Parameters of Bioelectrical Impedance Are Good Predictors of Nutrition Risk, Length of Stay, and Mortality in Critically Ill Patients: A Prospective Cohort Study.

Background: Assessment of nutrition risk in the intensive care unit (ICU) is limited by characteristics of critically ill patients, and new methods have been investigated for their applicability and predictive validity. The aim of the present study was to evaluate the validity of bioelectrical impedance analysis (BIA) parameters as predictors of nutrition risk and clinical outcomes in critically ill patients.

Methods: This was a prospective cohort study of patients admitted to an ICU.

Influence of Masticatory Behavior on Muscle Compensations During the Oral Phase of Swallowing of Smokers.

 Chewing and swallowing are physiologically interconnected functions, which share motor structures and supranuclear regions of the central nervous system (CNS), involving a sensorimotor synchrony.  To analyze the influence of masticatory behavior on muscular compensations in the oral phase of swallowing in smokers compared with nonsmokers.  A cross-sectional study comparing smokers and nonsmokers composed of 24 participants in each group.

Palliative care in Brasil: present and future.

Objective: To estimate the human resources and services needed to meet the demand of the Brazilian population who would benefit from palliative care, based on the population growth projection for 2040.

Methods: Population and mortality estimates and projections were obtained from the Brazilian Institute of Geography and Statistics. Service needs were estimated based on literature data.

Acute glycemic responses along 10-week high-intensity training protocols in type 1 diabetes patients.

Glycemic fluctuations were compared throughout 10-week high-intensity training protocols in T1DM patients. Differences were compared using the rate of change in glycaemia during exercise (RoC). HIIT sessions led to lower RoC in most weeks than other training protocols.

Prevalence of celiac disease in a large cohort of young patients with type 1 diabetes.

Background: Serological screening for celiac disease (CD) allows the identification of individuals genetically predisposed, as type 1 diabetes mellitus (T1DM). However, the diagnosis is confirmed by intestinal biopsy. The aim was to determine the prevalence of immunoglobulin-A anti-tissue transglutaminase antibodies (IgA-tTG) and CD in a large cohort of young T1DM patients.

Clinical communication skills and professionalism education are required from the beginning of medical training - a point of view of family physicians.

Background: The Brazilian undergraduate medical course is six years long. As in other countries, a medical residency is not obligatory to practice as a doctor. In this context, this paper aims to clarify what and when competencies in communication and professionalism should be addressed, shedding light on the role of university, residency and post-residency programmes.

Polysomnographic Aspects of Sleep Architecture on Self-limited Epilepsy with Centrotemporal Spikes: A Systematic Review and Meta-analysis.

Self-limited epilepsy with centrotemporal spikes is the most common paediatric epileptic syndrome, with growing evidence linking it to various degrees and presentations of neuropsychological dysfunction. The objective of this study is to evaluate the possible sleep macro and microstructural alterations in children with this diagnosis. A systematic review of published manuscripts was carried out in Medline, LILACS and Scielo databases, using the MeSH terms and .

Development of a simplified dysphagia assessment by dentists in older persons.

Objective: This study aimed to evaluate the diagnostic accuracy of a simplified clinical examination of swallowing by dentists and the Eating Assessment Tool (EAT-10), when compared with the diagnosis provided by a speech pathologist (gold standard).

Methods: Three dentists and 1 speech pathologist clinically evaluated 265 older persons in southern Brazil, 123 were residents in long-term care and 142 were community-dwelling, all able to respond to the research protocol independently. Accuracy, sensitivity, specificity, positive and negative predictive values (+PV and -PV), and positive and negative likelihood ratios (+LR and -LR) were calculated according to standard methods.

Characteristics of serogroup 20 S.pneumoniae isolates from Brazil.

Background: Although serogroup 20 is not part of any conjugate pneumococcal vaccine, its serotype 20A, but not 20B, belongs to the polysaccharide 23-valent formula. Little is known about its clinical, laboratorial and epidemiological characteristics.

Methods: The purpose of this study was to evaluate the bacterial genotypes (by PFGE and MLST), clinical characteristics of patients (from review of medical records) and antimicrobial susceptibility of serogroup 20 isolates which were recovered from patients with invasive pneumococcal disease (IPD) from 2007 to 2012.

Short Sleep Duration in the First Years of Life and Obesity/Overweight at Age 4 Years: A Birth Cohort Study.

Objective: To investigate whether short sleep duration from the first year of life influenced weight at an early age.

Study Design: During 2004, children born in Pelotas, Brazil, were enrolled in a cohort study. Sleeping habits during the previous 2 weeks were assessed, and the children were weighed and measured at 1-, 2-, and 4-year follow-ups.

A workshop on asthma management programs and centers in Brazil: reviewing and explaining concepts.

Objective: To report the results of a workshop regarding asthma management programs and centers (AMPCs) in Brazil, so that they can be used as a tool for the improvement and advancement of current and future AMPCs.

Methods: The workshop consisted of five presentations and the corresponding group discussions. The working groups discussed the following themes: implementation of asthma management strategies; human resources needed for AMPCs; financial resources needed for AMPCs; and operational maintenance of AMPCs.

Assessment of ICU readmission risk with the Stability and Workload Index for Transfer score.

Patient discharge from the ICU is indicated on the basis of clinical evidence and the result of strategies aimed at improving health care. Nevertheless, some patients might be discharged too early. We attempted to identify risk factors for unplanned ICU readmission, using a score for risk assessment, designated the Stability and Workload Index for Transfer (SWIFT) score.

Clostridium difficile infection in Brazil: a neglected problem?

The epidemiology of Clostridium difficile infection is virtually unknown in Brazil. In this prospective study, 8.3% of patients with nosocomial diarrhea were found to have toxigenic strains of C difficile in their feces.

Wilms tumor: experience of a hospital in southern Brazil.

Background: Wilms tumor (WT) is the most common renal malignancy of childhood. The aim of this study was to verify the epidemiological profile and prognosis of a sample of patients from Brazil and compare them to similar data from other Latin American studies.

Method: The sample consisted of consecutive patients diagnosed with WT in an oncohematology service of a referral hospital in Southern Brazil, between 1989 and 2009.

EVALUATION OF THE MORTALITY RATE ONE YEAR AFTER HIP FRACTURE AND FACTORS RELATING TO DIMINISHED SURVIVAL AMONG ELDERLY PEOPLE.

Objective: To evaluate the mortality rate after one year and correlated preoperative factors, among patients with hip fractures.

Methods: We prospectively studied 202 out of a total of 376 patients with a diagnosis of hip fracture who were admitted to the Hospital Cristo Redentor, between October 2007 and March 2009. The database with the epidemiological analysis was set up during their hospitalization, and follow-up data were obtained preferentially by phone.