Variáveis que influenciam a manutenção do aleitamento materno exclusivo

Pesquisa descritiva, exploratória e retrospectiva, com abordagem quantitativa, realizada em uma comunidade carente de São Paulo com o objetivo de verificar se a manutenção do aleitamento exclusivo (AE) nos primeiros seis meses é influenciada pelas variáveis: contato precoce na primeira hora após o nascimento, permanência em alojamento conjunto, tipo de parto e tipo de hospital. Os dados foram coletados de 75 prontuários e analisados com a metodologia de equações de estimação generalizada. Os resultados mostraram que as variáveis alojamento conjunto, tipo de hospital e tipo de parto interferiram na manutenção do AE, o mesmo não ocorrendo com o contato precoce. Concluiu-se que os índices de AE foram maiores nos casos em que mãe e bebê permaneceram constantemente juntos após o parto, em hospitais amigos da criança e após partos normais. Constatou-se que a assistência recebida pela mulher durante o processo de parto e nascimento influencia de forma direta a amamentação.

Transapical aortic valve implantation without angiography: proof of concept.

Background: Cardiac computed tomographic scans, coronary angiograms, and aortographies are routinely performed in transcatheter heart valve therapies. Consequently, all patients are exposed to multiple contrast injections with a following risk of nephrotoxicity and postoperative renal failure. The transapical aortic valve implantation without angiography can prevent contrast-related complications. Methods: Between November 2008 and November 2009, 30 consecutive high-risk patients (16 female, 53.3%) underwent transapical aortic valve implantation without angiography. The landmarks identification, the stent-valve positioning, and the postoperative control were routinely performed under transesophageal echocardiogram and fluoroscopic visualization without contrast injections. Results: Mean age was 80.1 +/- 8.7 years. Mean valve gradient, aortic orifice area, and ejection fraction were 60.3 +/- 20.9 mm Hg, 0.7 +/- 0.16 cm(2), and 0.526 +/- 0.128, respectively. Risk factors were pulmonary hypertension (60%), peripheral vascular disease (70%), chronic pulmonary disease (50%), previous cardiac surgery (13.3%), and chronic renal insufficiency (40%) (mean blood creatinine and urea levels: 96.8 +/- 54 mu g/dL and 8.45 +/- 5.15 mmol/L). Average European System for Cardiac Operative Risk Evaluation was 32.2 +/- 13.3%. Valve deployment in the ideal landing zone was 96.7% successful and valve embolization occurred once. Thirty-day mortality was 10% (3 patients). Causes of death were the following: intraoperative ventricular rupture (conversion to sternotomy), right ventricular failure, and bilateral pneumonia. Stroke occurred in one patient at postoperative day 9. Renal failure (postoperative mean blood creatinine and urea levels: 91.1 +/- 66.8 mu g/dL and 7.27 +/- 3.45 mmol/L), myocardial infarction, and atrioventricular block were not detected. Conclusions: Transapical aortic valve implantation without angiography requires a short learning curve and can be performed routinely by experienced teams. Our report confirms that this procedure is feasible and safe, and provides good results with low incidence of postoperative renal disorders. (Ann Thorac Surg 2010; 89: 1925-33) (C) 2010 by The Society of Thoracic Surgeons

A double layer model of the gas bubble/water interface

Zeta potential is a physico-chemical parameter of particular importance to describe sorption of contaminants at the surface of gas bubbles. Nevertheless, the interpretation of electrophoretic mobilities of gas bubbles is complex. This is due to the specific behavior of the gas at interface and to the excess of electrical charge at interface, which is responsible for surface conductivity. We developed a surface complexation model based on the presence of negative surface sites because the balance of accepting and donating hydrogen bonds is broken at interface. By considering protons adsorbed on these sites followed by a diffuse layer, the electrical potential at the head-end of the diffuse layer is computed and considered to be equal to the zeta potential. The predicted zeta potential values are in very good agreement with the experimental data of H-2 bubbles for a broad range of pH and NaCl concentrations. This implies that the shear plane is located at the head-end of the diffuse layer, contradicting the assumption of the presence of a stagnant diffuse layer at the gas/water interface. Our model also successfully predicts the surface tension of air bubbles in a KCl solution. (c) 2012 Elsevier Inc. All rights reserved.

Comparison of three acellular tests for assessing the oxidation potential of nanomaterials

Great effort is put into developing reliable, predictive, high-throughput, and low-cost screening approaches for the toxicity evaluation of ambient and manufactured nanoparticles (NP). These tests often consider oxidative reactivity, as oxidative stress is a well-documented pathway in particle toxicology. Based on a panel of six carbonaceous and five metal/metal oxide (Me/MeOx) nanoparticles, we: (i) compared the specifications (linearity, detection limits, repeatability) of three acellular reactivity tests using either dithiothreitol (DTT assay), dichlorofluorescein (DCFH assay), or ascorbic acid (AA-assay) as the reducing agent; and (ii) evaluated which physicochemical properties were important for explaining the observed reactivity. The selected AA assay was found to be neither sensitive nor robust enough to be retained. For the other tests, the surface properties of carbonaceous NP were of utmost importance for explaining their reactivity. In particular, the presence of "strongly reducing" surface functions explained most of its DCFH reactivity and a large part of its DTT reactivity. For the selected Me/MeOx, a different picture emerged. Whereas all particles were able to oxidize DCFH, dissolution and complexation processes could additionally influence the measured reactivity, as observed using the DTT assay. This study suggests that a combination of the DTT and DCFH assays provides complementary information relative to the quantification of the oxidative capacity of NP.

Citotoxicidade de tubos de PVC esterilizados em óxido de etileno após exposição à radiação gama

Materiais esterilizados em raios gama, ao serem re-esterilizados em óxido de etileno (EO), formam substâncias tóxicas? Esta questão norteou o objetivo deste estudo, que foi investigar o potencial efeito citotóxico do PVC esterilizado em radiação gama e re-esterilizado em EO pelo método da difusão em ágar em culturas celulares. Nove tubos de PVC foram submetidos à esterilização em radiação gama e re-esterilizados em EO. Os tubos foram divididos em um total de 81 unidades de análise, que foram testadas de forma a representar as superfícies internas, externas e massa de cada tubo. Concluiu-se que os materiais de PVC esterilizados em Radiação Gama e consecutivamente re-esterilizados em EO não são citotóxicos.

A produção de dados para o Sistema de Informação do Pré-Natal em unidades básicas de saúde

Esta pesquisa objetivou analisar o processo de produção de dados para o SISPRENATAL em Unidades Básicas de Saúde de Cuiabá, MT, Brasil. Um estudo qualitativo, exploratório e descritivo foi desenvolvido em oito unidades da Coordenadoria da Atenção Básica por meio de entrevistas semiestruturadas com profissionais que trabalham com o SISPRENATAL (enfermeiros, médicos, gestores e digitador) e análise documental comparativa entre os dados do sistema e os prontuários. A análise dos dados revelou inexistência de definição da participação da equipe na produção dos dados e modos diversos de preenchimento das fichas do sistema. O conhecimento dos profissionais sobre muitos aspectos das fichas foi divergente, o preenchimento das fichas foi feito de modo inadequado e foram verificadas falhas no sistema informatizado. Medidas como a capacitação dos profissionais, a revisão do sistema e de suas fichas são indispensáveis para a produção de informações fidedignas sobre a assistência pré-natal no município.

Arsenic(V) adsorption onto α-Al2O3 between 25 and 70°C

The adsorption of As(V) onto alpha -Al2O3 was investigated at 25, 50 and 70 degreesC using batch adsorption experiments. Results indicate that As is strongly adsorbed at low pH and gets progressively released to the fluid with increasing pH above 7. At any pH, increasing temperature favors aqueous species of As over surface species. Surface complexation constants were determined at the experimental temperatures by fitting the adsorption data. Adsorption reactions were then converted to semi-isocolumbic reactions, i.e, reactions with balanced like-charged aqueous species. Intrinsic adsorption constants of semi-isocolumbic reactions change linearly when plotted against inverse temperature, suggesting that the heat capacity of these reactions remains constant over the temperature range considered. This permitted thermodynamic parameters of intrinsic surface complexation constants to be determined. Changes in surface complexation constants result in a change in the surface speciation with increasing temperature. This change is similar to the one observed for aqueous species, i.e. increasing temperature favors less negatively charged species below a pH of 9 and more negatively charged species above a pH of 10. Comparison with the stability of As surface complexes with Fe suggests that surface complexes with Al are more stable. (C) 2001 Elsevier Science Ltd. All rights reserved.

The peroxisome proliferator-activated receptor alpha regulates amino acid metabolism.

The peroxisome proliferator-activated receptor alpha is a ligand-activated transcription factor that plays an important role in the regulation of lipid homeostasis. PPARalpha mediates the effects of fibrates, which are potent hypolipidemic drugs, on gene expression. To better understand the biological effects of fibrates and PPARalpha, we searched for genes regulated by PPARalpha using oligonucleotide microarray and subtractive hybridization. By comparing liver RNA from wild-type and PPARalpha null mice, it was found that PPARalpha decreases the mRNA expression of enzymes involved in the metabolism of amino acids. Further analysis by Northern blot revealed that PPARalpha influences the expression of several genes involved in trans- and deamination of amino acids, and urea synthesis. Direct activation of PPARalpha using the synthetic PPARalpha ligand WY14643 decreased mRNA levels of these genes, suggesting that PPARalpha is directly implicated in the regulation of their expression. Consistent with these data, plasma urea concentrations are modulated by PPARalpha in vivo. It is concluded that in addition to oxidation of fatty acids, PPARalpha also regulates metabolism of amino acids in liver, indicating that PPARalpha is a key controller of intermediary metabolism during fasting.

Use and records of child health handbook focused on growth and development

Objective To evaluate the use and records of the Child Health Handbook (CHH), especially growth and development. Method Cross-sectional study with 358 mother-child pairs registered in 12 Primary Health Centers (PHCs) of a small municipality. Mothers were interviewed at the PHC from February to April 2013 using a questionnaire. Data analysis was done using WHO Anthro software, Epi InfoTM and Stata. Results Fifty-three percent of the mothers were carrying the CHH at the time of the interview, similar to the proportion of mothers who were instructed to bring the CHH to health appointments. Annotations in the CHH during the visits were reported by 49%. The vaccination schedule was completed in 97% of the CHH, but only 9% and 8% of the CHH, respectively, contained growth charts and properly completed developmental milestones. Conclusion Low rates of use and unsatisfactory record-keeping in the CHH reinforce the need for investment in professional training and community awareness for the CHH to become an effective instrument of promotion of child health.

Understanding the experiences of caregivers of children with tuberculosis in directly observed therapy

Objective To understand the situations and communications experienced by caregivers of children with tuberculosis (TB) with regard to directly observed therapy (DOT). Method A descriptive exploratory study with a qualitative approach was applied and developed in the ambulatory of Programa Einstein na Comunidade de Paraisópolis (PECP). The data were collected using semi-structured interviews of 13 caregivers of children with TB in DOT. The Collective Subject Discourse (CSD) method was used to analyze the data. Results Seven CSDs were identified and grouped into four categories: "Living in a difficult situation", "Changing the family routine", "Responsibility almost always fall son the mother", and "Adapting to the DOT". Conclusions The difficulties faced by the caregiver of the child at the beginning of DOT significantly changed the familiar routine. The responsibility for its continuity was assigned to the mother, who must adapt to the demands of the treatment and face the situation.

O impacto do último enxágue na citotoxicidade de produtos críticos passíveis de processamento

RESUMO Objetivo Avaliar a citotoxicidade de produtos submetidos à contaminação desafio, limpeza baseada em procedimento operacional padrão (POP) validado e enxágue final em diferentes tipos de água: de torneira, deionizada, destilada, tratada por osmose reversa e ultrapurificada. Método Estudo experimental e laboratorial. Foram utilizadas como amostras 130 cânulas de hidrodissecção, 26 por grupo experimental, caracterizados, de acordo com a água utilizada no último enxágue. As amostras foram submetidas à contaminação desafio interna e externamente por uma solução contendo 20% sangue de carneiro desfibrinado e 80% de Cloreto de Sódio a 0,9%. Em seguida, tiveram o lúmen preenchido por solução viscoelástica, permanecendo em contato com o contaminante por 50 minutos, sendo então, processadas, de acordo com um POP validado. A citotoxicidade foi avaliada pela captura do corante vital vermelho neutro. Resultados Ausência de citotoxicidade nos extratos das amostras. Conclusão As amostras não demonstraram citotoxicidade, independentemente da qualidade de água utilizada no último enxágue. Os resultados apresentados puderam ser alcançados unicamente por meio do uso de um procedimento operacional padrão de limpeza validado, baseado em literatura científica, em recomendações oficiais e na legislação relacionada.

Avaliação da infestação de insetos-praga associados à batata (Solanum tuberosum L.) sob efeito de nutrientes nitrogenados e potássicos e teores acumulados de aminoácidos livres nas cultivares Achat e Monalisa

Evaluation of insect-pest infestation associated to potato (Solanum tuberosum L.) under effect of nitrogen and potassium fertilizers and the accumulated amount of free aminoacids in Achat and Monalisa cultivars. The objective of this work was to evaluate the occurence of insect-pests on potato plants influenced by dosages of nitrogen and potassium accumulated in plant organs. A total of 169 plants of the Achat and Monalisa cultivars were evaluated to determine the presence-absence of Diabrotica speciosa Germar, 1824 and Agrotis ipsilon Hüfnagel, 1767. The experiment was carried out and executed at the Universidade Federal Fluminense, and the delineation was complete randomized block design, with four replication and nine treatments, using three fertilization level (0; 75 and 150 Kg/ha) with N-urea + KCl. The aminoacid levels were adjusted by the Leucine standard-curve (µg/l), using the Ninhydrin method, at 570 nm. The results showed that the tubercles of Monalisa accumulated high free aminoacid levels with 7,95% in the treatment N1K2 and 7,75% in the N2K1.These treatments, induced the infestation by D. speciosa larvae in 27,03%, when the aminoacid level was 2,01 ± 0,58% (X ± EP), with probability of 0,0196

Ammonia toxicity to the brain.

Hyperammonemia can be caused by various acquired or inherited disorders such as urea cycle defects. The brain is much more susceptible to the deleterious effects of ammonium in childhood than in adulthood. Hyperammonemia provokes irreversible damage to the developing central nervous system: cortical atrophy, ventricular enlargement and demyelination lead to cognitive impairment, seizures and cerebral palsy. The mechanisms leading to these severe brain lesions are still not well understood, but recent studies show that ammonium exposure alters several amino acid pathways and neurotransmitter systems, cerebral energy metabolism, nitric oxide synthesis, oxidative stress and signal transduction pathways. All in all, at the cellular level, these are associated with alterations in neuronal differentiation and patterns of cell death. Recent advances in imaging techniques are increasing our understanding of these processes through detailed in vivo longitudinal analysis of neurobiochemical changes associated with hyperammonemia. Further, several potential neuroprotective strategies have been put forward recently, including the use of NMDA receptor antagonists, nitric oxide inhibitors, creatine, acetyl-L-carnitine, CNTF or inhibitors of MAPKs and glutamine synthetase. Magnetic resonance imaging and spectroscopy will ultimately be a powerful tool to measure the effects of these neuroprotective approaches.

In vitro assessment of the pulmonary toxicity and gastric availability of lead-rich particles from a lead recycling plant

Epidemiological studies in urban areas have linked increasing respiratory and cardiovascular pathologies with atmospheric particulate matter (PM) from anthropic activities. However, the biological fate of metal-rich PM industrial emissions in urban areas of developed countries remains understudied. Lead toxicity and bioaccessibility assessments were therefore performed on emissions from a lead recycling plant, using complementary chemical acellular tests and toxicological assays, as a function of PM size (PM(10-2.5), PM(2.5-1) and PM(1)) and origin (furnace, refining and channeled emissions). Process PM displayed differences in metal content, granulometry, and percentage of inhalable fraction as a function of their origin. Lead gastric bioaccessibility was relatively low (maximum 25%) versus previous studies; although, because of high total lead concentrations, significant metal quantities were solubilized in simulated gastrointestinal fluids. Regardless of origin, the finest PM(1) particles induced the most significant pro-inflammatory response in human bronchial epithelial cells. Moreover, this biological response correlated with pro-oxidant potential assay results, suggesting some biological predictive value for acellular tests. Pulmonary effects from lead-rich PM could be driven by thiol complexation with either lead ions or directly on the particulate surface. Finally, health concern of PM was discussed on the basis of pro-inflammatory effects, accellular test results, and PM size distribution.

Ocorrência do fungo entomopatogênico Isaria javanica (Frieder. & Bally) Samson & Hywell-Jones (Fungi, Sordariomycetes) em lagartas de Lonomia obliqua Walker (Lepidoptera, Saturniidae, Hemileucinae)

Este fungo foi isolado pela primeira vez de lagartas de L. obliqua de uma agregação em plátano (Platanus acerifolia (Aiton) Wild - Platanaceae), em Bento Gonçalves, RS, Brasil. Após isolamento, purificação e caracterização, realizou-se um teste de patogenicidade com lagartas sadias de L. obliqua para corroborar, sua infectividade pelo postulado de Koch. Constatou-se correspondência morfológica e molecular entre o inóculo e o reisolado, comprovando sua patogenicidade a L. obliqua.