O uso das pregas cutâneas e da circunferência muscular do braço no diagnóstico de desnutrição energético-protéica em pacientes adultos: estudo crítico.

The use of anthropometric measurements of triceps (TSF) and subscapular skinfolds (SSF) and mid-upper arm muscle circumference (MAMC) was examined as far as the diagnosis of energy-protein malnutrition (EPM) is concerned. The study was undertaken in five groups of patients (n = 231): arterial hypertension (AH, n = 63), chronic obstructive pulmonary disease (COPD, n = 17), hemodialyzed chronic renal failure (CRF, n = 19), critically ill patients with an acute event (CA, n = 42) and critically ill patients with chronic diseases (CCD, n = 90). The results were compared to those obtained in a group of healthy individuals (control group, n = 102). The control group and the group of patients were allocated in subgroups according to sex and age (less than 50 and more than 50 years). It was expected that significant differences would be found for the anthropometric values between the control subgroups and the COPD, the CRF and the CCD subgroups of patients. For the skinfold thicknesses (TSF and SSF), significant differences were found between CRF, CCD subgroups and the control subgroups under fifty years of age; however, the differences were not significant when the subgroups over fifty were analyzed. Concerning the MAMC, significant differences were found: 1 degree) between the CRF subgroups (males and females) and the control subgroups under fifty years of age; 2 degrees) between the CCD male subgroups (younger and older subgroups) and the respective control subgroups and 3 degrees) between the COPD and the control subgroups.(ABSTRACT TRUNCATED AT 250 WORDS)

Resposta metabólica de pacientes cirróticos (Child A) ao aumento da ingestão protéica e/ou calórica. Estudo do balanço nitrogenado.

The dietary protein assimilation by cirrhotic undernourished patients (lower lean body mass and plasma TBPA and RBP levels) was investigated in five-adult male subjects suffering from histologically diagnosed liver cirrhosis, in its clinically mild stage (Child-Turcotte-Pugh grade A). During the 9 day-dietary study the patients received orally a sequence of complete-regional diets containing different protein-energy compositions identified as (g prot/Cal/kg/day): D0 = 0.42/20.9; D1 = 0.91/37.5; D2 = 0.99/47.9 and D3 = 1.60/40.5. The respective N-balance values (g/day) found were (mean +/- SD): low protein calorie (D0) = -4.24 +/- 2.46; normal protein calorie (D1) = 0.66 +/- 1.99; normal protein-high calorie (D2) = 1.14 +/- 2.54; high protein normal calorie (D3) = 5.12 +/- 2.48. The correspondent urea-N output (g/kg/day) were D0 = 0.22 +/- 0.100; D1 = 0.238 +/- 0.099; D = 0.20 +/- 0.063 and D3 = 0.310 +/- 0.121. The present data thus suggest that protein rather than energy intake would be the limited factor for increasing the N-retention in (mild) cirrhotic patients whom tolerate well dietary protein at either normal or elevated levels.

Degradabilidade ruminal da matéria seca e da fração protéica da silagem de milho, do farelo de soja e do sorgo grão, em bovinos da raça nelore. Comparação com os dados obtidos pelo CNCPS

The nylon bag in situ degradation thecnique was employed to compare the data of the CNCPS to the ruminal degradability of the dry matter and crude protein in corn silage, soybean meal and sorghum grain, in four rumen fistulated Nellore steers, averaging 36 months of age and 520 kg of liveweight. A randomized complete block experimental design was used, where animals constituted the blocks. Two levels of concentrate, 18 and 39 %, were used in the diets. The forage used in the diets was corn silage and the concentrate ingredients were: soybean meal, cottonseed meal, corn grain and sorghum grain. There was a reduction in the potentially by degradable fraction (B) of the dry matter(DM) of the corn silage and sorghum grain with an increase in the concentrate level of the diet; however, the degradation rate(c) of the silage was similar for the two diets and the sorghum grain showed an increase of 28.4 %. The B fraction of the DM from the soybean meal was not affected by the diet, but its rate (c) was reduced by 18.1 %. The same effect was observed for the rate(c) of crude protein(CP) of the soybean meal, with a reduction of 38.1 %. The values for the effective degradability of the two fractions were not affected by the diet when the lag time was not considered. When lag time was considered, the degradability values of the studied feeds were superior in both fractions.

Eficácia e segurança do uso inalatório da adrenalina-L na laringite pós-intubação utilizada em associação com a dexametasona

Objective: to assess the efficacy and safety of the use of nebulized L-epinephrine associated with dexamethasone in post-intubation laryngitis. Method: we carried out a prospective, randomized, double-blind, placebo controlled study with two cohorts of patients with postintubation laryngitis graded 3 to 6 by Downes and Raphaely score and during two years. Our population was divided into two groups: A and B; both groups received intravenous dexamethasone and nebulized saline with (group B) and without (group A) L-epinephrine. The efficacy was assessed by Downes and Raphaely's score. The side effects of epinephrine were evaluated according to occurrence of arrhythmia, to increased blood pressure, and to average heart rate of group B in comparison to group A. Results: twenty-two patients were included in group A (average score = 4.8) and 19 in group B (average score = 5.2). During treatment, 3 patients in group A presented a score of 8 and were reintubated. This group also showed higher clinical scores than group B during the first two hours of the protocol; these results were not statistically significant. No side effects were observed due to epinephrine. The gasometric parameters were adequate in both groups, but better in the control group. Conclusions: we did not observe increased efficacy for the treatment of post-intubation laryngitis when nebulized L-epinephrine was used simultaneously with intravenous dexamethasone. Some indicators, however, did present a favorable trend when combined therapy was used and should be submitted to further evaluation.

Métodos de coleta de fezes e determinação dos coeficientes de digestibilidade da fração protéica e da energia de alimentos para o pacu, Piaractus mesopotamicus (Holmberg, 1887)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeito da temperatura ambiente e da restrição alimentar protéica ou energética sobre o ganho de peso e crescimento ósseo de frangos de corte

The effect of protein or energy restriction during the second week post-hatching on body weight gain and femur development of broiler chickens reared at different environmental temperatures (18°C, 25°C and 33°C) was studied. From 1 to 7 days of age and after a restriction period broilers were fed on a control diet with 2850 kcal ME/kg and 20% crude protein. From 8 to 14 days of age, two groups of broilers were fed on restricted energy and protein diets with 2565kcal ME/kg and 20% of crude protein or 2850kcal ME/kg and 15% of crude protein, respectively. At 14, 21, 28, 35 and 42 days, the bones were weighed and the length and width of bones measured. The protein restriction reduced the body weight gain and the diameter of bone at second week of life. After 21 days of age no differences between treatments for these traits were observed. The body weight gain and femur growth were not affected by energy restriction. The high temperature (33°C) reduced weight gain and femur diameter from 21 to 42 days of age, and femur length at 42 days of age. The protein restriction at second week or the high environmental temperature after 21 st day of life decreased body weight gain and femur growth of broiler chickens.

Eficácia e segurança da atorvastatina no tratamento de pacientes com hipercolesterolemia primária

Introduction: Hypercholesterolemia is an important risk factor for cardiovascular disease, the first cause of death and third reason for hospital admissions in Brazil. The reduction of serum cholesterol levels reduces morbidity and mortality from cardiovascular disease. The present study evaluated the efficacy and safety of atorvastatin in the treatment of Brazilian patients with primary hypercholesterolemia (types IIA and IIB dyslipidemias). Patients and methods: After a 4-week wash-out period, 152 patients were treated with atorvastatin at the initial dose of 10 mg/day. According to treatment efficacy within the first 8 weeks this dose could be increased to 20 mg/day. Treatment lasted for a total of 16 weeks, and its efficacy was evaluated by the reduction of serum levels of LDL-cholesterol, total cholesterol, HDL-cholesterol, and triglycerides, as well as by the propotion of patients that achieved the target levels recommended by the National Cholesterol Education Program - Adult Treatment Panel II (NCEP ATP II) Results: The analysis of efficacy was conducted in 145 patients. Atorvastatin led to significant reductions in the levels of LDL-cholesterol after 8 and 16 weeks of treatment (P<0.001 for both comparisons). The relative reduction of such levels was 38% (P<0.001 after 8 and 16 weeks). Atorvastatin also led to significant reductions of total cholesterol and triglycerides. At the end of the study, 81% of patients achieved the target LDL-cholesterol levels recommended by NCEP ATP II. Treatment was well tolerated, and was interrupted due to creatine phosphokinase elevation in only one patient. Conclusion: Atorvastatina is efficacious and safe in the treatment of patients with primary hypercholesteromia. © Copyright Moreira Jr. Editora. Todos os direitos reservados.

Um método de gestão de fornecedores baseado na avaliação da eficácia de auditorias realizadas na fase de desenvolvimento de produtos

The main goal of this work is to present a supplier's management method based on evaluation of audits performed at suppliers during products development phase. Audits are prioritized according to the impact of supplied parts on the development and its main goals are identification of risks, to propose and perform action plans and to evaluate periodically the supplier's performance to prevent problems. It is proposed that if the audits in the development phase be efficient, the supplied products will have good maturity to entry into service and stable performance. This issue was evaluated in a aeronautic company and the analyzed results in 2006 were considered good.

Avaliação comparativa da eficácia de fitoterápicos e produtos químicos carrapaticidas no controle do boophilus microplus (Canestrini, 1887) por meio do biocarrapaticidograma

The aim of this research was to evaluate the efficacy of plant extracts and chemical products for the control of Boophilus microplus. Three commercial products for the control of Boophilus microplus were in vitro evaluated, chemical compounds of cypermethrin + DDVP and organophosphate as recomended by the manufacturer, and also four plant extracts, Azadirachta indica (1%), Cymbopogon densiflorus, Lippia alba and Ipomoea asarifolia at different concentrations. The results showed that the chemical compounds tested had efficacy lower than 95% against the Boophilus microplus samples in the experiment. The extracts of all plants have shown some biological activity in the mortality of ingurgitated females and inhibition of egg crash, however the extract of Azadirachta indica presented efficacy higher than 95% in all tested concentrations, being the best sample tested in this experiment.

Métodos de avaliação da eficácia dos tratamentos para a dor.

Pain is a subjective condition and, thus, difficult to measure. The best tools to assess pain are the pain evaluation questionnaires, which provide either diagnostic, pain evolution or pain intensity information. To provide information which could help differentiate between nociceptive pain and neuropathic pain is one of the most important functions of these questionnaires. The questionnaires can measure pain intensity, quality of life, or sleep quality. Quality of life and sleep are two really important characteristics to assess the pain impact on patients' life. Pain intensity assessing questionnaires combine physical evaluations with questions, providing information either from the patient sensations or clinical assessment of pain manifestations as well as the underlying biological mechanisms (such as hyperalgesia or allodynia). For example, the Pain Detect questionnaire has two parts: the patient form (intuitive, with pictures and easy understandable) and the physician form. Thus, in this questionnaire, subjective information is provided by the patient and the objective one is provided by the physician. Other pain intensity questionnaires are NPSI, DN4, LANSS or StEP. Quality of life questionnaires are versatile (can be used in different pathologies). These questionnaires include functional self-evaluation questions, and other ones associated to physical and mental health. Two of such quality of life questionnaires are SF-36 and NHP. Sleep evaluation questionnaires include quantitative features such as the number of sleep interruptions, sleep latency or sleep duration as well as qualitative characteristics such as rest sensation, mood and dreams. One of the most used sleep evaluation questionnaires is PSQI, which includes patient questions and bed-partner questions, providing information from two points of view. Copyright 2009 Prous Science, S.A.U. or its licensors. All rights reserved.

Estudo clínico randomizado e aberto para avaliação de eficácia e superioridade dos medicamentos EF028 aerossol, EF028 creme e Andolba® frente ao tratamento controle e comparativo de não inferioridade entre os medicamentos EF028 aerossol, EF028 creme e Andolba® para avaliação de eficácia na redução da sintomatologia dolorosa

Aim: This study aimed to evaluate the efficacy of a new topical drug (EF028) in two separate presentations (aerosol and cream) in a comparative way with the already registered medication, Andolba® (benzocaine, benzoxiquina chloride benzeconio, menthol) and the negative control (hygiene), in the analgesic efficacy after episiotomy wound, reducing the requirement for systemic medication. Methods: 60 patients were voluntary post normal vaginal childbirth with episiotomy, were divided into four groups to comparatively assess the action of the product EF028 (cream and aerosol), Andolba® and soap, the efficacy of decreasing painful symptoms from daily use for 2 times a day for seven days. Clinical assessments and subjective pain occurred daily until the third postoperative day and on the 7th postoperative day. Results: The results showed that the drugs promoted a reduction of painful symptoms and there was no statistically significant difference (p <0.05) between presentations of drug EF028 (cream and aerosol) and Andolba® and the three products were significantly higher (p <0.05) to the control. Conclusions: The evaluated drugs EF028 aerosol, EF028 cream and Andolba® had similar efficacy in relieving the painful symptoms of the perineal region in postoperative episiotomy can be considered as indication for postoperative episiotomies. © Copyright Moreira Jr. Editora.

Estudo clínico randomizado, aberto e comparativo para avaliação de segurança, tolerabilidade e eficácia analgésica de duas diferentes apresentações de medicamento tópico na realização de curetagem dermatológica de molusco contagioso em pacientes pediátricos

Aim: This study aimed to compare the safety and analgesic efficacy of a new topical drug (in two different presentations: cream and aerosol) consisting of benzocaine, menthol and triclosan, in the curettage of molluscum contagiosum. Method: The study included 296 volunteers in different stages: 256 healthy adult volunteers for the safety evaluation, and 40 volunteers between 2 and 12 years old who presented Molluscum contagiosum, for the evaluation of tolerability and efficacy. Each volunteer represented two experimental units (left and right) where it was applied randomly the tested products (cream or aerosol) 30 minutes before the dermatological curettage, immediately after and twice a day during 7 days. Dermatological evaluations of safety and efficacy were performed immediately after the procedure, 3 and 7 days after the curettage. Results: During safety evaluation, the tested products showed no irritant, sensitizing, phototoxic or photosensitizing potential. Both presentations, cream and aerosol, were considered safe with no statistically significant differences between them. With respect to analgesic efficacy, the results showed that the medication promoted the reduction of painful symptoms and there was no statistically significant difference (p <0.05) between the two presentations. Conclusion: The tested product, in two different presentations, was considered safe and effective in controlling pain symptoms during and after the curettage of molluscum contagiosum. © Copyright Moreira Jr. Editora.

Descomposición del coeficiente de Gini por fuentes de ingreso: evidencia empírica para América Latina 1999-2005

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Eficácia do extrato aquoso do Triticum vulgare no tratamento de radiodermatites geradas pelo uso da radioterapia em gatos

The use of ionizing radiation in the treatment of oncological diseases in veterinary medicine has grown in recent years. In general, these animals are very well tolerated by the treatment with radioactive elements; however, the harmful effects that may occur are not always able to be controlled, particularly those relating to skin burns. Then, the purpose of this study was to evaluate the effects of aqueous extract of Triticum vulgare in treat of 10 cats radiodermatitis with squamous cell carcinoma (SCC), which were treated with radiotherapy as single modality treatment. The drug was used topically and daily until complete healing of wounds. Based on the findings, it may concluded beneficial effects of the drug, because it allowed the formation of granulation tissue and epithelization of wounds with epidermal repair not exuberant, good-quality cosmetics and, considering the deleterious effects that can result from cancer treatments.

Avaliação da segurança e eficácia de novo preenchedor à base de ácido hialurônico no tratamento dos sulcos nasolabiais e contorno dos lábios

Introduction: The use of dermal filling techniques for soft tissue augmentation has greatly increased in recent years. Hyaluronic acid is one of the most used temporary dermal fillers in the treatment of facial wrinkles, furrows, and folds due to its effectiveness and safety. Objective: To evaluate the efficacy and safety of Perfectha®, a new hyaluronic acid filler, for nasolabial folds and lip correction. Methods: Open, multicenter study comprising 87 women. Efficacy was evaluated by the Global Aesthetic Improvement Scale and the Wrinkle Severity Rating Scale. Safety was evaluated through observation and the reporting of side effects. Results: One week after the injection of the filler, improvement in nasolabial folds and lips was observed in 86% and 89% of the women, respectively. Mild or moderate transient inflammatory reaction and ecchymoses occurred in 15% and 9% of patients, respectively, mainly in nasolabial folds. Two patients presented labial herpes simplex after treatment of the lips. The good results were maintained in 76% and 57% of women for nasolabial folds and in 72% and 45% of women for lips after 3 and 6 months, respectively. Conclusion: Perfectha® was effective and safe for these indications.