Crianças com microcefalia pelo vírus Zika: delineamento e avaliação das alterações sensoriais

The aim was to identify the main sensory alterations in children with microcephaly caused by the Zika virus and the influence of care overload, using the Burden Interview scale. A cross-sectional study with a quantitative approach. Therefore, data were collected in the outpatient clinic of a tertiary hospital. To characterize the sociodemographic profile of children with zika virus microcephaly according to the Zarit care burden scale. For the analyses, descriptive statistics and the chi-square test were used. Finally, the care burden score was classified. Head circumference for boys was an average of 29.98 cm and 29.92 cm for girls. Mean age of 3 years and 7 months. Regarding gender, 53% were female. When related to the Zarit scale, females presented 25% from moderate to mild. 72% of the total were children between 3 and 4 years old. In the research findings correlated to the Zarit overload scale, children between 2.5 kg and 4.2 kg presented mild 31.7%. All children had a motor disorder. It is concluded that the most common sensory alterations in children with microcephaly are related to motor, followed by language. Regarding the burden of care, they presented mild.Objetivou-se identificar as principais alterações sensoriais em crianças com microcefalia pelo vírus Zika e a influência da sobrecarga de cuidados, através da escala Burden Interview. Um estudo transversal de abordagem quantitativa. Portanto, os dados foram coletados no ambulatório de um hospital terciário. Para caracterizar o perfil sociodemográfico das crianças com microcefalia pelo vírus zika conforme a escala de sobrecarga de cuidados de Zarit. Para as análises, utilizaram-se da estatística descritiva e do teste Qui-quadrado. Por fim, foi feita a classificação do escore de sobrecarga de cuidados. Perímetro Cefálico dos meninos foi média de 29,98 cm e 29,92 cm para as meninas. Média de idade de 3 anos e 7 meses. Em relação ao sexo, 53% eram feminino. Ao ser relacionado à escala de Zarit, o sexo feminino apresentou 25% de moderada a leve. 72% do total eram de crianças entre 3 e 4 anos. Nos achados da pesquisa correlacionados à escala de sobrecarga de Zarit, as crianças entre 2,5 Kg e 4,2 Kg apresentaram leve 31,7%. Todas as crianças apresentaram distúrbio motor. Conclui-se que as alterações sensoriais mais comuns nas crianças com microcefalia estão relacionadas ao motor seguido de linguagem. Em relação à sobrecarga de cuidados, apresentaram leve

Crianças com microcefalia pelo vírus Zika: delineamento e avaliação das alterações sensoriais

The aim was to identify the main sensory alterations in children with microcephaly caused by the Zika virus and the influence of care overload, using the Burden Interview scale. A cross-sectional study with a quantitative approach. Therefore, data were collected in the outpatient clinic of a tertiary hospital. To characterize the sociodemographic profile of children with zika virus microcephaly according to the Zarit care burden scale. For the analyses, descriptive statistics and the chi-square test were used. Finally, the care burden score was classified. Head circumference for boys was an average of 29.98 cm and 29.92 cm for girls. Mean age of 3 years and 7 months. Regarding gender, 53% were female. When related to the Zarit scale, females presented 25% from moderate to mild. 72% of the total were children between 3 and 4 years old. In the research findings correlated to the Zarit overload scale, children between 2.5 kg and 4.2 kg presented mild 31.7%. All children had a motor disorder. It is concluded that the most common sensory alterations in children with microcephaly are related to motor, followed by language. Regarding the burden of care, they presented mild.Objetivou-se identificar as principais alterações sensoriais em crianças com microcefalia pelo vírus Zika e a influência da sobrecarga de cuidados, através da escala Burden Interview. Um estudo transversal de abordagem quantitativa. Portanto, os dados foram coletados no ambulatório de um hospital terciário. Para caracterizar o perfil sociodemográfico das crianças com microcefalia pelo vírus zika conforme a escala de sobrecarga de cuidados de Zarit. Para as análises, utilizaram-se da estatística descritiva e do teste Qui-quadrado. Por fim, foi feita a classificação do escore de sobrecarga de cuidados. Perímetro Cefálico dos meninos foi média de 29,98 cm e 29,92 cm para as meninas. Média de idade de 3 anos e 7 meses. Em relação ao sexo, 53% eram feminino. Ao ser relacionado à escala de Zarit, o sexo feminino apresentou 25% de moderada a leve. 72% do total eram de crianças entre 3 e 4 anos. Nos achados da pesquisa correlacionados à escala de sobrecarga de Zarit, as crianças entre 2,5 Kg e 4,2 Kg apresentaram leve 31,7%. Todas as crianças apresentaram distúrbio motor. Conclui-se que as alterações sensoriais mais comuns nas crianças com microcefalia estão relacionadas ao motor seguido de linguagem. Em relação à sobrecarga de cuidados, apresentaram leve

LABORATORY PARAMETERS OF CEREBROSPINAL FLUID IN INDIVIDUALS WITH ENTEROVIRUS MENINGITIS: A DESCRIPTIVE STUDY

Introduction: Meningitis is the leading infectious syndrome that affects the central nervous system, and most cases are caused by viral infections, mainly enterovirus. The clinical diagnosis for meningitis etiology still presents major challenges. The analysis of polymerase chain reaction (PCR), white blood cells, red blood cells, glucose, protein, and lactate in the cerebrospinal fluid (CSF) provides the first clues to the diagnosis. However, the reference values of some parameters can suffer changes. Objective: Analyze laboratory parameters of CSF in patients with enterovirus meningitis according to age. Methods: A descriptive study was conducted based on data from a CSF reference service, located in São Paulo, Brazil, on 202 individuals who had enterovirus meningitis. Data was analysed by the Shapiro–Wilk and Kruskal–Wallis tests (CI = 95%, p <0.05) and represented by the median and percentile 25 and 75, respectively. Results: The cytological and biochemical parameters of the CSF shows us that proteins had median concentrations of 33.0mg/dL, glucose of 57.0mg/dl, lactate of 19.0mg/dL and the leukocyte of 119.0 cells/mm 3, with a predominance of lymphocytes (42%). It was found that age can cause cytological and biochemical changes in the parameters of CSF. Children younger than 2 years had a range percentage of neutrophils and monocytes different then children aged e” 2 and <6 years, and aged e” 6 and <10 years. The protein concentration range in CSF as well as glucose track can also change according to age. Conclusion: Age may lead to changes in cytological and biochemical parameters of CSF. CSF protein and glucose concentrations also change according to age

Higuchi fractal dimension applied to RR intervals in children with Attention Defi cit Hyperactivity Disorder

Background: Attention defi cit hyperactivity disorder (ADHD) is categorized by a lowered attention span, recklessness, and hyperactivity. Autonomic nervous system inequality has previously been studied using the same data by chaotic global techniques. We aim to compare the autonomic function of children with ADHD and controls by analyzing heart rate variability (HRV). Methods: 28 children with ADHD (22 boys, mean age 10.0 years ± 1.9 years) and 28 controls (15 boys, mean age 9.9 years ± 1.8 years) rested in supine position with spontaneous breathing for 20 minutes. Heart rate was recorded beat by beat. HRV analysis was performed by Higuchi Fractal Dimension technique. Results: ADHD promoted an increase in the Higuchi Fractal Dimension. The optimum value of Kmax was 10. Conclusion: ADHD signifi cantly altered cardiac autonomic modulation as measured by the Higuchi fractal dimension of HRV. It can therefore be stated that ADHD has increased the complexity of the HRV  signal through cardiac autonomic modulation

Rest energy expenditure is decreased during the acute as compared to the recovery phase of sepsis in newborns

<p>Abstract</p> <p>Background</p> <p>Little is known with respect to the metabolic response and the requirements of infected newborns. Moreover, the nutritional needs and particularly the energy metabolism of newborns with sepsis are controversial matter. In this investigation we aimed to evaluate the rest energy expenditure (REE) of newborns with bacterial sepsis during the acute and the recovery phases.</p> <p>Methods</p> <p>We studied nineteen neonates (27.3 ± 17.2 days old) with bacterial sepsis during the acute phase and recovery of their illness. REE was determined by indirect calorimetry and VO₂and VCO₂measured by gas chromatography.</p> <p>Results</p> <p>REE significantly increased from 49.4 ± 13.1 kcal/kg/day during the acute to 68.3 ± 10.9 kcal/kg/day during recovery phase of sepsis (P < 0.01). Similarly, VO₂(7.4 ± 1.9 <it>vs </it>10 ± 1.5 ml/kg/min) and VCO₂(5.1 ± 1.7 <it>vs </it>7.4 ± 1.5 ml/kg/min) were also increased during the course of the disease (P < 0.01).</p> <p>Conclusion</p> <p>REE was increased during recovery compared to the sepsis phase. REE of septic newborns should be calculated on individualized basis, bearing in mind their metabolic capabilities.</p

Prevalência e fatores associados à obesidade em crianças menores que cinco anos no município de Rio Branco – Acre

Introduction: The nutritional status of children is considered&nbsp;an important instrument in measuring the health conditions&nbsp;and quality of life of a population. The increasing prevalence of&nbsp;obesity in children is a significant public health problem as it is&nbsp;an important risk factor for obesity in adulthood.&nbsp;Objective: To evaluate the prevalence and factors associated&nbsp;with childhood obesity in the city of Rio Branco - Acre.&nbsp; Method: A database analysis was carried out from the Risk&nbsp;Factors and Morbidity Survey for Noncommunicable Diseases&nbsp;in the Municipality of Rio Branco / Health and Nutrition for&nbsp;Adults and Children in 2008.This cross-sectional study&nbsp;examined 687 children aged 0 to 60 months in urban and rural&nbsp;areas. Statistical analysis considered expansion and sample&nbsp;design. The prevalence of childhood obesity according to the&nbsp;anthropometric indices P / I (weight for age), P / E (weight for&nbsp;height) and BMI / I (Body Mass Index) were respectively 6.85%&nbsp;(95% CI = 5.30). - 8.80), 6.66% (95% CI = 3.22 - 13.27) and&nbsp;6.61% (95% CI = 3.25 - 12.98).&nbsp;Results: The final model showed a higher prevalence of obesity&nbsp;in the BMI / I index under the following conditions: home in the&nbsp;urban area (PR = 6.81; 95% CI = 1.27 - 36.38), electric lighting&nbsp;without meter (PR = 2.10; 95% CI = 1.22 - 3.59), mother’s&nbsp;height greater than 163cm (PR = 2.24; 95% CI = 1.12 - 4.47)&nbsp;and maternal obesity (RP = 2.37 95% CI = 1.19 - 4.72).&nbsp;Conclusion: The prevalence of obesity in the BMI / I index&nbsp;was high and is related to socioeconomic factors and specific&nbsp;maternal characteristics. It is necessary to promote actions that&nbsp;lead to the formation of a healthy lifestyle even in childhood.Introdução: O estado nutricional de crianças é considerado&nbsp;um instrumento importante na aferição das condições de&nbsp;saúde e qualidade de vida de uma população. A prevalência&nbsp;crescente da obesidade em crianças é um problema de saúde&nbsp;pública significante, pois é um fator de risco importante para a&nbsp;obesidade na vida adulta.&nbsp;Objetivo: Avaliar a prevalência e os fatores associados à&nbsp;obesidade infantil no município de Rio Branco – Acre.&nbsp;Método: Realizou-se análise de banco de dados provenientes&nbsp;do Inquérito de Fatores de Risco e Morbidade por Doenças&nbsp;Não-Transmissíveis no Município de Rio Branco / Saúde e&nbsp;Nutrição de Adultos e Crianças em 2008. Trata-se de um estudo&nbsp;transversal onde foram examinadas 687 crianças na faixa de&nbsp;0 a 60 meses nas zonas urbana e rural. A análise estatística&nbsp;considerou a expansão e o desenho da amostra. A prevalência&nbsp;da obesidade infantil segundo os índices antropométricos P/I&nbsp;(peso-para-idade), P/E (peso-para-estatura), e IMC/I (Índice de&nbsp;Massa Corporal-para-idade) foram respectivamente de 6,85%&nbsp;(IC95% = 5,30 – 8,80), 6,66% (IC95% = 3,22 – 13,27) e 6,61%&nbsp;(IC95% = 3,25 – 12,98).&nbsp;Resultados: O modelo final apresentou maior prevalência de&nbsp;obesidade para o índice IMC/I nas seguintes condições: local&nbsp;de domicílio na zona urbana (RP=6,81; IC95% = 1,27 – 36,38),&nbsp;iluminação elétrica sem medidor (RP=2,10; IC95% = 1,22 –&nbsp;3,59), altura da mãe maior que 163cm (RP=2,24; IC95% = 1,12&nbsp;– 4,47) e obesidade materna (RP=2,37; IC95% = 1,19 – 4,72).&nbsp;Conclusão: A prevalência da obesidade do índice IMC/I foi&nbsp;elevada e está relacionada à fatores socioeconômicos e&nbsp;características maternas específicas. É necessária a promoção&nbsp;de ações que levem a formação de um estilo de vida saudável&nbsp;ainda na infância

Chest associated to motor physiotherapy improves cardiovascular variables in newborns with respiratory distress syndrome

<p>Abstract</p> <p>Background</p> <p>We aimed to evaluate the effects of chest and motor physiotherapy treatment on hemodynamic variables in preterm newborns with respiratory distress syndrome.</p> <p>Methods</p> <p>We evaluated heart rate (HR), respiratory rate (RR), systolic (SAP), mean (MAP) and diastolic arterial pressure (DAP), temperature and oxygen saturation (SO₂%) in 44 newborns with respiratory distress syndrome. We compared all variables between before physiotherapy treatment vs. after the last physiotherapy treatment. Newborns were treated during 11 days. Variables were measured 2 minutes before and 5 minutes after each physiotherapy treatment. We applied paired Student t test to compare variables between the two periods.</p> <p>Results</p> <p>HR (148.5 ± 8.5 bpm vs. 137.1 ± 6.8 bpm - p < 0.001), SAP (72.3 ± 11.3 mmHg vs. 63.6 ± 6.7 mmHg - p = 0.001) and MAP (57.5 ± 12 mmHg vs. 47.7 ± 5.8 mmHg - p = 0.001) were significantly reduced after 11 days of physiotherapy treatment compared to before the first session. There were no significant changes regarding RR, temperature, DAP and SO₂%.</p> <p>Conclusions</p> <p>Chest and motor physiotherapy improved cardiovascular parameters in respiratory distress syndrome newborns.</p

PREVALENCE AND FACTORS ASSOCIATED WITH DEPRESSION IN MEDICAL STUDENTS

Introduction: depression, besides causing great psychological distress, may lead to poor academic performance and social relationships. Objective: to examine the prevalence of depressive symptoms in medical students from a northeastern region of Brazil. Methods: the population comprised 1024 students from first to twelfth semesters of two medical schools in Cariri, Ceará, Brazil. We used the questionnaire on sociodemographic characteristics and the Beck Depression Inventory II version. Results: the prevalence in this population for the diagnosis of depression was 28.8%.652 (63.7%) complied with all protocols to stay in research. After logistic regression, had a negative impact on studentsmental health: female Odds Ratio adjusted (ORa) (95% CI): 1.83 (1.19 to 2.82), reasonable physical health ORa (95% CI): 3.15 (2 0.09 to 4, 73), uncertainty about professional future ORa (95% CI): 2.97 (1.65 to 5.34), desire to change course ORa (95% CI): 2.51 (1.63 to 3.86), good social relationship but without participation in social activities ORa (95% CI): 1.96 (1.27 to 3.04), relationship difficulties ORa (95% CI): 11.40 (4.32 to 30.14) and rare leisure activities (95% CI): 2.45 (1.49 to 4.04) or eventual leisure activities ORa (95% CI): 3.04 (1.70 to 5.42 ). Conclusion: there was a high prevalence of depression among medical students in this region. Female, reasonable physical health, uncertainty over future career, desire to change course, do not participate in social activities and / or difficulties in relationships, sporadic or rare leisure activity were associated with increased risk of developing depressive symptoms

Envenenamentos ofídicos em uma região da Amazônia Ocidental Brasileira

Introduction: Snakebite accidents are a public health problem and are considered clinical emergencies, what makes studies in high-incidence regions very important. Objective: To describe the clinical and epidemiological aspects of patients suffering from snakebite accidents in a region of the Western Amazon, Brazil. Methods: It is a cross-sectional, retrospective and documentary quantitative approach, from 2015 to 2016, held at the Regional Hospital of Juruá, located in the city of Cruzeiro do Sul, Acre, Brazil. Epidemiological data were obtained from the forms of the Notification Disease Information System (SINAN), in the Epidemiological Surveillance Sector of the hospital. The following variables were verified: month of occurrence, snake identification (type of accident), accident location (urban and rural), locality, municipality, victim data (age group, sex, anatomical region affected), symptoms and signs circumstances of the accident, time elapsed between accident and care, number of ampoules used, and type of serum. Results: An average of 124 cases of snakebite accidents were treated per year (76.71 cases per 100,000 inhabitants/year), most of them were botropic accidents and the patients were male adult and rural workers, bitten in the lower limbs. More than 30% of cases were treated six hours after poisoning and 24-hour care is a risk factor for complications, as seven of the eight patients who had complications were treated within one day of the accident. Conclusion: It was presented a constant increase in the cases, which generated a worrying point of reflection, which may be associated with two factors, where one turns to the improvement in the displacement of victims (improvements in branch roads and implementation of SAMU speedboat) facilitating plus transport and telephone coverage by improving communication, or the failure of public health policies to provide better conditions and guidance to the population.Introdução: Os acidentes ofídicos são um problema de saúde pública e são considerados emergências clínicas, motivo este que torna os estudos em regiões de grande incidência muito importantes. Objetivo: Descrever os aspectos clínicos e epidemiológicos de pacientes vítimas de acidentes ofídicos em uma região da Amazônia Ocidental, Brasil. &nbsp;Método: Trata-se de um transversal, retrospectivo e documental de abordagem quantitativa, no período de 2015 a 2016, realizado no Hospital Regional do Juruá, localizado na cidade de Cruzeiro do Sul, Acre, Brasil. Os dados epidemiológicos foram obtidos a partir das fichas do Sistema de Informação de Agravos de Notificação (SINAN), no Setor de Vigilância Epidemiológica do hospital. Foram verificadas as seguintes variáveis: mês de ocorrência, identificação da serpente (tipo de acidente), local do acidente (zona urbana e rural), localidade, município, dados da vítima (faixa etária, sexo, região anatômica atingida), sintomas e sinais apresentados, circunstâncias do acidente, tempo decorrido entre o acidente e o atendimento, a quantidade de ampolas utilizadas e o tipo de soro no tratamento das vítimas. Resultados: Foram atendidos em média 124 casos de acidentes ofídicos por ano (76,71 casos por 100.000 habitantes/ano), sendo a maioria acidentes botrópicos e os pacientes constituídos por indivíduos adultos do sexo masculino e trabalhadores rurais, picados nos membros inferiores. Mais de 30% dos casos foram atendidos seis horas após o envenenamento e o atendimento após 24 horas é um fator de risco para complicações, uma vez que sete dos oito pacientes que apresentaram complicações foram atendidos depois de um dia do acidente. Conclusão: Apresentou um crescente constante nos casos, o que gerou um ponto de reflexão preocupante, que pode estar associado a dois fatores, onde um volta-se para a melhora no deslocamento das vítimas (melhorias nas estradas dos ramais e implantação de lancha do SAMU) facilitando mais o transporte e na cobertura de telefonia melhorando a comunicação, ou a falha das políticas de saúde pública na oferta de melhores condições e orientações para a população