Exposição neonatal a drogas ototóxicas e possíveis alterações auditivas

Introduction: Scientific evidence indicates that neonatal exposure to ototoxic drugs cause hearing loss in newborns. Objective: To characterize the use of ototoxic antibiotics in newborns (NB), treated in the Neonatal Intensive Care Unit (NICU) and evaluate possible hearing modifications. Methods: A descriptive cross-sectional quantitative approach, using data from medical records of infants who were at some time in the NICU and used antibiotics, including ototoxic, from January to June 2004 as much as 2010, and the data were compared and analyzed. Parents/guardians of infants born in 2004 were contacted and applied a questionnaire containing questions about the children’s hearing. These children were submitted to audiological evaluation. Results: There was significant reduction in the time of use, the amount of antibiotics prescribed to newborns and Vancomycin prescription in 2010 compared to 2004. The hearing tests of 13 born in 2004 showed: sensorineural hearing loss in only 2 (one with moderate hearing loss and descending configuration in pure tone audiometry and the other with bilateral cochlear impairment); audiometric thresholds within the normal range in 11 patients, and the presence of otoacoustic emissions in 9. In Evoked Auditory Brainstem Response (ABR) no changes were observed. Conclusion: The reduction in the time of use, the amount and types of antibiotics observed may be related to the adoption of a Protocol in 2008, by the service. In contrast, auditory alterations may be related to a neonatal exposure to antibiotics in 2004.

Depression and Cognitive Decline: Factors Related to Demographics and Psycho Pharmacotherapy on Elderly in Nursing Homes

Objectives: To identify the prevalence of neuropsychiatric disorders, especially DP and CD, on a sample of nursing home residents, relating this prevalence with some aspects of the demographics and psycho pharmacotherapy. Methods: 48 elders from two different nursing homes were selected. The collection of demographic and pharmacological data was made utilizing medical records. The medication was classified according to the Anatomical Therapeutic Chemical Code (ATC) criteria. The Geriatric Depression Scale (GDS 30) and the Mini Mental State Examination (MMSE) tests were utilized to determine the prevalence of DP and CD. Results: It was observed in the sample a high incidence of DP and CD among the researched elders. More schooling individuals tend to present less CD. Individuals with less CD indicatives present less symptomatology for DP. Of all the researched elders, 54,2% are submitted to psycho pharmacotherapy. Of all the consumed medicine, 16,5% belonged to the class of neuropsychiatric medicine. The medicated elders present, in average, a larger symptomatology for DP (12 points/average/GDS) than the non-medicated elders (9,9 points/average/GDS). The inverse occurs in relation to the CD indicatives. The use of psychotropics, especially in association, can have negative effects related to depression and cognition. Discussion: The pharmacotherapy, characterized for the polymedication and chronicity, especially of neuropsychiatric medicines, deserves special attention among elders, because the data suggest a significant relation between the utilization of medicines, singly or in association, and the increase of CD and DP. In addition, the data suggest that DP is a risk factor for CD and DM.

Perfil de mutações de resistência e polimorfismos genéticos em variantes do vírus da hepatite B circulantes na região de Botucatu

Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

Influence Analysis of Cleft Type and Supernumerary Teeth Eruption in the Prognosis of Bone Graft in Patients With Cleft Palate

Objective: The aim of this study was to investigate the influence of cleft type and supernumerary tooth eruption on the treatment of palatal clefts with alveolar bone grafts.Materials and Methods: In this article, medical records of 40 patients with palatal clefts and associated supernumerary teeth who were treated with alveolar bone grafting in the Hospital for Craniofacial Anomalies Rehabilitation were assessed. The patients were studied to assess the influence of supernumerary teeth and the cleft severity on the prognosis of the alveolar bone graft.Results: Forty medical records were included in the assessment. When the teeth in the cleft had an anatomic shape close to canine, we called them precanine. When they were very small or malformed, we called them anomalous lateral incisors. The teeth studied showed good prognoses and were more expressive in the preforaminal clefts (87.5%) than in the transforaminal ones (62.5%). Moreover, the transforaminal clefts presented a higher percentage in satisfactory and poor prognoses (37.5%). The authors found that supernumerary teeth influenced the maintenance of alveolar bone graft height and that transforaminal clefts presented a worse prognosis than preforaminal clefts.

Adequacy of antenatal care and its relationship with low birth weight in Botucatu, Sao Paulo, Brazil: a case-control study

Background: Birth weight reflects gestational conditions and development during the fetal period. Low birth weight (LBW) may be associated with antenatal care (ANC) adequacy and quality. The purpose of this study was to analyze ANC adequacy and its relationship with LBW in the Unified Health System in Brazil.Methods: A case-control study was conducted in Botucatu, Sao Paulo, Brazil, 2004 to 2008. Data were collected from secondary sources (the Live Birth Certificate), and primary sources (the official medical records of pregnant women). The study population consisted of two groups, each with 860 newborns. The case group comprised newborns weighing less than 2,500 grams, while the control group comprised live newborns weighing greater than or equal to 2,500 grams. Adequacy of ANC was evaluated according to three measurements: 1. Adequacy of the number of ANC visits adjusted to gestational age; 2. Modified Kessner Index; and 3. Adequacy of ANC laboratory studies and exams summary measure according to parameters defined by the Ministry of Health in the Program for Prenatal and Birth Care Humanization.Results: Analyses revealed that LBW was associated with the number of ANC visits adjusted to gestational age (OR = 1.78, 95% CI 1.32-2.34) and the ANC laboratory studies and exams summary measure (OR = 4.13, 95% CI 1.36-12.51). According to the modified Kessner Index, 64.4% of antenatal visits in the LBW group were adequate, with no differences between groups.Conclusions: Our data corroborate the association between inadequate number of ANC visits, laboratory studies and exams, and increased risk of LBW newborns. No association was found between the modified Kessner Index as a measure of adequacy of ANC and LBW. This finding reveals the low indices of coverage for basic actions already well regulated in the Health System in Brazil. Despite the association found in the study, we cannot conclude that LBW would be prevented only by an adequate ANC, as LBW is associated with factors of complex and multifactorial etiology. The results could be used to plan monitoring measures and evaluate programs of health care assistance during pregnancy, at delivery and to newborns, focusing on reduced LBW rates.

Phenotypic expression of homozygous hemoglobin S in relation to β-globin haplotypes, glutathione S-transferase polymorphisms and detoxification enzymes

Sickle cell anemia (SCA) shows a pathophysiology that involves multiple changes in sickle cell erythrocytes, vaso-occlusive episodes, hemolysis, activation of inflammatory mediators, endothelial cell dysfunction, and oxidative stress. These events complicate treatment and culminate in the development of manifestations such as anemia, pain crises and multiorgan dysfunction. The aim of this study was to evaluate, in SCA patients, oxidative stress and antioxidant capacity markers, correlating them to treatment with hydroxyurea (HU), β-globin haplotypes and glutathione S-transferase polymorphisms (GSTT1, GSTM1 and GSTP1), in comparison to a control group (CG). The study groups were composed of 48 individuals without hemoglobinopathies (CG), SCA patients treated with HU [AF (+HU), N = 13] and untreated SCA patients [AF (-HU), N = 15], after informed consent. The groups were analyzed using cytological, electrophoretic, chromatographic and molecular methods and information from medical records. The GSTM1 and GSTT1 polymorphisms were determined by multiplex PCR, while the GSTP1 polymorphism by PCR-RFLP. Biochemical parameters were measured using spectrophotometric methods [TBARS, TEAC and catalase (CAT) and GST activities] and a chromatographic method [glutathione (GSH)]. The fetal Hb (Hb F) levels observed in the SCA (+HU) group (10.9%) confirmed the already well-described pharmacological effect of HU, but the SCA (-HU) group also had high Hb F levels (6.1%), which may have been influenced by genetic factors not targeted in this study. We found a higher frequency of the Bantu haplotype (48.2%), followed by the Benin (32.1%) and also Cameroon haplotypes, rare in our population, and 19.7% of atypical haplotypes. The presence of Bantu haplotype was related to higher lipid peroxidation levels in patients, but also, it conferred a differential response to HU treatment, raising Hb F levels in 52.6% (P = 0.03). The protective effect of Hb F was confirmed, because the increase in their levels resulted in a 41.3% decrease in lipid peroxidation levels (r = -0.74, P = 0.0156). The genotypic frequency of the GST polymorphisms observed was similar to that of other studies in the Brazilian population, and its association with biochemical markers revealed a significant difference only for the GSTP1 polymorphism, where patients with genotype V/V showed higher GSH and TEAC levels (P = 0.04 and P = 0.03, respectively) compared to patients with genotype I/I. The TBARS levels were about five to eight times higher in the SCA (+HU) and SCA (-HU) groups, respectively, compared to controls, and HU produced a 35.2% decrease in lipid peroxidation levels in the SCA (+HU) group (P < 0.0001). Moreover, the SCA (+HU) group showed higher TEAC levels when compared to CG (P = 0.002). We did not find any significant difference in GST activity between the groups studied (P = 0.76), but CAT activity was about 17 and 30% lower in SCA (+HU) and SCA (-HU) groups, respectively (P < 0.00001). Plasma GSH levels were ~2 times higher in SCA patients than in the control group (P = 0.0005) and showed a positive correlation with TBARS levels, confirming its antioxidant function. HU treatment contributed to higher CAT activity and TEAC levels and lower lipid peroxidation, and its pharmacological effect showed a “haplotype-dependent” response. These findings may contribute to elucidating the potential of HU in ameliorating oxidative stress in SCA subjects.

Hydroxyurea in the sickle cell anemia: toxicity and effectiveness

Objective: to evaluate the use of hydroxyurea with regard to effectiveness and toxicity in people with sickle cell anemia. Method: this is a retrospective descriptive study, developed with 57 medical records of patients with sickle cell anemia, treated at the University Hospital Center of Campo Grande (Mato Grosso do Sul, Brazil), from 1993 to 2005. Inclusion criteria: electrophoresis of hemoglobin in medical record; regular use of drugs, for an average of 196 weeks; dosage; and hematological analyses before starting treatment. Exclusion criteria: living with other hemoglobinopathies. The variables evaluated were: neutrophils count; platelets; leukocytes; hemoglobin; time using hydroxyurea; drug response to the optimal dosage; and number and type of episodes of hospitalization. The research protocol was approved by the Ethics Committee of Universidade Federal de Mato Grosso do Sul, under the Protocol 645. Results: of the 57 medical records, 3 cases were evaluated. Comparing the hematological values, according to Portaria 872, enacted on 11/12/2002, it was found that: cases A, B, and C present an use of hydroxyurea (500 mg/day) for four years, with an average of 196 weeks. Case A, female, decreased painful episodes and frequency of hospitalization, keeping hematological values with no toxicity. In Case B, female, there was one hospitalization due to pain crises and important hemolysis. It stood out, in case C, male, neutropenia with hematological values < 2,000/mm3 . Conclusion: in the cases analyzed, we observed a drop in the number of hospitalizations with the decrease in painful crises from three to one a year, and there was no toxicity with regard to the dosage and time using hydroxyurea, in all three cases. For more comprehensive results, one suggests further study on this therapy with significant samples of this clientele.

A psicanálise entre a higiene mental e a escola nova na obra de Arthur Ramos: contribuições à história da educação no Brasil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

O ensino da implantodontia no curso de graduação de odontologia: o relato de experiência de uma instituição e o perfil dos pacientes atendidos na clínica de implantodontia das Faculdades Adamantinenses Integradas - FAI

Pós-graduação em Odontologia Preventiva e Social - FOA

Risco de Farmingham e evento cardiovascular em mulheres com síndrome dos ovários policísticos

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Cuida e ser cuidado: compreendendo as significações desse processo para famíliares cuidadores e idosos dependentes usuários de um Centro Dia

Pós-graduação em Saúde Coletiva - FMB

O efeito da musicoterapia na qualidade de vida e nos sintomas depressivos do paciente em hemodiálise

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Perfil da farmacoterapia utilizada por idosos institucionalizados: uma análise dos problemas relacionados ao uso de medicamentos em instituições de longa permanência para idosos

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

Frequência e perfil de gestantes com toxoplasmose em uma unidade de saúde de Matão - SP

Congenital toxoplasmosis is a serious public health case, for it causes irreversible damage to the embryo/fetus, which may cause its death. The identification and the care to pregnant women with suspect acute toxoplasmosis (IgM+) is performed in prenatal monitoring. This study aimed to measure the incidence and know the profile of positive pregnant women for toxoplasmosis in a Basic Health Unit (BHU) in Matão - SP, between the years 2011 to 2013. This is a retrospective descriptive study, from the medical records of pregnant women attended. The project was approved by the Municipal Departament of Health and BHU was chosen along the Municipal Epidemiological Surveillance. From 2011 to 2013, 189 women began prenatal care in the unit, an annual median of 71(±26.91), of which 17 (8.99%) were positive for the serological test indicative of acute phase (IgM+). The distribution over the trial period was: four cases in 2011, twelve cases in 2012 and one in 2013. Pregnant women IgM positive for toxoplasmosis attend by BHU were: age 24(±5.47) years; color: equally distributed among white, black and brown; as the number of pregnancies: multiparous (2±0.97), most of them with a cesarean delivery as obstetric history and possessed no other risk factors associated with pregnancy (94.12%); gave entrance at BHU with 13.65(±7.35) weeks of gestation and had a median of 5(±2.36) consultation on their prenatal care. The examination for toxoplasmosis was requested as recommended by the Health Ministry (HM) and the medication prescribed was Roxamicina® - spiramycin, as soon as the test results (IgM+) arrived. Of the 17 pregnant women, only 10 completed the pre-natal at BHU - attendance at the postpartum consult (58.8%). Of these, the deliveries were vaginal (55.55%), made preterm with 36.5 weeks of gestation at the Municipal Hospital. The babies were born alive (100%) with the weight of 2.68(±0.77) Kg and required special care hospital scope. From the ...

Prevalência de alterações sistêmicas em pacientes atendidos na disciplina de cirurgia e traumatologia bucomaxilofacial do curso de Odontologia da UNIARA

Introduction: pre-operative assessment is of fundamental importance for the prevention of transoperative and of postoperative complications. Objective: to identify the prevalence of diseases and systemic conditions in patients undergoing surgical treatment in the discipline of surgery and Traumatology of University Center of Araraquara, in the period of 2004 to 2009. Material and method: for the development of this study, a survey in medical records of patients was performed and the factors considered included: age, sex, presence of vices, and systemic conditions that affect the world’s population. The data obtained were analyzed quantitatively and recorded in a table. Result:  Considering all patient records analyzed (693), 340 affirmative responses were detected (49,06%) to one or more diseases. Cardiovascular diseases were the most prevalent (22,34%). Considering the prevalence of diseases related to age, the age of less than 20 years represented 16,32%; of 20-29 years, 43,06%; 30-39 years, 45,16%; 40-44 years, 48,64%; 45-49 years, 56,25%; 50-54 years, 58,33%; 55-59 years, 57,74%; 60-64 years, 70,37%; 65-69 years, 66,66%; and 70 years or more, 68,75%. Conclusion: diseases and systemic alterations with higher prevalence were cardiovascular diseases, anemia, sinusitis and diabetes. The frequency of affirmative answers to systemic conditions was age-dependent and there was a predominance of females. The tobacco addiction was the most frequent. Thus, it was found that the preoperative assessment of the health of patients who will undergo surgical dental treatment is of fundamental importance.