Eficácia da haptoglobina como marcador de hemólise no diagnóstico da síndrome HELLP

Introduction: The HELLP syndrome is a severe complication of pregnant women with preeclampsia (PE), characterized by association of hemolysis, changes in liver enzymes and thrombocytopenia. Hemolysis, defined by the presence of microangiopathic hemolytic anemia, is one of the characteristics in this syndrome. However, as hemolysis occurs in a short time there is some difficulty in its laboratory diagnosis. Therefore, the search for a more sensitive and specific method for hemolysis determination may help in the early diagnosis of the HELLP syndrome. Objectives: a) To determine the plasma concentration of haptoglobin in normotensive pregnant women and in pregnant women with PE, classified into mild PE, severe PE and HELLP/partial HELLP syndrome; b) To compare the efficacy of haptoglobin plasma concentration and serum total bilirubin as criteria for hemolysis diagnosis in HELLP/partial HELLP syndrome. Methods: We conducted a cross-sectional analytical and comparative study involving 66 pregnant women diagnosed with PE, being 25 cases with mild PE, 28 with severe PE, and 13 with HELLP/partial HELLP syndrome. Twenty-one normotensive pregnant women were included for comparison of haptoglobin plasma concentration between the groups and to determine the normal values for pregnant women. The variables studied were: maternal age, gestational age, systolic and diastolic blood pressure, proteinuria, hematocrit and hemoglobin values, platelet count, serum total bilirubin, lactate dehydrogenase (LDH), glutamic oxaloacetic transaminase (AST) and glutamic-pyruvic transaminase (ALT), urea, creatinine and uric acid, and also plasma concentrations of haptoglobin. The results were analyzed by nonparametric tests, with a significance level of 5%. Results: The values of urea, uric acid, AST, ALT and LDH were significantly higher, while the number of platelets was lower in pregnant women with HELLP/partial HELLP syndrome compared to pregnant women with mild PE and ...

Características clínicas da associação entre o bruxismo do sono e o refluxo gastroesofágico merecem atenção profissional

Introduction: Bruxism has been defined as an oral parafunctional activity that includes clenching and/or grinding the teeth while asleep or awake. In addition to sleep bruxism (SB), various other orofacial movements sporadically occur during sleep. Occasional regurgitation and heartburn due to gastroesophageal reflux (GER) are frequent in the general population. GER refers to the presence of symptoms that are secondary to the reflux of gastric content through the esophagus with or without signs of esophageal mucosal lesions. Dentists are often the first health care professionals to diagnose GER through observation of its oral manifestation. Objective: The aim of the present case reports was to discuss the diagnosis and clinical procedures followed in two patients with SB and GER, thereby contributing to the dissemination of knowledge about these two entities. We therefore recommend dentists to be alert to identifying the first signs of GER that appear in the oral cavity. Conclusion: At this point, we highlight the importance of treating the patient as a whole, in an endeavor to identify other sources of the problems that could contribute as factors aggravating these conditions.

Reabilitação oral de paciente com síndrome da combinação: relato de caso

The Combination Syndrome represents an important pathologic condition of the masticatory system that requires a complex rehabilitation treatment. The presence of flaccid mucosa is one of the most common features due to bone resorption of the pre-maxilla caused by anterior hyperfunction of the mandibular teeth on the maxillary complete denture, where the impact of oclusal loading in this region results in movement of the maxillary prosthesis into the ridge, resulting in increased resorption of the residual ridge, internal misfit and loss of the retention of the maxillary complete denture. The presence of flaccid mucosa, in such cases, leads to problems of support and stability of the maxillary complete denture, which can be treated by surgical reduction of the thickness of the tissue or using specific techniques of fabrication of prostheses. This article describes the oral rehabilitation of a patient with the Combination Syndrome where the surgical reduction of flaccid mucosa was not performed, using a modified technique of functional impression in two steps, with the objective of generating forces and less distortion in flaccid mucosa during functional impression.

Displasia ectodérmica hipohidrótica: un síndrome de interés para la odontología

Hypohidrotic ectodermal dysplasia (HED) is a rare disease of genetic etiology. The most frequent form is of recessive linked to X-chromosome inheritance with affected male and female carriers. It can occur through autosomal mutations, of the gene EDA1 gene being responsible for the majority of the cases. It is characterized by the triad: hypohidrosis, oligodontia and hypotrichosis. We present two cases of patients with HED in which we observed characteristic signs of this syndrome: delicate skin, sparce hair, eyebrows and eyelashes, periorbital wrinkles, perioral and periorbital hyperpigmentation, prominent lips, in addition the patient in case 2 also present the depressed nasal bridge. We also found decreased salivary and lacrimal secretion and maxillary hypoplasia in both cases. At the oral examination in case 1 the upper right and left deciduous canines and lower right deciduous canine were present, and in case 2 the upper and lower (right and left) deciduous canines and two upper (one right and other left) permanent incisors were present with altered morphology, all of these dental elements were healthy. The early dental treatment of patients with HED, especially in the presence of oligodontia, as observed in our cases, is important not only to provide a better quality of life for these patients in the short term, but also an attempt to minimize the changes in facial growth to which these patients are subject.

Síndrome de burnout em dentistas do serviço público

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

Aspetos da vida universitária e a síndrome de burnout

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

Síndrome de Burnout em cirurgiões-dentistas com diferentes atuações profissionais

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

Síndrome da ardência bucal: avaliação e tratamento

The burning mouth syndrome (BMS) is a relevant pathology that has been defined as a chronic pain with difficult diagnosis and treatment. The prevalence of BMS is estimate to be 15% of the general population, being more common in the elderly and middle-aged. Characterized by a burning sensation in more than one area, more frequently on the two thirds of the tongue, on the anterior half of the hard palate and on the mucosa of the upper lip, the BMS is associated with clinical signs of normality and normal laboratory findings. For several studies the BMS etiology is controversial because it is multifactorial since it can be caused by local, neuropathic, psychological and/or systemic factors. These controversies make the diagnosis more difficult, especially if the dentist does not have knowledge about the syndrome. Thus, the aim of this paper is to present, by means of a literature review, the main features of BMS, indicating the procedures that may be useful for diagnosis, and also the available therapeutic modalities in order to increasing the knowledge of health professionals so that patients with BMS may benefit from appropriate treatment, support and professional confidence, always aiming to better quality of life.

Análise da modulação do reflexo H do vasto medial em mulheres com síndrome da dor femoropatelar

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

Promoção da saúde por meio de atividades educativas sobre hábitos de sono

A good night sleep is part of a healthy lifestyle. However, children and adolescents replace sleeping hours by several other activities. This project aimed to disseminate information about sleeping and stimulate some reflections about the risk factors to health arising frompersonal and collective habits. A group of 1014 junior high school students from five schools in the city of Assis-SP, participated in the project. The students visited an exhibition about the theme "sleeping and health" and took part of group assignments. Issues related to sleeping and alternatives to promote healthy sleeping habits in day-life context were discussed. The activities were planned and executed by six trainees under the supervision of the responsible teacher. The majority of the visitors reported pleasure (90% of students) and interest in the subject; (85%) enjoyed learning new information about it (93%). Among the activities performed, 25% of visitors particularly enjoyed playful educational activities, 19% the oral presentation and 23% all the activities without distinction. Group discussion on everyday situations encouraged the adolescents to reevaluate previous experiences and knowledge that were not always consistent with current scientific knowledge. Undergraduate students had a rich practical opportunity that stimulated them to create health education strategies for adolescents. Some adolescents got more involved in the activities and others were more stimulated by the change of school routine. The activities were feasible and can be designed according to the target public. Certainly individual experience was sporadic and we suggest that future projects might be improved by stimulating bigger schools and more teachers to participate.

Acompanhamento psicológico de criança com problema de sono: um relato de caso

Difficulties with sleep are frequent in the pre-schooler children. The aim of this study was to present a case report of behavioural intervention by parental guidance to sleeping problems in a pre-schooler child. Participated in this study a four years old boy that had difficulties to sleep without the presence of his parents and his mother who was oriented through a parental program. The program of intervention was composed by five sessions in which the mother acquired education about the child’s sleep, received orientation about the establishment of time and routine to sleep and about the use of techniques (extinction and positive reinforcement) for the improvement of the sleep difficulties. The sleep and behaviour were evaluated in four periods (pre-treatment, post-treatment, one and six months follow up) according to the following instruments: 1) UNESP Scale of Habits and Hygiene of the Sleep – Children Version, 2) Scale of Sleep Disorders for Children and Teenagers, 3) Child Behavior Checklist (CBCL 1,5-5) and 4) sleep diary. The results showed that after intervention the child developed independent sleep, reduced the bed resistance and showed improvement in daily behaviors. To conclude: a behavioral intervention by parental guidance was effective to sleep problems of the child.

Análise de Alterações Cromossômicas, Mutações no Éxon 1 e do Padrão de Metilação da Região Promotora do Gene FOXO3 em Síndrome Mielodisplásica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeitos do treinamento resistido na síndrome metabólica: uma revisão sistemática com meta-análise e um ensaio clínico randomizado

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

Diretrizes de conduta e tratamento de síndromes febris periódicas: síndrome de febre periódica, estomatite aftosa, faringite e adenite

To establish guidelines based on scientific evidence for the management of periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA) syndrome. The Guideline was prepared from 5 clinical questions that were structured through PICO (Patient, Intervention or indicator, Comparison and Outcome), to search in key primary scientific information databases. After defining the potential studies to support the recommendations, these were graduated considering their strength of evidence and grade of recommendation. 806 articles were retrieved and evaluated by title and abstract; from these, 32 articles were selected to support the recommendations. 1. PFAPA is a diagnosis of exclusion established on clinical grounds, and one must suspect of this problem in children with recurrent and periodic febrile episodes of unknown origin, or with recurrent tonsillitis interspersed with asymptomatic periods, especially in children in good general condition and with preservation of weight and height development; 2. Laboratory findings are nonspecific. Additional tests do not reveal pathognomonic changes; 3. The evidence supporting an indication for surgical treatment (tonsillectomy with or without adenoidectomy), is based on two non-blinded randomized clinical trials with small numbers of patients; 4. The use of prednisone at the onset of fever in patients with PFAPA proved to be an effective strategy. There is still need for more qualified evidence to support its use in patients with PFAPA; 5. Despite promising results obtained in studies with IL-1ß inhibitors, such studies are limited to a few case reports.

Associação entre Síndrome de burnout, uso prejudicial de álcool e tabagismo em profissionais de enfermagem nas unidades de teripa intensiva do Hospital das Clínicas de Botucatu-UNESP

Pós-graduação em Saúde Coletiva - FMB