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Apesar dos avanços da obstetrícia, a prematuridade ainda se configura como um dos grandes problemas de saúde pública, em virtude da morbidade e da mortalidade neonatal que causa. O objetivo deste estudo foi investigar fatores de risco maternos para nascimentos de prematuros em uma maternidade pública de Imperatriz-MA. Um estudo comparativo transversal foi realizado com 116 puérperas, por meio de entrevistas estruturadas. Os dados coletados foram analisados através do Software Epi-Info, versão 3.5.1. As variáveis que tiveram associação estatisticamente significante com a prematuridade foram: renda mensal inferior a 2 salários mínimos (p=0,046); estresse na gestação (p=0,027); primiparidade (p=0,044); assistência pré-natal ausente ou inadequada (pA pesar de los avances en la obstetricia y la prematuridad sigue siendo un problema importante de salud pública debido a la morbilidad y mortalidad neonatal que causa. El objetivo de este estudio fue investigar los factores de riesgo maternos para los nacimientos prematuros en una maternidad pública en Imperatriz, MA. Un estudio comparativo de la sección transversal se llevó a cabo con 116 madres, a través de entrevistas estructuradas. Estudio caso-control se realizó con 116 mujeres, agrupadas en el caso de (58) y control (58), a través de entrevistas estructuradas. Los datos fueron analizados con Epi-Info versión 3.5.1. Las variables que mostraron una asociación estadísticamente significativa con el parto prematuro fueron ingresos mensuales Despite advances in obstetrics, prematurity is still a major public health problem because of the neonatal morbidity and mortality it causes. The objective of this study was to investigate maternal risk factors for premature births in a public maternity in the city of Imperatriz-MA. A cross-sectional comparative study was conducted with 116 mothers, through structured interviews. The data were analyzed using Epi-Info version 3.5.1. The variables that showed statistically significant association with preterm delivery were monthly income below two minimum wages (p = 0.046), stress during pregnancy (p = 0.027), primiparity (p = 0.044), absent or inadequate prenatal care (p

Leaf area has significant effect on tree transpiration, and its measurement is important to many study areas. This work aimed at developing a non-destructive, practical, and empirical method to estimate the total leaf area of green dwarf coconut palms (Cocos nucifera L.) in plantations located at the northern region of Rio de Janeiro state, Brazil. A mathematical model was developed to estimate total leaf area values (TLA) as function of the average lengths of the last three leaf raquis (LR3), and of the number of leaves in the canopy (NL). The model has satisfactory degree of accuracy for agricultural engineering purposes.

O acesso aos serviços de saúde é uma das características importantes e um desafio ao Sistema Único de Saúde. Este estudo tem por objetivo compreender as dificuldades dos homens com DST no acesso à consulta. Trata-se de uma pesquisa qualitativa com homens atendidos em uma unidade de referência de DST, na cidade de Fortaleza, Ceará, Brasil, em novembro de 2003. A mesma foi aprovada pelo Comitê de Ética e utilizou a técnica de análise de conteúdo na análise e interpretação dos resultados. As entrevistas centraram-se na categoria acesso. Os achados evidenciaram que os homens com DST enfrentam dificuldade no acesso à consulta, mesmo utilizando diferentes mecanismos para consegui-la. Os serviços são oferecidos em horários incompatíveis com a demanda. Este fato é agravado pela falta de planejamento do número de consultas e de profissionais disponíveis para o atendimento dos casos de DST. Concluímos que precisa haver um investimento maior em nível do SUS na melhoria do acesso à consulta para homens com DST e faz-se necessário que, do ponto de vista institucional, a oferta de serviços leve em consideração a demanda da população.

As hemoglobinopatias estão incluídas dentre as doenças hereditárias mais freqüentes nas populações humanas. Estudos realizados em diferentes regiões do Brasil têm demonstrado que as hemoglobinas anormais S e C são as mais prevalentes. Com o objetivo de investigar a prevalência de hemoglobinas anormais no período neonatal, foram analisadas 1.940 amostras de sangue de cordão umbilical provenientes de recém-nascidos de três maternidades da cidade de Natal, Rio Grande do Norte. Todas as amostras foram submetidas à eletroforese de hemoglobina em acetato de celulose utilizando tampão Tris-EDTA-Borato pH 8,5. As amostras que apresentaram hemoglobinas anormais foram submetidas à eletroforese em gel de ágar pH 6,2 para confirmação. Foram identificadas 37 (1,91%) amostras com hemoglobinas anormais, das quais 29 (1,50%) com traço falciforme (Hb FAS), 06 (0,31 %) com Hb C, uma (0,05 %) com anemia falciforme (Hb FS) e uma (0,05 %) apresentou Hb Bart's, sugerindo alfa talassemia. Os resultados encontrados evidenciam a necessidade de implantação da triagem de hemoglobinopatias em recém-nascidos na nossa população.

Descreve-se a mortalidade proporcional de dentistas residentes na cidade de São Paulo, entre 1980 e 2000, segundo causas de óbito, em busca de possíveis indicações de risco atribuíveis ao trabalho, com dados levantados na Fundação Sistema Estadual de Análise de Dados. A análise comparativa usou informações análogas para médicos e engenheiros. O estudo dos diferenciais de óbito segundo causa básica indicou a ausência de alterações significantes, apontando risco potencial de óbito aumentado para dentistas em relação a médicos e engenheiros. Os óbitos de dentistas não apresentaram piores indicadores para categorias globais e específicas de doenças infecciosas, neoplasias, suicídio, doenças do sistema nervoso central e do aparelho circulatório. Foi observada indicação de excesso sistemático de óbitos de engenheiros por causas externas em geral, por acidentes de trânsito, quedas acidentais e demais acidentes em particular. Registrou-se a ausência de discrepâncias significantes que apontassem para risco diferencial atribuível ao trabalho de dentistas. Essa observação sugere que a Odontologia pode ser considerada uma profissão segura, ao menos no que diz respeito à exposição a riscos sistemáticos de óbito.

OBJECTIVE: To study patterns of alcohol consumption and prevalence of high-risk drinking. METHODS: A household survey was carried out in a sample of 2,302 adults in Salvador, Brazil. Cases of High-Risk Drinking (HRD) were defined as those subjects who referred daily or weekly binge drinking plus episodes of drunkenness and those who reported any use of alcoholic beverages but with frequent drunkenness (at least once a week). RESULTS: Fifty-six per cent of the sample acknowledged drinking alcoholic beverages. Overall consumption was significantly related with gender (male), marital status (single), migration (non-migrant), better educated (college level), and social class (upper). No significant differences were found regarding ethnicity, except for cachaça (Brazilian sugarcane liquor) and other distilled beverages. Overall 12-month prevalence of high-risk drinking was 7%, six times more prevalent among males than females (almost 13% compared to 2.4%). A positive association of HRD prevalence with education and social class was found. No overall relationship was found between ethnicity and HRD. Male gender and higher socioeconomic status were associated with increased odds of HRD. Two-way stratified analyses yielded consistent gender effects throughout all strata of independent variables. CONCLUSIONS: The findings suggest that social and cultural elements determine local patterns of alcohol-drinking behavior. Additional research on long-term and differential effects of gender, ethnicity, and social class on alcohol use and misuse is needed in order to explain their role as sources of social health inequities.

OBJETIVOS: analisar a evolução do Projeto Carteiro Amigo nos anos de 1996 a 2002 no Brasil. MÉTODOS: foi realizado estudo descritivo. Os dados foram coletados por meio de relatórios e de contatos telefônicos com os setores responsáveis nos estados. RESULTADOS: o Ministério da Saúde implantou o Projeto, em 1999, em oito estados do Nordeste brasileiro onde foram treinados 3.000 carteiros e potencialmente beneficiadas 665.000 crianças menores de um ano e gestantes. No ano de 2000 o projeto treinou 6.100 carteiros das regiões Norte, Centro-Oeste e Nordeste, que levaram informações para cerca de 1.000.000 de mães de crianças menores de um ano e gestantes. Nos anos de 2001 e 2002 o projeto aconteceu em todo o Brasil. Em 2001 participaram 16.500 carteiros beneficiando 2.900.000 crianças menores de um ano e gestantes. Em 2002, foram treinados 23.400 carteiros, estimando-se cerca de 3.400.000 os beneficiários. CONCLUSÕES: esse projeto, em processo crescente no país, conquistou a confiança da população, e dos parceiros envolvidos, sendo uma estratégia importante para incentivar a prática da amamentação no país.

RESUMO OBJETIVOS: avaliar o cumprimento dos "Dez Passos para o Sucesso do Aleitamento Materno" nos hospitais "Amigos da Criança" (HAC) no Brasil. MÉTODOS: estudo descritivo transversal de avaliação dos "Dez Passos..." dos HAC, realizado nos anos de 1999 e 2000, por avaliadores da Iniciativa Hospital Amigo da Criança (IHAC), credenciados pelo Ministério da Saúde, usando o formulário de pré-avaliação da IHAC. RESULTADOS: foram analisados os questionários de 137 HAC (90%) do total de 152 HAC credenciados na época no país. Observou-se que 92% dos HAC atenderam todos os "Dez Passos..." Os passos um, três, seis, sete, oito e nove apresentaram mais de 98% de cumprimento. O passo cinco foi o menos atendido. Comparando as regiões do país, observou-se que, no Nordeste, no Sul e no Sudeste, 90% dos hospitais foram aprovados em todos os "Dez Passos..." Na região Norte, apenas 50% dos hospitais cumpriram todos os "Dez Passos..." CONCLUSÕES: analisando a folha de dados gerais dos hospitais com pendências na avaliação dos passos, observa-se que 73,7% foram credenciados antes de 1997, sugerindo a necessidade de avaliações periódicas. A implantação de um sistema de monitoramento dessa iniciativa, contribuirá para a melhoria da qualidade da assistência e dos índices de aleitamento materno no país.

O objetivo deste trabalho foi estabelecer a influência do reprodutor e da alimentação sobre o desempenho de cordeiros em confinamento. O delineamento experimental foi o inteiramente casualizado, com arranjo fatorial 2x4, costituído de dois grupos genéticos (Santa Inês x sem raça definida (SRD) e Somalis x SRD) e concentrado de milho em gão, farelo de soja e sal mineral a 15%, 30%, 45% e 60%. Trinta e dois animais foram confinados em baias individuais e cada um constituiu uma repetição. As dietas eram compostas de feno de leucena (Leucaena leucocephala) e concentrado, na forma de ração completa. O aumento de concentrado na dieta dos animais causou incrementos lineares (P0,05) entre os concentrados, porém o grupo genético Somalis x SRD mostrou-se superior (P

This paper is a translation from IUPAC nomenclature document by K. Danzer and L. A. Currie (Pure Appl. Chem., 1998, 70(4), 993-1014). Its goal is to establish an uniform and meaningful approach to terminology (in Portuguese), notation, and formulation for calibation in analytical chemistry. In this first part, general fundamentals of calibration are presented, namely for both relationships of qualitative and quantitative variables (relations between variables characterizing certain types analytes of the measured function on the other hand and between variables characterizing the amount or concentration of the chemical species and the intensities of the measured signals, on the other hand). On this basis, the fundamentals of the common single component calibration (Univariate Calibration) which models the relationship y = f(x) between the signal intensities y and the amounts or concentrations x of the analyte under given conditions are represented. Additional papers will be prepared dealing with extensive relationships between several intensities and analyte contents, namely with multivariate calibrations and with optimization and experimental design.

A comparative study of the Fourier (FT) and the wavelet transforms (WT) for instrumental signal denoising is presented. The basic principles of wavelet theory are described in a succinct and simplified manner. For illustration, FT and WT are used to filter UV-VIS and plasma emission spectra using MATLAB software for computation. Results show that FT and WT filters are comparable when the signal does not display sharp peaks (UV-VIS spectra), but the WT yields a better filtering when the filling factor of the signal is small (plasma spectra), since it causes low peak distortion.

Foram utilizadas 42 vacas ou novilhas mestiças, de aptidão leiteira, distribuídas em dois tratamentos: T1 ( n=22 ) - grupo controle, sem tratamento hormonal; T2 (n=20) - grupo tratado com buserelina no quarto dia após a transferência de embrião (inovulação), com o objetivo de avaliar o efeito do tratamento hormonal na taxa de gestação e nas concentrações plasmáticas de progesterona das receptoras de embrião bovino. As coletas de sangue para obtenção do plasma sangüíneo foram realizadas no dia da inovulação (dia 0) e de dois em dois dias, num total de cinco amostras por receptora. O diagnóstico de gestação foi realizado via transretal. O uso de um agonista do GnRH (Buserelina) no 4º dia após a inovulação não resultou em diferença entre os tratamentos na taxa de gestação. Entretanto, os níveis de progesterona das receptoras gestantes do grupo-tratado foram maiores em comparação às do grupo-controle.

This review presents the evolution of simultaneous multicomponent analysis by absorption spectrophotometry in the ultraviolet and visual regions in terms of some qualitative and quantitative analysis techniques, otimization methods, as well as applications and modern trends.

O objetivo desta investigação foi identificar a prevalência da anemia e alguns de seus potenciais determinantes em 754 crianças de áreas urbanas de sete municípios na região do semi-árido baiano. Hemoglobina foi determinada em 745 crianças de um a 72 meses de idade. Para o grupo etário de seis a 72 meses um valor de hemoglobina < 11,0 g/dl identifica a anemia segundo recomendação da OMS enquanto o valor

Foram estudados 754 pré-escolares de áreas urbanas de sete municípios do semi-árido do Estado Bahia, Brasil, com o objetivo de determinar a prevalência da hipovitaminose A e sua associação com a idade, sexo, renda em salário-mínimo, escolaridade materna e adequação dietética em vitamina A. Na amostra estudada não se registrou nenhum caso de sinais e/ou sintomas de xeroftalmia durante o exame clínico-oftalmológico. Em 563 crianças foi possível a coleta de sangue para determinação de retinol sérico; encontrou-se um valor médio de 20,3 µg/dl (DP=10,8µg/dl) e uma prevalência de 15,3% de níveis deficientes (abaixo de 10,0 µg/dl). Em todos os sete municípios estudados a prevalência de retinol sérico deficiente foi superior a 5,0% que é nível crítico proposto pela OMS para considerar a hipovitaminose A como problema de saúde pública. A distribuição de retinol sérico encontrada não teve relação com o sexo das crianças, mas com a idade, diminuindo a prevalência de níveis deficientes e baixos na medida em que a idade aumenta. Não se encontrou associação entre renda familiar per capita ou escolaridade materna e a prevalência de níveis de retinol deficiente. Os resultados de consumo alimentar provenientes do inquérito recordatório de 24h mostraram que apenas 8% das crianças consumiram quantidades adequadas de retinol ou de seus precursores; 66% ingeriam abaixo da metade e quase 35% delas não chegaram a ingerir nem um quarto da quantidade recomendada para sua faixa etária. A carência de vitamina A deve ser considerada como problema de saúde pública severo, tanto pela alta prevalência de níveis deficientes de retinol em todos os municípios como também pela dimensão da inadequação dietética.

This study aimed to analyze whether there is an association between intimate partner violence during pregnancy and time to return to sexual activity after childbirth in the BRISA cohort in São Luís, Maranhão State, Brazil, between 2010 and 2013. This is a longitudinal study conducted with 665 women. Intimate partner violence during pregnancy was measured using an instrument created and validated by the World Health Organization to measure violence against women. Time to return to sexual activity after childbirth was investigated using a structured questionnaire. Logistic regression models were used to analyze whether there is an association between intimate partner violence during pregnancy and time to return to sexual activity after childbirth. The prevalence of violence by an intimate partner during pregnancy was 24.06%. The prevalence of women who returned to sexual activity within 3 months after childbirth was 67.96%. When analyzing the association between exposure and outcome, no association was found in the crude model (OR = 0.88; 95%CI: 0.60-1.30), nor in the adjusted model (OR = 1.00; 95%CI: 0.61-1.63). The study results highlight the importance of providing comprehensive care to women, considering both physical and psychological aspects, since violence has a significant impact on several aspects of women's lives.

This article discusses questions concerning the future of humanity in the face of threats to the health of populations, whose impact has been exacerbated in the course of inequalities in all parts of the world, pari passu with global development in the hegemonized model since last century. The COVID-19 pandemic is a good example that illustrates this dissonance between development and inequalities. Questions were formulated to be debated about the construction of the future of world society, based on the understanding of the evolutionary character of life on the planet vis-à-vis the evils that affect large contingents of the population and represent powerful risks for this evolutionary process. These questions call attention to the discussion around social participation in the definition and control of public policies, as opposed to the hegemony of private interests in the formulation and execution of these policies, both in the scenarios of each country and in the international context.

Objective: To investigate the effects of depressive symptoms in childhood on the intellectual development of young adults., Methods: Study conducted with a birth cohort of São Luís, Maranhão, Brazil, composed of 339 participants evaluated between 7 and 9 years and between 18 and 19 years. Structural equation modeling (young adult education, sex, race/color) and childhood variables (nutritional status, depressive symptoms, cognitive function, head of household's and mother's education, family income) were used. In addition, head of household's occupation, mother's age, and presence of partner were tested as determinants of adults' intelligence quotient (IQ)., Results: Presence of depressive symptoms in childhood triggered a reduction of 0.342 in standard deviation (SD) and -3.83 points in the average IQ of adults (p-value < 0.001). Cognitive function in childhood had a total and direct positive effect (standardized coefficient [SC] = 0.701; p-value < 0.001) on IQ, increasing 7.84 points with each increase in level. A positive indirect effect of child nutritional status (SC = 0.194; p-value = 0.045), head of household's (SC = 0.162; p-value = 0.036), and mother's education was identified, the latter mediated by cognitive function in childhood (SC = 0.215; p-value = 0.012) on the IQ of young people., Conclusion: Presence of depressive symptoms in childhood triggered a long-term negative effect on intelligence, reducing the IQ score in adulthood.

Objective: To present a study protocol to compare glucose and reflexology in pain relief in neonate intensive care during arterial punctures., Methods: A randomized, controlled, double-blind clinical trial protocol will be carried out at a teaching hospital maternity, with30 newborns admitted to neonate intensive care who are to undergo blood collection by arterial puncture. They will be randomly assigned to a control group (25% glucose) or an intervention group (foot reflexology). The primary outcome will be neonate pain scores during and after arterial puncture. Secondary outcomes will be crying time and variation in neonates' vital signs during and after the arterial puncture procedure. Registration number RBR-639bff., Discussion: The results of this trial will provide new insights into the most appropriate intervention for the relief of neonate pain during painful procedures.

Background: The right ventricular hypertrophy and dilation observed in pulmonary artery hypertension (PAH) damages the left ventricle (LV) dynamics by flattening the interventricular septum., Objective: To investigate whether low- to moderate-intensity resistance exercise training (RT) is beneficial to LV and cardiomyocyte contractile functions in rats during the development of monocrotaline (MCT)-induced PAH., Methods: Male Wistar rats (Body weight: ~ 200 g) were used. To assess the time to potential heart failure onset (i.e., end point), rats were divided into sedentary hypertension until failure (SHF, n=6) and exercise hypertension until failure (EHF, n=6) groups. To test RT effects, rats were divided into sedentary control (SC, n = 7), sedentary hypertension (SH, n=7), and exercise hypertension (EH, n=7) groups. PAH was induced by two MCT injections (20 mg/kg, with 7 days interval). Exercise groups were submitted to an RT protocol (Ladder climbing; 55-65% of carrying maximal load), 5 times/week. Statistical significance was assumed at P &lt; 0.05., Results: RT prolonged the end point (~25 %), enhanced the physical effort tolerance (~ 55%), and mitigated the LV and cardiomyocyte contractility dysfunctions promoted by MCT by preserving the ejection fraction and fractional shortening, the amplitude of shortening, and the velocities of contraction and relaxation in cardiomyocytes. RT also prevented increases in left ventricle fibrosis and type I collagen caused by MCT, and maintained the type III collagen and myocyte dimensions reduced by MCT., Conclusion: Low- to moderate-intensity RT benefits LV and cardiomyocyte contractile functions in rats during the development of MCT-induced PAH.

Objective: Evaluate the effect of essential oil in odor reduction for intestinal ostomy bags., Method: Primary study, semi-experimental, prospective clinical trial with quantitative approach. A product prepared with Melaleuca armillaris leaves was tested in ostomy pouches, with and without effluents, for adhesion and odor control. Instrument: Labeled Magnitude Scale., Results: Colostomized participants, with a mean age of 73 ± 14.94, predominantly males; and informal caregivers, with a mean age of 44 ± 8.98, predominantly females. In the visual evaluation of the oil, 100% of the participants perceived its adherence. Regarding the evaluation of effluent odor by the colostomized, five reported "strong odor" before oil use and, six reported "weak" odor after use (p = 0.005). Five informal caregivers reported "very strong" effluent odor before oil use; and one reported "weak" and nine reported "moderate" after use (p = 0.0025)., Conclusion: There was a reduction in the odor of effluents in the ostomy pouches with the essential oil of Melaleuca armillaris at 10%. Application for patent registration in the Brazilian National Institute of Industrial Property (INPI) under no. BR 10 2020 026987 9.

In the last decades, important advances have been made in the treatment of pulmonary arterial hypertension (PAH), a severe, progressive, incurable, and potentially fatal disease. For an adequate therapy, correct hemodynamic diagnosis and etiology classification are fundamental. Many etiologies - rheumatic disease, portal hypertension, congenital heart diseases, schistosomiasis - require specific measures, in addition to drug therapy for PAH. The specific therapy for PAH is based on medications that act on three pathophysiological pathways - prostacyclin, endothelin, and nitric oxide pathways. These drugs have multiple presentations (oral, intravenous, subcutaneous, and inhaled) and have changed the history of PAH. This review presents an overview of drug therapy strategies and different forms and peculiarities of PAH.

HIV infection is the subject of one of the chapters of the "Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections", published by the Brazilian Ministry of Health in 2020. It is important that health professionals and managers learn the signs and symptoms of HIV infection and know how to diagnose it, in order to provide appropriate treatment and reduce complications. HIV infection has become a chronic disease and its treatment includes addressing common comorbidities in clinical practice such as arterial hypertension, diabetes and dyslipidemia, in addition to cardiac risk assessment, cancer prevention and guidance on immunization. Initiation of treatment for all HIV patients, regardless of clinical or immunological criteria, adopted by the Ministry of Health since 2013, has now been simplified with more tolerable first-line medications and with fewer drug interactions, which makes its management easy to implement, including by Primary Health Care.

Background: We still do not have information regarding the impact of the COVID-19 pandemic on medical care activity in Brazil., Objective: To describe the repercussions of the COVID-19 pandemic on the care routine of a tertiary hospital, which is a regional reference in cardiology and oncology., Methods: Cross-sectional cohort study. We conducted a survey of medical visits from March 23, 2020 (when local commerce was closed) to April 23, 2020 (P20), in comparison with the same period in 2019 (P19)., Results: We found decreases in the number of cardiology consultations, exercise tests, Holter, ambulatory blood pressure monitoring, electrocardiogram, and echocardiogram (90%, 84%, 94%, 92%, 94%, and 81%, respectively). In relation to cardiac surgery and cardiac catheterization, there were 48% and 60% decreases, respectively. There was an increase in the number of percutaneous transluminal coronary angioplasties (33%) and definitive pacemaker implantations (29%). There were 97 admissions to the ICU during P19, in contrast with 78 during P20, a 20% decrease. Visits to the cardiac emergency room (45%) and admissions to the cardiology ward (36%) also decreased. The decrease in oncology consultations was 30%. Chemotherapy sessions decreased from 1,944 to 1,066 (45%), and radiotherapy sessions decreased by 19%., Conclusion: COVID-19 has led to a considerable decrease in the number of consultations in outpatient clinics for cardiology, oncology, and other specialties. There was a concerning decrease in the number of cardiac surgeries, chemotherapy sessions, and radiotherapy sessions during the initial weeks of the pandemic. The number of people seeking care in the cardiac emergency room and the number of admissions to the cardiology ward and ICU also decreased, generating concern regarding the evolution and prognosis of these patients with pathologies other than COVID-19 during this pandemic time. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).

The study aimed to compare biomarkers in groups of adolescents classified simultaneously according to body mass index (BMI) and body fat percentage measured by air displacement plethysmography. This was a cross-sectional study with 533 adolescents 18 to 19 years of age in São Luís, Maranhão, Brazil. BMI was classified as adequate (< 25kg/m2) versus excess weight (≥ 25kg/m2). High body fat percentage was defined as ≥ 25% for males and ≥ 30% for females. The adolescents were classified in four groups: "normal weight" (adequate BMI and body fat percentage), "normal weight obese" (adequate BMI with high body fat percentage), "excess weight with adequate body fat percentage", and "excess weight with high body fat percentage". Girls showed higher proportions of "normal weight obesity" (15.6%) and "excess weight with high body fat percentage" (17.1%). "Normal weight obese" adolescents exhibited higher mean values for total cholesterol (172.5mg/dL) and LDL-cholesterol (103.5mg/dL). Those with "excess weight and high body fat percentage" showed lower mean HDL-cholesterol (43.2mg/dL) compared to the other groups, higher mean interleukin-6 (2.7pg/mL) than "normal weight" and "excess weight and adequate body fat percentage" adolescents, and higher median triglycerides (114.0mg/dL) and C-reactive protein (0.14ng/mL) than "normal weight" and "normal weight obese" adolescents. Those with "excess weight and adequate body fat percentage" exhibited the same C-reactive protein levels as those with "excess weight and high body fat percentage". Assessment of nutritional status by BMI alone is limited, since 6.8% of the adolescents presented high body fat percentage despite normal BMI, and those who were "normal weight obese" had two biomarkers that were worse than for adolescents with "excess weight and high body fat percentage".

Introduction: Primary care is considered a gateway to other levels of care, however, men seek mainly specialized or emergency services, especially when they already have some affection., Objective: the objective was to verify how male users evaluate first contact access in primary care., Methodology: Cross-sectional study, conducted in Campina Grande/PB, from October 2016 to February 2017, with 384 men. A sociodemographic form and the Primary Care Assessment Tool (PCATool) were used., Results: There was an association between service use and age (p = 0.001), income (p = 0.036), creed (p = 0.018) and knowledge of the National Men's Health Policy (p = 0.007); The components of first contact access (utilization and accessibility) obtained a score of 5.79 and 2.7 respectively, being this attribute considered by users as poorly oriented to primary care. Ensuring accessibility and reception in primary care is critical. The service must be organized to have the ability to receive and respond positively to the health demands of the population, to have resoluteness and ability to link the service with the user., Conclusion: Users do not perceive primary care as a gateway to the health system, and efforts should be made to ensure first contact access.

Objective: To present a case series of pulmonary arteriovenous malformations (PAVMs), describing the main clinical findings, the number/location of pulmonary vascular abnormalities, the clinical complications, and the treatment administered., Methods: This was a retrospective observational study evaluating patients with PAVM divided into two groups: hereditary hemorrhagic telangiectasia (HHT); and idiopathic PAVM (iPAVM)., Results: A total of 41 patients were selected for inclusion, but only 33 had PAVMs. After clinical evaluation, 27 and 6 were diagnosed with HHT and iPAVM, respectively. In the HHT group, the mean age was 49.6 years and 88.9% were female. In that group, 4 patients had an SpO2 of < 90% and the most common clinical finding was epistaxis. In the iPAVM group, the mean age was 48.1 years and 83.3% were female. In that group, 3 patients had an SpO2 of < 90%. Computed tomographic pulmonary angiography showed that most of the PAVMs were in the lower lobes: 56.4% in the HHT group and 85.7% in the iPAVM group. Embolization was performed in 23 patients (in both groups). At this writing, 10 patients are scheduled to undergo the procedure. One of the patients who underwent embolization was subsequently referred for pulmonary resection., Conclusions: In both of the PAVM groups, there was a predominance of women and of fistulas located in the lower lobes. Few of the patients had respiratory symptoms, and most had an SpO2 > 90%. The treatment chosen for all patients was percutaneous transcatheter embolization.

Background: Spontaneously hypertensive rats (SHR) show deficit in thermal balance during physical exercise., Objective: To assess the effects of low-intensity physical exercise training on thermal balance of hypertensive rats undergoing an acute exercise protocol., Methods: Sixteen-week-old male Wistar rats and SHR were allocated into four groups: control Wistar rats (C-WIS), trained Wistar (T-WIS), control SHR (C-SHR) and trained SHR (T-SHR). Treadmill exercise training was performed for 12 weeks. Blood pressure, resting heart rate and total exercise time was measured before and after the physical exercise program. After the exercise program, a temperature sensor was implanted in the abdominal cavity, and the animals subjected to an acute exercise protocol, during which internal body temperature, tail skin temperature and oxygen consumption until fatigue were continuously recorded. Mechanical efficiency (ME), work, heat dissipation threshold and sensitivity were calculated. Statistical significance was set at 5%., Results: Physical training and hypertension had no effect on thermal balance during physical exercise. Compared with C-WIS, the T-WIS group showed higher heat production, which was counterbalanced by higher heat dissipation. Hypertensive rats showed lower ME than normotensive rats, which was not reversed by the physical training., Conclusion: Low-intensity physical training did not affect thermal balance in SHR subjected to acute exercise.

Psittacosis is a rare disease caused by Chlamydophila psittaci, an intracellular bacteria transmitted by contaminated birds. The clinical and radiological presentations are nonspecific. We describe a case of a 42-year-old woman, with known exposure to birds, who presented to the emergency department with one-week evolution of myalgia, polyarthritis, and respiratory symptoms. At admission, she had fever, respiratory failure, raised inflammatory markers and bilateral interstitial infiltrates at chest radiography. Considering the clinical findings and epidemiological background, we raised the hypothesis of a Chlamydophila psittaci atypical pneumonia that was serologically confirmed. Tetracyclines are the mainstay of treatment and the macrolides are an effective alternative. We highlight the importance of the epidemiological context in the early diagnosis and treatment of this infection.

Objectives: The prevalence of sleep problems in elderly, such as insomnia, is a relevant issue in our society. Poor sleep quality is viewed by many as an inevitable result of aging. In this context, this study aimed to estimate the prevalence and associated factors of sleeping disturbances in elderly men and women (60 years and older)., Methods: The present study is part of SABE Study (Health, Well-being and Aging), a cohort conducted in São Paulo, Brazil. The sample included in the present cross-sectional study comprised 1,334 elderly people aged 60 years or older. Sleep disturbances were assessed based on responses of study participants on whether they had experienced any sleep disturbance in the past month., Results: Among the elderly assessed, 44.9% had overall sleep disturbances, which were more frequent in women (51.5%) and in 75 to 79 years old (48.2%). According to the regression analysis, the variables gender, joint diseases, as well as nocturia and urinary incontinence, were associated with sleep disorders. Increase in sleep disturbances was found not to be linearly age-dependent., Conclusions: Gender, pain, urinary and nocturia incontinence were factors associated with sleep disorders. Thus, we might conclude that the absence of sleep disturbances in older adults depends on gender and health status.

Lyme disease is an endemic zoonosis, the most prevalent tick-transmitted infection in temperate areas of Europe, North America and Asia. It is a multisystemic disease with cutaneous, musculoskeletal, neurologic and cardiac manifestations, according to the stage of the disease. We describe a case of late neuroborreliosis in an Erasmus programme student living in Porto. We discuss the importance of the epidemiological suspicion, the clinical approach, the diagnostic criteria and the most adequate treatment.

Objective: To evaluate the impact of the use of the molecular test for Mycobacterium tuberculosis and its resistance to rifampin (Xpert MTB/RIF), under routine conditions, at a referral hospital in the Brazilian state of Bahia., Methods: This was a descriptive study using the database of the Mycobacteriology Laboratory of the Octávio Mangabeira Specialized Hospital, in the city of Salvador, and georeferencing software. We evaluated 3,877 sputum samples collected from symptomatic respiratory patients, under routine conditions, between June of 2014 and March of 2015. All of the samples were submitted to sputum smear microscopy and the Xpert MTB/RIF test. Patients were stratified by gender, age, and geolocation., Results: Among the 3,877 sputum samples evaluated, the Xpert MTB/RIF test detected M. tuberculosis in 678 (17.5%), of which 60 (8.8%) showed resistance to rifampin. The Xpert MTB/RIF test detected M. tuberculosis in 254 patients who tested negative for sputum smear microscopy, thus increasing the diagnostic power by 59.9%., Conclusions: The use of the Xpert MTB/RIF test, under routine conditions, significantly increased the detection of cases of tuberculosis among sputum smear-negative patients.

This study estimated the percentages of incomplete immunization with new vaccines and old vaccines and associated factors in children 13 to 35 months of age belonging to a birth cohort in São Luís, the capital of Maranhão State, Brazil. The sample was probabilistic, with 3,076 children born in 2010. Information on vaccination was obtained from the Child's Health Card. The new vaccines, namely those introduced in 2010, were meningococcal C and 10-valent pneumococcal, and the old vaccines, or those already on the childhood immunization schedule, were BCG, hepatitis B, human rotavirus, polio, tetravalent (diphtheria, tetanus, pertussis, Haemophilus influenzae b), yellow fever, and triple viral (measles, mumps, rubella). The study used hierarchical modeling and Poisson regression with robust variance. Prevalence ratios (PR) and 95% confidence intervals (95%CI) were calculated. Incomplete immunization was higher with new vaccines (51.1%) than with old vaccines (33.2%). Children 25 to 35 months of age (PR = 1.27; 95%CI: 1.14-1.41) and those in economic classes D/E (PR = 1.20; 95%CI: 1.06-1.35) were only significantly associated with new vaccines; low maternal schooling (PR = 1.58; 95%CI: 1.21-2.06), unavailability of outpatient and/or hospital care for the child (PR = 1.20; 95%CI: 1.04-1.38), and unavailability of the vaccine in health services (PR: 1.28; 95%CI: 1.12-1.46) were only associated with old vaccines. Immunization strategies should consider the vulnerability of older preschool-age children and those belonging to classes D and E, especially when new vaccines are introduced, as well as children of mothers with low schooling. Strategies should also address problems with the availability of health services and vaccines.

Objective: To evaluate access to technologies for prevention and control of Congenital Syphilis (CS) by pregnant women., Methodology: Multi-case study that analyzed prenatal care to pregnant women with syphilis, which aimed at identifying the aspects that hinder their access to soft, soft-hard and hard health technologies that may contribute to the prevention of SC. The field research was done from April to September 2011 at four Health Units of two Regional Executive Divisions in Fortaleza City. Data was collected through observation and interviews with the health professionals and coordinators of the different units, the Statistic Medical Attendance Service professionals, health agents and pregnant women. Soft technologies include active search for pregnant women and home visits; light-hard technologies correspond to counseling, and hard technologies to the gathering of biological material for the serological diagnosis of syphilis and the treatment of pregnant woman and their sexual partners. The analysis consisted in contextualizing and interpreting the meanings of the answers obtained considering access as the main focus., Results: Professionals have difficulty dealing with the subjective issues that involve sexually transmitted infections, and the units have problems in organizational aspects, continuity of care delivery and physical structure, which compromise the access of pregnant women to the technologies for prevention and control of CS., Discussion: Pregnant women with syphilis do not have access to different technologies for prevention and control of CS, a situation that makes early diagnosis of syphilis unfeasible and possibly contributes to poor syphilis indicators in Fortaleza.

Introduction:: Diseases of old age have shown increasing prevalence in society. One of them is stroke, which can be conceptualized as the interruption of cerebral blood supply due to a leakage or blood vessel obstruction caused by clots., Objective:: To verify the associations between sociodemographic factors and the functional capacity of elderly affected by stroke., Methods:: This is an epidemiological, cross-sectional, and quantitative study, including 118 elderly people with paralyses due to stroke, who were registered in one of the Family Health Strategies units of Campina Grande, Paraíba, Brazil. Data were collected by means of home interviews. Two questionnaires were used, in which one was directed for assessment of sociodemographic variables and the second was called Barthel index for assessing the functional capacity of the subjects regarding the activities of daily life. The analysis was conducted using the statistical program SPSS., Results:: There was a predominance of the female gender, widowed, without schooling, and with household income of up to one Brazilian minimum wage. The average age was 65 years (± 9.63). The Barthel index internal consistency was satisfactory, presenting values of Cronbach's alpha coefficient in the range of 0.897-0.918. Total correlation of corrected items was greater than 0.4, and Cronbach's alpha with a deleted item was also greater than 0.8. The activities with higher level of achievement difficulty were urination and evacuation. Association between functional capacity with race, age range, and schooling was found., Conclusion:: It was seen that demographic factors might interfere with the functional capacity of elderly affected by stroke. Hence, it is believed that this investigation might have contributed to the reflection on this issue, thus supporting the promotion of these people's access to health assistance programs.

The objective of this study was to investigate factors associated with intimate partner violence after disclosing the diagnosis of sexually transmissible diseases (STDs) in Fortaleza, Ceará State, Brazil. This cross-sectional study enrolled 221 individuals treated at STD clinics. Multivariate logistic regression was performed. A total of 28.1% of individuals committed some type of intimate partner violence after disclosure of the diagnosis. Committing intimate partner violence was associated with alcohol use (OR = 2.79; 95%CI: 1.25-6.22; p = 0.012), the partner having relations with someone else during the current relationship (OR = 4.71; 95%CI: 2.24-9.91; p = 0.000), a history of violence prior to the STD (OR = 2.87; 95%CI: 1.22-6.73; p = 0.015), and having suffered violence after diagnosis of the STD (OR = 6.53; 95%CI: 3.06-13.93; p = 0.000). Intimate partner violence following disclosure of the STD signals that health professionals should identify patients' difficulties in revealing an STD diagnosis to their partners.

Objective: To describe the prevalence of short stature among children of Karapotó ethnic background., Methods: Cross-sectional, population-based study that included children between 6 and 59 months of age from the Plak-Ô native village and the Terra Nova settlement, São Sebastião, Alagoas, carried out between 2008 and 2009. Short stature was evaluated by the Height/Age index, using as cutoff z score ≤-2. The prevalence of short stature was determined by comparing simple and relative frequencies. The population growth curves were compared to the WHO reference curves. Data analysis included the outcome variable: Height/Age and the predictor variables: place of residence, gender, age, anemia, birth weight, family income, maternal literacy. The chi-square test was used to compare the categorical variables, whereas the chi-square test with Yates correction was used for dichotomous variables, considering as statistically significant p-values≤0.05., Results: The prevalence of short stature was 15.6% for children from the Terra Nova settlement and 9.1% for those from Plak-Ô native village. The prevalence of short stature among the Karapotó ethnicity was 13.4%. The variables: maternal literacy, family income and low birth weight were statistically associated with short stature., Conclusions: The observed short stature prevalence rates are significant, being characterized as a public health problem. Among the associated factors, the following are noteworthy: unfavorable conditions of maternal literacy, family income and low birth weight. The planning of strategies to reverse the situation must take such factors into consideration., (Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.)

Objective: to describe the implementation of the Fast Test (FT) of syphilis and HIV in prenatal care in primary healthcare units in Fortaleza, Ceará., Method: a descriptive study with a quantitative approach. There were training supervisions carried out in 24 units between May and August 2014, and the inclusion criterion was to have at least one trained professional., Results: the physical space, the availability, validity and the performance of FT in prenatal were analyzed. The data were presented in simple frequency tables. It was identified adequate space in 79.2% of the units, availability of FT in 62.5%, performing the tests in 37.5%, and of these, 55.6% doing these procedures in routine prenatal care., Conclusion: the primary units have difficulties in implementing FT in syphilis and HIV in the prenatal routine. This activity is seen as an effective strategy to reduce vertical transmission of these infections.

Objective: Identifying at what age infants enrolled in public day care centers are introduced to soft drinks and industrialized juice, as well as comparing the nutritional composition of these goods with natural fruit juice., Methods: A cross-sectional study with the mothers of 636 children (aged 0 to 36 months) from nurseries of day care centers, who were asked questions about the age of feeding introduction. This study evaluated the proximate composition of soft drinks and artificial juice, comparing them with those of natural fruit juice regarding energy, sugar, fiber, vitamin C, and sodium values. The chemical composition of fruit juice was obtained by consulting the Table of Food Composition and, for industrialized drinks, the average nutritional information on the labels of the five most consumed product brands., Results: The artificial drinks were consumed before the first year of life by more than half of the children studied, however, approximately 10% consumed them before the age of 6 months. With regard to the comparison among the drinks, artificial fruit juice beverages and soft drinks proved to contain from nine to 13 times higher amounts of sodium, and 15 times less vitamin C than natural juices., Conclusions: The introduction of soft drinks and industrialized juice in the diet of infants was inopportune and premature. When compared to natural fruit juice, these have inferior nutritional composition, which suggests the urgent need for measures based on strategies for food and nutrition education in order to promote awareness and the maintenance of healthy eating habits., (Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.)

Objective: To evaluate the nutritional status of schoolchildren, resident in a semiarid region in the Northeastern Brazil., Methods: This is a cross-sectional study, involving 860 children and adolescents aged from 5-19 years-old, enrolled in three public schools in the county. The selection of schools was non-probabilistic type and unintentional. The initial population, which integrated the database, was composed by 1,035 children and teenagers, and 175 students (16.9%) were excluded because of inconsistency in the anthropometric data, resulting in a sample of 860 students. The following outcomes were considered: stunting (malnutrition), overweight and obesity (overweight), being the height/age and body mass index/age (BMI/Age), indices respectively used. Children and adolescents with height <-2 standard deviations and overweight and obese weight z score ≥1 were considered stunted. The statistical analysis was descriptive., Results: The prevalence of stunting and overweight/obesity was 9.1% and 24.0%, respectively. Overweight and stunting were higher in adolescents aged 15 and over, compared to other age groups analyzed. In relation to gender, malnutrition presented itself in a similar way, but overweight was more frequent among females., Conclusions: The results revealed that excess weight, here represented by the sum of overweight and obesity, was more prevalent than stunting (malnutrition), highlighting the urgent need for attention to this problem in order to design interventions capable of contributing to the improvement of schoolchildren nutritional status., (Copyright © 2014 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.)

Objective: To translate into Portuguese and to culturally adapt the malnutrition screening tool for hospitalized children, Strongkids., Methods: This study documents the translation of the tool from the original version (English) into Portuguese. The translation and cultural adaptation of the content of this tool consisted of six stages, according to the methodology proposed by Beaton et al (initial translation, synthesis of translations, back translation, verification of the cultural equivalence process, pre-test, and evaluation of the cultural adaptation process). In the first stage, translation was performed by two independent translators, followed by their synthesis and reconciliation; in the third one, the reconciled version was back translated and, then, a pre-final one that retained all linguistic equivalence was developed. In the fifth step, a pre-test of the pre-final version was performed in order to verify the understanding of the items and a final version of the tool was developed., Results: The pre-final version of the tool was applied to 30 parents/guardians and to 20 healthcare professionals in order to verify its understanding by both. The main alterations were the adaptation of technical terms in order to meet the recommendations of health professionals, and the adjustment of terms for parents/guardians understanding., Conclusions: The Portuguese translation of the tool was easily understood by parents/guardians and health professionals, and it should be useful to screen the risk of malnutrition in hospitalized children.

Objective: To describe the construction of a factor of allocation of financial resources, based on the population's health needs., Methods: Quantitative study with data collected from public databases referring to the state of Pernambuco, Northeastern Brazil, between 2000 and 2010. Variables which reflected epidemiological, demographic, socio-economic and educational processes were selected in order to create a factor of allocation which highlighted the health needs of the population. The data sources were: SUS (Brazilian Unified Health System) Department of Computer Science, Atlas of Human Development in Brazil, IBGE (Brazilian Institute of Geography and Statistics), Information System on Public Health Budgets, National Treasury and data from the Pernambuco Health Secretariat between 2000 and 2010. Pearson's coefficient was used to assess linear correlation and the factor of allocation was calculated using analysis by artificial neural networks. The quartiles of the municipalities were defined according to their health needs., Results: The distribution shown here highlights that all the coastal region, a good part of the Mata Norte and Mata Sul regions and the Agreste Setentrional and Agreste Central regions are in Quartile 1, that which has the largest number of municipalities. The Agreste Meridional region had municipalities in all of the quartiles. In the Pajeú/Moxotó region, many of the municipalities were in Quartile 1. Similar distribution was verified in the Sertão Central region. In the Araripe region, the majority of the municipalities were in Quartiles 3 or 4 and the São Francisco region was divided between Quartiles 1, 2 and 3., Conclusions: The factor of allocation grouped together municipalities of Pernambuco according to variables related to public health needs and separated those with extreme needs, requiring greater financial support, from those with lesser needs.

Objective: To review possible peculiarities in biological mechanisms related to responses of thermoregulatory and specific sweat glands in exercise performed by children in hot environments., Data Sources: Review of 47 articles published between 1960 and 2011 in the electronic databases MedLine and SciELO Brazil using the following key-words: 'children', 'heat', 'sweating', 'thermoregulation', 'sweat gland', and 'exercise', alone or in combination, in addition to a doctoral thesis about the subject., Data Synthesis: Pre-pubertal sweat rate during exercise is lower than among adults. Children have different thermoregulatory characteristics, with a small sweat output rate due to small sweat glands. High ratio between surface and body mass increases the absorption of heat during exercise under thermal stress in children, raising the risk of hyperthermia symptoms. However, great blood flow to skin contributes to the better control of thermal homeostasis in children. Small size of the gland, low cholinergic sensibility, low levels of circulating catecholamines during stress, and lack of androgenic hormone explain the occurrence of low elimination of sweat in exercises performed by children., Conclusions: Children present immature sweat glands. Thus, physical activity combined with high temperatures is not well-tolerated by children and youngsters, with great vulnerability to thermal injury. In the heat, strict control of fluid intake and attentive monitoring of weather conditions should have especial attention for the safe practice of exercises.

Background: The physiopathology of Preeclampsia (PE) is characterized by a deficiency in the process of placentation, systemic endothelial dysfunction and Central Nervous System (CNS) hyperflow. From a clinical point of view, it would be interesting to determine the occurrence of these phenomena before the onset of clinical manifestations of the disease, raising the possibility of new methods for predicting PE., Objective: Compare the process of placentation, endothelial function and CNS hyperflow in pregnant women at high risk for the development of PE who subsequently developed or not the syndrome., Methods: A total of 74 pregnant women underwent the Flow-Mediated Dilation (FMD) of the brachial artery, Doppler study of uterine and ophthalmic arteries for the assessment of endothelial function, process of placentation and central hyperflow, respectively. The examinations were performed between 24 and 28 weeks of gestation and were followed until the postpartum period for data collection., Results: Fifteen patients had PE and 59 remained normotensive until the puerperium. Patients who subsequently developed PE had between 24 and 28 weeks of gestation, higher pulsatility index of uterine arteries and lower values of FMD (p < 0.001 and p = 0.001, respectively). However, there was no difference in the values obtained in the resistive index in the ophthalmic artery (p = 0.08)., Conclusion: The data obtained suggest that the deficiency in the process of placentation and endothelial dysfunction chronologically precede the clinical manifestations of PE, which does not occur with CNS hyperflow.

This qualitative study aims to discuss the potential of Critical-emancipative Workshops utilizing the Tree of Knowledge as a facilitator strategy. The theoretical basis that constitutes this workshop was: the critical-emancipative education and empowerment; emotions as constructors of knowledge; the dialectical approach to transform reality and awareness; participation and shared responsibility. The study was conducted with 95 professionals working in 12 Family Health Staff in a city in the province of São Paulo, Brazil. The results indicate that the potential of the Critical-emancipatory Workshops relate directly to theoretical basis. The dynamics Tree of Knowledge used in the evaluation was powerful to reveal them. Thus, the workshops constitute an important tool for nursing in terms of their educational dimension, particularly, to face gender-based violence against women.

Purposes: To analyze the sociodemographic and behavioral profile of sex partners, the proportion of those inadequately treated as well as to verify how many of them were inadequately treated and why some were not treated., Methods: Quantitative study with data collected from May to October, 2008 at five public maternities in Fortaleza, Ceará. A survey was carried out with parturients who were hospitalized with syphilis and had a stable sex partner. We analyzed sociodemographic variables and those related to communication, diagnosis and treatment of sex partners. The data were entered into the Statistical Package for the Social Sciences and were analyzed using frequency distributions, measures of central tendency and dispersion., Results: The study included 56 pregnant women. Most sexual partners were young adults aged on average 29 years, 50% of them had studied for less than seven years, 82.1 worked and 46.4% had a family income of less than a minimum wage. Of all the partners, 92.9% were the child's father and 69.6% lived with the women. Fifty percent and 12% were alcohol and drug users, respectively. Most partners (75.0%) were told about the diagnosis by the women, and in 78.6% of cases they were aware of the VDRL result before or during the prenatal period. However, 25.0% of the women did not communicate the result to their partners for the following reasons: not knowing the importance of the partner's treatment (50.0%), not being together after the diagnosis (42.9%) and having a quarrel (7.1%). Of the partners who were informed about the result before or during the prenatal period, 56.0% were treated and six (42.8%) were considered to have been properly treated. Among the ones who did not receive treatment, 63.6% refused it because they did not feel sick, because they did not believe in the treatment and because they were afraid of injections., Conclusions: Partners are told about the syphilis diagnosis of the pregnant women; however, only a few are properly treated.

Background: Aerobic capacity is essential to physical performance, and low aerobic capacity is related to the triggering of various cardiovascular diseases., Objective: To compare the morphology and contractility of isolated rat cardiomyocytes with low performance and standard performance for exercise., Methods: Wistar rats with 10 weeks of age underwent a protocol of treadmill running to fatigue, and were divided into two groups: Low Performance (LP) and Standard Performance (SP). Then, the animals were sacrificed, the heart was quickly removed and, by means of enzymatic dissociation, left ventricular cardiomyocytes were isolated. The cell and sarcomeres length and width of cardiomyocytes were measured using an edge detection system. The isolated cardiomyocytes were electrically stimulated at 1 and 3 Hz and cell contraction was measured by registering the change of their length., Results: The cell length was shorter in the LP group (157.2 ± 1.3 µm; p < 0.05) compared to SP (161.4 ± 1.3 µm), and the same result was observed for the volume of cardiomyocytes (LP, 25.5 ± 0.4 vs. SP, 26.8 ± 0.4 pL; p < 0.05). The time to peak contraction (LP, 116 ± 1 vs. SP 111 ± 2 ms) and total relaxation (LP, 143 ± 3 vs. SP 232 ± 3 ms) were higher in the LP group., Conclusion: We conclude that left ventricular myocytes of animals with low performance for exercise are smaller than animals with standard performance. In addition to that, they present losses in contractile capacity.

Introduction: Liver abscesses are a clinical entity difficult to diagnose and treat; therefore, a high index of suspicion is usually important. The majority of pyogenic liver abscesses are polymicrobial, with enteric and anaerobic bacteria being the most common. Staphylococcus aureus are found in around 7% of the liver abscesses, as reviewed in literature. This infection usually results from hematogenous dissemination of bacteria that's infecting some other organ. There are no published series on this matter, only case-reports., Objectives and Methods: In order to investigate the physiopathology, diagnosis and natural history of liver abscesses, namely those caused by methicillin-resistant Staphylococcus aureus (MRSA), we conducted a retrospective review by studying the clinical files of the patients diagnosed with liver abscess/portal pyemia between January of 2004 and December of 2009, with a total of 117 patients., Results: Fever and abdominal pain were the most common symptoms. Nearly all patients had a CT scan for diagnosis. Only 81.2% of patients had microbiological products collected. The most common pathogen isolated was Escherichia coli. MRSA was isolated in 7.6% of abscesses. Percutaneous drainage combined with antibiotic therapy was the most frequent treatment used. All MRSA isolated were susceptible to trimethoprim-sulfamethoxazole and vancomycin. The underlying conditions most frequently found were biliary diseases, followed by recent abdominal surgery, which in turn was the most frequent predisponent condition in MRSA liver abscesses. The total mortality rate was 17.9%. One patient died in the group of abscesses caused by MRSA., Conclusion: MRSA is an important pathogen in hospital-acquired infections and intraabdominal infections are no exception. We find the association with post abdominal surgery very important. These findings have remarkable implications in therapeutics, prognosis and investigation.

The objectives of the study were to assess sound pressure level (SPL) in two rooms of a Neonatal Intensive Care Unit (NICU) and to identify their sources. This quantitative-descriptive study was conducted in two rooms of a NICU of a University Hospital in São Paulo, Brazil. Three dosimeters were used to register SPL (total of 261 hours). A 48-hour register of noise sources was obtained. The results showed high SPL in both rooms. The greatest mean Leq were 71.0 dBA (room A) and 68.0 dBA (room B). Main noise sources in both units were: NICU hallway noise, traffic and conversation among professionals. The results indicate that SPLs in NICU rooms are higher than the levels recommended by regulatory agencies. A guideline was developed and an educational program was implemented as a means to reduce sound pressure levels.