Uso antenatal de corticosteóide e evolução clínica de recém-nascidos pré-termo

Objectives: To describe the use of antenatal corticosteroid and clinical evolution of preterm babies. Methods: An observational prospective cohort study was carried out. All 463 pregnant women and their 514 newborn babies with gestational age ranging from 23 to 34 weeks, born at the Brazilian Neonatal Research Network units, were evaluated from August 1 to December 31, 2001. The data were obtained through maternal interview, analysis of medical records, and follow-up of the newborn infants. Data analysis was performed with the use of chi-square, t Student, Mann-Whitney, and ANOVA tests and multiple logistic regression, with level of significance set at 5%. Results: Treatment was directly associated with the number of prenatal visits, with maternal hypertension and with the antenatal use of tocolytic agents. Babies from treated pregnant women presented better Apgar scores at the 1st and 5th minute, reduced need for intervention in the delivery room and lower SNAPPE II. They were born with higher birth weight, longer gestational age and needed less surfactant use, ventilation, and oxygenation time. After multiple logistic regression, the use of antenatal corticosteroid independently improved birth conditions, decreased ventilation time, being related to increased occurrence of neonatal sepsis. Conclusions: The use of corticosteroid was associated with better prenatal care and birth conditions, better preterm evolution but higher risk of infection. © 2007 Sociedad Chilena de Pediatría.

Ocorrência de mastite clínica e subclínica causada por Trichosporon beigelii em um rebanho leiteiro

Trichosporon beigelii was isolated from four and three Holstein heifers with clinical and subclinical mastitis respectively, during the extension activities of Nucleus of Mastitis Research - NUPEMAS - FMVZ - UNESP - BOTUCATU - BRAZIL. This fungus is considered extremely important because it is responsible for superficial skin infections, known as white piedra. According with literature, there is no record of isolation of this agent from mastitis in Brazil. This fact confirms the importance of microbiological studies to lead the treatment correctly to prevent the increase of bacterial resistance and secondary fungal infections that uses the inefficient antimicrobial as substratum for its development.

Variabilidade clínica na determinação da dose tóxica oral em intoxicação experimental por fluoroacetato de sódio em gatos

The sodium monofluoroacetate (FAC) or compound 1080 is a potent rodenticide used for a rodents and vertebrate pest control. It was prohibited in many countries because of its high toxicity, but in Brazil exist evidences of ilegal use causing the intoxication in children and domestic animals. The fluoroacetate metabolite, fluorocitric acid, blocks body energy production by inhibit the Krebs cycle, resulting in neurological and cardiacs signs. In the present study, four group of oral toxic dosis of the FAC were compared in cats. The best oral toxic dose for clinical signs presentation, without cause acute lethality, was 0,45mg/kg. The clinical variability was dosis dependent and its intensity, in crescent order, was: light signs (dose 1: 0,3mg/kg), light to moderate (dose 2: 0,4mg/kg), moderate to severe (dose 3: 0,45mg/ kg) and severe (dose 4: 0,5mg/kg). There was individual clinical variability between animals that received the same oral toxic dose.

Anatomia do nervo isquiático em mocós (Kerodon rupestris WIED, 1820) aplicada a clínica de animais silvestres

To know the origin of the ischiatic nerve in mocos (Kerodon rupestris Wied,1820) near by intervertebral forames and the muscling belonging to its routes were used 10 adult animals, from CEMAS-ESAM. After natural obit, they were fixed in formol (10%) and dissected to exposition and to singt of the ischiatic nerve. The results were indicated in percentage. Variations in the quantity of the lumber and sacral vertebras nere observed, five animals (50,00%) reveled seven lumbar vertebras and three sacral ones; two animals recrealed seven lumbar vertebras and four sacral ones, and two animals reveled six lumbar vertebras and three sacral ones. An animal (10,00%) revealed six lumbar vertebras and four ones. Therefore, the origin of the nerve was differentiated five animals (50,00%) had the participation of L 7,S 1,S 2; two animals (20,00%) with L 7,S 1; and a little part of S 2. Two animals (20,00%) with L 6,S 1,S 2, and an animal (10,00%) with L 6,S 1, and a little part of S 2. The last root of the ischiatic nerve in all its origins, contribute to the constitution of the first root of pudental nerve. It was verified that in all its route, the ischiatic nerves (100,00%) ceded branches to the muscles: medial gluteus, deep gluteus, superficial gluteus, emiting muscular branches to the femoral biceps or to thigh, and to the semimembranous and semi-tendinous muscles, that is continuous with a high calibre trunk, originating the fibular nerve(sideways), the tibial nerve(medial) and the lateral plantar sural cutaneous nerve (caudal).

Anoftalmia congênita clínica - alterações oculares e sistêmicas associadas

Purpose: To describe alterations observed in patients with congenital clinical anophthalmia and the occurrence of association with other ocular and extra ocular abnormalities. Methods: An observational retrospective study was conducted evaluating 12 patients with congenital clinical anophthalmia at Faculdade de Medicina de Botucatu-UNESP, between 1992 and 2005. In those patients it was observed the ocular abnormalities, severity, laterality, follow-up and to systemic abnormalities associated. The congenital clinical anophthalmia have been associated to major severity abnormalities extra-oculars, mainly when the anophthalmia was bilateral, such agenesis of corpus callosum, others craniofacial anomalies and cardiac defects. In the cases unilateral, the alteration associated more frequently was the facial asymmetry, showing the direct correlation between anophthalmos and development of orbit and face. Conclusion: There was relation between congenital clinical anophthalmia and ocular abnormally and extra-ocular abnormally. Patients with bilateral anophthalmos disease have more severe alterations. anophthalmia congenital attends a course with abnormalities of development of the face.

Patologia clínica em aves de produção - Uma ferramenta para monitorar a sanidade avícola - Revisäo

Clinical pathology has been used in veterinary medicine for many years to evaluate metabolic changes that may indicate any sign of disease in animals. Even though the use of blood parameters is routine in companion animals, it is not commonly used for avian clinical evaluation either wild or production birds. Among others, the lack of information of avian blood reference values has limited the use of this tool in avian medicine. The blood parameters in avian medicine are helpful to evaluate aspects related to animal health for wild and also production birds. Thus, this review paper presents some ways to use clinical pathology parameters to evaluate and to monitor the avian health.

Equilíbrio em indivíduos com acidente vascular encefálico: Clínica Escola de Fisioterapia da Uniararas

Objective. To describe balance of stroke patients in the UNIA-RARAS Physical Therapy clinic school evaluating the correlation with age and time of lesion. Method. It was an observational study with 22 subjects, both genders, with diagnosis of stroke, ages ranged from 23 to 86 years old. The subjects were submitted to balance evaluation with Berg's Scale of Functional Balance (BSFB), Brazilian version, composed by fourteen tasks. Results. Stroke patients had an average punctuation of 37 points, showing a high risk of falls. There was no significant correlation between the patient's age and time of lesion with BSFB punctuation. Conclusion. This study showed that stroke patients present high risks of falls, independently of age and time of lesion.

Razões para substituição de restaurações em clínica integrada

Objective: To analyze the reasons for replacing amalgam and composite resin restorations of patients treated at the Integrated Clinic Discipline of the Dental School of Araçatuba (UNESP), SP, Brazil. Method: After examining the patients for data collection to obtain a diagnosis, the treatment plan was outlined using a clinical form containing the restorations to be replaced, the reasons for replacing, the restorative material of choice and the number of restored surfaces. Next, all restorations indicated for replacement were examined as to their real need of replacement by 5 calibrated examiners taking into account the theorical concepts on the proposed criteria for the need of replacing or not. The analyzed period comprised 5 years (2001 to 2005). The criteria adopted for replacement were attached to the data collecting form in order to standardize the analysis of the restorations. Results: 856 patients were treated within the studied period and 753 needed restoration replacement. The main reasons for replacing amalgam restorations were defective marginal adaptation (40.9%), recurent caries (24.1%) and deficient anatomical form (15.4%). The main reasons for replacing resin restorations were esthetics (31.4%), defective marginal adaptation (29.2%) and recurent caries (20.7%). Conclusion: In spite of the little clinical experience of the studied population (undergraduate students), the reasons for replacing restorations were in accordance with the literature, having estehtics as the main reason for the replacement of composite resin restorations and defective marginal adaptation for amalgam restorations.

Significância clínica de tromboembolismo venoso recorrente

Recurrent venous thromboembolism is a significant problem leading to increased morbidity and mortality. It has a high impact on patients' quality of life and imposes a great financial burden on society. Cumulative recurrence has been reported as 40% at 10 years, while the chance of developing postthrombotic signs and symptoms in the lower extremities almost quadruples when ipsilateral. There is also a higher chance of developing pulmonary hypertension. Important factors for recurrence are unprovoked episodes of deep vein thrombosis, malignancy and older age. The evidence for other factors is controversial. Accurate diagnosis and treatment tailored to the patients' history, thrombotic events and risk factors are necessary to optimize management and prevent recurrence.

Avaliação clínica e parasitológica de cães naturalmente infectados por Leishmania (Leishmania) chagasi submetidos a tratamento com antimoniato de meglumina e alopurinol

Aiming to assess the efficacy of the treatment, to verify the occurrence of possible disease relapses and to search for the presence of parasites after the treatment, seven dogs naturally infected by Leishmania sp., were submitted to a treatment with meglumine antimoniate and allopurinol. For this, lymph node and bone marrow aspiration biopsies were carried out at seven moments. After the end of the six-month observation period all dogs were submitted to euthanasia. Then, spleen and liver imprints and in vitro cultures were carried out to search for amastigote forms of the parasite. All animals presented remission of the symptoms and during all the observation period no dog presented relapse of the disease, although amastigote forms of the parasite were observed in two of the animals at the end of the experiment. Thus, it was possible to conclude that the treatment promotes clinical healing but it does not eliminate the parasites completely.

Apatia na doença de alzheimer: Contribuição para uma visão clínica da progressão da demência

In addition to cognitive impairment, apathy is increasingly recognized as an important neuropsychiatric syndrome in Alzheimer's disease (AD). Aims: To identify the relationship between dementia severity and apathy levels, and to discuss the association of this condition with other psychopathological manifestations in AD patients. Methods: This study involved 15 AD patients (mean age: 77 years; schooling: 4.9 years), with mild, moderate and severe dementia, living in Rio Claro S P, Brazil. Procedures included evaluation of cognitive status by the Mini-Mental State Examination, Clinical Dementia Rating, and Global Deterioration Scale. Apathy syndrome was assessed by the Apathy Evaluation Scale and Neuropsychiatric Inventory (NPI-apathy domain). Other psychopathological manifestations such as depression were also considered. Results: Patients with more severe dementia presented higher levels of apathy, reinforcing the hypothesis that apathy severity aggravates as the disease progresses. Using the Spearman coefficient correlation an association was identified between the MMSE and Apathy Evaluation Scale (r=0.63; p=0.01), and also between the MMSE and NPI-apathy domain (r=0.81; p=0.01). Associations were also found between the Global Deterioration Scale and Apathy Evaluation Scale (r=0.58; p=0.02), and between the Global Deterioration Scale and NPI-apathy domain (r=0.81; p=0.01). Conclusions: Apathy is a distinct syndrome among patients with AD and increases with global deterioration.

Avaliação clínica e microbiológica do tratamento da estomatite protética com tintura de Schinus terebinthifolius Raddi (Aroeira)

Objective: To evaluate the clinical efficacy of Schinus terebinthifolius Raddi (aroeira) tincture in the treatment of denture stomatitis. Method: Eighteen removable denture wearers with clinical diagnosis of type II denture stomatts and presence of candidosis associated to the denture use, as confirmed by clinical and mycological examinations, were selected for the study. The patients were allocated to two groups: TG (test group) - treatment with Schinus terebinthifolius Raddi (aroeira) tincture; CG (control group), treatment with nystatin. All patients were instructed to clean the dentures with toothbrush and dentifrice, and then apply the product on the palatal mucosa and on denture surface 3 times a day, during 15 consecutive days, removing the denture at bedtime and keeping it in a receptacle with water. At the 15th day of use, the clinical and mycological examinations were redone to evaluate treatment efficacy. Data were analyzed statistically by Wilcoxon and Mann-Whitney tests at 5% significance level. Results: The inflammatory process and Candida spp. infect on were eliminated in 66.7% and 77.8% of the cases, respectively, in TG. In CG, elimination of the inflammatory process and fungal infect on occurred in 77.8% and 88.9% of the cases, respectively. These results were statistically significant (p=0.01). There was no statistically significant difference between the treatments (p>0.05). In all cases, fungal infect on was detected only on the denture, and C. albicans was the most prevalent microorganism, being present in 94.4% of the cases. Conclusion: The treatment with Schinus terebinthifolius Raddi (aroeira) tincture was effective in the treatment of denture stomatitis, promoting remission of the inflammatory process and Candida spp infection.

N-acetilcisteína - Ação antioxidante e utilização na clínica de pequenos animais

For a long time, N-acetylcysteine was only used as a mucolytic and as an expectorant agent in the treatment of paracetamol/ acetaminophen intoxication. With the advent of studies on free radicals, antioxidants are gaining prominence and the N-acetylcysteine is amongst them. The objective of this article is to emphazise the farmacological activity of this amino acid in affections in the small animal clinical routine, as well as to show new perspectives of its use in humans, which could, in the future, form the base for similar studies in dogs and cats.

Evaluación del impacto de una intervención educativa en atención farmacéutica y farmacia clínica

Introduction: The World Health Organization considers pharmaceutical care (PC) of fundamental importance for the patient and the community. Its exercise requires knowledge and skills, which can be acquired in academic and/or continuing educations, credited for effectiveness and impact evaluation. However, few manuscripts in the literature have showed the contribution of the educational interventions on the knowledge, skill and attitude of students and professionals who participate in scientifi c events related to PC. Objective: To evaluate the impact of an educational intervention (EI), and its degree of satisfaction, to pharmacists and pharmacy students. Method: A quasi-experimental study was performed, through an extension course with 40 hours of lectures approaching issues related to PC and clinical pharmacy (CP). Participants answered a survey which was handed out before and after the EI. The statistic tests of Sinais and Mann-Whitney were applied to evaluate the EI signifi cance. Results: Participants (n= 49) were mostly (n= 34) students and performing activities related to PC and CP (n= 20). Statistics differences, before and after the EI, were found in the scores of knowledge, skill and attitude (p <0.001). The evaluated item which showed the most improvement was the last one. Most (n= 30) had exceeded or met their expectations (n= 19). Conclusions: The analysis of the data led us to conclude that an EI of 40 h/week about knowledge, skill and attitude in PC using traditional methods, improves knowledge and problem-solving skills of participants. ©2012 Ediciones Mayo, S.A. All rights reserved.

Caracterização clínica, diagnóstico histopatológico e distribuição geográfica das neoplasias mamárias em cadelas de salvador, Bahia

Spontaneous tumors of the mammary gland in female dogs, represent the most frequent neoplasms observed in the small animal clinic, which explains the high interest of researchers in the study of this lesion. This study aimed to determine the frequency of mammary tumors in female dogs treated at HOSPMEV/UFBA, in Salvador, from January 2006 to April 2008, as well as to carry out the clinical characterization, histopathologic classification and the georeferencing of this pathology. The results showed a high prevalence of mammary tumors in female dogs, with most of the tumors in more advanced stages and the carcinomas in mixed tumors the predominant histologic type. There was maalso a.correlation between socioeconomic characteristics of the study population with known prognostic factors for mammary neoplasms in female dogs. These results reflect the delay in providing veterinary medical care. Thus, it's important to educate the population regarding the prevention and detection of mammary cancer in female dogs looking for an early diagnosis and appropriate therapy.