Association between menopausal symptoms, sexual function, and sexual activity - a cross-sectional study.

Introduction: To analyse the possible association between menopausal symptoms (somatic-vegetative, psychological, and urogenital) and sexual function with the maintenance of the sexual activity of women in menopause. Material and methods: This cross-sectional study comprised 96 menopausal women aged 40-59 (52.88 ±4.05) years, who presented a positive score to the menopause rating scale (MRS) and had serum levels of follicle stimulating hormone ≥ 25 IU/ml. Participants who used hormone replacement therapy were excluded. Results: It was observed that participants who had an active sexual life had lower medians in the somatic-vegetative (p < 0.001) and psychological symptoms (p = 0.006), as well as in the general score (p = 0.001) at the MRS; in addition, they had better sexual function in 4 domains (p < 0.005): excitement, lubrication, orgasm, and pain, as well as in the total score of the female sexual function index questionnaire (p < 0.005). It was also found that, regardless of the type of menopause (surgical or natural), women who did not engage in sexual activity had a score of 5.651 points more in the MRS (p = 0.004), demonstrating that the practice of sexual activity predicts in 10.4% the variation in the symptom score. Conclusions: Menopausal women who maintain sexual activity had a lower score on the menopause symptom score and better sexual function compared to those who did not perform sexual activity.

Enzyme engineering and its industrial applications.

Recently, there has been an increase in the demand for enzymes with modified activity, specificity, and stability. Enzyme engineering is an important tool to meet the demand for enzymes adjusted to different industrial processes. Knowledge of the structure and function of enzymes guides the choice of the best strategy for engineering enzymes. Each enzyme engineering strategy, such as rational design, directed evolution, and semi-rational design, has specific applications, as well as limitations, which must be considered when choosing a suitable strategy. Engineered enzymes can be optimized for different industrial applications by choosing the appropriate strategy. This review features engineered enzymes that have been applied in food, animal feed, pharmaceuticals, medical applications, bioremediation, biofuels, and detergents.

Stroke survivors with the same levels of exercise as healthy individuals have lower levels of physical activity.

BACKGROUND: Physical activity and exercise are different constructs. However, professionals usually employ heterogeneous definitions for these distinct constructs, resulting in nonspecific and inaccurate assessments, which compromise clinical decision making. PURPOSE: The aim of this study was to verify if the levels of physical activity behave similarly between individuals with stroke and healthy-control individuals with the same levels of exercise. METHODS: Seventy-five stroke survivors and 75 healthy-control individuals matched by levels of exercise, age, and sex were evaluated. The level of exercise was classified as inactive, insufficient, and moderate/vigorous according to the Centers for Disease Control and Prevention criteria. The level of physical activity was assessed with the Human Activity Profile (HAP) and classified as "inactive," "moderately active," and "active." The physical activity level was compared between groups of subjects (stroke versus healthy-control) and subgroups of the level of exercise ("inactive," "insufficient," and "moderate/vigorous" level of exercise) (α = 5%). RESULTS: Stroke survivors had a significantly lower level of physical activity (HAP: 51 ± 22 and 71 ± 19 points, respectively). Only for individuals with stroke, a statistically significant difference was found in the levels of physical activity between subgroups of level of exercise, specifically between "inactive" and "moderate/vigorous" subgroups (HAP:47 ± 22 and 70 ± 8 points, respectively). CONCLUSIONS: Physical activity behaved differently between individuals with stroke and healthy-control individuals with the same levels of exercise. Individuals with stroke had worse physical activity levels than matched controls. Furthermore, different from individuals with stroke, in healthy-control individuals with different levels of exercise, the level of physical activity was similar.

Effects of diet-induced hypercholesterolemia and gold nanoparticles treatment on peripheral tissues.

Cholesterol is a lipid molecule of great biological importance to animal cells. Dysregulation of cholesterol metabolism leads to raised blood total cholesterol levels, a clinical condition called hypercholesterolemia. Evidence has shown that hypercholesterolemia is associated with the development of liver and heart disease. One of the mechanisms underlying heart and liver alterations induced by hypercholesterolemia is oxidative stress. In this regard, in several experimental studies, gold nanoparticles (AuNP) displayed antioxidant properties. We hypothesized that hypercholesterolemia causes redox system imbalance in the liver and cardiac tissues, and AuNP treatment could ameliorate it. Young adult male Swiss mice fed a regular rodent diet or a high cholesterol diet for eight weeks and concomitantly treated with AuNP (2.5 µg/kg) or vehicle by oral gavage. Hypercholesterolemia increased the nitrite concentration and glutathione (GSH) levels and decreased the liver's superoxide dismutase (SOD) activity. Also, hypercholesterolemia significantly enhanced the reactive oxygen species (ROS) and GSH levels in cardiac tissue. Notably, AuNP promoted the redox system homeostasis, increasing the SOD activity in hepatic tissue and reducing ROS levels in cardiac tissue. Overall, our data showed that hypercholesterolemia triggered oxidative stress in mice's liver and heart, which was partially prevented by AuNP treatment.

Modulating effect of DL-kavain on the mutagenicity and carcinogenicity induced by doxorubicin in Drosophila melanogaster.

Kavain, kavalactone, present in Piper methysticum exhibits anticonvulsive, analgesic, anxiolytic, antiepileptic, antithrombotic, anti-inflammatory and antioxidant properties. Given its importance, the aim of the present study was to assess (1) the mutagenic and carcinogenicity of kavain administered alone and (2) the antimutagenic and anticarcinogenic potential when administered simultaneously with the chemotherapeutic drug doxorubicin (DXR) using the Somatic Mutation and Recombination Test (SMART) and Epithelial Tumor Test (ETT) using Drosophila melanogaster as a model system. Third-stage larvae from a standard (ST) and high metabolic bioactivation (HB) crosses were treated with different kavain concentrations (32, 64 or 128 µg/ml), alone or in conjunction with DXR (0.125 mg/ml). In ST descendants, kavain produced no significant mutagenic or recombinogenic effects. In the HB cross, mutagenic activity was observed at kavain concentrations of 64 and 128 µg/ml. In the DXR and kavain co-treatment, a modulating effect of the DXR-mediated mutagenic response dependent upon the concentration was detected in both crosses. In ETT, no marked carcinogenic or anticarcinogenic activity was noted for kavain. However, when kavain was combined with DXR synergistic induction of tumors by the chemotherapeutic drug occurred indicating that kavain enhanced the carcinogenic action of DXR.

Yangambin and Epi-yangambin Isomers: New Purification Method from Ocotea fasciculata and First Cytotoxic Aspects Focusing on In Vivo Safety.

Ocotea fasciculata presents yangambin (YAN) and its isomer epi-yangambin (EPI-YAN) as major lignans, which are employed as the plant markers for quality control purposes and as potential pharmacological compounds. However, a gap between the pure isomers and safety and efficacy protocols is faced by the scientific community. In this context, this work aimed to report (i) a new and advantageous purifying process in a semi-preparative scale for YAN and EPI-YAN isolation from Ocotea fasciculata, and (ii) an in vitro cytotoxicity study to estimate, for the first time, the LD50 values of the isolated epimers, as well as the influence of albumin concentration in cell culture medium. The best condition for epimers isolation was achieved in normal-phase liquid chromatography. The lignan fraction (LF), previously obtained from the plant ethanolic extract, was purified yielding 17% and 29% of YAN and EPI-YAN, respectively. The in vitro study demonstrated that YAN and EPI-YAN were safe, and only at the highest concentration studied, a decrease on cell viability was observed. The estimated LD50 value was higher than 1612 mg/kg for both epimers. The LF, on the other hand, demonstrated an estimated LD50 of 422 mg/kg. Lignan cytotoxicity studies also evidenced that the higher cell viability was related to the higher concentration of fetal bovine serum as a source of albumin in medium. This is the first time the LD50 and safety of the isolated epimers were estimated, opening up great perspectives of success in in vivo studies.

Is α-Tocopherol or Sodium Ascorbate Effective as Antioxidant on Fracture Resistance of Bleached Teeth?

AIM: To evaluate the effect of two antioxidant formulations (sodium ascorbate and α-tocopherol) on fracture resistance of endodontically treated teeth. MATERIALS AND METHODS: Sixty human premolars were endodontically treated and divided into six groups (n = 10): G1 (negative control)-unbleached and restored with composite resin; G2 (positive control)-bleached in three sessions, using hydrogen peroxide (15 H2O2) plus titanium dioxide (TiO2) nanoparticles, photoactivated by LED laser system and restored with composite resin; G3-bleaching similar to G2, after the use of 10% sodium ascorbate gel for 24 hours and restored with composite resin; G4-similar to G3, but with the use of 10% sodium ascorbate solution and restored with composite resin; G5 and G6-similar to G3, but with the use of 10% α-tocopherol in alcohol or carbopol, respectively, and was also restored. A mechanical fracture resistance test was performed and the Kruskal-Wallis test was used to evaluate the results (α = 0.05). RESULTS: No statistical difference was observed in fracture resistance between groups (p > 0.05). Regarding the antioxidant and pharmaceutical formulation applied, no statistical difference was detected in any comparison (p > 0.05). The frequency of fractures considered favorable was higher in G1 and G3 compared to the other groups. CONCLUSION: The endodontically treated teeth bleached with 15 H2O2 plus TiO2 nanoparticles and photoactivated with the LED laser did not decrease the fracture resistance and the use of sodium ascorbate or α-tocopherol did not increase the crown fracture resistance. CLINICAL SIGNIFICANCE: The literature reports a significant reduction in the bond strength of restorations on the bleached dentin. Therefore, the use of antioxidant agents may have a promising effect on fracture resistance of endodontically treated teeth.

Characterization of esterase activity from an Acetomicrobium hydrogeniformans enzyme with high structural stability in extreme conditions.

The biotechnological and industrial uses of thermostable and organic solvent-tolerant enzymes are extensive and the investigation of such enzymes from microbiota present in oil reservoirs is a promising approach. Searching sequence databases for esterases from such microbiota, we have identified in silico a potentially secreted esterase from Acetomicrobium hydrogeniformans, named AhEst. The recombinant enzyme was produced in E. coli to be used in biochemical and biophysical characterization studies. AhEst presented hydrolytic activity on short-acyl-chain p-nitrophenyl ester substrates. AhEst activity was high and stable in temperatures up to 75 °C. Interestingly, high salt concentration induced a significant increase of catalytic activity. AhEst still retained ~ 50% of its activity in 30% concentration of several organic solvents. Synchrotron radiation circular dichroism and fluorescence spectroscopies confirmed that AhEst displays high structural stability in extreme conditions of temperature, salinity, and organic solvents. The enzyme is a good emulsifier agent and is able to partially reverse the wettability of an oil-wet carbonate substrate, making it of potential interest for use in enhanced oil recovery. All the traits observed in AhEst make it an interesting candidate for many industrial applications, such as those in which a significant hydrolytic activity at high temperatures is required.

Occupational stress among health workers of a university hospital. / Estresse ocupacional entre trabalhadores de saúde de um hospital universitário.

OBJECTIVE: To evaluate the occupational stress among health workers in a university hospital. METHODS: Cross-sectional study conducted with health workers in the areas of nursing and medicine at a university hospital in southern Brazil. The data were collected between August of 2011 and August of 2012 by a questionnaire of characterization and Job Stress Scale. A descriptive and univariate analysis was performed (Kruskal-Wallis). RESULTS: The participants presented high demand and high control of the work and low social support, indicating an active work. Nurses had less control over work (p<0.001) and physicians received more social support (p=0.006). Reduced social support was related to greater exposure to stress among nursing assistants and technicians (p=0.012). CONCLUSION: Workers who felt the low social support had higher exposure to stress. It is necessary to implement stress prevention strategies among health workers, such as the strengthening of social support at work.

In Vitro Adherence of Oral Bacteria to Different Types of Tongue Piercings.

The purpose of this work was to verify in vitro adherence of E. corrodens and S. oralis to the surface of tongue piercings made of surgical steel, titanium, Bioplast, and Teflon. For this, 160 piercings were used for the count of Colony Forming Units (CFU) and 32 piercings for analysis under scanning electron microscopy. Of these, 96 (24 of each type) were individually incubated in 5 mL of BHI broth and 50 µL of inoculum at 37°C/24 h. The other 96 piercings formed the control group and were individually incubated in 5 mL of BHI broth at 37°C/24 h. Plates were incubated at 37°C/48 h for counting of CFU/mL and data were submitted to statistical analysis (p value <0.05). For E. corrodens, difference among types of material was observed (p < 0.001) and titanium and surgical steel showed lower bacterial adherence. The adherence of S. oralis differed among piercings, showing lower colonization (p < 0.007) in titanium and surgical steel piercings. The four types of piercings were susceptible to colonization by E. corrodens and S. oralis, and bacterial adhesion was more significant in those made of Bioplast and Teflon. The piercings presented bacterial colonies on their surface, being higher in plastic piercings probably due to their uneven and rough surface.

[Composition of the electrocautery smoke: integrative literature review]. / Composição da fumaça produzida pelo bisturi elétrico: revisão integrativa da literature.

OBJECTIVE: To identify the composition of the smoke produced by electrocautery use during surgery. METHOD: Integrative review with search for primary studies conducted in the databases of the US National Library of Medicine National Institutes of Health, Cumulative Index to Nursing and Allied Health Literature, and Latin American and Caribbean Health Sciences, covering the studies published between 2004 and 2014. RESULTS: The final sample consisted of 14 studies grouped into three categories, namely; polycyclic aromatic hydrocarbons, volatile compounds and volatile organic compounds. CONCLUSION: There is scientific evidence that electrocautery smoke has volatile toxic, carcinogenic and mutagenic compounds, and its inhalation constitutes a potential chemical risk to the health of workers involved in surgeries.

New blend of renewable bioplastic based on starch and acetylated xylan with high resistance to oil and water vapor.

Renewable materials of biological origin exhibit attractive properties in relation to traditional plastics, as they can be partially or completely replaced, thereby reducing environmental impacts. Hemicelluloses are a group of polysaccharides that have expanded applications when acetylated. Acetylation can improve the mechanical strength and water vapor barrier properties of xylan-based bioplastics. By partially acetylating xylan in the present study, it was possible to use water as a solvent for the film-forming solution and starch as a second polysaccharide in the formation of bioplastics. Xylan was modified via partial chemical acetylation by varying the reaction time, solvent, and catalyst content. The bioplastics were formed by non-acetylated xylan and acetylated xylan with degrees of substitution (DS) of 0.45 and 0.9, respectively, with starch to form blends using glycerol as a plasticizer. Acetylation with DS 0.45 showed better results in increasing the hydrophilicity of the bioplastic. On the other hand, acetylation influenced the thermal stability of bioplastics, increasing the maximum temperature of the degradation rate from 302 °C to 329 °C and 315 °C, owing to changes in the crystallinity of the polymers. In addition to the modulus of elasticity 2.99 to 290.61 and 274.67 MPa for the non-acetylated bioplastic and the bioplastic with DS of 0.45 and 0.90, respectively. Thus, the films obtained presented suitable physicochemical properties for use in various industrial applications, such as active and intelligent packaging in the food sector.

Quality of life and factors associated among public university employees retired due to disabilities.

OBJECTIVE: to analyze quality of life and factors associated among public university employees retired due to disabilities. METHOD: a cross-sectional study conducted with a sample of public university employees retired due to disabilities. A characterization questionnaire and the World Health Organization Quality of Life - Disabilities instrument were applied via telephone or online contacts from November 2019 to September 2020. The associated factors were verified through multiple linear regression. RESULTS: of the 80 retirees due to disability, 15% were professors and 85% had a technical-administrative career. As for the factors associated with Quality of Life, continuous medication use (ßadj: -0.25; p=0.02) and problems in the nervous system (ßadj: -0.21; p<0.05) were associated with the Overall domain; continuous medication use (ßadj: -0.23; p=0.04), to the Physical domain; smoking (ßadj: -0.21; p<0.05) and mental and behavioral disorders (ßadj: -0.21; p<0.01), to the Psychological domain; smoking (ßadj: -0.46; p<0.01) and respiratory (ßadj: -0.21; p=0.03) and circulatory (ßadj: -0.21; p=0.03) problems, to the Social domain; smoking (ßadj: -0.33; p<0.01) and problems in the nervous system (ßadj: -0.22; p=0.04), to the Environmental domain; mental and behavioral disorders, to the Disabilities module (ßadj: -0.29; p<0.01) and to the Discrimination domain (ßadj: -0.21; p<0.05); and smoking (ßadj: -0.32; p<0.01) and problems in the nervous system (ßadj: -0.20; p<0.05), to the Inclusion domain. The Autonomy domain did not present any association. CONCLUSION: the retirees under study presented impaired Quality of Life.

An umbrella systematic review of the effect of physical exercise on mental health of women in menopause.

IMPORTANCE: The menopausal transition has been related to worsening mental health. The literature also points out that being physically active during menopause is associated with a favorable effect on climacteric symptoms, specifically on psychological aspects. OBJECTIVES: The aims of the study are to analyze the effects of physical activity on mental health during menopause through an umbrella review and to evaluate the quality of the included Systematic Reviews and meta-analyses (MAs). EVIDENCE REVIEW: A MeaSurement Tool to Assess Systematic Reviews was used to evaluate the methodological quality of the included studies and the Grading of Recommendations Assessment, Development and Evaluation was applied to assess the level of the evidence of the results. In addition, the effect size of the revised meta-analyses (MAs) was calculated. FINDINGS: A total of 9 systematic reviews/MAs were included, published between 2014 and 2020. In the A MeaSurement Tool to Assess Systematic Reviews methodological quality assessment, 8 studies were classified as "high quality" and 1 as "low quality." In terms of quality of the evidence for each result through the Grading of Recommendations Assessment, Development and Evaluation classification, approximately 75% of the studies were classified as "moderate quality," 22.2% as "high quality," and 22.2% as "low quality," with the greatest bias concerning the high heterogeneity of the included studies. In addition, the studies showed low overlap. Despite the high heterogeneity, we can highlight the importance of the practice of physical activity by women in menopause, to prevent and/or reduce problems related to mental health. CONCLUSIONS AND RELEVANCE: There was a positive effect of the interventions on depression, however, with no difference between durations (short or long). Regarding stress, the interventions applied did not show a positive effect. The studies that investigated depression linked to anxiety presented conflicting results.

Factors associated with work activity of technical-administrative staff from state universities retired due to disability.

OBJECTIVE: To verify the factors associated with the type of work activity performed by university technical-administrative staff retired due to disability. METHOD: Cross-sectional research with 68 workers, conducted using an electronic questionnaire between November 2019 and September 2020. Data were collected on sociodemographic, occupational characterization and causes of disability. Data were analyzed descriptively and by multiple logistic regressions. RESULTS: Health professionals were more likely to have mental and behavioral disorders, associated with females and regardless of age. The chances of the nervous system diseases were higher in workers who performed administrative work, being associated with higher education. Operational employees were more likely to have musculoskeletal diseases associated with primary and secondary education and were male, regardless of age. CONCLUSION: There was an association between work activity performed before retirement and the diseases responsible for disability, with differences between gender, age, and educational levels.

The Effect of Body Practices and Physical Exercise on Sexual Function of Menopausal Women. A Systematic Review with Meta-Analysis.

Objective: To review randomized clinical trials on Body Practices (BP) and Physical Exercise (PE) in menopausal women and describe their effect on sexual function. Methods: Searches carried out electronically in five databases, with a temporal criterion of 10 years of publication, from August to September 2022. Methodological quality and risk of bias were assessed using the Cochrane collaboration scale and PEDro (Physiotherapy Evidence Database Physiotherapy Evidence Database) scale score. Results: The majority of the studies presented a "'low" or "'uncertain" risk of bias. The instruments for assessing sexual function were heterogeneous. Interventions included mindfulness, relaxation hypnosis, Kegel exercises, yoga, and aerobic exercise, and generally lasted 12 weeks. Seven studies were included, of which six made up the meta-analysis, showing high heterogeneity (I2 = 94.2%; p < 0.0001). The analysis of subgroups with BP showed high heterogeneity (I2 = 94.2%; p < 0.01); interventions with PE presented more favorable results (I2 = 0%; 0; p = 0.90); the sexual function instruments showed high heterogeneity (I2 = 90%; p < 0.01); and instruments of quality of life and menopausal symptoms with domains of sexual function presented favorable results for BP and PE (I2 = 0%; p = 0.63). The funnel chart presents the studies in a dispersed manner, which implies publication bias. Conclusions: Interventions with PE proved to be more efficient compared to BP, however, there are a low number of studies with PE, and those found are limited to aerobic training, without sufficient data on intensity, volume, and frequency. Further studies with PE are needed for the treatment of sexual function symptoms in order to more comprehensively describe their effect.

Influencing factors for microplastic intake in abundant deep-sea lanternfishes (Myctophidae).

Plastic debris is ubiquitous in the hydrosphere. Yet, we lack an understanding of contamination among deep-sea species and primarily how each trait can influence microplastic intake. We investigated microplastic contamination in the digestive tract of hyper-abundant mesopelagic lanternfishes (n = 364 individuals) from the Southwestern Tropical Atlantic, captured from 90 to 1000 m depth. Overall, microplastics were detected in most individuals analysed (frequency of occurrence = 68 %). Large microplastics, mostly of a filamentous shape were the most frequent, followed by smaller fragments and foams. Microplastics made of high-density polymers (PET, PVC, PA, SBR rubber) were more prevalent than low-density ones (PE, EVA and PBD rubber), especially under deeper layers. Larger microplastics were detected in lanternfishes captured off the northeastern Brazilian coast (mean 0.88 ± SE 0.06 mm) compared to those from around the Rocas Atoll and Fernando de Noronha Archipelago (0.70 ± 0.07 mm; p≤ 0.05), ∼350 km from the continent. Moreover, lanternfishes that migrate from the upper mesopelagic (200-500 m) to the epipelagic layers (<200 m) had simultaneously the highest intake and the smallest particles (1.65 ± 0.17 particles individual-1 and 0.55 ± 0.07 mm; p≤ 0.05). Biological mediated transport of microplastics from the epipelagic to the mesopelagic waters was evinced, but fishes foraging in shallower layers had the lowest intake (1.11 ± 0.10 part. ind.-1; p≤ 0.05). Furthermore, the jaw length was positively associated with an increment in microplastic intake (Incidence Rate Ratio = 1.1; p≤ 0.05). The lanternfishes that preferably prey upon fish larvae are more prone to microplastic intake than their counterparts, which forage mostly on crustaceans and gelatinous zooplankton (p≤ 0.05).

Mat Pilates and belly dance: Effects on patient-reported outcomes among breast cancer survivors receiving hormone therapy and adherence to exercise.

BACKGROUND: Breast cancer treatment leads to several side effects. Exercise can help to reduce these side effects. However, it is unknown whether a mat Pilates or a belly dance intervention can improve the patient-reported outcomes of these women. OBJECTIVE: Examine the effects of a 16-week exercise intervention (mat Pilates or belly dance) on patient reported outcomes (PROs) among breast cancer survivors, at 16 weeks, six months, and 12 months; and investigate sociodemographic and clinical predictors of intervention adherence. METHODS: Seventy-four breast cancer survivors who were receiving hormone therapy were randomly allocated into mat Pilates (n = 25), belly dance (n = 25) or control group (educational sessions) (n = 24). Mat Pilates and belly dance groups received a 16-week intervention, delivered three days a week and 60 min a session. The control group received three education sessions and continue usual care. The patient reported outcomes assessed were depressive symptoms (Beck Depression Inventory), stress (Perceived Stress Scale), optimism (Life Orientation Test), fatigue (FACT-F), sleep quality (Pittsburgh Sleep Quality Index) and pain (VAS), clinical and sociodemographic characteristics, and habitual physical activity (IPAQ short). RESULTS: All three groups showed a significant improvement in fatigue, and this effect was maintained during follow-up. No significant effects were found for depressive symptoms, optimism, stress, or pain. A history of exercise prior to breast cancer and be inactive after diagnosis were significant predictors of adherence to interventions. CONCLUSION: Mat Pilates, belly dance and a few educational sessions can be effective in improving fatigue after 16 weeks of intervention. REGISTRATION: ClinicalTrials.gov (NCT03194997).

[Work-related illness in nursing: an integrative review]. / O adoecer pelo trabalho na enfermagem: uma revisão integrativa.

Man's endless search for methods of performing different activities leads to increased workloads, which eventually result in physical, psychological and emotional conditions. The objective of this study was to seek scientific evidence regarding the types of work-related conditions or illnesses in nursing, as well as the means of coping and preventing occupational diseases and accidents. An integrative review was performed on the electronic health databases using the following descriptors: occupational disease, occupational prevention, and nursing worker. Twenty-seven articles were found. It was realized that nurses have back pain and musculoskeletal injuries, suffer accidents with sharp-edged materials and endure stress and tension at work, in addition to exposure to environmental pollution and dermatitis.

Clinical aspects and therapeutic approach of drug-induced adverse skin reactions in a quaternary hospital: a retrospective study with 219 cases.

BACKGROUND: Adverse drug reactions are frequent, with cutaneous manifestations being the most common. In the hospital environment, the incidence of cutaneous drug reactions varies from 2% to 3%. OBJECTIVE: To analyze the profile of cutaneous drug reactions, relating clinical forms, suspected medications, histopathological alterations, systemic repercussions, treatment and course. METHODS: Clinical, retrospective and observational study of patients seen by the Dermatology Interconsultation team from January 2013 to December 2016. RESULTS: The frequency of cutaneous drug reactions among the evaluated patients was 13.6%, with 219 cases diagnosed. In 65.7%, the reaction was considered mild, of which the most common was exanthema, while in 34.2%, the reaction was considered severe, with DRESS being the main form of reaction(18.2%). Antibiotics (36.5%) and anticonvulsants (10%) were the most involved drugs. In addition to drug discontinuation, systemic corticosteroids were prescribed in 47% of cases and intravenous immunoglobulin (IVIg) in 4.5%. Of the mild forms, in 62%, expectant management and/or exclusive use of symptomatic treatment was used. STUDY LIMITATIONS: Retrospective study, with limitations inherent to this type of investigation; lack of some information in medical records; long evaluation period, with a possible change in external validity. CONCLUSION: The most frequently identified clinical form was exanthema, and antibiotics and anticonvulsants were the most frequently involved drug classes. About one-third of the patients had severe cutaneous drug reactions, with DRESS being the main one. Cutaneous drug reactions are frequent in clinical practice, and the dermatologist should be called in as soon as possible to assist in the diagnosis and management of these cases.