Transtornos alimentares

Instituto Estadual de Diabetes e Endocrinologia Grupo de Obesidade e Transtornos AlimentaresUniversidade Federal do Rio de Janeiro Instituto de PsiquiatriaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de PsiquiatriaUNIFESP, EPM, Depto. de PsiquiatriaSciEL

Systematic review and meta-analysis of the use of prokinetics in gastroesophageal reflux and in gastroesophageal reflux disease in Pediatrics

OBJECTIVE: To evaluate, by systematic review and meta-analysis, randomized studies comparing the prokinetics (domperidone, bromopride, metoclopramide and bethanechol) to placebo in the treatment of gastroesophagic reflux (GER) and gastroesophagic reflux disease (GERD) in children. METHODS: Bibliographic search for randomized clinical trials (Medline, EMBASE, Biological Abstracts, ISI/Web of Science, CINAHL, Lilacs e Cochrane). The primary outcome was the modification of reflux symptoms. Other outcomes were: GER-related complications, alterations in control exams, life quality, adverse events and abandon of treatment. RESULTS: The metanalysis included four studies on domperidone, two on metoclopramide, and one on bethanechol. No study of bromopride was retrieved. The risk of non-response to the treatment was significantly smaller in children that received prokinetics in comparison to placebo (RR 0.35, 95%CI 0.14-0.88). Individual therapeutic advantage regarding placebo was related to domperidone (n=126; RR 0.27; 95%CI 0.14-0.52, NNT 3; I2 0%) and bethanechol (n=44; RR 0.19; 95%CI 0.05-0.55; NNT 2), but not to metoclopramide (n=71; RR 0.63; 95%CI 0.07-5.71; I2 92.2%). CONCLUSIONS: The evidence for prokinetic use in GER and GERD in children is limited because the few studies report preliminary trials that evaluate short-term responses and show methodological limitations.OBJETIVO: Avaliar, por meio de revisão sistemática e metanálise, estudos randomizados que comparam os procinéticos domperidona, bromoprida, metoclopramida e betanecol ao placebo no tratamento do refluxo gastroesofágico (RGE) e da doença do refluxo gastroesofágico (DRGE) em crianças. MÉTODOS: BUsca bibliográfica de ensaios clínicos randomizados (Medline, EMBASE, Biological Abstracts, ISI/Web of Science, CINAHL, Lilacs e Cochrane). O desfecho primário foi eficácia na modificação dos sintomas de refluxo, conforme definição de autores das fontes primárias. Outras variáveis de interesse foram: complicações relacionadas ao RGE, alterações nos exames laboratoriais de controle, qualidade de vida, eventos adversos e abandono do tratamento. RESULTADOS: Foram incluídos quatro estudos com domperidona, dois com metoclopramida, um com betanecol. Nenhum estudo com bromoprida foi localizado. O risco de não resposta ao tratamento foi significativamente menor para os procinéticos quando comparados ao placebo (RR 0,35; IC95% 0,14-0,88). A vantagem terapêutica individual em relação ao placebo se manteve para a domperidona (n=126; RR 0,27; IC95% 0,14-0,52; NNT 3; I2 0%) e betanecol (n=44, RR 0,19, IC95% 0,05-0,55, NNT 2), mas não para metoclopramida (n=71; RR 0,63; IC95% 0,07-5,71, I2 92,2%). CONCLUSÕES: A evidência para o uso de procinéticos no RGE e na DRGE em crianças é limitada, pois os poucos estudos são ensaios preliminares de resposta em curto prazo e com limitações metodológicas.UFPel Centro de Medicina Baseada em EvidênciasHospital de Clínicas de Porto Alegre Instituto Nacional de Ciência e Tecnologia Translacional em MedicinaUFRJ Instituto de PsiquiatriaUNIFESP Departamento de PsiquiatriaUNIFESP, Depto. de PsiquiatriaSciEL

Tecnología, materia y lugar: Procesos de modernización en la obra española de la posguerra. Instituto de enseñanza media, Málaga. Arquitecto: Miguel Fisac

La trayectoria de Miguel Fisac (1913-2006) recorre el siglo XX de la arquitectura española, dejando traslucir la complejidad de la búsqueda de la modernidad en un régimen que reclamaba formas academicistas para su mensaje identitario nacional. El Instituto de Enseñanza Media y Escuela de Comercio en Málaga con sus bellos pórticos de hormigón de sección variable, su tratamiento científico de la luz, el espacio humanizado de sus patios, y la vinculación al lugar, ejemplifica una apuesta por la arquitectura como laboratorio tecnológico. La documentación original nos desvela su valor añadido al tratarse de un segundo proyecto del autor; en este artículo se analiza la obra construida, en contraste con la monumentalidad y simetría del primer proyecto; representando los cambios operados en la arquitectura española de posguerra. Fisac introduce una nueva arquitectura docente en el paisaje andaluz de mediados del XX. Profundamente deteriorada, esta investigación propone su puesta en valor.Miguel Fisac’s career spans the twentieth century Spanish architecture (b.1913-d.2006) and mirrors the complexity characterizing the search for modernity in a regime concerned with reclaiming an academicism in order to convey the clichés of nationalism. Challenging official architecture, the High School and School of Commerce in Malaga, with its succession of concrete porticoes, his technical use of light and the humanized space of its patios, exemplifies this stake in modern architecture as a field for technological experimentation. The documentation discloses an added value to this work, revealing that there had been two proposals. This article compares these, contrasting the actual building to the monumentality and the symmetry of the first proposal, corroborating a major shift that took place in Spanish post-war architecture. Fisac introduced a new educational architecture into the Andalusian landscape of the midtwentieth century. Deeply deteriorated, this research seeks to establish its value by means of a rigorous process of documentatio

Serological study of vaccinia virus reservoirs in areas with and without official reports of outbreaks in cattle and humans in São Paulo, Brazil

Vaccinia virus (VACV), the etiological agent of an exanthematic disease, has been associated with several bovine outbreaks in Brazil since the end of the global vaccination campaign against smallpox. It was previously believed that the vaccine virus used for the WHO global campaign had adapted to an unknown wild reservoir and was sporadically re-emerging in outbreaks in cattle and milkers. At present, it is known that Brazilian VACV is phylogenetically different from the vaccinia virus vaccinal strain, but its origin remains unknown. This study assessed the seroprevalence of orthopoxviruses in domestic and wild animals and farmers from 47 farms in three cities in the southwest region of the state of São Paulo with or without official reports of outbreaks in cattle or humans. Our data indicate a low seroprevalence of antibodies in wild animals and raise interesting questions about the real potential of wild rodents and marsupials as VACV reservoirs, suggesting other routes through which VACV can be spread

Direitos humanos das gestantes encarceradas

Esta pesquisa documental traz como tema os direitos das gestantes em situação de encarceramento no Brasil, apresentando as conquistas legais dessa população e o desafio da efetivação dos direitos nas políticas públicas. Em pleno século XXI, mulheres encarceradas e gestantes estão dando à luz algemadas, sendo obrigadas a escolherem entre o direito de estarem próximas à suas famílias e o direito de amamentar, uma vez que o Estado brasileiro não oferece prisões adequadas suficientes para acolher gestantes e mães com seus filhos. Levantaremos quais são esses direitos, garantidos nas legislações, porém denunciados pelas organizações públicas e privadas que defendem os direitos dessa população. A relevância social e acadêmica deste estudo se dá pelo fato dessas mulheres estarem institucionalizadas e discriminadas. O que encontramos, sinteticamente, são violações de direitos humanos essenciais para a sobrevivência nas prisões. Questões estas pertinentes tanto para Assistentes Sociais como para qualquer profissional de todas as áreas

Análise de Conglomerados na Técnica do Repertório de Constructos Pessoais

The aim of this preliminary survey is to explore some of the possibilities provided by cluster analysis appliedto the Repertory Grid Technique. Two analysis were performed: The analysis of the elements and the analysis of the constructs,as defined by George Kelly's Personal Construct Theory. The produced dendrograms allowed to make a perceptivemap of the client (woman), helping to find which constructs and structures of constructs are related to her current psychologicalproblems. Results were compared to client's empirical and qualitative evaluations obtained in the clinical setting, providingadditional information that had not been raised by previous diagnostic sessions.Este estudo explorará algumas das possibilidades do uso da análise de conglomerados aplicada à Técnica do Repertório de Constructos Pessoais através de um estudo de caso. Foram realizadas duas análises: a dos elementos e a dos constructos, conforme definidos pela Teoria dos Constructos Pessoais de George Kelly. Os dendrogramas resultantes das análises permitiram traçar um mapa perceptivo da cliente, com vistas a se descobrir quais constructos e estruturas de constructos estão relacionados à sua problemática atual. Os resultados foram comparados às avaliações empíricas e qualitativas da cliente obtidas durante a terapia, revelando informações adicionais não aventadas durante as sessões prévia

Depression, glycemic control and type 2 diabetes

<p>Abstract</p> <p>Background</p> <p>Comorbid depression in diabetes has been suggested as one of the possible causes of an inadequate glycemic control. The purpose of this study was to investigate the association between major depression and the glycemic control of type 2 diabetes mellitus (T2DM).</p> <p>Methods</p> <p>Seventy T2DM patients were evaluated. They underwent a psychiatric examination using the following instruments: Structured Clinical Interview for DSM-IV and Beck Depression Inventory. The diabetes status was assessed in the short-term (glycemia, glycated hemoglobin) clinical control.</p> <p>Results</p> <p>The presence of current depression was observed in 18.6% (13/70). In addition, type 2 diabetes patients who displayed depression evidenced higher levels of glycated hemoglobin (8.6 ± 2.0 vs. 7.5 ± 1.8; p = 0.05) when compared to those who did not exhibit a mood disorder.</p> <p>Conclusions</p> <p>In our sample, the presence of depression seems to impact on the short-term control of T2DM. The authors discuss the clinical utility of these findings in the usual treatment of diabetes.</p

Rabies virus in a pregnant naturally infected southern yellow bat (Lasiurus ega)

Current knowledge on bat lyssavirus infections in their native hosts is limited and little is known about the virulence, virus dissemination and transmission among free-living insectivorous bats. The present study is a brief description of rabies virus (RABV) dissemination in tissues of a naturally infected pregnant southern yellow bat (Lasiurus ega) and its fetuses, obtained by reverse-transcriptase polymerase chain reaction (RT-PCR). The RT-PCR was positive in samples from the brain, salivary gland, tongue, lungs, heart, kidneys and liver. On the other hand, the placenta, three fetuses, spleen, intestine and brown fat tissue tested negative. This research demonstrated the absence of rabies virus in the fetuses, thus, in this specific case, the transplacentary transmission was not observed