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.

Estudio exploratorio sobre el mercado laboral y la gestión del personal de enfermería

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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.

Como desenhar e escrever um protocolo de pesquisa clínica em Cosmiatria

Cosmetic Dermatology is a growing subspecialty. High-quality basic science studies have been published; however, few double-blind, randomized controlled clinical trials, which are the major instrument for evidence-based medicine, have been conducted in this area. Clinical research is essential for the discovery of new knowledge, improvement of scientific basis, resolution of challenges, and good clinical practice. Some basic principles for a successful researcher include interest, availability, persistence, and honesty. It is essential to learn how to write a protocol research and to know the international and national regulatory rules. A complete clinical trial protocol should include question, background, objectives, methodology (design, variable description, sample size, randomization, inclusion and exclusion criteria, intervention, efficacy and safety measures, and statistical analysis), consent form, clinical research form, and references. Institutional ethical review board approval and financial support disclosure are necessary. Publication of positive or negative results should be an authors' commitment. © 2013 by Anais Brasileiros de Dermatologia.

Forámenes emisarios del cráneo humano: Características anatómicas y sus relaciones con la neurocirugía clínica

The recognition of emissary foramens is important not only for understanding the regional neurovascular anatomy, but also to distinguish normal from potentially abnormal structures. Thus, the aim of this study was to review the literature on anatomical and clinical aspects of the mastoid, parietal and sphenoid emissary foramens. It was found that the emissary foramen presents importance in clinical practice because it acts as a route of spread of extracranial infection to the intracranial structures and also possible complications in neurosurgery, due to its influence in the performance of techniques such as radiofrequency rhizotomy for treatment of trigeminal neuralgia. The anatomical knowledge of the emissary foramens is important due to variability in their incidence in the human skull and its relation to the dura mater sinuses.

Estimación de la mortalidad infantil a partir de la historia clínica perinatal

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Evolução de pacientes com AIDS pós cART: Evolução clínica e laboratorial de pacientes com AIDS após 48 semanas de tratamento antirretroviral

Combination Antiretroviral Therapy (cART) aims to inhibit viral replication, delay immunodeficiency progression and improve survival in AIDS patients. The objective of this study was to compare two different schemes of cART, based on plasma viral load (VL) and CD4+ T lymphocyte count, during 48 weeks of treatment. For this purpose, 472 medical charts of a Specialized Outpatient Service were reviewed from 1998 to 2005. Out of these, 58 AIDS patients who had received a triple drug scheme as the initial treatment were included in the study and two groups were formed: Group 1 (G1): 47 individuals treated with two nucleoside reverse-transcriptase inhibitors (NRTI) and one non-nucleoside reverse-transcriptase inhibitor; Group 2 (G2): 11 patients treated with two NRTI and one protease inhibitor. In G1 and G2, 53.2% and 81.8% respectively were patients with an AIDS-defining disease. The T CD4+ lymphocyte count increased progressively up until the 24th week of treatment in all patients, while VL became undetectable in 68.1% of G1 and in 63.6% of G2. The study concluded that the evolutions of laboratory tests were similar in the two treatment groups and that both presented a favorable clinical evolution.

Avaliação clínica, laboratorial e dos marcadores bioquímicos do estresse oxidativo hepatocelular em ratos diabéticos induzidos pela aloxana

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Caracterização e classificação da deglutição orofaríngea do idoso institucionalizado: avaliaçao clínica fonoaudiológica

Pós-graduação em Bases Gerais da Cirurgia - FMB

Avaliação clínica e microbiológica da irrigação subgengival com iodo-povidine 10% como adjunto à terapia periodontal não-cirúrgica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)