ABSTRACT
Abstract Sjogren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs, associated with sicca syndrome but also with systemic involvement with varying degrees of severity. Despite their importance, some systemic manifestations, mainly liver, gastrointestinal, and pancreatic are not routinely evaluated. To address these manifestations, the Sjögren's Syndrome Committee of the Brazilian Society of Rheumatology conducted a broad systematic review of the literature on studies investigating prevalence and diagnosis of these symptoms in Sjogren´s patients and made recommendations based on the findings. Agreement between the experts was achieved using the Delphi method. This is the second part of this guideline, providing 6 recommendations for liver, gastrointestinal, and pancreatic care of SS patients.
ABSTRACT
Abstract Sjogren's Syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs, associated with sicca syndrome but also with systemic involvement with varying degrees of severity. Despite their importance, these systemic manifestations are not routinely evaluated and there is no homogenous approach to their diagnosis or evaluation. To close this gap, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of epidemiologic and clinical features of these manifestations and made recommendations based on the findings. Agreement between the experts was achieved using the Delphi method. The first part of this guideline summarizes the most important topics, and 11 recommendations are provided for the articular, pulmonary, and renal care of SS patients.
ABSTRACT
Os distúrbios hidroeletrolíticos e o equilíbrio ácido-básico são frequentes no dia a dia de especialidades clínicas e cirúrgicas. O entendimento da sua fisiopatologia é essencial para o seu tratamento adequado. Este artigo discursa sobre os distúrbios hidroeletrolíticos e os do equilíbrio ácido-básico mais comuns.
Electrolyte disorders and acid-base balance occur on a daily basis in both clinical and surgical specialties. The pathophysiological understanding of these disorders is essential for their appropriate treatment. This article addresses the most common electrolyte and acid-base disorders.
Subject(s)
Water-Electrolyte Imbalance/classification , Acid-Base Equilibrium/physiology , Alkalosis , Hypernatremia , Hyponatremia , Ketosis , Potassium/metabolism , Water-Electrolyte Imbalance/physiopathologyABSTRACT
Objetivos: Avaliar o prognóstico clínico-neurológico de crianças que apresentaram crises convulsivas no período neonatal, verificando a incidência e o impacto da ocorrência de epilepsia pós-neonatal em relação ao desenvolvimento neuropsicomotor e qualidade do sono.Métodos: Realizou-se um estudo transversal em uma coorte histórica de recém-nascidos que apresentaram crises convulsivas confirmadas por observação clínica e eletroencefalograma ou vídeo-eletroencefalograma, durante internação na Unidade de Terapia Intensiva Neonatal do Hospital São Lucas da PUCRS, em Porto Alegre/RS, entre janeiro de 2004 e dezembro de 2009. As crianças foram avaliadas quanto ao desenvolvimento neuropsicomotor (teste de Denver II), hábitos do sono (Inventário dos Hábitos de Sono para Crianças Pré-escolares) e ocorrência de epilepsia pós-neonatal.Resultados: O grupo com seguimento foi constituído por 12 meninos e 10 meninas com idade variando entre 2 e 6 anos. Dez pacientes (45,5%) apresentavam epilepsia pós-neonatal. Todas as crianças com epilepsia apresentaram resultado anormal ou questionável no teste de Denver II. As médias do escore total do Inventário do Sono e das suas subescalas demonstraram um predomínio de bom padrão de sono em ambos os grupos (com e sem epilepsia). Os escores variaram de 5 a 59 (média 34,84±14,61), sendo que as crianças com epilepsia apresentaram os escores mais baixos no Inventário do Sono, sugerindo melhores hábitos de sono. A diferença do escore de sono entre os dois grupos foi de 13.25 (intervalo de confiança 95% 1,39 a 25,11; p=0,030).Conclusões: O estudo evidenciou alta incidência de epilepsia após crises convulsivas neonatais e associação de epilepsia com indicadores de atraso no desenvolvimento neuropsicomotor. A qualidade do sono apresentou-se de forma regular na amostra estudada.
Aims: To evaluate the clinical and neurological outcome of children who had seizures in the neonatal period, checking the incidence and impact of the occurrence of postnatal epilepsy in relation to neuropsychomotor development and quality of sleep.Methods: A cross sectional study was carried out in a historical cohort of infants who had seizures confirmed by clinical observation and electroencephalogram or video electroencephalogram, during hospitalization in the Neonatal Intensive Care Unit of São Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul, in Porto Alegre/RS, Brazil, from January 2004 to December 2009. Children were evaluated for neuropsychomotor development (Denver II test), sleep habits (Inventory of Sleep Habits for Preschool Children), and occurrence of post neonatal epilepsy.Results: Group with follow-up consisted of 12 boys and 10 girls aged between 2 and 6 years. Ten patients (45.5%) had post-neonatal epilepsy. All children with epilepsy showed abnormal or questionable Denver II test. The means of total score on the Inventory of Sleep and its subscales showed a predominance of good sleep pattern in both groups (with and without epilepsy). The scores ranged from 5 to 59 (mean 34.84±14.61). Children with epilepsy had the lower scores in the Inventory of Sleep, suggesting better sleep habits. The difference in the sleep score between the two groups was 13.25 (95% confidence interval 1.39 to 25.11, p=0.030).Conclusions: The study showed high incidence of epilepsy after neonatal seizures and association with indicators of delayed neuropsychomotor development. Quality of sleep presented a regular pattern in the study sample.