OBJETIVO: Determinar a prevalência de anticoagulante lúpico (LAC) e dos isótipos de anticardiolipina (ACL) e suas eventuais associações clínicas. PACIENTES E MÉTODOS: Estudo retrospectivo que avaliou manifestações clínicas e laboratoriais em indivíduos que apresentaram positividade para anticorpos antifosfolipídios no Hospital Edmundo Vasconcelos entre março de 2005 e junho de 2006. RESULTADOS: Cento e seis indivíduos (média de idade 42,2 ± 14,1 anos, 84% do sexo feminino) foram incluídos no estudo. A prevalência de trombose foi de 17,9% (19/106) e de morbidade gestacional foi de 12,3% (13/106). O diagnóstico de Síndrome Antifosfolípide (SAF) foi feito em 23,6% (25/106), sendo primária em 68% (17/25) e secundária em 32% (8/25). A prevalência de ACL foi de 97,1% (103/106) e de LAC foi de 11,4% (5/44 dos exames realizados). ACL isótipos IgM, IgG e IgA foram encontrados em 100%, 23,3% e 4,9% dos 103 soros ACL positivos, respectivamente. Para o diagnóstico de SAF, a ACL IgM apresentou sensibilidade de 92% e especificidade de 1,2%, enquanto a ACL IgG teve sensibilidade de 40% e especificidade de 82,5%. A ausência de ACL IgG teve alto valor preditivo negativo (81,4%) para SAF. O LAC apresentou sensibilidade de 18,7% e especificidade de 92,8%. A curva Receiver Operating Characteristic (ROC) demonstrou maior área abaixo da curva para ACL IgG e LAC. CONCLUSÃO: Em amostra aleatória de indivíduos com anticorpos antifosfolipídios positivos, ACL IgG e LAC apresentaram maior especificidade para o diagnóstico de SAF, que se caracterizou pela maior prevalência de trombose.

Yacon (Smallanthus sonchifolius (Poepp.) H. Rob) is a natural source of fructooligosaccharides (FOS) studied for its potential as a functional food for prevention and management of chronic diseases, in part associated with its positive impact on glycemic response and body weight. However, yacon beneficial effect on glucose response and food intake control are still controversial. We investigated the acute effect of yacon consumption on glycemic response, subjective appetitive sensations, and food intake in a crossover trial. Fifteen healthy adults consumed 350 mL of yacon (21 g of yacon flour with 7.4 g of FOS) or control shake, on two non-consecutive days (washout). Yacon shake did not affect glycemic response, appetite or food intake. However, it is possible that positive effects of yacon consumption may turn evident only after its chronic consumption. Further studies are needed to assess the long-term effect of yacon consumption on glucose response and body weight control.

Introdução: É sabido que a medicina veterinária é uma ciência que se ocupa do atendimento médico aos animais. No entanto, esta não é a única modalidade de trabalho. É responsabilidade também desta ciência, e consequentemente do profissional que atua nela - o médico veterinário -, compreender quais são os impactos ambientais e atuar para que eles sejam minimizados. Deste modo, cabe ao veterinário pesquisar e conscientizar a sociedade quanto ao manejo dos diversos impactos ambientais, muitas vezes possíveis de serem reparados, e incluir na sua prática profissional, atitudes que reduzam a degradação do ambiente e a preservação do ecossistema. Objetivo: Investigar as contribuições da medicina veterinária na redução da degradação ambiental, e verificar as possibilidades de manejo do médico veterinário frente aos cuidados com o ambiente, e assim atuar enquanto um educador ambiental. Metodologia: A pesquisa foi realizada por meio de uma pesquisa bibliográfica integrativa nas bases de dados Scielo, e Lilacs, com as palavras chave: “meio ambiente”, “impactos no ecossistema” e “interferência antrópica” e “médico veterinário no contexto do meio ambiente”. Considerações: Observa-se que os impactos ambientais são em grande parte causados pelo homem. Dessa maneira, é importante avaliar o quanto a sociedade influencia as mudanças causadas no ecossistema, bem como as alterações que prejudicam a moradia de diversos animais. No que se refere a atuação do médico veterinário para além da conscientização da sociedade, atuando assim, como um educador ambiental, constata-se também que este profissional possui uma obrigação ética no manejo dos materiais que utiliza. Portanto, o descarte correto de materiais que o veterinário utiliza, pode contribuir para uma redução da degradação ambiental, e há também os estudos de taxonomia que revelam a causa da morte dos animais – importante para investigar se houve ato criminal. Por fim, o médico veterinário atua como educador ambiental e fiscal, ao passo que pode denunciar atos criminosos que comprometem o ecossistema, e assim contribuir para uma sociedade com mais qualidade de vida no que tange o contexto ambiental.

A prevalência da obesidade vem aumentando e apresentando alterações ao longo dos anos com predominâncias nas populações mais pobres, principalmente entre as mulheres. O objetivo deste trabalho foi verificar a correlação entre circunferência de cintura e renda em mulheres de 18 a 60 anos em uma clínica escola de Belo Horizonte-MG. Trata-se de um estudo quantitativo, de caráter transversal, descritivo, retrospectivo, com dados coletados de fichas de anamnese inicial de pacientes que procuraram atendimento nutricional. Como critério de inclusão utilizou-se: idade, sexo, circunferência de cintura (CC), índice de massa corporal (IMC), ter informado renda individual, renda familiar e escolaridade. Com o fim de investigar os fatores que podem estar relacionados com índices morfométricos observados, foram consideradas como variáveis preditoras a renda familiar e o nível de escolaridade, e como variáveis resposta a classificação de CC e IMC. Os resultados mostram que a maior parte dos indivíduos com pré-obesidade (n=39, 32,5%), obesidade grau I (n=23, 35,38%), grau II (n=12, 41,37%) e III (n=5, 41,66%) tem idade acima dos 40 anos. Assim como mostram que a classificação da CC aumenta em consonância com a idade, onde a maior parte das mulheres classificadas com risco muito elevado tem idade entre 41 a 60 anos (n=54, 40,90%). As mulheres com rendas menores apresentam maior CC, observada através da classificação, sendo 74,60% (n= 47) das classificadas com risco elevado e 85,60% (n= 113) das com risco muito elevado. A predominância de obesidade em mulheres de baixa renda, constatada no presente estudo, evidencia o atual modelo de pobreza urbana.

Abstract Objective Assess the mediating role of breastfeeding self-efficacy in the association between the Kangaroo Neonatal Intermediate Care Unit and exclusive breastfeeding. Method Cross-sectional study nested in a cohort, carried out in the Neonatal Unit of a Brazilian university hospital between September 2018 and March 2020. The sample consisted of 114 newborns weighing ≤1800 g and their mothers who were divided into those who participated in the first and second stages of the Kangaroo Method and those who only passed through the first stage, categorized as the Conventional group. To assess the self-efficacy of breastfeeding, the Breastfeeding Self Efficacy Scale - Short-Form was used. The Mann-Whitney test was used to compare the breastfeeding self-efficacy score between the groups, and Fisher's exact test to compare rates of exclusive breastfeeding. The adjusted structural equation model was used to check for the mediating effect of breastfeeding self-efficacy. The significance level adopted was 5%. Results The kangaroo group had a higher rate of exclusive breastfeeding at hospital discharge (p= 0.000). There was a positive association between having remained in the kangaroo (p= 0.003) and the breastfeeding self-efficacy score (p= 0.025) with the rate of exclusive breastfeeding at hospital discharge. Breastfeeding self-efficacy did not act as a mediator. Conclusion The self-efficacy of breastfeeding and the stay of the low birth weight newborn baby in the kangaroo unit acted positively and independently in exclusive breastfeeding, and the self-efficacy of breastfeeding did not act as a mediator in this association.

Abstract Renicolids are parasites that inhabit the renal tubules and ureters of molluscivorous and piscivorous birds. Puffinus puffinus is a migratory seabird that was identified as the definitive host of Renicola spp. Studies focusing on the renicolid species and the resulting renal lesions are valuable for their association with causes of stranding in seabirds. The aim of this study was to identify the renicolid trematodes and evaluate the histological findings in two P. puffinus stranded on the coast of Paraná state, Brazil. The parasites were evaluated by histologic, ultrastructural and molecular assays, while tissue changes were analyzed by histologic methods. The morphological and morphometrical characteristics of the parasites, along with polymerase chain reaction and sequencing assays (ribosomal and mitochondrial regions), identified the species as Renicola sloanei. The results also suggest that this helminth can be the adult form of Cercaria pythionike. The dilation of collecting ducts was the main histological finding in the kidneys. In conclusion, R. sloanei was identified, and for the first time, P. puffinus was described as a host of this digenean inducing mild renal changes.

Introduction: Anaemia can be considered the most common extra-intestinal manifestation in inflammatory bowel disease. Nevertheless, anaemia is often under-diagnosed and under-treated both in adults and children with inflammatory bowel disease. Herein, we report the consensus statements on the management of anaemia in inflammatory bowel disease developed by the Portuguese Working Group on Inflammatory Bowel Disease (known as Grupo de Estudo da Doença Inflamatória Intestinal - GEDII) to aid clinicians in daily management of inflammatory bowel disease patients.Material and Methods: A comprehensive literature review was conducted in order to prepare consensus statements on the following topics: (1) prevalence and diagnosis of anaemia in inflammatory bowel disease, (2) iron supplementation for the prevention of anaemia in inflammatory bowel disease and (3) treatment of anaemia in inflammatory bowel disease. The final statements for each topic were discussed at a consensus meeting and rated according to the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence. Consensus: It was concluded that anaemia has a high incidence and prevalence in inflammatory bowel disease, particularly in those with active disease and hospitalised. Patients with anaemia had decreased quality of life and frequently complained of fatigue. Absolute indications for intravenous therapy should be considered: (1) moderate to severe anaemia (haemoglobin < 10.5 g/dL) or clearly symptomatic anaemia; (2) previous intolerance to oral iron supplements; (3) inappropriate response to oral iron; (4) active severe intestinal disease; (5) need for a quick therapeutic response (e.g. surgery in the short term); (6) concomitant therapy with erythropoiesis-stimulating agent; and (7) patient’s preference. 

Background: The effects of antenatal corticosteroids (ANSs) on twins are not well established. Objective: To determine the impact of ANS use according to the number of fetuses. Methods: Retrospective cohort study of newborns between 23 and 33 weeks of gestational age, birth weight from 400 to 1499 g, without malformations, delivered at 20 public university hospitals from 2010 to 2014. Exposed group: Received ANS (any time, any dose) and no exposed group: no received ANS. Analysis of birth conditions and clinical outcomes. Association of variables, relative risks, and 95% confidence intervals estimated from the adjustment of log-binomial regression models. Results: About 7165 premature infants were analyzed: 5167 singleton, 937 twins, and 104 triplets. Characteristics of gestations with one, two, or three fetuses not receiving ANS were similar. Reduced hemodynamic instability in single and twins gestations in the first 72 h were observed (Adj R 2 Twins = 0.78; 95% CI = 0.69–0.86) (Adj R 2 Singles = 0.79; 95% CI = 0.62–0.99). Reduced peri-intraventricular hemorrhage (Adj R 2 Twins = 0.54; 95% CI = 0.36–0.78) (Adj R 2 singles = 0.54; 95% CI = 0.36–0.78); and early sepsis reduction on single and triplex gestations (Adj R 2 triplex = 0.51; 95% CI = 0.27–0.94) (Adj single R 2 = 0.51; 95% CI = 0.27–0.94) were observed. Conclusions: This study demonstrates ANS produces an important protective factor for severe intraventricular hemorrhage and hemodynamic instability in single and multiple pregnancies. ANS had a protective effect on death and birth conditions improvement just in single gestations. Regarding respiratory aspects was not observed the protective effect in the single or multiple gestations.

Abstract Objectives To evaluate the impact of invasive mechanical ventilation associated with two serum inflammatory cytokines and clinical indicators, on the second day of life, as predictors of bronchopulmonary dysplasia in very low birth weight preterm infants. It was hypothesized that the use of invasive mechanical ventilation in the first hours of life is associated with biomarkers that may predict the chances of preterm infants to develop bronchopulmonary dysplasia. Methods Prospective cohort of 40 preterm infants with gestational age <34 weeks and birth weight <1500 g. The following were analyzed: clinical variables; types of ventilator support used (there is a higher occurrence of bronchopulmonary dysplasia when oxygen supplementation is performed by long periods of invasive mechanical ventilation); hospitalization time; quantification of two cytokines (granulocyte and macrophage colony stimulating factor [GM-CSF] and eotaxin) in blood between 36 and 48 h of life. The preterm infants were divided in two groups: with and without bronchopulmonary dysplasia. Results The GM-CSF levels presented a significantly higher value in the bronchopulmonary dysplasia group (p = 0.002), while eotaxin presented higher levels in the group without bronchopulmonary dysplasia (p = 0.02). The use of continuous invasive mechanical ventilation was associated with increased ratios between GM-CSF and eotaxin (100% sensitivity and 80% specificity; receiver operating characteristic area = 0.9013, CI = 0.7791–1.024, p < 0.0001). Conclusions The duration of invasive mechanical ventilation performed in the first 48 h of life in the very low birth weight infants is a significant clinical predictor of bronchopulmonary dysplasia. The use of continuous invasive mechanical ventilation was associated with increased ratios between GM-CSF and eotaxin, suggesting increased lung injury and consequent progression of the disease.