Perfil de gestantes internadas com hiperêmese em uma maternidade pública do Rio de Janeiro

Objective: to evaluate the sociodemographic and obstetric profile. clinical and nutritional status, as well as the nutritional status of the newborn, in pregnant women hospitalized for hyperemesis gravidarum, from 2013 to 2016. Methods: observational, retrospective and cross-sectional study, in which data from medical records of hospitalized pregnant women with hyperemesis gravidarum were analyzed. in a public maternity hospital in Rio de Janeiro. Descriptive analysis included classic procedures such as simple averages and frequency. Result: In the period of 4 years, 34 pregnant women with hyperemesis gravidarum were hospitalized, but the sample consisted of 21 pregnant women, mostly adults, brown or white, eutrophic, primiparous without previous diseases, living in Rio de Janeiro and who had not planned the pregnancy. The mean length of hospital stay was 6 days, with duration of symptoms ranging from 2 to 12 days. 75% of multiparous pregnant women reported a history of hyperemesis gravidarum. More than 60% had insufficient total gestational weight gain, all babies were born at term and 76.2% had adequate birth weight for their age. Conclusion: Despite the small sample, an increase in the incidence of hyperemesis gravidarum in the years studied and a high prevalence of insufficient total weight gain can be observed.Objetivo: avaliar o perfil sociodemográfico, obstétrico. clínico e nutricional, bem como o estado nutricional do recém-nato, em gestantes internadas por hiperêmese gravídica, no períiodo de 2013 a 2016. Métodos: estudo observacional, retrospectivo e transversal, no qual foram analisados dados de prontuários de gestantes com hiperêmese gravídica internadas em uma maternidade pública do Rio de Janeiro. A análise descritiva incluiu procedimentos clássicos como médias e frequência simples. Resultado: No período de 4 anos, foram internadas 34 gestantes com hiperêmese gravídica, mas a amostra foi composta por 21 gestantes, em sua maioria, adultas, pardas ou brancas, eutróficas, primípares sem doenças prévias, moradoras do Rio de Janeiro e que não haviam planejado a gestação. O tempo médio de internação foi de 6 dias, com duração dos sintomas variando de 2 até 12 dias. 75% das gestantes multíparas relataram história de hiperêmese gravídica. Mais de 60% apresentaram ganho de peso gestacional total insuficiente, todos os bebês nasceram a termo e 76,2% com peso ao nascer adequado para a idade. Conclusão: Apesar da amostra reduzida, percebe-se um aumento na indcidência de hiperêmese gravídica nos anos estudados e elevada prevalência de ganho peso total insuficiente

O idoso, sua casa e suas coisas:contribuições para criação de um entorno mais acolhedor para os maiores de 60 anos

En Brasil, vivimos el fenómeno inédito del envejecimiento poblacional y de la longevidad. En menos de una década el número de ancianos superará al de los jóvenes. Con esta nueva realidad surgen también nuevos comportamientos, deseos y demandas. El presente artículo analiza la relación de afecto del anciano con su casa y sus cosas, y propone subsidios para la construcción de un entorno más adecuado para aquellos que están envejeciendo. Este texto se divide en cinco secciones: (1) El panorama demográfico y las perspectivas y tendencias de la organización de la vida de las personas mayores en Brasil; (2) hipótesis traídas de áreas distintas sobre la relación de los ancianos con sus casas, (3) reflexiones sobre la casa y los artefactos como soporte de memoria e identidad; (4) la relación de personas mayores con sus casas y cosas de acuerdo con resultados obtenidos en investigación cualitativa. Al final, se espera proveer una alerta a los profesionales involucrados con la creación de ambientes, productos y servicios, que tengan en cuenta los deseos, aspiraciones y sentimientos de los ancianos, especialmente en lo que se refiere a sus preferencias sobre vivienda. De esta forma, el artículo se suma a otros estudios que proporcionan subsidios para aquellos que quieran desarrollar productos, servicios y ambientes que atiendan las demandas emocionales de esa población, proporcionándoles más calidad de vida.In Brazil, we experience the unprecedented phenomenon of population aging and longevity. In less than a decade the number of the eldery will exceed the Young, with this new reality also arise new behaviors, desires and demands. The purpose of this article is to provide information about the relationship of affection of the elderly with their home and their objects, and to provide subsidies for the construction of an environment more suitable for those who are aging. This article is structured in 5 sections that present: (1) the demographic panorama and the tendencies of the household arrangements of the elderly in Brazil; (2) hypotheses brought from different areas about the relationship of the elderly with their homes, (3) reflections about the home and the artifacts as support of memory and identity; (4) the relation of the elderly with their houses and things according to results obtained in qualitative research. Finally, it is expected to provide an alert to professionals involved in the creation of environments, products and services that take into account the desires, aspirations and feelings of the elderly, especially regarding their preferences about housing. In this way, the article joins other studies that provide subsidies for those who want to develop products, services and environments that meet the emotional demands of this population, providing them with a better quality of life.No Brasil, vivenciamos o fenômeno inédito do envelhecimento populacional e da longevidade. Em menos de uma década o número de idosos ultrapassará o de jovens. Com essa nova realidade surgem também novos comportamentos, desejos e demandas. O presente artigo tem como objetivo trazer informações sobre relação de afeto do idoso com sua casa e suas coisas, e trazer subsídios para construção de um entorno mais adequado para aqueles que estão envelhecendo. Esse artigo está estruturado em 5 seções que apresentam: (1) o panorama demográfico e as tendências dos arranjos domiciliares de idosos no Brasil; (2) hipóteses trazidas de áreas distintas sobre a relação dos idosos com suas casas, (3) reflexões sobre a casa e os artefatos como suporte de memória e identidade; (4) a relação de pessoas idosas com suas casas e coisas de acordo com resultados obtidos em pesquisa qualitativa. Ao fim, espera-se prover um alerta aos profissionais envolvidos com a criação de ambientes, produtos e serviços, que levem em consideração os desejos, aspirações e sentimentos dos idoso, especialmente no que tange suas preferências sobre moradia. Dessa forma, o artigo soma-se a outros estudos que fornecem subsídios para aqueles que queiram desenvolver produtos, serviços e ambientes que atendam as demandas emocionais dessa população, proporcionando a eles mais qualidade de vida

MicroRNAs-Based Imaging Techniques in Cancer Diagnosis and Therapy.

Cancer is one of the most serious global health concerns in different populations. Several studies indicated that there are many potentially promising cellular and molecular targets for cancer therapy within cancer cells and their microenvironment. Among different cellular and molecular targets involved in cancer pathogenesis, microRNAs (miRNAs) are well known as key targets for cancer therapy. miRNAs are one of main classes of non-coding RNAs. These molecules play important roles in different critical processes of cancer pathogenesis. Hence, this makes miRNAs as a suitable tool for cancer diagnosis and therapy. There are different approaches for monitoring miRNAs in cancer patients. Some conventional approaches including next-generation sequencing, real-time polymerase chain reaction (PCR), northern blotting, and microarrays could be used for assessment of miRNAs expression. Some studies revealed that the utilization of these approaches associated with various limitations. Recently, it has been revealed that molecular imaging techniques are powerful tools for monitoring of different cellular and molecular targets involved in various diseases such as cancer. These techniques help investigators to investigate and monitor miRNAs functions through assessing different targets by fluorescent proteins, bioluminescent enzymes, molecular beacons, as well as various nanoparticles. Therefore, utilization of molecular imaging techniques could assist investigators to better monitor and more effectively treat patients during different phases of malignancy. Here, we give a review on the current state of miRNAs-based imaging techniques in cancer diagnosis and therapy. J. Cell. Biochem. 9999: 1-8, 2017. © 2017 Wiley Periodicals, Inc

O papel do BNDES na ampliação do financiamento aos ODS: Lições do edital de Blended Finance

The Brazilian Development Bank - BNDES has a long history promoting sustainable economic and social development. In addition to traditional credit (directly or through financial agents) and equity participation, it offers project structuring services, guarantee fund management and applies non-reimbursable resources to encourage projects with positive social and environmental impact. In line with most recent trends of development institutions and best global practices, it is starting to use Blended Finance structures to leverage private resources and achieve the Sustainable Development Goals (SDGs). The objective of this article is to demonstrate lessons learned from its initiative and point out paths and challenges in promoting the agenda in the country.O Banco Nacional de Desenvolvimento Econômico e Social - BNDES tem um longo histórico de atuação na promoção do desenvolvimento econômico e social de forma sustentável. Além do crédito tradicional (direto ou por intermédio de agentes financeiros) e da participação acionária, oferece serviços de estruturação de projetos, gestão de fundos garantidores e aplica recursos não reembolsáveis para estimular projetos de alto impacto social e ambiental positivo. Em linha com a atuação mais recente de instituições de desenvolvimento e utilizando as melhores práticas mundiais, vem buscando utilizar mecanismos de finanças híbridas (Blended Finance) com o objetivo de alavancar recursos, sobretudo privados, para atingimento dos Objetivos de Desenvolvimento Sustentável (ODS). O objetivo do presente artigo é demonstrar as lições aprendidas com sua iniciativa e apontar caminhos e desafios no fomento à agenda no país

Identificação de broncoaspiração por disfagia orofaríngea em pacientes com pneumonia comunitária

A pneumonia é uma inflamação do parênquima pulmonar resultante do processo infeccioso ou inflamatório, responsável por 5% do total das mortes notificadas no mundo, instalando-se geralmente em indivíduos cujos mecanismos de defesa encontram-se comprometidos. A relação estreita entre as alterações da deglutição e a predisposição para pneumonias bacterianas de repetição e sua associação com desordens neuromusculares tem sido objeto constante de pesquisas. Objetivo: propor um protocolo clínico para detecção de broncoaspiração entre pacientes com pneumonia sem realização de videofluoroscopia. Metodologia: 70 pacientes com média de idade de 67,5±16,3 anos, foram submetidos a 2 protocolos de avaliação da deglutição validados na literatura: Tohara (2003) e Xerez (2002). Resultados: Foram considerados aspiradores pelo exame clínico 62,9% (44/70). Ser classificado aspirador pelo exame clínico mostrou correlação estatística significativa com a presença de doença neurológica e redução do estado de alerta (p<0,001). Conclusão: o exame clínico foi capaz de detectar os pacientes em risco para pneumonia aspirativa. A presença da associação de fatores deve levar a equipe a adotar cautela maior no manuseio da alimentação do paciente com pneumonia que pode ser de origem aspirativa.Pneumonia is a pulmonary parenchyma inflammation that results from an infectious or inflammatory process, responsible for 5% of all deaths reported in the world; it usually affects individuals whose defense mechanisms are compromised. The close association between swallowing abnormalities and the predisposition to repetitive bacterial pneumonia and its association with neuromuscular disorders have been the aim of many studies. Aim: To propose a clinical protocol to detect bronchoaspiration in patients with pneumonia, without videofluoroscopy. Method: 70 patients with mean age of 67.5±16.3 years were submitted to two swallowing evaluation protocols, previously validated in literature: Tohara (2003) and Xerez (2002). Results: 62.9% (44/70) of the patients were considered aspirators by the clinical examination, which showed a significant statistical correlation with the presence of neurological disorders and reduction in the state of alertness (p <0.001). Conclusion: The clinical examination was able to detect the patients at risk for aspiration pneumonia. The association of risk factors should lead the healthcare team to exercise more caution when planning the diet of the patient with pneumonia, as it can be the aspiration type

Perfil, critérios de indicação e desfecho da inserção de gastrostomia em um hospital pediátrico universitário

Objective: To describe the profile of patients undergoing a gastrostomy, the recommendations and outcome of this insertion in a Pediatric Teaching Hospital. Method: This was a retrospective, quantitative, and descriptive study that researched the records of patients who underwent a gastrostomy between January 2010 and December 2012. Results: The diseases and conditions most frequent were chronic infantile encephalopathy (77.5%), pneumonia (67.5%), seizures (57.5%), and malnutrition (42.5%). Although most patients presented a history of dysphagia (62.5%), oral feeding was observed most frequently as the most common form of nutrition, before the gastrostomy insertion (42.5%), followed by nasoenteric tube (40%). The introduction of nutrition by gastrostomy was successful and occurred an average of 2.82 (± 1.19) days after insertion. Six months after their gastrostomy, 80% of patients continued feeding only through this access tube and only 2.5% had removed the gastrostomy; 45% of the participants had gastrostomy complications, with extravasation of gastric material (15%) and local inflammation (15%) being the most frequent. Conclusion: The profile of patients undergoing gastrostomy is mostly of individuals with neurological and respiratory diseases, without respiratory support, of the male gender, and feeding by oral cavity or nasoenteric tube for a prolonged period. The main recommendation criteria were dysphagia and neurological diseases. Regarding the outcome, the introduction of nutrition by gastrostomy was successful; most individuals remained with this long-term nutritional support and the most common complications were gastric material extravasation and local inflammationsObjetivo: Descrever o perfil dos pacientes submetidos à gastrostomia, os critérios de indicação e o desfecho dessa inserção em um hospital pediátrico universitário. Método: Estudo retrospectivo, quantitativo e descritivo, através de pesquisa em prontuários de pacientes submetidos à gastrostomia no período entre janeiro/2010 e dezembro/2012. Resultados: As doenças e condições de base mais frequentes foram: encefalopatia crônica da infância (77,5%), pneumonia (67,5%), crise convulsiva (57,5%) e desnutrição (42,5%). Apesar da maioria dos pacientes apresentar história de disfagia (62,5%), observou-se como via de nutrição mais frequente antes da inserção da gastrostomia a via oral (42,5%), seguida pela nasoenteral (40%). A introdução de dieta pela gastrostomia foi bem sucedida e ocorreu em média 2,82(± 1,19) dias após a sua inserção. Após seis meses de realização da gastrostomia, 80% dos pacientes permaneceram alimentando-se exclusivamente através desta via e somente 2,5% retirou a gastrostomia. 45% dos participantes apresentaram complicações da gastrostomia, sendo extravasamento do material gástrico (15%) e inflamação local (15%) as mais frequentes. Conclusão: O perfil dos pacientes submetidos à gastrostomia é de indivíduos, em sua maioria, com doença neurológica e respiratória, sem suporte respiratório, do sexo masculino e alimentando-se por via oral ou sonda nasoenteral por período prolongado. Os principais critérios de indicação foram doença neurológica e disfagia. Em relação ao desfecho, a introdução de dieta pela gastrostomia é bem sucedida, a maioria dos indivíduos permanece com este suporte nutricional a longo prazo e as complicações mais frequentes são extravasamento do material gástrico e inflamações na área da gastrostomi

In vitro Antiplasmodial Activities of Alkaloids Isolated from Roots of Worsleya procera (Lem.) Traub (Amaryllidaceae)

A combined phytochemical, crystallographic and biological study of Worsleya procera roots was performed. Fifteen alkaloids were identified by gas chromatography mass spectrometry (GC-MS) and seven of them were isolated. The structures of the alkaloids were elucidated by spectroscopic methods, and a detailed crystallographic study of tazettine was carried out. The isolated alkaloids and the obtained extracts were tested in vitro against Plasmodium falciparum (3D7 and K1 strains) and human hepatocarcinoma cells (HepG2) to assess their antiplasmodial and cytotoxic effects, respectively. One of the isolated alkaloid derivatives, lycorine, exhibited antiplasmodial activity against both sensitive (3D7) and resistant (K1) parasite strains in the low micromolar range (half-maximal sample inhibitory concentration (IC50) values of 2.5 and 3.1 µM, respectively) and displayed a low cytotoxicity profile, with a selectivity index greater than 100. Our findings indicate that lycorine is a hit for antimalarial drug discovery. Keywords: isoquinolinic alkaloids; Amaryllidaceae; Plasmodium falciparum; lycorine; tazettin

Application and effects of neuromuscular electrical stimulation in the rehabilitation of oropharyngeal dysphagia: a literature review

Objective: To analyze the different methods of Neuromuscular Electrical Stimulation (NMES) in the intervention of oropharyngeal dysphagia. Methods: Review using the descriptors: “deglutition disorders” and “electrical stimulation” in PubMed, BVS, SciELO, and MedLine, from 1997 to 2015. Classified according to the CAPES Integrated System (SiCAPES), PEDro, and Jadad scales. Results: There were 165 articles found, from which 25 were selected according to the theme. Between 2009-2012 there were more publications (60%, n = 15). Case-control was the most reported type of study (28%, n = 7). Most individuals were investigated after a stroke (44%, n = 11). The most popular type of therapy considered NMES at rest and traditional therapy (TT) (28%, n = 8), NMES during swallowing and TT (28%, n = 7), and NMES at rest (24%, n = 3). Vital Stim® was the most cited electrical stimulation device (32%, n = 8). Transcutaneous electrical nerve stimulation was the most reported (76%, n = 19). As to location, electrodes placed on the neck (48%, n = 12) and submental (44%, n = 11) stood out. Electric current commonly used: FES (40%, n = 10) and TENS (24%, n = 6). Fluoroscopy was the prevailing evaluation method (52%, n = 13). For SiCAPES distribution, the greatest number of materials was classified as B2 (36%, n = 9) and A1 (16%, n = 4). On the PEDro scale, the studies mostly scored 11 (24%, n = 6) and 10 (16%, n = 4). Considering the Jadad scale, (24%, n = 6) the studies scored 3 points. Conclusion: A higher prevalence of therapeutic effect on hyolaryngeal complex elevation, an important airway defense mechanism during swallowing, and the use of FES current and electrodes placed on the submental region or neck. Further research is needed, with defined etiological groups, to prove the therapeutic effect in the medium and long termObjetivo: Analisar os diferentes métodos de Eletroestimulação Neuromuscular (EENM) na intervenção das disfagias orofaríngeas. Metódos: Revisão através dos descritores: “transtornos de deglutição” e “estimulação elétrica” nas bases PubMed, BVS, SciELO e MedLine, de 1997 a 2015. Classificados segundo Sistema Integrado CAPES (SiCAPES), Escala PEDro e Jadad. Resultados: 165 artigos encontrados. 25 selecionados de acordo com o tema proposto. Entre 2009-2012 (60%, n = 15) ocorreu maior número de publicações. Caso Controle foi o tipo de estudo mais relatado (28%, n = 7). A maioria investigou indivíduos pós acidente vascular cerebral (44%, n = 11). O tipo de terapia mais recorrente considera EENM em repouso e terapia tradicional (TT) (28%, n = 8), EENM durante a deglutição e TT (28%, n = 7) e EENM em repouso (24%, n = 3). Vital Stim® foi o aparelho de eletroestimulação mais citado (32%, n = 8). A eletroestimulação transcutânea foi a mais relatada (76%, n = 19). Quanto à localização, destacam-se eletrodos fixados na região do pescoço (48%, n = 12) e submentual (44%, n =11). Correntes mais utilizadas: FES (40%, n = 10) e TENS (24%, n = 6). Videofluoroscopia é o método de avaliação predominante (52%, n = 13). Pela distribuição SiCAPES o maior número de materiais classificam-se em B2 (36%, n = 9) e A1 (16%, n=4). Na Escala PEDro os trabalhos pontuaram, principalmente, em 11 (24%, n = 6) e 10 (16%, n = 4). Considerando a Escala Jadad, (24%, n = 6) estudos obtiveram 3 pontos. Conclusão: Observouse maior prevalência de efeito terapêutico na elevação do complexo hiolaríngeo, importante mecanismo de defesa das vias respiratórias durante a deglutição, utilização da corrente FES, e eletrodos posicionados na região submentual ou de pescoço. Novas pesquisas são necessárias, com grupos etiológicos definidos, para comprovação do efeito terapêutico a médio e longo praz

Minimal prevalence of Huntington’s disease in the South of Brazil and instability of the expanded CAG tract during intergenerational transmissions

Huntington’s disease (HD) is due to dominant expansions of the CAG repeat of the HTT gene. Meiotic instability of the (CAG)n might impact the disorder frequency. We report on HD minimal prevalence in Rio Grande do Sul (RS) state, Brazil, and on intergenerational instability of the (CAG)n in HD families. Symptomatic and at-risk subjects from 179 HD families were ascertained between 2013 and 2016. Clinical, molecular and family history data were obtained. Expanded (CAG)n length differences between parent and child (delta-expanded-(CAG)n) were calculated. Effect of parental age on the (CAG)n instability upon transmission was inferred by correlating delta-expanded-(CAG)n between siblings to their age differences. HD minimal prevalence in RS state was estimated as 1.85:100,000 inhabitants. Alleles with (CAG)27-35 were found on 21/384 non-disease associated chromosomes (5.5%); among 253 expanded alleles, four (1.6%) were within reduced penetrance range with (CAG)36-39. In 32 direct transmissions, mean instability was larger among paternal than maternal transmissions. In direct transmissions and in 51 sibling pairs, parental age at the time of child birth were not correlated with delta-expanded-(CAG)n. Briefly, HD prevalence in RS state was lower than those reported for European populations. Expanded (CAG)n transmissions were unstable and not associated to parental age

ATXN3, ATXN7, CACNA1A, and RAI1 genes and mitochondrial polymorphism a10398g did not modify age at onset in spinocerebellar ataxia type 2 patients from South America

The spinocerebellar ataxia type 2 (SCA2) is a rare autosomal dominant neurodegenerative disease caused by expansions of a CAG repeat tract at ATXN2 gene. These repeats range from 22 to 31 CAG in normal alleles and from 32–34 to 64 and more, in expanded alleles. ATXN2 expansion accounts for around 50 % of the variability in age at onset (AO) of symptoms . Former studies reported that other genes may be responsible for small effects in SCA2 AO. The CAG repeats’ length (CAGn) at RAI1 gene would explain 4 % of the remaining variance in AO in 46 SCA2 patients with no clear-cut geographical origin. Two publications studied candidate genes among patients with highly discordant AO, from an original sample of 394 patients from Holguin, Cuba Their data pointed to the CAGn at CACNA1A gene [3] and to a polymorphism of the mitochondrial complex I A10398G (rs2853826) as modifiers of SCA2 AO. We have previously found that longer CAGn at ATXN3 gene were associated with earlier ages at onset in a former sample of 49 SCA2 patients from Brazil. SCA2 AO was associated with the CAGn at ATXN7 gene in a European cohort of 289 SCA2 patients but this association was not confirmed in a second cohort [6]. Since replications in additional, independent samples of patients are required to validate a genetic association, we aimed to investigate these same loci in a South American cohort of SCA2 in order to add evidences on their role as modifiers of AO in this disease