Objectives: to describe preliminary data referred to epileptic seizures and the probability of occurring these epileptic seizures in the infants' first months of life with congenital Zika virus (ZIKV) syndrome. Methods: concurrent cohort study including newborns and infants with congenital Zika virus syndrome attended at the specialized outpatient clinic at IMIP, Recife, Pernambuco, from October 2015 to May 2016. Results: data on 106 infants were analyzed with confirmed or suspected association to ZIKV infection. Forty children (38.7%) presented an epileptic seizure, classified at 43.3% of the cases as being spasms, 22.7% as generalized tonic seizures, 20.5% as partial and 4.5% other types of seizures. The median of days until the first report on the occurrence of epileptic seizure was 192 days of life. Conclusions: children with congenital Zika virus syndrome presented a high incidence of epileptic seizures before the end of the first semester of life, and spasm was the epileptic seizure mostly observed.

In 2006, Brazil will initiate universal immunization of its 4-million infants with a live attenuated serotype G1P[8] human rotavirus vaccine. In anticipation of the national immunization program, this study was undertaken to characterize rotavirus strains circulating among children in Recife, one of the largest cities in the northeast region of Brazil. Group A rotaviruses were detected in 102 (35%) of 290 faecal specimens collected from children under 5 years of age who presented with acute diarrhoea during a 1-year period between May 2004 and April 2005. In addition to the globally common G1P[8] serotype that accounted for 49% of strains, emerging rotavirus serotypes G8P[6] and G9P[8] represented 2% and 29% of strains, respectively. Following cell culture adaptation, RNA-RNA hybridization demonstrated that two Brazilian G8P[6] rotavirus strains shared a high level of genomic RNA homology with Malawian G8P[6] strains, and a Brazilian G9P[8] strain was related most closely to a G9P[8] strain from India. The results suggest that certain rotavirus strains have a much wider global circulation than generally appreciated. Continued global spread of such strains might challenge the efficacy of current rotavirus vaccines.

RESUMO Introdução A percepção sobre o ambiente educativo pode influenciar o desempenho acadêmico, e a sua análise fornece subsídios importantes para melhorá-lo. Objetivo Avaliar a percepção do estudante acerca do ambiente educativo do Hospital Dom Malan/Imip durante o internato médico. Método Estudo do tipo survey, envolvendo 105 estudantes no período de abril a setembro de 2013. Foi utilizado o questionário Dundee Ready Education Environment Measure (Dreem). Resultados Foram considerados os seguintes resultados: questões individuais, as cinco dimensões e o Dreem global. A percepção geral foi considerada “more positive than negative” (pontuação 144,4/200), e a análise das dimensões revelou: percepção da aprendizagem: “a more positive perception”; percepção sobre os preceptores: “model course organisers” (49,5%); percepção dos resultados acadêmicos: “feeling more on the positive side” (70,5%); percepção do ambiente geral: “a more positive atitude” (55,2%); percepção das relações sociais: “not a nice place” (90,5%); e percepção geral do ambiente educativo: “more positive than negative” (69,5%). Não houve diferença estatisticamente significante quando comparados os dois grupos (p >0,05). Conclusões A percepção geral foi positiva, e a dimensão das relações sociais foi apontada como problemática.

Objec ve:To compare learning outcomes of postpartum hemorrhage simula on training based on either instruc onal design guidelines or best prac ce. Methods:A pretest-post-test non-equivalent groups study was conducted among obstetrics and gynecology residents in Recife, Brazil, from June 8 to August 30, 2013.The instruc onal design group included 13 teams, whereas the best prac ce group included seven teams. A standardized task checklist was used for scenario analysis and the propor on of correctly executed tasks compared (post-test minus pretest). Results:The instruc onal design group scored higher than the best prac ce group for total number of tasks completed (median difference 0.46 vs 0.17; P< 0.001; effect size[ r ]=0.72). Similar results were observed for communica on (median difference 0.56 vs 0.22; P= 0.004; r= 0.58), laboratory evalua on (median difference 0.83 vs 0.00; P< 0.001; r= 0.76), and mechanical management (median difference 0.25 vs -0.15; P= 0.048; r= 0.39). Speed of learning was also increased. The median differences were 0.20 for the instruc onal design group compared with 0.05 for the best prac ce group at 60 seconds ( P= 0.015; r= 0.49), and 0.49 versus 0.26 ( P= 0.001; r= 0.65) at 360 seconds. Conclusion:The use of simula on training for postpartum hemorrhage that was based on instruc onal design guidelines yielded be er learning outcomes than did training based on best prac ce. K E Y W O R D S Educa on ; Instruc onal design ; Postpartum hemorrhage ; Simula on training ; Situa onal awareness ; Training 1 | INTRODUCTION Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide, par cularly among deaths that are considered avoidable. 1 Frequently reported assistance failures associated with preventable PPH include delay in diagnosis, poor communica on, insufficient teamwork, and lack of adequate educa on and training. 2,3 Simula on training has emerged as a widespread strategy to overcome such failures. Systema c reviews of simula on-based healthcare educa on debate the best way to deliver instruc onal features to ensure op mal effec veness of training. 4,5 Nonetheless, a growing body of evidence recommends that training formats should be based on reliable educa onal principles, par cularly instruc onal design guidelines. 6 The Four-Component Instruc onal Design model 7 and Merrill ' s First Principles of Instruc on 8 summarize the main guidelines. According to the guidelines, effec ve instruc on should contain authen c, relevant, and daily real-world problems, emphasize prac ce at 100 | DE MELO ET AL. different levels of complexity, and provide feedback and diminishing instruc onal support through training. 7When devising a PPH simula on training format based on instruconal design guidelines, the learning objec ves should be clearly idenfied and summarized in strategies that aim to overcome recurrent assistance failures. Such learning objec ves include situa onal awareness enhancement, 9 improvement of both communica on and teamwork skills and a tudes, 10 and reinforcem...

Perinatally human immunodeficiency virus (HIV)-infected children are fighting acquired immune deficiency syndrome (AIDS) and becoming adolescents. The objective of this study was to examine long-term outcomes among perinatally HIV-1-infected adolescents. Cross-sectional clinical and laboratory data were collected for 49 perinatally HIV-infected adolescents followed at the Instituto de Medicina Integral Prof. Fernando Figueira (IMIP's) Hospital from 1987 to 2007. The mean age of these adolescents was 12.5 years, the majority were female (73.5%) with a mean follow-up duration of 9.0 years, 71.4% of adolescents had no signs of HIV infection, 81.6% had normal CD4(+) lymphocyte count, and 53.1% had undetectable HIV viral load. HIV disclosure to the adolescent was reported in 31 (63.3%) participants. The majority were in school (89.8%) but failure and drop-out were reported by 51% and 28.6% of the subjects, respectively. All five domains of quality of life (QOL) measured revealed high scores. The majority of long-term adolescent survivors showed HIV-infection control and high scores of QOL, but with problems in schooling functioning that need early detection and intervention.

OBJECTIVETo analyze women’s perceptions and coping regarding the discovery of an HIV infection.METHODSA qualitative study in an HIV/AIDS Specialist Helpdesk in Recife, PE, Northeastern Brazil, from January to September 2010, involving eight women living with asymptomatic HIV aged between 27 and 37 years, without criteria for diagnosis of AIDS infected through intercourse and monitored by the service for at least one year. Forms were used to characterize the clinical situation and semi-structured interviews to understand perceptions and feelings related to personal trajectory after diagnosis and different ways of facing the diagnosis in family and social life. Content analysis was performed as suggested by Bardin.RESULTSThe thematic category that emerged was stigma and discrimination. The women had life trajectories marked by stigma, which was perceived as discrimination after the diagnosis and in the experiences of everyday life. The revelation of the infection was perceived as limiting to a normal life, leading to the need to conceal the diagnosis. The discriminatory attitudes of some health care professionals, non-specialist in HIV/AIDS, had a negative impact on future experiences in other health services. Besides the effects of institutional stigma, the perception of women was that the service did not include dedicated space for the expression of other needs beyond the disease, which could help in fighting the infection.CONCLUSIONSLiving with HIV was strongly linked to stigma. The results show the importance of strengthening educational approaches and emotional support at the time of diagnosis in order to facilitate coping with the condition of seropositivity.

OBJETIVOS: verificar a freqüência do rotavírus em crianças de zero a cinco anos com doença diarréica e desnutrição moderada e grave, hospitalizadas no Instituto Materno Infantil Prof. Fernando Figueira (IMIP). MÉTODOS: foi realizado um estudo série de casos durante o período de agosto de 2004 e junho de 2005. No total fizeram parte do estudo 50 crianças. Utilizou-se um questionário pré-codificado e foi montado um banco de dados no software Epi-info 6.0. As amostras de fezes foram analisadas quanto à presença do rotavírus, através de técnicas de imunoensaio enzimático. RESULTADOS: verificou-se que a freqüência do rotavírus na doença diarréica do grupo estudado foi de 24,0%. Em geral as famílias eram pobres, 96,0% delas com renda familiar per capita inferior a R$150,00. Com relação às crianças dois terços (60,4%) receberam leite materno por um período inferior a três meses e 10% delas nunca haviam sido vascinadas. CONCLUSÕES: o estudo traz contribuição para o conhecimento da etiologia da diarréia na criança com desnutrição, no entanto, se faz necessária a realização de estudos com um maior número de crianças para que os resultados possam ser mais conclusivos.

The active methodology produced better results than the traditional methodology in a ward-based context. This study seems to be valuable in terms of the new evidence it demonstrates on learning methodologies in the context of the ward round.