A consulta de enfermagem no enfrentamento da COVID-19: vivências na atenção primária à saúde

Objetivo: descrever as experiências vividas na realização das consultas de enfermagem na Atenção Primária à Saúde no atendimento às pessoas com sintomas de COVID-19. Método: estudo qualitativo, descritivo, do tipo relato de experiência. As consultas de enfermagem foram realizadas entre maio e novembro de 2020 em uma Unidade Básica de Saúde de uma capital do Sul do Brasil. Resultados: as consultas ocorreram de forma presencial e/ou teleconsulta. Por meio da teoria das Necessidades Humanas Básicas e protocolos assistenciais identificarem-se necessidades biopsicossociais, e foram realizadas as intervenções de enfermagem. Identificou-se os diagnósticos de enfermagem conforme a Classificação Internacional para a Prática de Enfermagem. Conclusão: a presença de protocolos assistências dando suporte à consulta de enfermagem, possibilitaram maior autonomia profissional, destacando o protagonismo do enfermeiro no acesso do usuário ao sistema de saúde e na resolutividade da Atenção Primária no contexto pandêmico

Functional independence of one- to four-year-old children with myelomeningocele

Myelomeningocele is caused by neural tube closure defects and represents the second cause of locomotion disability in children. Functional independence depends on level of spine injury and assessment is important to determine proper therapeutic approaches. We aimed to describe functional Independence and level of injury in 15 children, aged one to four years and with complete spinal cord injury caused by myelomeningocele. This is an observational transversal study developed in the Ibirapuera University and Santa Cecília University. The Pediatric Evaluation of Disability Inventory (PEDI) was used to ask parents about the functional independence of children in daily life activities. The International Standards for Neurological Classification of Spinal Cord Injury of the American Spinal Injury Association was used to determine the motor and sensory levels. Nine girls and six boys were assessed (27.0 ±11.8 months of age). Three children showed thoracic level, nine showed high lumbar level, two were classified as low lumbar, and one as sacral level. PEDI scores varied from 15 to 60% on the self-care area, from 10 to 15% on mobility, and from 19 to 58% on social function. High variability was observed on the functional independence of children with myelomeningocele, detected by self-care and social function areas of PEDI. Mobility was the most affected domain.El mielomeningocele es causado por defecto en el cierre del tubo neural. La enfermedad representa la segunda causa de deficiencia crónica en el aparato locomotor en niños. La independencia funcional depende del nivel de la lesión medular y su evaluación es importante para determinar enfoques terapéuticos adecuados. El objetivo fue describir la independencia funcional y el nivel de lesión de 15 niños de seis meses a cuatro años con lesión medular completa causada por mielomeningocele. Se realizó un estudio observacional del tipo transversal en las Universidades Ibirapuera y Santa Cecilia. Se aplicó el Inventario de Evaluación Pediátrica de Discapacidad (Pediatric Evaluation of Disability Inventory, PEDI) con los padres para evaluar la independencia funcional en las actividades de vida diaria de los niños. La escala de Estándares Internacionales para la Clasificación Neurológica de la Lesión Medular de la Asociación Americana de la Lesión Medular (International Standards for Neurological Classification of Spinal Cord Injury of the American Spinal Injury Association) fue utilizada para determinar el nivel motor y sensitivo de la lesión. Se evaluaron seis niños y nueve niñas (27,0 ± 11,8 meses de edad). Tres niños presentaron lesión torácica, nueve presentaron lesión lumbar alta, dos presentaron lesión lumbar baja y una presentó lesión en el sacro. Las puntuaciones en la PEDI variaron del 15 al 60% en el dominio autocuidado, del 10 al 15% en el ámbito de la movilidad y del 19 al 58% en el ámbito de la función social. Hubo gran variabilidad en el desempeño funcional de los niños con mielomeningocele, detectada por los campos autocuidado y función social de la PEDI. Los niños presentaron gran daño en el dominio de la movilidad.A mielomeningocele é causada por defeito no fechamento do tubo neural. A doença representa a segunda causa de deficiência crônica no aparelho locomotor em crianças. A independência funcional depende do nível da lesão medular e sua avaliação é importante para a determinação de abordagens terapêuticas adequadas. O objetivo foi descrever a independência funcional e o nível de lesão de 15 crianças de seis meses a quatro anos com lesão medular completa causada por mielomeningocele. Foi realizado um estudo observacional do tipo transversal nas Universidades Ibirapuera e Santa Cecília. O Inventário de Avaliação Pediátrica de Incapacidade (Pediatric Evaluation of Disability Inventory - PEDI) foi aplicado com os pais, para avaliação da independência funcional nas atividades de vida diária das crianças. A escala de Padrões Internacionais para Classificação Neurológica de Lesão da Medula Espinhal da Associação Americana de Lesão Medular (International Standards for Neurological Classification of Spinal Cord Injury of the American Spinal Injury Association) foi utilizada para determinar o nível motor e sensitivo da lesão. Foram avaliados seis meninos e nove meninas (27,0±11,8 meses de idade). Três crianças apresentaram lesão torácica, nove apresentaram lesão lombar alta, duas apresentaram lesão lombar baixa e uma apresentou lesão sacral. As pontuações na PEDI variaram de 15 a 60% no domínio autocuidado, de 10 a 15% no domínio mobilidade e de 19 a 58% no domínio função social. Houve grande variabilidade no desempenho funcional de crianças com mielomeningocele, detectada pelos domínios autocuidado e função social da PEDI. As crianças apresentaram grande prejuízo no domínio mobilidade

Accuracy of the urine point-of-care circulating cathodic antigen assay for diagnosing Schistosomiasis mansoni infection in Brazil: a multicenter study

Secretaria de Vigilância em Saúde / Fundo Nacional de Saúde / Ministério da Saúde - [TED/FNS: 118/2017; SIAFI: 691919 / 25000.479741/2017-05Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Educação em Ambiente e Saúde. Rio de Janeiro, RJ, Brasil.Universidade Federal do Ceará. Departamento de Análises Clínicas e Toxicológicas. Fortaleza, CE, Brasil.Fundação Oswaldo Cruz. Instituto René Rachou. Belo Horizonte, MG, Brasil.Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos. Instituto Evandro Chagas. Laboratório de Parasitoses Intestinais, Esquistossomose e Malacologia. Ananindeua, PA, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Educação em Ambiente e Saúde. Rio de Janeiro, RJ, Brasil.Universidade Federal do Espírito Santo. Centro de Ciências da Saúde. Unidade de Doenças Infecciosas. Vitória, ES, Brasil / Pontifícia Universidade Católica do Rio Grande do Sul. Laboratório de Parasitologia Biomédica. Porto Alegre, RS, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil / Yale University. School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, CT, USA.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Educação em Ambiente e Saúde. Rio de Janeiro, RJ, Brasil.Pontifícia Universidade Católica do Rio Grande do Sul. Laboratório de Parasitologia Biomédica. Porto Alegre, RS, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos. Instituto Evandro Chagas. Laboratório de Parasitoses Intestinais, Esquistossomose e Malacologia. Ananindeua, PA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.Pontifícia Universidade Católica do Rio Grande do Sul. Laboratório de Parasitologia Biomédica. Porto Alegre, RS, Brasil.Universidade Federal do Ceará. Departamento de Análises Clínicas e Toxicológicas. Fortaleza, CE, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.Pontifícia Universidade Católica do Rio Grande do Sul. Laboratório de Parasitologia Biomédica. Porto Alegre, RS, Brasil.Fundação Oswaldo Cruz. Instituto René Rachou. Belo Horizonte, MG, Brasil.Background: The World Health Organization recommends a market-ready, urine-based point-of-care diagnostic test for circulating cathodic antigens (CCA) to determine the prevalence of S. mansoni. This study evaluated the performance of the URINE CCA (SCHISTO) ECO TESTE® (POC-ECO), which is currently available in Brazil. Methods: Residents from eight sites with different prevalence estimates provided one urine sample for POC-ECO and one stool sample for Kato-Katz (KK) and Helmintex® (HTX) testing as an egg-detecting reference for infection status. Results: None of the study sites had significantly higher POC-ECO accuracy than KK. Conclusions: POC-ECO is not currently recommended in Brazilian schistosomiasis elimination programs

Aprimoramento da detecção de ovos de Schistosoma mansoni em sedimento produzido pelo metodo Helmintex®

A esquistossomose é endêmica em 74 países, afetando mais de 200 milhões de pessoas. No Brasil, o Schistosoma mansoni é o único agente etiológico da esquistossomose, que atinge 19 estados. Medidas de controle e tratamento efetivo podem resultar em diminuição da carga parasitária de indivíduos com a forma severa da doença. Assim, quando não forem utilizados métodos diagnósticos com sensibilidade adequada para acompanhamento, essas medidas podem dificultar o diagnóstico, favorecendo a permanência da infecção por longos períodos, além da contaminação ambiental e consequentemente a exposição à população local à reinfecção. Nestas áreas, ou onde ocorreu introdução recente de S. mansoni, os métodos parasitológicos clássicos para encontrar ovos nas fezes não demonstram eficácia. Embora as técnicas imunológicas e moleculares sejam consideradas atualmente as principais ferramentas de diagnóstico, são necessários métodos parasitológicos para a confirmação da infecção. Recentemente, o Helmintex® foi descrito como um método diagnóstico altamente sensível que isola ovos a partir de 30 gramas de fezes através da interação dos ovos com microesferas paramagnéticos em um campo magnético. Apesar da sensibilidade, sua limitação está no número de lâminas a serem analisadas, tornando o processo demorado e inviável para aplicação na rotina clínica.Neste contexto, este trabalho abre perspectivas para a utilização de novas ferramentas na tentativa de otimizar a detecção de ovos de S. mansoni na última etapa do método Helmintex®, utilizando a quimioluminescência, com o uso de luminol, e a coloração por ninidrina. Solução de luminol 0,01 % foi adicionada aos sedimentos de Helmintex®, processados com fezes humanas, e em soluções contendo diferentes quantidades de ovos de S. mansoni provenientes de fígados de camundongos experimentalmente infectados, de cultivo in vitro e de fezes. A emissão de luz visível foi observada a olho nu em câmara escura e o tempo de duração da luz emitida foi contado até que a luz se extinguisse. O tempo de duração da luz para as amostras com ovos de cultivo foi superior ao das amostras de fígado quando comparado estatisticamente, porém não foi observada emissão de luz em amostras contendo ovos provenientes de fezes. Outra alternativa testada foi a coloração do sedimento final com ninidrina. Os sedimentos de Helmintex® contendo ovos de S. mansoni foram fixados com etanol 70 % e depositados em papel filtro Whatman Grau 541, imersos em uma solução de ninidrina:etanol (30:70%) para posterior visualização dos ovos corados em microscópio óptico. O tempo de leitura de cada filtro foi cronometrado. As condições ideais para incubação com a ninidrina foram estabelecidas em 15 minutos à 24 °C. O tempo de leitura para cada amostra foi, em média, de 23 minutos. Em comparação com o método Helmintex® original, a utilização de ninidrina diminuiu o tempo de leitura do sedimento final em, ao menos, 450 minutos.Os resultados deste trabalho mostraram que a implementação de novas ferramentas em métodos diagnósticos já existentes podem contribuir para um melhor desempenho de técnicas sensíveis, porém com aplicação limitada em estudos de campo, e abrem perspectivas para novos estudos que visam investigar e otimizar etapas primordiais de métodos de concentração.Schistosomiasis is endemic in 74 countries, affecting more than 200 million people. In Brazil, Schistosoma mansoni is the only causative agent of schistosomiasis, which affects 19 states. Control measurements and effective treatment can result in a decrease of the parasitic load of individuals with the severe form. In this matter, when diagnostic methods with adequate sensitivity for monitoring are not used, those measurements may difficult diagnosis, favoring the persistence of the infection for long periods, as well as the environmental contamination and consequently exposure to local population reinfection. In these areas, or where there was recent introduction of S. mansoni, classic parasitological methods to find eggs in feces are not efficient. Although immunological and molecular techniques are currently considered as main diagnostic tools, parasitological methods re necessary to confirm the infection. Helmintex™ has been recently described as highly sensitive diagnostic method that isolates eggs from 30 gram of feces through the interaction of eggs with paramagnetic microspheres in a magnetic field.Despite the sensibility, its limitation lies in the number of slides to be analyzed, making the process time consuming and not applicable for clinical routine. In this context, this work opens perspectives for the use of new tools in an attempt to optimize S. mansoni egg detection in the last step of the Helmintex™, using chemiluminescence, with the use of luminol, and ninhydrin staining. Luminol solution 0. 01 % was added to the Helmintex™ sediments, previously processed with human feces, and in solutions containing different amounts of S. mansoni eggs from liver of experimentally infected mice, from in vitro culture and from feces. The emission of visible light was observed with naked eye in a dark chamber and the duration time of the emitted light was counted until total light extinction. Light duration time for samples with in vitro eggs was superior than for the liver samples when statistically compared, but no light emission was observed in samples containing eggs from stool. Another alternative tested was the ninhydrin staining. Helmintex™ sediments containing S. mansoni eggs were fixed with 70% ethanol and deposited on Whatman Grade 541 filter paper, immersed in a solution of ninhydrin:ethanol (30: 70 %) for later eggs visualization at the optical microscope.Reading time for each filter was counted and registered. Ideal conditions for incubation with ninhydrin were established in 15 minutes at 24 °C. Reading time for each sample was, in general, of 23 minutes. When compared to the original Helmintex™ method, the use of ninhydrin decreased the reading time of the final sediment in, at least, 450 minutes. The results of this work showed that the implementation of new tools in existent diagnostic methods may contribute to a better performance of sensitive techniques with limited application in field studies, and open perspectives to new studies that aim to investigate and to optimize primordial steps of concentration methods

Technology for the treatment promotion of adults living with HIV: Positive o Cuidado (Positive the Care)

ABSTRACT Objectives: to develop a responsive website focused on treatment adherence for adult users living with HIV. Methods: technological study conducted between August and October 2020, in the light of Pierre Lévy’s theoretical-philosophical framework, using the Double Diamond Process methodology associated with the five stages of The Elements of User Experience framework. Results: it was developed the responsive website Positive Care (Positive o Cuidado), composed of an initial presentation screen and 13 other screens named: Family Health and You; Undetectable = Untransmissible; Antiretroviral Drugs; Routine Tests; Vaccination; Antiretroviral Delivery; Drug Interactions; Combined Prevention; Support Services; Healthy Life; Family and Reproductive Planning; Covid 19; and Questions, Curiosities, and Myths. Final Considerations: the responsive website was developed based on the software design and programming process and has requirements/functionalities with the potential to strengthen the collective intelligence about HIV and, consequently, to promote treatment adherence by its users

The affinity of magnetic microspheres for Schistosoma eggs

Schistosomiasis is a chronic parasitic disease of humans, with two species primarily causing the intestinal infection: Schistosoma mansoni and Schistosoma japonicum. Traditionally, diagnosis of schistosomiasis is achieved through direct visualisation of eggs in faeces using techniques that lack the sensitivity required to detect all infections, especially in areas of low endemicity. A recently developed method termed Helmintex (TM) is a very sensitive technique for detection of Schistosoma eggs and exhibits 100% sensitivity at 1.3 eggs per gram of faeces, enough to detect even low-level infections. The Helminthex (TM) method is based on the interaction of magnetic microspheres and schistosome eggs. Further understanding the underlying egg-microsphere interactions would enable a targeted optimisation of egg-particle binding and may thus enable a significant improvement of the Helmintex (TM) method and diagnostic sensitivity in areas with low infection rates. We investigated the magnetic properties of S. mansoni and S. japonicum eggs and their interactions with microspheres with different magnetic properties and surface functionalization. Eggs of both species exhibited higher binding affinity to the magnetic microspheres than the non-magnetic microspheres. Binding efficiency was further enhanced if the particles were coated with streptavidin. Schistosoma japonicum eggs bound more microspheres compared with S. mansoni. However, distinct differences within eggs of each species were also observed when the distribution of the number of microspheres bound per egg was modelled with double Poisson distributions. Using this approach, both S. japonicum and S. mansoni eggs fell into two groups, one having greater affinity for magnetic microspheres than the other, indicating that not all eggs of a species exhibit the same binding affinity. Our observations suggest that interaction between the microspheres and eggs is more likely to be related to surface charge-based electrostatic interactions between eggs and magnetic iron oxide rather than through a direct magnetic interaction

The Interaction Between Schistosome Eggs and Magnetic Microspheres

Paper presented at the 10th International Conference on the Scientific and Clinical Applications of Magnetic Carriers that took place in Dresden (Germany) during June 10-14th, 2014.Schistosomiasis is a public health problem affecting more than 200 million people in Asia, Africa and America. Two main species may cause the intestinal infection in humans: Schistosoma mansoni and Schistosoma japonicum. Helmintex® is a new very sensitive method for detection of Schistosoma eggs in human faeces based on the interaction of eggs and paramagnetic microspheres, with 100 % sensitivity at limit of 1.3 eggs per gram. The objective of this study was to investigate the magnetic properties of Schistosoma eggs and the interaction of microspheres with the eggs to enable optimization of the Helmintex® method. Eggs from both species were isolated from livers of infected mice and separately incubated with four types of microspheres at pH7 and pH 8 at an egg/microsphere ratio of 1:500 for 30 minutes with no applied magnetic field. The polystyrene microspheres were a) magnetic iron oxide coated; b) magnetic iron oxide and streptavidin coated; c) uncoated, d) streptavidin coated. The conjugates were sieved to remove unbound microspheres. An optical microscope was used to determine the distribution of the numbers of microspheres bound per egg. The observed distributions were well modeled with double Poisson distributions. At pH 7, both theS. japonicum and S. mansoni eggs appeared to fall into two types, one type having a greater affinity for magnetic iron oxide coated spheres than the other. S. japonicum eggs had a higher affinity for magnetic iron oxide coated microspheres than S. mansoni. Strepdavidin coating reduced the affinity for both species. At pH 8, the affinities of both species of eggs for the magnetic microspheres was reduced. In the absence of magnetic iron oxide coating, there was very little affinity of the eggs for microspheres. These observations suggest that the interaction between the microspheres and eggs is more likely to be related to electrostatic interactions between eggs and magnetic iron oxide rather than through magnetic interactions

The affinity of magnetic microspheres for Schistosoma eggs

Schistosomiasis is a chronic parasitic disease of humans, with two species primarily causing the intestinal infection: Schistosoma mansoni and Schistosoma japonicum. Traditionally, diagnosis of schistosomiasis is achieved through direct visualisation of eggs in faeces using techniques that lack the sensitivity required to detect all infections, especially in areas of low endemicity. A recently developed method termed Helmintex™ is a very sensitive technique for detection of Schistosoma eggs and exhibits 100% sensitivity at 1.3 eggs per gram of faeces, enough to detect even low-level infections. The Helminthex™ method is based on the interaction of magnetic microspheres and schistosome eggs. Further understanding the underlying egg-microsphere interactions would enable a targeted optimisation of egg-particle binding and may thus enable a significant improvement of the Helmintex™ method and diagnostic sensitivity in areas with low infection rates. We investigated the magnetic properties of S. mansoni and S. japonicum eggs and their interactions with microspheres with different magnetic properties and surface functionalization. Eggs of both species exhibited higher binding affinity to the magnetic microspheres than the non-magnetic microspheres. Binding efficiency was further enhanced if the particles were coated with streptavidin. Schistosoma japonicum eggs bound more microspheres compared with S. mansoni. However, distinct differences within eggs of each species were also observed when the distribution of the number of microspheres bound per egg was modelled with double Poisson distributions. Using this approach, both S. japonicum and S. mansoni eggs fell into two groups, one having greater affinity for magnetic microspheres than the other, indicating that not all eggs of a species exhibit the same binding affinity. Our observations suggest that interaction between the microspheres and eggs is more likely to be related to surface charge-based electrostatic interactions between eggs and magnetic iron oxide rather than through a direct magnetic interaction.This work was funded by grants from the Australian Research Council (ARC) and National Health and Medical Research Council (NHMRC) of Australia, a University of Western Australia/University of Queensland (Australia) Bilateral Research Collaboration Award as well as grants from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and the Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul (FAPERGS) in Brazil. Travel to Australia by RRFC was funded by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil. SK is funded by an NHMRC Early Career Fellowship (GNT 1052760). LG is the beneficiary of a post-doctoral grant from the AXA Research Fund (Europe)

The use of the circulating cathodic antigen (Cca) urine cassette assay for the diagnosis and assessment of cure of schistosoma mansoni infections in an endemic

Universidade do Estado do Pará. Programa de Pós-Graduação Strictu Sensu em Biologia Parasitária na Amazônia. Belém, PA, Brasil / Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Laboratório de Parasitoses Intestinais, Esquistossomose e Malacologia. Ananindeua, PA, Brasil.Universidade do Estado do Pará. Programa de Pós-Graduação Strictu Sensu em Biologia Parasitária na Amazônia. Belém, PA, Brasil / Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Laboratório de Parasitoses Intestinais, Esquistossomose e Malacologia. Ananindeua, PA, Brasil.Universidade do Estado do Pará. Programa de Pós-Graduação Strictu Sensu em Biologia Parasitária na Amazônia. Belém, PA, Brasil / Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Laboratório de Parasitoses Intestinais, Esquistossomose e Malacologia. Ananindeua, PA, Brasil.Universidade do Estado do Pará. Programa de Pós-Graduação Strictu Sensu em Biologia Parasitária na Amazônia. Belém, PA, Brasil / Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Laboratório de Parasitoses Intestinais, Esquistossomose e Malacologia. Ananindeua, PA, Brasil.Pontifícia Universidade Católica do Rio Grande do Sul. Programa de Pós-Graduação em Medicina e Ciências da Saúde. Laboratório de Parasitologia Biomédica. Porto Alegre, RS, Brasil.Universidade Federal de Minas Gerais. Departamento de Parasitologia. Belo Horizonte, MG, Brasil.Universidade do Estado do Pará. Programa de Pós-Graduação Strictu Sensu em Biologia Parasitária na Amazônia. Belém, PA, Brasil / Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Laboratório de Parasitoses Intestinais, Esquistossomose e Malacologia. Ananindeua, PA, Brasil.INTRODUCTION: Schistosomiasis is a poverty-related disease that affects people in 78 countries worldwide. This study aimed to evaluate the point-of-care circulating cathodic antigen (POC-CCA) test performance using sensitive parasitological methods as a reference standard (RS) in individuals before and after treatment. METHODS: The RS was established by combining the results of 16 Kato-Katz slides and the Helmintex® method. Positivity rates of the POC-CCA test and Kato-Katz and Helmintex® methods were calculated before treatment and 30 days afterward. Furthermore, the sensitivity, specificity, accuracy, and kappa coefficient before treatment were determined by comparing the methods. The cure rate was defined 30 days after treatment. RESULTS: Among the 217 participants, the RS detected a total of 63 (29.0%) positive individuals. The POC-CCA test identified 79 (36.4%) infections. The evaluation of POC-CCA test performance in relation to the RS revealed a sensitivity of 61.9%, specificity of 74.0%, accuracy of 70.5%, and kappa coefficient of 0.33. Out of the 53 remaining participants after treatment, a total of 45 (81.1%) showed egg negative results, and 8 (18.9%) were egg positive according to the RS. A total of 5 (9.4%) egg-positive and 37 (69.8%) egg-negative individuals were positive by the POC-CCA test. CONCLUSIONS: Our data show that the POC-CCA test has potential as an auxiliary tool for the diagnosis of Schistosoma mansoni infection, yielding better results than 16 Kato-Katz slides from three different stool samples. However, the immunochromatographic test lacks sufficient specificity and sensitivity for verifying the cure rate after treatment

Functional independence of one- to four-year-old children with myelomeningocele

<p></p><p>ABSTRACT Myelomeningocele is caused by neural tube closure defects and represents the second cause of locomotion disability in children. Functional independence depends on level of spine injury and assessment is important to determine proper therapeutic approaches. We aimed to describe functional Independence and level of injury in 15 children, aged one to four years and with complete spinal cord injury caused by myelomeningocele. This is an observational transversal study developed in the Ibirapuera University and Santa Cecília University. The Pediatric Evaluation of Disability Inventory (PEDI) was used to ask parents about the functional independence of children in daily life activities. The International Standards for Neurological Classification of Spinal Cord Injury of the American Spinal Injury Association was used to determine the motor and sensory levels. Nine girls and six boys were assessed (27.0 ±11.8 months of age). Three children showed thoracic level, nine showed high lumbar level, two were classified as low lumbar, and one as sacral level. PEDI scores varied from 15 to 60% on the self-care area, from 10 to 15% on mobility, and from 19 to 58% on social function. High variability was observed on the functional independence of children with myelomeningocele, detected by self-care and social function areas of PEDI. Mobility was the most affected domain.</p><p></p