Aleitamento materno : fatores que influenciam o desmame precoce em lactentes menores de dois anos de idade

Orientador: Prof. Dr. Herberto José Chong NetoDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Saúde da Família. Defesa : Curitiba, 25/08/2022Inclui referências: p. 51-57Resumo: Os índices de Aleitamento Materno variam entre regiões e populações urbanas e rurais, sofrendo influência de inúmeros fatores, os quais impactam influenciando o sucesso ou fracasso da prática da amamentação. O presente estudo teve por objetivo principal identificar os fatores que podem influenciar o desmame precoce no município de Corbélia - PR. Trata-se de um estudo de corte transversal de caráter quantitativo descritivo realizado no município de Corbélia - PR, com 130 mulheres mães de crianças com idade entre 0 e 23 meses e 29 dias de vida. Foi possível observar, por meio dos resultados deste estudo, um índice de aleitamento materno (AM) em menores de seis meses de 85,5%, no entanto quando se trata de aleitamento materno exclusivo (AME) nessa faixa etária o índice caiu para 22,3%. Os profissionais da atenção primária à saúde (APS) têm papel fundamental no apoio e promoção do AM, devendo este ser assunto desde o começo da gestação tal qual o alerta a respeito das dificuldades e percalços que podem surgir durante esse processo. Torna-se necessário e de grande valia a qualificação dos profissionais bem como a implementação de protocolos assistenciais acerca do AM nos serviços de saúde a fim de garantir e padronizar as orientações, além de fortalecer as políticas públicas de promoção e proteção do AM.Abstract: Breastfeeding occurrence varies between urban and rural regions and population and it's influenced by countless factors, which impact the breastfeeding practice and influence its success or failure. This study aimed to identify the factors that may influence the early weaning in the city of Corbélia - PR. It is a descriptive quantitative cross-sectional study carried out in the city of Corbélia, performed with 130 women, mothers whose babies' ages go from 0 to 23 months and 29 days old. With this study's results, it became possible to observe an 85,5% of BF occurrence within children younger than six months old, however when it comes to EBF within the same age, the occurrence level lowered to 22,3%. The PHC professionals play a fundamental role in supporting and promoting BF, and this matter should be discussed since the beggining of pregnancy as well as the warning about the difficulties and drawbacks that may happen during this process. The professionals' qualification is necessary and hugely important just as implementing care protocols about the BF within the health services in order to assure and standardize the instructions, besides strengthening public policies for promoting and protecting the BF

Uropathogenic Escherichia coli pathogenicity islands and other ExPEC virulence genes may contribute to the genome variability of enteroinvasive E-coli

Background: Enteroinvasive Escherichia coli (EIEC) may be the causative agent of part of those million cases of diarrhea illness reported worldwide every year and attributable to Shigella. That is because both enteropathogens have many common characteristics that difficult their identification either by traditional microbiological methods or by molecular tools used in the clinical laboratory settings. While Shigella has been extensively studied, EIEC remains barely characterized at the molecular level. Recent EIEC important outbreaks, apparently generating more life-threatening cases, have prompted us to screen EIEC for virulence traits usually related to extraintestinal pathogenic E. coli (ExPEC). That could explain the appearance of EIEC strains presenting higher virulence potential. Results: EIEC strains were distributed mainly in three phylogroups in a serogroup-dependent manner. Serogroups O124, O136, O144, and O152 were exclusively classified in phylogroup A O143 in group E and O28ac and O29 in group B1. Only two serogroups showed diverse phylogenetic origin as follows: O164 was assigned to groups A, B1, C, and B2 (one strain each), and O167 in groups E (five strains), and A (one strain) (Table 1). Eleven of 20 virulence genes (VGs) searched were detected, and the majority of the 19 different VGs combinations found were serogroup-specific. Uropathogenic E. coli (UPEC) PAI genetic markers were detected in all EIEC strains. PAIs I-J96 and IICFT073 were the most frequent (92.1 and 80. 4%, respectively). PAI IV536 was restricted to some serogroups from phylogroups A, B1 and E. PAI I-CFT073 was uniquely detected in phylogroups B2 and E. A total of 45 (88%) strains presented multiple PAI markers (two to four). PAIs IJ96 and IICFT073 were found together in 80% of strains. Conclusions: EIEC is a DEC pathovar that presents VGs and pathogenicity island genetic markers typically associated with ExPEC, especially UPEC. These features are distributed in a phylogenetic and serogroup-dependent manner suggesting the existence of stable EIEC subclones. The presence of phylogroups B2 and E strains allied to the presence of UPEC virulence-associated genes may underscore the ongoing evolution of EIEC towards a hypervirulent pathotype.Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior - CAPESUniv Fed Sao Paulo, Dept Microbiol Immunol & Parasitol, Rua Botucatu 862, BR-04023062 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Microbiol Immunol & Parasitol, Rua Botucatu 862, BR-04023062 Sao Paulo, SP, BrazilWeb of Scienc

A SOLIDARIEDADE COMO BASE PARA EFETIVAÇÃO DIREITOS HUMANOS NO ÂMBITO INTERNACIONAL.

O presente artigo tem objeto de estudo a solidariedade como base para efetivação dos direitos humanos no âmbito internacional. Preliminarmente será feito um breve resgate histórico sobre a evolução dos direitos humanos, partindo do período axial dando maior enfoque ao chamado “Direito Internacional dos Direitos Humanos”, nascidos do pós-segunda guerra mundial que surgiu como forma de resposta as atrocidades cometidas pelo nazismo. Em um segundo momento, será abordado os efeitos da globalização (que segundo SUPIOT, não é algo novo, mas sim apenas uma etapa do processo de mundialização) na efetivação dos direitos humanos, aqui o objetivo do presente trabalho não é negar os efeitos positivos que surgiram com este evento, mas, apontar os processos violentos que se manifestaram desde o surgimento da globalização como é o caso da aporofobia. Por fim pretende-se apontar formas que garantam a efetivação dos direitos humanos no cenário internacional, apoiada no método sistêmico de Niklas Luhmann, apontando relações que fortaleçam laços de solidariedade que fortifiquem os direitos humanos, afastando um cenário de desconstrução de direitos que foram arduamente conquistados ao longo da história da humanidade.

Do Atta sexdens rubropilosa workers prepare leaves and bait pellets in similar ways to their symbiotic fungus?

Leaf-cutting ants rely on the obligate symbiosis with a fungus, Leucoagaricus gongylophorus, on which they feed. This fungus garden is maintained preferentially with green leaves in combination with other tissues of plant origin. The nutritional composition of this symbiotic relationship is extremely beneficial for the colony, representing the main food source for larvae and an important food component of adult workers. The objective of this study was to observe the behavioral repertoire of Atta sexdens rubropilosa during the preparation and incorporation of two different substrates, leaves and bait pellets, as well as the participation of each caste in these processes this process. The first substrate offered to the colonies were Citrus sp. leaves cut into disks and the second were pellets of citrus pulp bait formulated without the active ingredient. The observations were made under a stereomicroscope and were started when the first portion of the substrate offered was carried to the fungus garden. The behaviors executed during preparation and incorporation of the leaf disks, and subsequently of the bait pellets, were recorded using three colonies, with six repetitions of 5 and 7 hours per colony, respectively. Eight behavioral acts were recorded for the three castes found, irrespective of the substrate processed by the workers. Licking was the most frequently executed behavioral act, which occurred throughout the observation period, regardless of the substrate offered. Gardeners and generalists were the castes most engaged in the execution of this behavior. Considering the large number of individuals involved in the execution of this task, it can be concluded that this behavior is important for dispersion of the active ingredient and contamination of workers inside the colony.

Mindfulness-based intervention reduces sensitivity parameters in women with chronic painful TMD

Objective: to analyze clinical parameters suggestive of central sensitization in women with chronic painful temporomandibular disorder before and after an intervention based on mindfulness. Method: Eleven women aged 27 to 44 years (36.36 ± 5.61), diagnosed with chronic painful TMD (Diagnostic Criteria for Temporomandibular Disorders), participated in the study. Hyperalgesia, allodynia and LDP pressure pain threshold were assessed at trigeminal and extra-trigeminal points before and after the mindfulness-based intervention, as well as the application of the MAAS questionnaire (Mindful Attention Awareness Scale ”- MAAS). The 8-week mindfulness program was offered to study participants, based on the Mindfulness Trainings International - MTI protocol, in weekly 2-hour sessions and a 4-hour session. Results: There was a significant reduction in allodynia, hyperalgesia and an increase in the pressure pain threshold, in addition to a significant increase in the level of mindfulness (p <0.05) as a marker of effectiveness of the offered mindfulness-based intervention. Conclusion: Healthier indexes in clinical parameters suggestive of central sensitization investigated after the intervention, represent a significant improvement in the relationship of the person with a chronic illness that generates continuous unpleasant experiences such as TMDObjetivo: analizar parámetros clínicos sugestivos de sensibilización central en mujeres con trastorno temporomandibular doloroso crónico antes y después de una intervención basada en la atención plena. Método: Participaron once mujeres de 27 a 44 años (36.36 ± 5.61), diagnosticadas con TMD dolorosa crónica. La hiperalgesia, la alodinia y el umbral de dolor de presión de LDP se evaluaron en los puntos trigémino y extra-trigémino antes y después de la intervención basada en la atención plena, así como la aplicación del cuestionario MAAS (Escala de conciencia de atención consciente "- MAAS). El programa de atención plena de 8 semanas se ofreció a los participantes basado en el protocolo Mindfulness Trainings International - MTI, en sesiones semanales de 2 horas y una sesión de 4 horas. Resultados: Reducción en la alodinia, hiperalgesia y un aumento en el umbral de dolor por presión, además de un aumento en el nivel de atención plena (p <0.05) como un marcador de efectividad de la intervención ofrecida. Conclusión: los índices más saludables en los parámetros clínicos sugestivos de sensibilización central investigados después de la intervención, representan una mejora significativa en la relación de la persona con una enfermedad crónica que genera experiencias continuas desagradables como TMD.Objetivo: analisar parâmetros clínicos sugestivos de sensibilização central em mulheres com disfunção temporomandibular dolorosa crônica antes e após uma intervenção baseada em mindfulness. Método: onze mulheres com idade entre 27 e 44 anos (36,36 ± 5,61), com diagnóstico de disfunções temporomandibulares dolorosa crônica (Diagnostic Criteria for Temporomandibular Disorders),participaram do estudo. A hiperalgesia, a alodinia e o limiar de dor à pressão foram avaliados em pontos trigeminais e extra-trigeminais antes e após a intervenção baseada em mindfulness, bem como a aplicação do questionário Mindful Attention Awareness Scale. O programa de mindfulness de 8 semanas foi oferecido às participantes do estudo, com base no protocolo Mindfulness Trainings International, em sessões semanais de 2 horas e uma sessão de 4 horas. Resultados: houve redução significativa da alodinia, da hiperalgesia e aumento do limiar de dor à pressão, além de aumento significativo do nível de atenção plena (p < 0,05) enquanto marcador de efetividade da intervenção baseada em mindfulness oferecida. Conclusão: índices mais saudáveis nos parâmetros clínicos sugestivos de sensibilização central investigados após a intervenção, representam melhora significativa na relação da pessoa com quadro de enfermidade crônica geradora de experiências desagradáveis contínuas como a disfunções emporomandibulares

Systematization of nursing in preventing infections in intensive care unit

Objective: to identify possible interfaces between the Systematization of Nursing Care and the prevention of infections in the Intensive Care Unit. Methods: It was performed through direct observation of reality, in an Intensive Care Unit, in the State of Rio Grande do Norte. In the context studied, the SAE was sometimes performed, disregarding the specificities of each patient, in terms of infection prevention. During the admission to the sector, and in the elaboration of the patient's history, the individual risk factors for the occurrence of infections were not investigated. Results: During the physical examination and the care plan, some principles of asepsis were not respected. The SAE in the studied ICU is incipient, and its stages attend more to institutional routines than to the needs of patient care. Conclusion: It is possible to articulate to SAE the prevention and control of infections, adding it to nursing care

Dietary leucine supplementation minimises tumour-induced damage in placental tissues of pregnant, tumour-bearing rats

Background: The occurrence of cancer during pregnancy merges two complex, poorly understood metabolic and hormonal conditions. This association can exacerbate the conditions of both the mother and the foetus. The branched-chain amino acid leucine enhances cellular activity, particularly by increasing protein synthesis. This study aimed to analyse the modulatory effect of a leucine-rich diet on direct and indirect tumour-induced placental damage. This was accomplished by evaluating the expression of genes involved in protein synthesis and degradation and assessing anti-oxidant enzyme activity in placental tissues collected from pregnant, tumour-bearing rats. Results: Pregnant rats were either implanted with Walker 256 tumour cells or injected with ascitic fluid (to study the indirect effects of tumour growth) and then fed a leucine-rich diet. Animals in a control group underwent the same procedures but were fed a normal diet. On the 20th day of pregnancy, tumour growth was observed. Dams fed a normoprotein diet showed the greatest tumour growth. Injection with ascitic fluid mimicked the effects of tumour growth. Decreased placental protein synthesis and increased protein degradation were observed in both the tumour-bearing and the ascitic fluid-injected groups that were fed a normoprotein diet. These effects resulted in low placental DNA and protein content and high lipid peroxidation (measured by malondialdehyde content). Decreased placental protein synthesis-related gene expression was observed in the tumour group concomitant with increased expression of genes encoding protein degradation-associated proteins and proteolytic subunits. Conclusions: Consumption of a leucine-rich diet counteracted the effects produced by tumour growth and injection with ascitic fluid. The diet enhanced cell signalling, ameliorated deficiencies in DNA and protein content, and balanced protein synthesis and degradation processes in the placenta. The improvements in cell signalling included changes in the mTOR/eIF pathway. In conclusion, consumption of a leucine-rich diet improved placental metabolism and cell signalling in tumour-bearing rats, and these changes reduced the deleterious effects caused by tumour growth16CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP302863/2013-32010/00209-9; 2011/08276-0; 2013/16115-

Avaliação da fragilidade de idosos em tratamento quimioterápico ambulatorial

Aim: to characterize and verify the fragility of the elderly in outpatient chemotherapy treatment in a university hospital of southern Brazil, and to identify the association between fragility and the following variables: chemotherapeutic effect, treatment time and selfreported diseases. Method: cross-sectional study conducted with 70 elderly in the chemotherapy outpatient, from August to September 2014 by means of Edmonton Frail Scale and characterization form. Results: fifty percent did not present fragility, 31.4% were apparently vulnerable and 18.6% had some level of fragility. Among the frail elderly, 15.7% had mild fragility, 1.4% moderate and 1.4% severe. The association between frailty and self-reported diseases, time of treatment and chemotherapeutic effects was not statistically significant. Conclusion: it was point to applicability of the scale to identify predisposing factors for the fragility syndrome and to enable preventive actions for the elderly in chemotherapeutic treatmentObjetivo: caracterizar y verificar la fragilidad de los ancianos en tratamiento de quimioterapia ambulatoria, en un hospital universitario, en el sur de Brasil, e identificar la asociación entre la fragilidad y las variables de efecto quimioterapéutico, relacionadas al tiempo de tratamiento y la enfermedad auto reporte. Método: estudio transversal realizado con 70 ancianos de un ambulatorio de quimioterapia, entre agosto y septiembre de 2014, a través de la Edmonton Frail Scale y forma de caracterización. Resultados: 50% no presentaron fragilidad, 31,4% eran aparentemente vulnerables y 18,6% tenía algún nivel de fragilidad. Entre los ancianos frágiles 15,7% tenían una fragilidad leve, 1,4% moderada y 1,4% severa. La asociación entre fragilidad y enfermedades auto referidas, y tiempo de tratamiento y efectos quimioterápicos no presentó significancia estadística. Conclusión: se observó la aplicabilidad de la escala para identificar factores predisponentes para el síndrome de fragilidad y viabilizar acciones preventivas a los ancianos en tratamiento quimioterápico.Objetivo: caracterizar e verificar a fragilidade de idosos em tratamento quimioterápico ambulatorial em um Hospital Universitário da região Sul do Brasil e, identificar a associação entre a fragilidade e as variáveis: efeito quimioterápico, tempo de tratamento e doenças autorreferidas. Método: estudo transversal desenvolvido com 70 idosos em um ambulatório de quimioterapia, de agosto a setembro de 2014, por meio da Edmonton Frail Scale e do formulário de caracterização. As análises estatísticas foram realizadas no programa Statistical Package for the Social Sciences versão 21. Resultados: houve predomínio de idosos do sexo masculino (61,4%), casados (62,8%), com ensino fundamental incompleto (71,4%), com renda mensal de até dois salários mínimos (82,8%) e a metade não apresentava fragilidade (50%). Conclusão: as variáveis analisadas não apresentaram significância, portanto não representam um fator de risco para a fragilidade de idosos em tratamento quimioterápico