Background: Current researches associate long fasting periods to several adverse consequences. The fasting abbreviation to 2 h to clear liquids associated with the use of drinks containing carbohydrates attenuates endocrinometabolic response to surgical trauma, but often is observed children advised to not intake food from 00:00 h till the scheduled surgical time, regardless of what it is. Aim: To evaluate the safety of a protocol of preoperative fasting abbreviation with a beverage containing carbohydrates, and early postoperative feeding in children underwent elective small/mid-size surgical procedures during a national task-force on pediatric surgery. Methods: Thirty-six patients were prospectively included, and for several reasons five were excluded. All 31 who remained in the study received a nutritional supplement containing 150 ml of water plus 12.5% maltodextrin 2 h before the procedure. Data of the pre-operative fasting time, anesthetic complications and time of postoperative refeeding, were collected. Results:Twenty-three (74.2%) were males, the median age was 5 y, and the median weight was 20 kg. The median time of pre-operative fasting was 145 min and the time of post-operative refeeding was 135 min. There were no adverse effects on the anesthetic procedures or during surgery. Post-operatively, two children (6.5%) vomited. Conclusion: The abbreviation of pre-operative fasting to 2 h with beverage containing carbohydrate in pediatric surgery is safe. Early refeeding in elective small/mid-size procedures can be prescribed.
PURPOSE:To validate the gastroschisis experimental model in female rats and the effects on the glutamine fetal morphology during pregnancy. METHODS:Twelve pregnant rats Wistar were separated in two groups: Group I (n = 6 rats, 71 fetuses) took glutamine and Group II (n = 6 rats, 75 fetuses) took isocaloric supplementation. At the 18 th day of pregnancy, female rats were taken to hysterotomy and the fetuses which were selected for the act of gastroschisis were partially removed from the womb and by the laparotomy technique, the exclusion of the intestine was done. After that, fetuses were put in the womb cavity again and the rats' abdomen sutured. At the 21 st day of pregnancy, date before delivery, by C-section ordinary animals and the ones with gastroschisis were removed and studied separately.The morphometrical parameters studied were the body weight (PC); the intestine weight (PI); the intestine length (CI) and its relations (PI/PC, PI/CI e PC-PI). RESULTS:The intestine weight (PI) and the intestine length (CI) were different in fetuses with gastroschisis (p<0.05), however no difference between the groups regarding supplementation with glutamine. CONCLUSIONS:The gastroschisis experimental model is valid and reproducible. The nutritional therapy with glutamine did not change the morphometrical parameters. Key words: Gastroschisis. Glutamine. Fetal Development. Rats. Validation of the gastroschisis experimental model and the influence of the mother's diet enriched with glutamine in the fetal morphology
Drowning is the fourth leading cause of accidental death in adults and the third in children and adolescents worldwide. Drowning is usually caused by asphyxia due to aspiration of fluid that obstructs the airways and is responsible for changes in gas exchange, which lead to hypoxemia (insufficient oxygen levels in the blood) and metabolic acidosis. This study aimed to analyze cases of drowning in the metropolitan region of Cuiabá from January to December 2014. The analysis consisted of the observation of 1200 reports from the Instituto Medico Legal de Cuiabá, which presented 25 cases of drowning; all were men (100%), with a predominance of adults (52%), of which there was a predominance of the age group between 31 and 60 years (36%), higher incidence of drowning cases in September (28%) and more than half of the deaths from this fatality (60%) occurred in the freshwater Cuiabá river, on the banks near the capital of the state of Mato Grosso.
The multimodal protocols of perioperative care, as a European project of ERAS-Enhanced Recovery After Surgery and, in Brazil, the project ACERTO (Acceleration of Total Post-Operative Recovery), emerged as relevant alternatives to reduce preoperative discomforts, including anxiety, thirst, hunger, and enhance the recovery of surgical patients. These initiatives, supported by scientific evidence, advocate the fasting abbreviation with the ingestion of clear liquids up to 2 hours before elective surgery, as a strategy to reduce insulin resistance, immunomodulation and for the purpose of anesthetic induction, without causing risks of aspiration of gastric contents, as well as early refeeding with a small volume of diet, capable of stimulating the gastrointestinal tract and reducing the period of postoperative ileus. In this way, the literature shows that such measures are safe and bring several benefits, such as reducing hospitalization time and reducing the number of complications.
A violência crescente nos centros urbanos, acometendo a população mais economicamente ativa mostra o grande desafio na atual conjuntura da segurança pública em nosso país. Dessa forma, foi realizado uma análise epidemiológica descritiva transversal do perfil de morte violenta de Cuiabá e região (Grande Cuiabá). Foram utilizados 486 prontuários de necropsia de vítima de morte violenta do Instituto Médico Legal de Cuiabá (IML), no período de 2014 a 2015.Adultos entre 20 e 49 anos, cútis parda e do sexo masculinos foram as principais vítimas de morte violentas. Sobressaiuse as mortes em vias públicas 64,6%, a energia mecânica foi responsávelpor 92,6% das mortes violentas. Quanto a causa mortis notou-se que traumatismo crânio-encefálico (TCE) e choque hipovolêmico correspondiam a 74,4% das vitimas.Conclui-se que adultos pardo do sexo masculino em idade produtiva são as principais vitimas por morte violenta na Grande Cuiabá, evidenciando um grave problema social.Palavras-chave: homicídios, violência urbana, segurança pública.
Introdução: O perfil de óbitos em menores de 18 anos no Brasil mudou de forma considerável após a urbanização do País, quando com o aumento populacional a criminalidade também começou a se intensificar, e os indivíduos passaram a ser mais vulneráveis à violência. Objetivo: O principal objetivo deste estudo é analisar a frequência e as características de mortes violentas em menores de 18 anos, ressaltando as causas predominantes de forma geral e específicas para grupos de indivíduos. Métodos: Foi realizado um estudo epidemiológico descritivo do tipo transversal, retrospectivo, no Instituto Médico Legal (IML) da cidade de Cuiabá, no estado do Mato Grosso, nos anos de 2015 e 2016. Resultados: Os resultados demonstraram que as causas de morte externa têm sido responsáveis pela maioria dos óbitos, especificamente os acidentes de trânsito e a perfuração por arma de fogo. O maior percentual foi de indivíduos entre 13 e 18 anos e do sexo masculino. Conclusão: O aumento de óbitos por causas violentas tem sido explicado pelo fato de os jovens estarem em contato com a criminalidade cada vez mais precocemente, sendo expostos a agressões, perfuração por arma de fogo e acidentes com frequência. Os não brancos, do sexo masculino, que estão na faixa etária de 13 a 18 anos, são os mais vulneráveis a essas causas de morte. Além da violência, as crianças e adolescentes vêm sendo vítimas dos acidentes, especificamente de trânsito, responsáveis por 21,5% das causas de óbito.
Estima-se um alto índice de consumo de bebidas alcoólicas no Brasil sendo que, na população geral, 52% se declararam consumidores de álcool. Devido ao aumento crescente do consumo de álcool, os setores de saúde precisam estar preparados, uma vez que o consumo alcoólico e a embriaguez na direção, têm um impacto negativo na sociedade e envolve, além de aspectos legais, os bioéticos. Verifica-se ainda um percentual elevado de infrações envolvendo embriaguez na direção pois a lei na sua essência é rigorosa no que se concerne à punição. Pois, ao que está previsto hoje, o quantitativo do álcool no sangue é mais importante do que o investimento em práticas saudáveis de vida e prevenção de acidentes. Diante disso, o objetivo desse estudo foi refletir acerca da avaliação quantitativa e qualitativa da embriaguez aplicada atualmente no Brasil. Para isso, realizou-se uma análise de artigos científicos de revisão e protocolos de instituições competentes. Notou-se que cada ser humano possui uma velocidade própria no metabolismo do álcool, portanto, fatores múltiplos devem ser apreciados durante a condenação do suposto crime de embriaguez. Além disso novos estudos devem investigar a correlação da concentração alcoólica no corpo humano conforme as manifestações clínicas apresentadas. Com isso, a sociedade necessita da segurança na aplicação das leis propostas
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