Causes of hospitalization in the National Healthcare System of children aged zero to four in Brazil

INTRODUÇÃO: Estudar as causas de hospitalização de crianças auxilia na compreensão do perfil de adoecimento e na elaboração de planos de atenção à saúde para prevenir o agravamento das doenças e evitar as internações hospitalares. OBJETIVO: Identificar nos dados oficiais causas de hospitalização em crianças de zero a quatro anos, para compreender quais doenças as têm levado à hospitalização no Brasil. MÉTODO: Pesquisa de abordagem quantitativa, descritiva, exploratória e inferencial, cujos dados foram colhidos do site do DATASUS, no período compreendido entre os anos de 1998 a 2007. Os dados foram transcritos em tabelas, organizados de forma quantitativa, analisados em estatística descritiva e inferencial. RESULTADOS: Indicam uma distribuição heterogênea da morbidade entre as regiões do país, prevalecendo como primeira causa de internação hospitalar em crianças de zero a quatro anos as doenças do aparelho respiratório, seguidas das doenças infecciosas e parasitárias. CONCLUSÃO: Esses dados permitem refletir sobre a maneira em que os serviços de saúde podem se organizar para implementar a integralidade na atenção à saúde para esse grupo etário, com foco na atenção primária, com prioridade na prevenção dos agravos respiratórios e das doenças infecciosas e parasitárias, pois esses dois agrupamentos são considerados parte das doenças cujo acometimento se dá por causas sensíveis à atenção ambulatorial e podem ser evitados e/ou minimizados pelas ações de atenção básica.INTRODUCTION: Examining the causes of hospitalization of children improves the understanding of disease profiles and the preparation of health care planning requirements to prevent the worsening of diseases and to avoid hospitalizations. OBJECTIVE: Identify in official databases the true causes of hospitalizations among children aged zero to four in order to better understand which illnesses have been responsible for their hospitalizations in Brazil. METHOD: Quantitative, descriptive, exploratory and inferring approach study, whose databases were collected from the National Health System Database (DATASUS), in the period between the years of 1998 to 2007. Databases were put into tables, quantitatively organized, and analyzed in descriptive and inferring statistics. Results indicated a heterogeneous morbidity distribution within the regions of the country, in which respiratory tract conditions prevail as the number one cause of hospitalizations of children aged from zero to four, followed by human parasitic infectious diseases. CONCLUSION: The databases studied allow a reflection on how healthcare facilities can organize themselves in order to fully implement health care for the outlined age group of zero-to-four-children, focusing on primary care, with the priority for prevention of respiratory conditions and human parasite infectious diseases, given these two groups are considered part of the conditions that occur due to outpatient care-sensitive causes and that may be avoided and/or minimized by actions in primary care

Glycerine associated molecules with herbicide for controlling Adenocalymma peregrinum in cultivated pastures

The weed Adenocalymma peregrinum that is popularly known in Brazil as “ciganinha”, belongs to the family Bignoniaceae. The only way to control this plant species in crop fields is by the application of herbicides on the stump or directly on the stem. The present study aimed to analyze the effect of glycerine in controlling A. peregrinum (MIERS) L.G.Lohmann when applied on the stem. The glycerin used as a spray application of herbicide, underwent pre-purification processes with different concentrations of phosphoric acid (85%) and was characterized for water content, sulphated ash, total glycerol, matter organic non-glycerol (MONG), methanol and pH. For the analysis of the chemical composition of the stem lignin, holocellulose, extractives, calorific value and elementary quantitative determination of C, N, H, S were determined, as well as the total content of oxygen from the stem. The field work was installed at the town of Alvorada-TO, following the randomized complete block design with six treatments and four replications. Results show that the stem of A. peregrinum contains a significant amount of nitrogen, compared to other species, and high lignin content which makes it the most resistant species. The use of glycerin combined to the herbicide (picloram and triclopyr), was not efficient when compared to diesel oil. It was observed that the glycerin has potential as a vehicle for applying herbicides, leaving much to the development of new studies to make changes in its physicalchemical characteristics.Key words: Weeds, pastures, management, Adenocalymma peregrinum

Associations of Aortic Distensibility and Arterial Elasticity With Long-Term Visit-to-Visit Blood Pressure Variability: The Multi-Ethnic Study of Atherosclerosis (MESA)

BACKGROUND Although higher visit-to-visit variability (VVV) of blood pressure (BP) is associated with increased cardiovascular disease risk, the physiological basis for VVV of BP is incompletely understood. METHODS We examined the associations of aortic distensibility (assessed by magnetic resonance imaging) and artery elasticity indices (determined by radial artery pulse contour analysis) with VVV of BP in 2,640 and 4,560 participants, respectively, from the Multi-Ethnic Study of Atherosclerosis. Arterial measures were obtained at exam 1. BP readings were taken at exam 1 and at 3 follow-up visits at 18-month intervals (exams 2, 3, and 4). VVV was defined as the SD about each participant’s mean systolic BP (SBP) across visits. RESULTS The mean SDs of SBP were inversely associated with aortic distensibility: 7.7, 9.9, 10.9, and 13.2mm Hg for quartiles 4, 3, 2, and 1 of aortic distensibility, respectively (P trend < 0.001). This association remained significant after adjustment for demographics, cardiovascular risk factors, mean SBP, and antihypertensive medication use (P trend < 0.01). In a fully adjusted model, lower quartiles of large artery and small artery elasticity (LAE and SAE) indices were also associated with higher mean SD of SBP (P trend = 0.02 for LAE; P trend < 0.001 for SAE). CONCLUSIONS In this multiethnic cohort, functional alterations of central and peripheral arteries were associated with greater long-term VVV of SBP

ALIMENTAÇÃO E ANTROPOMETRIA DE ESCOLARES PRÉ-ADOLESCENTES: SUBSÍDIOS PARA ATUAÇÃO DO ENFERMEIRO NA PREVENÇÃO DA OBESIDADE

Objetivo: Conhecer hábitos de alimentação usual de pré-adolescentes e sua avaliação antropométrica, com vistas a subsidiar as ações de prevenção da obesidade aos enfermeiros da atenção primária. Método: Pesquisa descritiva e exploratória, cuja coleta de dados ocorreu com pré-adolescentes de duas escolas de município do Oeste do Paraná, em 2017 e 2018, por meio de instrumento contendo hábitos de consumo, recordatório alimentar 24h e dados antropométricos, analisados por estatística descritiva. Resultados: Predominou o sexo masculino (55,1%), na faixa etária de 10 anos (74,3%). Na antropometria, 56,9% foram eutróficos, embora 22,4% apresentassem sobrepeso e 20,7% obesidade. A média de refeições diárias foi quatro e o grupo de carboidratos foi ingerido por 100% dos adolescentes, seguida de açúcares com 86%, com variação dos demais grupos alimentares de acordo com a faixa etária. Conclusão: O excesso de peso foi expressivo, e dos grupos alimentares consumidos pelos escolares predominou carboidratos e açúcares. Assim, introduzir a alimentação saudável na adolescência nos dias de hoje é necessário. O ambiente escolar é local propício para que o enfermeiro desenvolva educação em saúde, pois o estímulo contínuo e precoce relacionado a boa alimentação possibilita a diminuição no desenvolvimento de doenças crônicas

Protective Effects of Tropical Fruit Processing Coproducts on Probiotic Lactobacillus Strains during Freeze-Drying and Storage

This study evaluated the protective effects of coproducts from agroindustrial processing of the tropical fruits acerola (Malpighia glabra L., ACE), cashew (Anacardium occidentale L., CAS), and guava (Psidium guayaba L., GUA) on the probiotics Lactobacillus paracasei L-10, Lactobacillus casei L-26, and Lactobacillus acidophilus LA-05 during freeze-drying and storage. The occurrence of damage to membrane integrity, membrane potential, and efflux activity of Lactobacillus cells after freeze-drying was evaluated by flow cytometry, and viable counts were measured immediately after freeze-drying and during 90 days of storage under refrigerated or room temperature conditions. Probiotic strains freeze-dried without substrate had the overall highest count reductions (0.5 ± 0.1 to 2.9 ± 0.3 log cycles) after freeze-drying. Probiotics freeze-dried with fruit processing coproducts had small cell subpopulations with damaged efflux activity and membrane potential. Average counts of probiotics freeze-dried with ACE, CAS, or GUA after 90 days of storage under refrigerated or room temperature were in the range of 4.2 ± 0.1 to 5.3 ± 0.2 and 2.6 ± 0.3 to 4.9 ± 0.2 log CFU/g, respectively, which were higher than those observed for strains freeze-dried without substrate. The greatest protective effects on freeze-dried probiotics were overall presented by ACE. These results revealed that ACE, CAS, and GUA can exert protective effects and increase the stability of probiotic lactobacilli during freeze-drying and storage, in addition to supporting a possible added-value destination for these agroindustrial coproducts as vehicles for probiotics and for the development of novel functional foods.Fil: Araújo, Caroliny Mesquita. Universidade Federal Da Paraiba; BrasilFil: Sampaio, Karoliny Brito. Universidade Federal Da Paraiba; BrasilFil: Dantas Duarte Menezes, Francisca Nayara. Universidade Federal Da Paraiba; BrasilFil: Tayse da Cruz Almeida, Erika. Universidade Federal Da Paraiba; BrasilFil: Lima, Marcos dos Santos. Instituto Federal do Sertão de Pernambuco. Departamento de Tecnologia de Alimentos; BrasilFil: Bordin Viera, Vanessa. Universidade Federal Campina Grande. Centro de Educação e Saúde; BrasilFil: Fernandez Garcia, Estefânia. Universidade Federal Da Paraiba; BrasilFil: Gomez Zavaglia, Andrea. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos; ArgentinaFil: Leite de Souza, Evandro. Universidade Federal Da Paraiba; BrasilFil: Gomes de Oliveira, Maria Elieidy. Universidade Federal Da Paraiba; Brasi

The Physiological Mechanisms of Effect of Vitamins and Amino Acids on Tendon and Muscle Healing: A Systematic Review

© 2018 Human Kinetics, Inc.To evaluate the current literature via systematic review to ascertain whether amino acids/vitamins provide any influence on musculotendinous healing and if so, by which physiological mechanisms. Methods: EBSCO, PubMed, ScienceDirect, Embase Classic/Embase, and MEDLINE were searched using terms including "vitamins," "amino acids," "healing," "muscle," and "tendon." The primary search had 479 citations, of which 466 were excluded predominantly due to nonrandomized design. Randomized human and animal studies investigating all supplement types/forms of administration were included. Critical appraisal of internal validity was assessed using the Cochrane risk of Bias Tool or the Systematic Review Centre for Laboratory Animal Experimentation Risk of Bias Tool for human and animal studies, respectively. Two reviewers performed duel data extraction. Results: Twelve studies met criteria for inclusion: eight examined tendon healing and four examined muscle healing. All studies used animal models, except two human trials using a combined integrator. Narrative synthesis was performed via content analysis of demonstrated statistically significant effects and thematic analysis of proposed physiological mechanisms of intervention. Vitamin C/taurine demonstrated indirect effects on tendon healing through antioxidant activity. Vitamin A/glycine showed direct effects on extracellular matrix tissue synthesis. Vitamin E shows an antiproliferative influence on collagen deposition. Leucine directly influences signaling pathways to promote muscle protein synthesis. Discussion: Preliminary evidence exists, demonstrating that vitamins and amino acids may facilitate multilevel changes in musculotendinous healing; however, recommendations on clinical utility should be made with caution. All animal studies and one human study showed high risk of bias with moderate interobserver agreement (k = 0.46). Currently, there is limited evidence to support the use of vitamins and amino acids for musculotendinous injury. Both high-quality animal experimentation of the proposed mechanisms confirming the physiological influence of supplementation and human studies evaluating effects on tissue morphology and biochemistry are required before practical application.Peer reviewe

COLETA DE SECREÇÃO TRAQUEAL: ESTUDO COMPARATIVO DE TÉCNICAS

Objective: The objective of this study is to compare, by means of microbiological analysis, two techniques of tracheal aspirates in intubated or tracheostomized patients. Methodology: The study was conducted from May to June 2012, in HUSM at UFSM, becoming an experimental study, qualitative and quantitative, comparative trial. There were two data collection techniques in each hipersecretive patient, intubated or tracheostomized, requiring analysis of secretion, with the same random order. In technique 1 the secretion was aspirated until probe was with a sufficient amount of secretion, after the aspiration tube was cut with sterile scissors, into small pieces within the sterile flask. In technique 2, when the probe had a sufficient amount of secretion, it was clamped, the extender was disconnected and connected to the suction end of the oxygen flow meter. Following, the probe tip was placed into a sterile collection vial while the flow meter was connected to 15 l / min so that the secretion present inside the tube is pushed into the pot. Results: The bacteria most commonly found in the Intensive Care Unit were Pseudomonas aeruginosa (13.64%) and Acinetobacter baumannii (13.64%) also had the presence of Candida spp (18.18%). The relationship between both techniques is equal (Kappa coefficient), both as a Gram stain for bacteria. Conclusion: The microbiological analysis showed that the collection techniques with the tracheal secretion tube and cut the flow of oxygen are equivalent. Soon both can be used in hospital routine.Keywords: Infection, Artificial Respiration, Microbiological Analysishttp://dx.doi.org/10.5902/2236583411376 Objetivo: Comparar, por meio de análise microbiológica, duas técnicas de coleta de secreção traqueal. Metodologia: estudo experimental, quantitativo, comparativo, cego, randomizado, desenvolvido na Unidade de Tratamento Intensivo (UTI). Foram realizadas duas técnicas de coleta em cada paciente hipersecretivo, entubado ou traqueostomizado, que necessitou de análise de secreção, sendo a ordem das mesmas aleatória. Na técnica 1 a sonda de aspiração foi cortada com tesoura estéril e colocada em pequenas parte dentro de frasco estéril. Já na técnica 2, a secreção que estava dentro da sonda de aspiração foi empurrada por fluxômetro de oxigênio para dentro do frasco estéril. Resultados: Os microorganismos mais encontrados na UTI foram Pseudomonas aeruginosa (13,64%), Acinetobacter baumanni (13,64%), e Candida spp (18,18%). A relação entre ambas às técnicas foi de igualdade (coeficiente Kappa), tanto para a De Gram como para a identificação das bactérias. Conclusão: A análise microbiológica demonstrou que as técnicas de coleta de secreção traqueal com a sonda cortada e com o fluxo de oxigênio são equivalentes. Logo ambas podem ser utilizadas na rotina hospitalar.Descritores: Infecção Hospitalar; Respiração Artificial; Análise Microbiológica.

Percutaneous discectomy: a current treatment for lumbar disc herniation Discotomia percutânea: tratamento vigente para hérnia De Disco lombar Discectomía percutánea: un tratamiento vigente para la hernia Discal lumbarresumen

ABSTRACT Objective: Describe the functional outcomes of patients with contained lumbar disc herniation (L4-L5, L5-S1) treated with manual percutaneous nucleotomy (MPN) and demonstrate that it remains a technique with good results. Methods: A prospective, longitudinal study with 110 patients contained with lumbar disc herniation (LDH) treated with (MPN). The evaluation was pre-surgical and 4, 30, 180 and 365 days after the surgery. We used Numeric Pain Scale (NPS), Oswestry Disability Index (ODI) and Macnab criteria. Descriptive and inferential statistics for differences. Results: N=110: 58 (52.72%) men, 52 (47.27%) women; average age 37.95 years (14-56) ± 10.60; most affected level: L4-L5 in 63 (57.14%) patients. NPS preoperative average: 7.75 (5-9) ± 1.12, and at 365 days: 2.14 (0-7) ± 2.37. The mean preoperative ODI was 37% (28%-40%) + 3.06, and at 365 days 9.52% (0%-40%) + 13.92. The prognosis (ODI) was good to 79 (71.81%) patients at 365 days, regular in 26 (23.63%) and poor in 5 (4.57%), corresponding respectively to patients with no, mild, moderate and severe disability. The Macnab criteria showed similar results (p = 0.00, 95% CI 0.00 to 0.13 -Student&apos;s t). Conclusions: The results were good at one-year follow-up (p = 0.00), demonstrating that the MPN is still a good option for lumbosciatic pain relief. Keywords: Diskectomy, Percutaneous; Intervertebral disc; Hernia; Low back pain. (p = 0,00, ic 95% 0,00-0,13 -t de student diferencias. resultados: n = 110: 58 (52,72%) hombres, 52 (47,27%) mujeres; edad promedio 37,95 años (14-56) + 10,60; nivel más afectado: l4-l5 en 63 (57,14%) pacientes. enD preoperatorio promedio: 7,75 (5-9) (p = 0,00, ic 95% 0,00-0,13 -t de studen

Reduction in blood pressure for elevated blood pressure/stage 1 hypertension according to the American College of Cardiology/American Heart Association guideline and cardiovascular outcomes

Aims Few studies have examined the relationship of blood pressure (BP) change in adults with elevated BP or stage 1 hypertension according to the American College of Cardiology (ACC)/American Heart Association (AHA) guideline with cardiovascular outcomes. We sought to identify the effect of BP change among individuals with elevated BP or stage 1 hypertension on incident heart failure (HF) and other cardiovascular diseases (CVDs). Methods We conducted a retrospective cohort study including 616 483 individuals (median age 46 years, 73.7% men) with elevated and results BP or stage 1 hypertension based on the ACC/AHA BP guideline. Participants were categorized using BP classification at one-year as normal BP (n = 173 558), elevated BP/stage 1 hypertension (n = 367 454), or stage 2 hypertension (n = 75 471). The primary outcome was HF, and the secondary outcomes included (separately) myocardial infarction (MI), angina pectoris (AP), and stroke. Over a mean follow-up of 1097 ± 908 days, 10 544 HFs, 1317 MIs, 11 070 APs, and 5198 strokes were recorded. Compared with elevated BP/stage 1 hypertension at one-year, normal BP at one-year was associated with a lower risk of developing HF [hazard ratio (HR): 0.89, 95% CI:0.85–0.94], whereas stage 2 hypertension at one-year was associated with an elevated risk of developing HF (HR:1.43, 95% CI:1.36–1.51). This association was also present in other cardiovascular outcomes including MI, AP, and stroke. The relationship was consistent in all subgroups stratified by age, sex, baseline BP category, and overweight/obesity. Conclusion A one-year decline in BP was associated with the lower risk of HF, MI, AP, and stroke, suggesting the importance of lowering BP in individuals with elevated BP or stage 1 hypertension according to the ACC/AHA guideline to prevent the risk of developing CVD.</p

Avaliação clínica, mamográfica e frequência de doenças mamárias em pacientes de um serviço privado de saúde

Introdução: O câncer de mama é a neoplasia maligna de maior incidência na população feminina, apresentando crescimento contínuo na última década. A mamografia de rastreamento é considerada o teste mais sensível para a detecção precoce do câncer de mama, mesmo que dependente do seu padrão de qualidade, o que inclui competência profissional e equipamentos adequados.Objetivos: Avaliar a frequência de doenças mamárias e o rastreio mamográfico utilizado no serviço privado de saúde.Métodos: Realizou-se um estudo com corte transversal com 3193 de pacientes que foram atendidas em um serviço privado de Saúde da Mulher, no período de janeiro de 1988 a janeiro de 2010, sendo excluídas as pacientes que não permitiram que seus dados fossem estudados, as que já haviam tratado previamente de um câncer de mama e as pacientes com prontuários incompletos.Resultados: Foram revisados 3076 prontuários, com identificação de 117 pacientes com alterações mamográficas e ou alterações clínicas mamárias. A média de idade das pacientes avaliadas foi de 45,01 + 13,32 anos. A história familiar de câncer de mama foi identificada por 15,40% das pacientes (n=18) e 27 pacientes (23,1%) relataram tratamento mamário prévio. Verificou-se que a idade foi o fator mais importante no determinismo do câncer de mama (p<0,001; X2=64,68) e que quanto maior o número de mamografias realizadas ao longo da vida, menor a freqüência de diagnóstico de câncer invasor da mama (p<0,05).Conclusões: Concluem os autores que as políticas de saúde devem levar em consideração o rastreio mamográfico como um elemento importante para o diagnóstico precoce do câncer de mama