Frequency of acute myeloid leukemia in children attended in Belém, Pará from August 2005 to May 2009

Introdução: A leucemia mieloide aguda (LMA) tem incidência variável nas diferentes regiões do Brasil. Objetivos: Determinar a frequência dos subtipos de LMA em crianças entre 0-17 anos, atendidas em Belém, Pará, no período de agosto de 2005 a maio de 2009. Casuística e métodos: Estudo retrospectivo com 278 pacientes com diagnóstico de leucemias agudas ou crônicas com base nos critérios clínicos, morfológicos (classificação franco-americana-britânica [FAB]/Organização Mundial da Saúde [OMS]) e de perfil imunofenotípico por citometria de fluxo para determinação da frequência de subtipos de LMA. Resultados: Foram encontrados 70 (25,18%) casos de LMA; destes, 37 (52,9%) eram crianças entre 0-17 anos (idade mediana de 7 anos e 8 meses). Não houve diferença estatística em relação ao gênero. Observou-se maior frequência de LMA dos subtipos M2 (18/37 - 48,6%) e M0/M1 (10/37 - 27%), principalmente na primeira década de vida (16/28 [57,1%] LMA M2 e 9/28 [32,1%] LMA M0/M1). Conclusão: Na população pediátrica, os tipos de LMA M2, M0/M1 e M3 foram, respectivamente, as mais frequentes.

História Oral: Metodologia do Diálogo

A história oral, como metodologia qualitativa de pesquisa, traz outras dimensões ao debate historiográfico. Por meio dela o historiador consegue visualizar diversos pontos de vista de um determinado fato histórico. Neste aspecto, cabe ressaltar que sua utilização depende da compreensão de que o diálogo entre pesquisador e entrevistado apresenta especificidades. Utilizar-se da história oral requer a compreensão de que a pesquisa somente é possível mediante a vontade do pesquisador, o qual delimita seu tema e seus personagens, expondo muito de si em seu trabalho. Além disso, deve-se notar que nenhum personagem irá narrar sua história sem calcular o que esta narrativa poderá trazer de consequências para si, sejam elas negativas sejam positivas. Assim, buscar o depoimento implica em saber que se está adentrando em questões de natureza privada, as quais são ainda mais delicadas quando os personagens em questão estão vivos e dispostos a avaliar o que seu depoimento pode causar em sociedade.

DECREASING PREVALENCE OF THE ACUTE/SUBACUTE CLINICAL FORM OF PARACOCCIDIOIDOMYCOSIS IN MATO GROSSO DO SUL STATE, BRAZIL

Com o objetivo de avaliar o comportamento da paracoccidioidomicose nas últimas três décadas, dados clínicos e epidemiológicos de 595 pacientes atendidos dentre 1980 a 2009 no Hospital da Universidade Federal de Mato Grosso do Sul foram estudados. Sexo, faixa etária, forma clínica, associação com tuberculose ou AIDS e mortalidade foram comparados por década em que a doença foi diagnosticada. Observou-se, nas três décadas do estudo, uma redução do percentual de mulheres, de pacientes do grupo de 20 a 39 anos, assim como de casos com a forma aguda/subaguda. Estas alterações estão intimamente relacionadas e podem ser analisadas simultaneamente. Houve aumento de casos de coinfecção com AIDS da primeira para segunda década, coincidindo com o surgimento da epidemia, e manteve-se estável durante a década seguinte. Não houve alteração da taxa de coinfecção com tuberculose, que no geral foi de 6,9% o que reforça a importância desta comorbidade. A taxa geral de mortalidade foi de 6,7% e também não variou entre as décadas estudadas. A manutenção da taxa de óbitos chama a atenção para a relevância dessa doença negligenciada.

Quantitative EEG evaluation in patients with acute encephalopathy

Objetivos Investigar o uso do EEG quantitativo (qEEG) em pacientes com encefalopatias agudas (EAs ) e anormalidades da atividade de base no EEG. Método s pacientes foram divididos em prognóstico favorável (grupo A, 43 pacientes) e desfavorável (grupo B, 5 pacientes). O programa EEGLAB foi utilizado para a análise do qEEG. Um gráfico da potência espectral de todos os canais foi gerado para cada participante. Os dois grupos foram comparados estatisticamente. Resultados No grupo A, a análise espectral revelou picos (frequências teta e alfa) em 84% (38/45) dos pacientes. No grupo B, um pico espectral na frequência delta foi detectado em um paciente. Os pacientes remanescentes dos dois grupos não apresentaram picos espectrais. A análise estatística mostrou menores frequências registradas nos eletrodos posteriores dos pacientes do grupo B. Conclusão O qEEG pode ser útil na avaliação de pacientes com EAs auxiliando na determinação do prognóstico.

Candida spp. adherence to oral epithelial cells and levels of IgA in children with orthodontic appliances

Adhesion and colonization of the oral cavity by Candida albicans is an initial step in candidosis. Orthodontic and other oral appliances seem to favor candidal presence. The aim of this work was to compare the presence of Candida species in saliva, their adherence to oral epithelial cells, and the levels of anti-C. albicans IgA in children with or without orthodontic appliances. This study included 30 children 5 to 12 years old (9.1 ± 1.7 years old) who were users of removable orthodontic devices for at least 6 months and 30 control children of similar ages (7.7 ± 1.5 years old). The presence of yeast species in the saliva was evaluated by microbiological methods. Candida species were identified using phenotypic methods. Anti-C. albicans IgA levels in saliva were analyzed by ELISA. The yeasts adhering to oral epithelial cells were assessed by exfoliative cytology. No statistically significant differences were observed for saliva yeast counts and anti-C. albicans IgA levels between the studied groups. Children with orthodontic devices exhibited more yeast cells adhering to oral epithelial cells and a higher percentage of non-albicans species relative to the control group. In conclusion, orthodontic appliances may favor the adherence of Candida to epithelial cells but do not influence the presence of these yeasts in saliva, and the levels of anti-C. albicans IgA do not correlate with yeast adherence or presence of Candida in the oral cavity

Influência de características físicas e química dos materiais de abutments de implantes em zircônia e titânio na adesão e viabilidade de células epiteliais gengivaiS OBA-9

Pós-graduação em Reabilitação Oral - FOAR

Protective role of melatonin in mouse spermatogenesis induced by sodium arsenite

Arsenic is a testicular environmental toxic. Melatonin (Me), being a potent antioxidant, may reduce the damage caused by arsenic in male fertility. The effects of daily oral exposure of Sodium Arsenite (As; 7.0 mg/kg/bw); Melatonin (Me, 10.0 mg/kg/bw); Me (10.0 mg/kg/bw) plus As (7.0 mg/kg/bw), and Negative Control (NaCl 0.9%) in male CF-1 adult mice were assessed in acute (8.3 days), chronic (33.2 days) and recovery (66,4 days) of testicular damage. We evaluated changes in testicular weight and histopathological, morphometric measurements, expression of COX-2 and Androgen Receptor (AR) antigens and lipid peroxidation levels. Treatment resulted in decreased tubular diameter and AR expression, and increased: interstitial area, luminal diameter, COX-2 expression levels and of lipid peroxidation. Co-administration of As and Me partially decreased germ cell degeneration and AR expression levels, improving testicular histopathological parameters. These results indicate that As causes toxicity and testicular germ cell degeneration by induction of oxidative stress. Me partially protects from this damage in mouse testis, acting as scavenger of oxygen radical species.

Melatonin Protective Role in Mouse Cauda Epipidymal Spermatozoa Damage Induced by Sodium Arsenite

We evaluated the sperm parameters such as cauda epididymis weight, sperm count, sperm morphology and sperm DNA stability of adult CF-1 male mice treated daily (oral exposure) with the toxic sodium arsenite (As, 7.0 mg/kg/body weight); Melatonin (Me, 10.0 mg/kg/bw), Me (10.0 mg/kg/bw) plus As (7.0 mg/kg/bw) and Negative Control (NaCl 0.9%) to assess acute (8.3 days), chronic (33.2 days) and recovery of testicular damage (66.4 days). Arsenic decreases the number of sperm from chronic treatment (33.2 days) and this effect continued until 66.4 days of treatment. The toxic effect of As also altered the morphology of spermatozoa in all treatment periods when compared to the negative control group. However, Metalonin induced protective effects in periods of 33.2 and 66.4 days of treatment. Additionally, the stability of DNA was significantly affected by arsenic in all periods, but the chronic treatment (33.2 days) in the AsMe revealed increased stability compared to the group treated with arsenic only. Melatonin partially protects sperm toxicity caused by Arsenic, especially during periods of 33.2 and 66.4 days.

Extended Daily Dialysis in Acute Kidney Injury Patients: Metabolic and Fluid Control and Risk Factors for Death

Intermittent hemodialysis (IHD) and continuous renal replacement therapies (CRRT) are used as Acute Kidney Injury (AKI) therapy and have certain advantages and disadvantages. Extended daily dialysis (EDD) has emerged as an alternative to CRRT in the management of hemodynamically unstable AKI patients, mainly in developed countries.Objectives: We hypothesized that EDD is a safe option for AKI treatment and aimed to describe metabolic and fluid control of AKI patients undergoing EDD and identify complications and risk factors associated with death.Study Selection: This is an observational and retrospective study describing introduction of EDD at our institution. A total of 231 hemodynamically unstable AKI patients (noradrenalin dose between 0.3 and 1.0 ucg/kg/min) were assigned to 1367 EDD session. EDD consisted of 6-8 h of HD 6 days a week, with blood flow of 200 ml/min, dialysate flows of 300 ml/min.Data Synthesis: Mean age was 60.6 +/- 15.8 years, 97.4% of patients were in the intensive care unit, and sepsis was the main etiology of AKI (76.2). BUN and creatinine levels stabilized after four sessions at around 38 and 2.4 mg/dl, respectively. Fluid balance decreased progressively and stabilized around zero after five sessions. Weekly delivered Kt/V was 5.94 +/- 0.7. Hypotension and filter clotting occurred in 47.5 and 12.4% of treatment session, respectively. Regarding AKI outcome, 22.5% of patients presented renal function recovery, 5.6% of patients remained on dialysis after 30 days, and 71.9% of patients died. Age and focus abdominal sepsis were identified as risk factors for death. Urine output and negative fluid balance were identified as protective factors.Conclusions: EDD is effective for AKI patients, allowing adequate metabolic and fluid control. Age, focus abdominal sepsis, and lower urine output as well as positive fluid balance after two EDD sessions were associated significantly with death.

Citral: A monoterpene with prophylactic and therapeutic anti-nociceptive effects in experimental models of acute and chronic pain

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Composition and Activity against Oral Pathogens of the Essential Oil of Melampodium divaricatum (Rich.) DC.

The chemical composition of the essential oil isolated from the aerial parts of Melampodium divaricatum (Rich.) DC. (Asteraceae) was characterized by GC-FID and GC/MS analyses. (E)-Caryophyllene (56.0%), germacrene D (12.7%), and bicyclogermacrene (9.2%) were identified as the major oil components. The antimicrobial activity of the oil against seven standard strains of oral pathogens from the American Type Culture Collection (ATCC) was evaluated by determining minimum inhibitory concentrations (MICs) using the microdilution method. MIC Values below 100 mu g/ml were obtained against Streptococcus sobrinus (90 mu g/ml), Lactobacillus casei (30 mu g/ml), S. mutans (20 mu g/ml), and S. mitis (18 mu g/ml). In contrast, the MIC values of the major oil compound (E)-caryophyllene were higher than 400 mu g/ml against all pathogens, suggesting that the activity of the oil might depend on minor oil components and/or on synergistic effects. The M. divaricatum essential oil is a promising agent to include in anticariogenic oral rinse formulations for the control of oral pathogens.

General and oral health-related quality of life among caregivers of Parkinson's disease patients

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Predictors of Beta-Blocker Intolerance and Mortality in Patients After Acute Coronary Syndrome

Purpose: To investigate the predictors of intolerance to beta-blockers treatment and the 6-month mortality in hospitalized patients with acute coronary syndrome (ACS).Methods: This was a single-center, prospective, and longitudinal study including 370 consecutive ACS patients in Killip class I or II. BBs were prescribed according to international guidelines and withdrawn if intolerance occurred. The study was approved by the institutional ethics committee of our university. Statistics: the clinical parameters evaluated at admission, and the related intolerance to BBs and death at 6 months were analyzed using logistic regression (p<0.05) in PATIENTS.Results: BB intolerance was observed in 84 patients and was associated with no prior use of statins (OR: 2.16, 95%CI: 1.26-3.69, p= 0.005) and Killip class II (OR: 2.5, 95%CI: 1.30-4.75, p=0.004) in the model adjusted for age, sex, blood pressure, and renal function. There was no association with ST-segment alteration or left anterior descending coronary artery plaque. Intolerance to BB was associated with the greatest risk of death (OR: 4.5, 95%CI: 2.15-9.40, p<0.001).Conclusions: After ACS, intolerance to BBs in the first 48 h of admission was associated to non previous use of statin and Killip class II and had a high risk of death within 6 months.

Diastolic function and functional capacity after a single session of continuous positive airway pressure in patients with compensated heart failure

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Oral health associated with quality of life of people living with HIV/AIDS in Brazil

Background: The epidemic of HIV/AIDS enters into its fourth decade and is still considered an important public health problem in developed and developing countries. The purpose is verify the oral health and other factors that influence the quality of life of people living with HIV/AIDS attending a public service reference in Brazil.Methods: The participants answered the questionnaire on socio-demographic conditions, issues related to HIV and daily habits. The quality of life was analyzed by the HIV/AIDS Targeted Quality of Life (HAT-QoL) instrument with 42 items divided into nine domains: General Activity, Sexual Activity, Confidentiality concerns, Health Concerns, Financial Concern, HIV Awareness, Satisfaction with Life Issues related to medication and Trust in the physician. The oral health data were collected by means of the DMFT index, use and need of dentures and the Community Periodontal Index, according to the criteria proposed by the World Health Organization, by a calibrated researcher. Bivariate and multiple linear regressions were performed.Results: Of the participants, 53.1% were women and had a mean age of 42 years, 53.1% had eight years or less of schooling and 20.3% were not employed. In analyzing the quality of life domain of the HAT-QoL, with a lower average there was: Financial concern (39.4), followed by Confidentiality concern (43.2), Sexual activities (55.2) and Health concerns (62. 88). There was an association between the variables: do not have link to employment (p < 0.001), is brown or black (p = 0.045), alcohol consumption (p = 0.041), did not make use of antiretroviral therapy (p = 0.006), high levels of viral load (p = 0.035) and need for dentures (p = 0.025), with the worse quality of life scores.Conclusion: Socioeconomic and inadequate health conditions had a negative impact on the quality of life of people with HIV/AIDS.