual de Feira de Santana e no desenvolvimento de ações práticas frente a uma dada comunidade, ações essas fundamentadas nos princípios da interprofissionalidade e do trabalho em equipe. AbstractThe process of interprofessional health education happens when two or more professions work together, learning among themselves, with the other and about the other. In order to develop collaborative work and aiming for improvements in the quality of health care, especially with regard to context of Unified Health System, the Education Program for Health Work (EPHW), articulated with health institutions, prepares and trains professionals with a focus on collective work in these services. For this actually happen, the reality and the health needs of a given region, where these professionals will work directly, are taken into account, as well as a solid prior methodological training on the subject. This experience report demonstrates the contribution of EPHW/Interprofessionality in the training of students from different areas of health by the State University of Feira de Santana and in the development of practical actions before a given community. These actions are based on the principles of interprofessionality and team work