Y Juliano

Study of mechanisms and factors related to sexual abuse in female children and adolescents

OBJETIVO: estudar mecanismos e fatores relacionados com o abuso sexual, comparando suas frequencias entre vitimas criancas e adolescentes. METODOS: estudo retrospectivo de 617 vitimas de abuso sexual atendidas entre julho de 1994 e agosto de 1999 pelo Centro de Referencia da Saude da Mulher; 71 criancas (idade < 10 anos) e 546 adolescentes (10 a 20 anos). As variaveis de estudo foram crime sexual; constrangimento; presuncao de violencia; tipificacao do agressor; numero de agressores; situacao da vitima no momento do crime; e ocorrencia de traumas fisicos. Os dados foram informatizados em programa Epi Info 6 e os resultados analisados pelo teste de x². RESULTADOS: o estupro ocorreu em 90,8% das adolescentes e o atentado violento ao pudor em 46,5% das criancas. A violencia presumida (VP) foi mais frequente nas criancas (63,4%) e a grave ameaca nas adolescentes (63,2%). A inocencia consilli foi VP exclusiva entre criancas, atingindo 59,5% das adolescentes. Entre criancas, 84,5% foram abusadas por agressores identificaveis, geralmente do nucleo familiar, enquanto desconhecidos violentaram 72,3% das adolescentes. Nas criancas, o abuso ocorreu em 42,3% em suas residencias e em 28,2% na do agressor. Adolescentes foram vitimadas durante atividades cotidianas (34,8%) e no percurso do trabalho ou escola (28,4%). A maioria das pacientes nao apresentou traumas fisicos genitais ou extragenitais. CONCLUSOES: criancas foram submetidas, principalmente, ao atentado violento ao pudor, perpetrado por agressor conhecido, por meio de violencia presumida e em ambientes privados. Nas adolescentes predominou o estupro por agressores desconhecidos, sob grave ameaca, em ambientes nao domesticos.

A prospective study of nutrition education and oral nutritional supplementation in patients with Alzheimer's disease

BackgroundWeight loss in patients with Alzheimers disease (AD) is a common clinical manifestation that may have clinical significance.ObjectivesTo evaluate if there is a difference between nutrition education and oral nutritional supplementation on nutritional status in patients with AD.MethodsA randomized, prospective 6-month study which enrolled 90 subjects with probable AD aged 65 years or older divided into 3 groups: Control Group (CG) [n = 27], Education Group (EG) [n = 25], which participated in an education program and Supplementation Group (SG) [n = 26], which received two daily servings of oral nutritional supplementation. Subjects were assessed for anthropometric data (weight, height, BMI, TSF, AC and AMC), biochemical data (total protein, albumin, and total lymphocyte count), CDR (Clinical Dementia Rating), MMSE (Mini-mental state examination), as well as dependence during meals.ResultsThe SG showed a significant improvement in the following anthropometric measurements: weight (H calc = 22.12, p =< 0.001), BMI (H calc = 22.12, p =< 0.001), AC (H calc = 12.99, p =< 0.002), and AMC (H calc = 8.67, p =< 0.013) compared to the CG and EG. BMI of the EG was significantly greater compared to the CG. There were significant changes in total protein (H calc = 6.17, p =< 0.046), and total lymphocyte count in the SG compared to the other groups (H cal = 7.94, p = 0.019).ConclusionOral nutritional supplementation is more effective compared to nutrition education in improving nutritional status.

Prevalência de sobrepeso e obesidade em escolares da região de Parelheiros do município de São Paulo

OBJECTIVE: To establish the prevalence of overweight and obesity in school children from low socioeconomical status. METHODS: This cross sectional study randomly enrolled 218 eighteen students out of 1.500 students with six to 14 years old from three schools located in Parelheiros, Sao Paulo, Brazil. Children with a diagnosis and or treatment of metabolic or endocrine diseases were excluded. The studied children had an anthropometric evaluation of weight and height, and body mass index was calculated. All children answered a questionnaire about daily food consumption and physical activity. RESULTS: The prevalence of obesity and overweight were respectively 14.7 and 16.5%. Among these students, the low consumption of fruits (10.8 and 10.8%), vegetables (16.3 and 9.1%) and the high consumption of candies (72.2 and 78.1%) were associated with weight excess. Poor physical activities was common among obese (81.3%) and overweight (77.8%) students. CONCLUSIONS: The evaluated students, despite living in a poor region of Sao Paulo, showed a profile of nutritional transition, with high obesity and overweight rates.

Gel from unripe Musa sapientum peel to repair surgical wounds in rats

PURPOSE To determine the optimum concentration of a gel obtained from unripe banana (Musa sapientum) peel for wound treatment in rats. METHODS A randomized triple blind study was conducted with 40 Wistar rats, which were divided into 4 groups: CG, control group; G2%, 2% gel concentration group; G4%, 4% gel concentration group; and G10%, 10 % gel concentration group. The banana peel gel was applied daily, for 7 days, to a 4-cm(2) wound created on the back of each animal of all groups. After this period, the wounds were biopsied. Statistical analysis was carried out using the Kruskal-Wallis test complemented by the Student-Newman-Keuls test. RESULTS Macroscopic examination revealed that partial epithelialization occurred in all groups. Wound contraction was also observed in all groups and ranged from 1.38 to 1.57 mm in the study groups, and from 1.03 to 1.10 mm in the control group, with significant differences (p < 0.05) between the groups: CG and G10%, G2% and G4%, G2% and G10%. The interquartile deviation was smaller between the groups CG and G4%. CONCLUSION The 4% gel obtained from unripe banana peel (G4%) resulted in better epithelialization of wounds healed by secondary intention compared with other gel concentrations.

Results of nutritional intervention in children and adolescents with cystic fibrosis

OBJECTIVE Few studies have verified longitudinally the evolution of the nutritional status of patients with cystic fibrosis. The objective of this study is to follow the evolution of the nutritional status, body composition and energy consumption, macronutrients and micronutrients ingested by children and adolescents by means of nutritional interventions at the Clinic of Cystic Fibrosis/Pediatric Pneumology of the Department of Pediatrics of Universidade Federal de São Paulo. METHODS 18 patients were involved in this study, thirteen males and five females with ages ranging from 0.3 to 18.4 years. We performed three evaluations: evaluation 1 (M1--prenutritional intervention), M2 after 6 months, and M3 after 12 months. In these three instances we verified: the z score for weight/age, weight/height and height/age and the calculation of a 3-day diet record. We verified the body composition (anthropometry) in M1 and M3. The nutritional interventions were hypercaloric, hyperproteic, with adequate amount of ingested macronutrients and micronutrients. RESULTS We observed an increase in the z score for height/age (M1=-1.07; M2=-0.69; M3=-0.50) and fat-free mass after the nutritional interventions, without improvement in the z score for weight/height and fat mass. We verified an increase in the energy intake during M2 (139%) and M3 (132%) compared to M1 (106%). Remarkable increase in the intake of protein, calcium, iron and vitamin C by the patients was found. The occurrence of anemia was found in 44% (8/18) of the patients. CONCLUSION The improvement of the z score in height/age and fat-free mass was probably due to the increase in energy consumption after the nutritional intervention. A significant improvement in the z score for weight/height and fat mass was not found, probably due to a gain in height and fat-free mass.

Frequência de hemorragia peri-intraventricular e seus fatores associados em recém-nascidos prematuros

RESUMOObjetivo:Identificar a frequencia de hemorragia peri-intraventricular e levantar seus fatores associados em recem-nascidos prematuros.Metodos:Realizou-se um estudo transversal com levantamento de prontuarios de recem-nascidos prematuros que realizaram ultrassonografia transfontanelar no ano de 2007 em um hospital da periferia da zona sul da cidade de Sao Paulo.Resultados:Foram encontradas frequencia de 50% entre os recem-nascidos prematuros que realizaram ultrassonografia transfontanelar e frequencia de 15,35% dentre todos os recem-nascidos prematuros nesse hospital no ano de 2007. Observaram-se, como fatores associados a hemorragia intracraniana estatisticamente [...]

Frequency of peri-intraventricular hemorrhage and its associated factors in premature newborns

OBJECTIVE To identify the frequency of intracranial hemorrhage and its associated factors in premature newborns. METHODS A cross-sectional study based on a survey of medical records of premature neonates submitted to transfontanellar ultrasound at a hospital located in a southern neighborhood of the city of São Paulo, in 2007. RESULTS A 50% rate of intracranial hemorrhage was found among premature newborns submitted to transfontanellar ultrasound, and 15.35% among all premature babies born in this hospital in 2007. The statistically significant factors associated to intracranial hemorrhage were gestational age less than 32 weeks, absence of prenatal care, invasive mechanical ventilation, infection, blood transfusion, hyaline membrane disease, hyponatremia and hyperglycemia. CONCLUSIONS The frequency of peri-intraventricular hemorrhage was 50% in patients at risk and 15.35% among all premature babies; the associated factors were gestational age less than 32 weeks, absence of prenatal care, need of invasive mechanical ventilation, infection, blood transfusion, hyaline membrane disease, hyponatremia and hyperglycemia.

Efeitos do pneumoperitônio no rato

Effects of pneumoperitoneum in rats. The effects of different pneumoperitoneal pressures on kidney and liver functions and on arterial gasometry in rats are provided. A sample of twenty male rats weighing from 350 to 400 grams and distributed into two groups of ten animals was used. Each animal served as experimental control from which blood samples were collected before introducing CO2 into the peritoneal cavity. Samples underwent pressures of 4 and 6 mm Hg during one hour. Results show that increase in intra-abdominal pressure by CO2 in rats causes changes in their arterial gasometry, liver and kidney. However, no liver or kidney lesions during the above mentioned time were reported.

Avaliação das internações de crianças de 0 a 5 anos por infecções respiratórias em um hospital de grande porte

RESUMOObjetivo:Avaliar internacoes de criancas de 0 a 5 anos por infeccoes respiratorias em um hospital de grande porte da zona sul de Sao Paulo.Metodos:Foram utilizados 4.240 prontuarios de criancas internadas com os diagnosticos de pneumonia, broncopneumonia, bronquiolite e bronquite, no ano de 2008 a 2009, utilizando-se como base idade, genero e estacoes do ano.Resultados:Desse total de criancas entre 0 a 60 meses de idade, 139 (3,2%) tiveram pneumonia, com discreto predominio do sexo feminino, e 73,4% ocorreram entre 12 a [...]

Model of extensive and severe tracheal stenosis in dogs

PURPOSE To create an animal model of extensive longitudinal tracheal stenosis (TS) that can be useful to test different surgical techniques of tracheal reconstruction. METHODS Twenty male mongrel dogs were submitted to standard TS and randomly distributed to observation for 3 weeks (n=10) or 6 weeks (n=10). Under general anesthesia, an elliptical area (major axis from 1st to 20th ring and minor axis 40% of tracheal diameter) was resected and the stumps were sutured. The internal and external diameters were measured (before and after the observation time) and the stenosis index was calculated. Blood samples were collected (gasometry, hematocrit and hemoglobin.) before and after the surgical proceedings. RESULTS The weight was significant lower in the animals of 6 weeks (15,551+/-3286.2) in comparison with those of 3 weeks observation (17,250+/-3575.0). No significant differences were noted in the extension of the trachea on the 21st day (21.2+/- 1.8) or 42nd day (21.1+/-1.7). The mean (40.1) and the median (40.5) of rings counted on the 21st day were quite similar to mean (38.1) and median (39.0) that were counted on the 42nd day. In the animals of group A (3 weeks) the mean (46.8%) and the median (49.8%) of index stenosis showed no significant difference (Mann Whitney test p<0.001) in comparison with the mean (55.1%) and median (52.4%) of the animals from group B (6 weeks). No mechanical or biochemical distresses were recorded through all period of observation. CONCLUSION The surgical proceeding was effective to promote a model of longitudinal and extensive tracheal stenosis.