Predictors of smoking cessation in smokers with chronic periodontitis: a 24-month study.

The purpose of this 24-month study was to identify predictors of smoking cessation in a cohort of smokers with chronic periodontitis, attending a multidisciplinary smoking cessation program. Of the 286 subjects screened, 116 were included and received non-surgical periodontal treatment and smoking cessation therapy, which consisted of lectures, cognitive behavioral therapy, and pharmacotherapy, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists, during periodontal maintenance sessions at 3, 6, 12 and 24 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and was validated by exhaled carbon monoxide (CO) measurements. The Fagerström Test for Cigarette Dependence was used to assess smoking dependence. Of the 61 individuals that remained up to the 24-month examination, 31, 21 and 18 declared that they were not smoking at 3, 12 and 24 months, respectively. Smoking cessation after 24 months was associated with the male gender (OR = 3.77, 95%CI = 1.16-12.30), baseline CO levels less than 10ppm (OR = 5.81, 95%CI 1.76-19.23), not living or working with another smoker (OR = 7.38, 95%CI 1.76-30.98) and a lower mean Fagerström test score (OR = 5.63, 95%CI 1.55-20.43). We concluded that smoking cessation was associated with demographic, smoking history and cigarette dependence variables.

Predictors of smoking cessation in smokers with chronic periodontitis: a 24-month study

Abstract The purpose of this 24-month study was to identify predictors of smoking cessation in a cohort of smokers with chronic periodontitis, attending a multidisciplinary smoking cessation program. Of the 286 subjects screened, 116 were included and received non-surgical periodontal treatment and smoking cessation therapy, which consisted of lectures, cognitive behavioral therapy, and pharmacotherapy, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists, during periodontal maintenance sessions at 3, 6, 12 and 24 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and was validated by exhaled carbon monoxide (CO) measurements. The Fagerström Test for Cigarette Dependence was used to assess smoking dependence. Of the 61 individuals that remained up to the 24-month examination, 31, 21 and 18 declared that they were not smoking at 3, 12 and 24 months, respectively. Smoking cessation after 24 months was associated with the male gender (OR = 3.77, 95%CI = 1.16-12.30), baseline CO levels less than 10ppm (OR = 5.81, 95%CI 1.76-19.23), not living or working with another smoker (OR = 7.38, 95%CI 1.76-30.98) and a lower mean Fagerström test score (OR = 5.63, 95%CI 1.55-20.43). We concluded that smoking cessation was associated with demographic, smoking history and cigarette dependence variables.

Estado nutricional, autopercepção do estado nutricional e experimentação de drogas lícitas em adolescentes / Nutritional status, nutritional self-perception, and use of licit drugs in adolescents

Objetivo:Associar o estado nutricional e a autopercepção do estado nutricional com a experimentação de drogas lícitas em adolescentes.Métodos:Estudo transversal no qual 210 adolescentes responderam a um questionário sobre experimentação de álcool e tabaco e sobre suas autopercepções nutricionais. Foi analisada a concordância entre autopercepção nutricional do adolescente e seu estado nutricional, bem como associações entre o estado nutricional, a autopercepção nutricional, sexo, idade e presença de tabagistas em casa com a experimentação de álcool e tabaco. As variáveis foram analisadas separadamente em análise bivariada e, a seguir, análise múltipla determinou fatores associados à experimentação.Resultados:Participaram do estudo 210 adolescentes com mediana de idade de 148 meses, 56,6% do sexo feminino. Do total da amostra, 6,6% já experimentaram cigarro e 20% já experimentaram álcool; 32,3% tinham Z-escore IMC≥1 e 12,85% tinham Z-escore IMC≥2 e 50,7% acertaram suas classificações nutricionais. Após análise multivariada, apenas a autoimagem sobre o peso influenciou estatisticamente na experimentação de fumo. Pacientes que se identificavam com peso muito alto apresentaram maior chance de experimentação de fumo (odds ratio (OR) 13,57; intervalo de confiança (95% IC) 2,05-89,8; p=0,007); em relação ao uso de álcool, adolescentes que se identificavam com peso alto apresentaram chance de uso de álcool 2,40 vezes maior do que crianças que se viam com peso normal (IC 95% 1,08-5,32; p=0,031).Conclusões:Adolescentes com autopercepção de excesso de peso podem constituir um grupo de risco para a experimentação de álcool e tabaco.

Objective:To associate the nutritional status and the self-perception of nutritional status with the use of licit drugs among adolescents.Methods:A cross-sectional study was conducted in which 210 adolescents answered a questionnaire on alcohol and tobacco experimentation and self-perceptions about their nutritional status. The correspondence between the adolescents' perception of their own nutritional status and actual nutritional status was analyzed, as well as associations between nutritional status, self-perception of nutritional status, gender, age, and presence of smokers at home with alcohol and tobacco use. The variables were analyzed separately in a bivariate analysis and, subsequently, a multivariate analysis determined the factors associated with drug use.Results:The study included 210 adolescents with a median age of 148 months; 56.6% were females. Of the total sample, 6.6% have tried cigarettes, and 20% have tried alcohol; 32.3% had BMI Z-Score ≥1, 12.85% had BMI Z-Score ≥2, and 50.7% had a correct perception of his/her weight. After a multivariate analysis, only the self-perception about weight statistically influenced experimentation of tobacco, and patients who identified themselves as having very high weight were more likely to experiment tobacco (odds ratio (OR) 13.57; confidence interval (95% CI) 2.05-89.8; p=0.007); regarding alcohol use, adolescents who identified themselves as having high weight were 2.4 times more likely to experiment with alcohol than adolescents that identified themselves as having normal weight (95% CI 1.08-5.32, p=0.031).Conclusions:Adolescents with self-perception of excess weight may constitute a risk group for alcohol and tobacco use.

[Nutritional status, nutritional self-perception, and use of licit drugs in adolescents]. / Estado nutricional, autopercepção do estado nutricional e experimentação de drogas lícitas em adolescentes.

OBJECTIVE: To associate the nutritional status and the self-perception of nutritional status with the use of licit drugs among adolescents. METHODS: Cross-sectional study in which 210 adolescents answered a questionnaire on alcohol and tobacco experimentation and self-perceptions about their nutritional status. The correspondence between the adolescents' perception of their own nutritional status and actual nutritional status was analyzed, as well as associations between nutritional status, self-perception of nutritional status, gender, age, and presence of smokers at home with alcohol and tobacco use. The variables were analyzed separately in a bivariate analysis and, subsequently, a multivariate analysis determined the factors associated with drug use. RESULTS: The study included 210 adolescents with a median age of 148 months; 56.6% were females. Of the total sample, 6.6% have tried cigarettes, and 20% have tried alcohol; 32.3% had BMI Z-Score≥1, 12.85% had BMI Z-Score≥2, and 50.7% had a correct perception of his/her weight. After a multivariate analysis, only the self-perception about weight statistically influenced experimentation of tobacco, and patients who identified themselves as having very high weight were more likely to experiment tobacco (odds ratio (OR) 13.57; confidence interval (95% CI) 2.05-89.8; p=0.007); regarding alcohol use, adolescents who identified themselves as having high weight were 2.4 times more likely to experiment with alcohol than adolescents that identified themselves as having normal weight (95% CI 1.08-5.32, p=0.031). CONCLUSIONS: Adolescents with self-perception of excess weight may constitute a risk group for alcohol and tobacco use.

Effect of smoking cessation on non-surgical periodontal therapy: results after 24 months.

AIM: The aim of this 24-month prospective study was to assess the effect of smoking cessation on non-surgical periodontal therapy (NSPT) in adult subjects with chronic periodontitis. MATERIALS AND METHODS: Relative to a previous 12-month follow-up study, recruitment and follow-up period were extended, resulting in 116 eligible among the 286 screened subjects. They received NSPT and concurrent smoking cessation interventions. Periodontal maintenance was performed every 3 months. A calibrated examiner, blinded to smoking status, performed full-mouth periodontal examination in six sites per tooth at baseline, 3, 12 and 24 months of follow-up. Expired air carbon monoxide concentration measurements and interviews were performed to gather demographic and behavioural information. RESULTS: From the 116 enrolled subjects, 61 remained up to 24 months of follow-up. Of these, 18 quit smoking (Q), 32 continued smoking (NQ) and 11 oscillated (O) at 24 months of follow-up. Thereby, Q showed significantly higher mean CAL gain in diseased sites and higher reduction in the proportion of sites with CAL ≥ 3 mm, when compared to NQ. In addition, Q presented significantly higher mean probing depth reduction relative to NQ(p ≤ 0.05). CONCLUSION: Smoking cessation promoted additional benefits on NSPT in chronic periodontitis subjects.

Avaliação do resultado terapêutico de um ambulatório antitabágico multidisciplinar / Assessment of outpatient smoking cessation clinic, in a general hospital

INTRODUÇÃO: O tabagismo é reconhecido, atualmente, como um dos maiores problemas de saúde em todo o mundo. Há uma "epidemia" global de uso de tabaco nos países em desenvolvimento, no século 21. OBJETIVOS: Analisar: as características gerais dos indivíduos matriculados espontaneamente em um ambulatório antitabágico; a eficácia geral do tratamento antitabágico e dos medicamentos; as mudanças nas características dos participantes antes e após a Lei Ambiente Fechado Livre do Cigarro em São Paulo e os níveis de cotinina urinária em fumantes ativos, passivos e controles. CASUÍSTICA E MÉTODOS: Foi realizado um estudo de coorte histórica cujo critério de inclusão foi a matrícula no ambulatório antitabágico do HU USP, no período de 2004 a 2011. Os dados foram coletados por meio de consulta a protocolos padronizados e ao sistema informatizado do serviço. Foram analisados os resultados de dosagens de cotinina e creatinina realizadas em amostras biológicas. RESULTADOS: Dentre os 1736 pacientes atendidos houve predomínio de mulheres (62,1%), brancos (75,3%) e indivíduos com idade entre 41 e 60 anos (63,1%). Aproximadamente 80% iniciaram o tabagismo antes dos 20 anos e 75% apresentaram grau de dependência moderado a grave. Dentre os 620 indivíduos acompanhados a partir de 2009, 34,5% abandonaram o tabagismo. Dentre eles, 21,5% obtiveram êxito até o quarto contato com o ambulatório. O uso de vareniclina e terapia de reposição de nicotina (TRN) aumentaram a probabilidade de sucesso (RRR= 2,73 e 2,78, respectivamente; p < 0,001 para ambas). Quanto maior o número de reuniões frequentadas no ambulatório, maior a probabilidade de sucesso terapêutico (p < 0,001). A análise da dosagem da cotinina urinária mostrou concentrações de cotinina urinária 18,7 vezes maior no grupo de tabagistas ativos comparados aos tabagistas passivos. CONCLUSÃO: O sucesso do ambulatório antitabágico do HU manteve-se em acordo com grande parte dos índices de sucesso terapêutico...

INTRODUCTION: Smoking is recognized today as one of the major health problems worldwide. There is a global "epidemic" of tobacco use in developing countries in the 21st Century. OBJECTIVES: Analyze: the general characteristics of individuals spontaneously enrolled in an outpatient smoking cessation clinic; the overall effectiveness of the smoking cessation treatment and medication; the changes in the characteristics of participants before and after the Smoke-Free Environment Act in São Paulo and the levels of urinary cotinine in active and passive smokers and controls. CASES AND METHODS: A historical cohort study was conducted, of which the inclusion criterion was the registration in the outpatient smoking cessation Clinic in the HU USP, in the period from 2004 to 2011. Data were collected by consultation of standardized protocols and of the computerized service system. The results of cotinine and creatinine measurements performed on biological samples were analyzed. RESULTS: Among the 1736 patients treated, there was a predominance of women (62.1%), whites (75.3%) and individuals aged between 41 and 60 years (63.1%). Approximately 80% began smoking before age 20 and 75% showed moderate to severe degree of dependence. Among the 620 individuals monitored from 2009 on, 34.5% quit smoking. Among them, 21.5% obtained success up to the fourth contact with the clinic. The use of varenicline and nicotine replacement therapy (NRT) increased the probability of success (RRR= 2.73 and 2.78, respectively; p < 0.001 for both). The greater the number of meetings attended at the clinic, greater the probability of treatment success (p < 0.001). The analysis of urinary cotinine dosage showed urinary cotinine concentrations 18.7 times higher in the active smokers group, compared to the passive smokers group. CONCLUSION: The success of the smoking cessation clinic in the HU remained largely in accordance with most therapeutic success rates found...

Impact of the rapid antigen detection test in diagnosis and treatment of acute pharyngotonsillitis in a pediatric emergency room.

OBJECTIVE: To evaluate the impact of the routine use of rapid antigen detection test in the diagnosis and treatment of acute pharyngotonsillitis in children. METHODS: This is a prospective and observational study, with a protocol compliance design established at the Emergency Unit of the University Hospital of Universidade de São Paulo for the care of children and adolescents diagnosed with acute pharyngitis. RESULTS: 650 children and adolescents were enrolled. Based on clinical findings, antibiotics would be prescribed for 389 patients (59.8%); using the rapid antigen detection test, they were prescribed for 286 patients (44.0%). Among the 261 children who would not have received antibiotics based on the clinical evaluation, 111 (42.5%) had positive rapid antigen detection test. The diagnosis based only on clinical evaluation showed 61.1% sensitivity, 47.7% specificity, 44.9% positive predictive value, and 57.5% negative predictive value. CONCLUSIONS: The clinical diagnosis of streptococcal pharyngotonsillitis had low sensitivity and specificity. The routine use of rapid antigen detection test led to the reduction of antibiotic use and the identification of a risk group for complications of streptococcal infection, since 42.5% positive rapid antigen detection test patients would not have received antibiotics based only on clinical diagnosis.

Impacto do uso da prova rápida para estreptococo beta-hemolítico do grupo A no diagnóstico e tratamento da faringotonsilite aguda em pronto-socorro de Pediatria / Impact of the rapid antigen detection test in diagnosis and treatment of acute pharyngotonsillitis in a Pediatric emergency room / Impacto del uso de la prueba rápida para estreptococos beta-hemolíticos del grupo A en el diagnóstico y tratamiento de la faringotonsilitis en emergencia de Pediatría

OBJETIVO: Avaliar o impacto da realização rotineira da prova rápida para pesquisa de estreptococo do grupo A no diagnóstico e tratamento da faringotonsilite aguda em crianças. MÉTODOS: Estudo prospectivo e observacional que contou com a utilização de protocolo de pesquisa estabelecido na Unidade de Emergência do Hospital Universitário da Universidade de São Paulo para o atendimento de crianças e adolescentes com faringotonsilite aguda. RESULTADOS: Com base na avaliação clínica, dos 650 pacientes estudados, antimicrobianos seriam prescritos para 389 indivíduos (59,8%) e, com o uso da pesquisa de estreptococo do grupo A, foram prescritos em 286 pacientes (44,0%). Das 261 crianças que não receberiam antibiótico pelo quadro clínico, 111 (42,5%) tiveram pesquisa de estreptococo do grupo A positiva. O diagnóstico baseado no quadro clínico apresentou sensibilidade de 61,1%, especificidade de 47,7%, valor preditivo positivo de 44,9% e valor preditivo negativo de 57,5%. CONCLUSÕES: O diagnóstico clínico da faringotonsilite estreptocócica mostrou baixa sensibilidade e especificidade. O uso rotineiro da prova rápida para pesquisa de estreptococo permitiu a redução do uso de antibióticos e a identificação de um grupo de risco para as complicações da infecção estreptocócica, pois 42,5% dos pacientes com prova rápida positiva não receberiam antibióticos, se levado em consideração apenas o diagnóstico clínico.

OBJECTIVE: To evaluate the impact of the routine use of rapid antigen detection test in the diagnosis and treatment of acute pharyngotonsillitis in children. METHODS: This is a prospective and observational study, with a protocol compliance design established at the Emergency Unit of the University Hospital of Universidade de São Paulo for the care of children and adolescents diagnosed with acute pharyngitis. RESULTS: 650 children and adolescents were enrolled. Based on clinical findings, antibiotics would be prescribed for 389 patients (59.8%); using the rapid antigen detection test, they were prescribed for 286 patients (44.0%). Among the 261 children who would not have received antibiotics based on the clinical evaluation, 111 (42.5%) had positive rapid antigen detection test. The diagnosis based only on clinical evaluation showed 61.1% sensitivity, 47.7% specificity, 44.9% positive predictive value, and 57.5% negative predictive value. CONCLUSIONS: The clinical diagnosis of streptococcal pharyngotonsillitis had low sensitivity and specificity. The routine use of rapid antigen detection test led to the reduction of antibiotic use and the identification of a risk group for complications of streptococcal infection, since 42.5% positive rapid antigen detection test patients would not have received antibiotics based only on clinical diagnosis.

OBJETIVO: Evaluar el impacto de la realización de rutina de la prueba rápida para investigación de estreptococos del grupo A en el diagnóstico y tratamiento de la faringotonsilitis aguda en niños. MÉTODOS: Estudio prospectivo y observacional que contó con el uso de protocolo de investigación establecido en la Unidad de Emergencia del Hospital Universitario de la USP para la atención a niños y adolescentes con faringotonsilitis aguda. RESULTADOS: Con base en la evaluación crítica, de los 650 pacientes estudiados, antimicrobianos serían prescritos a 389 individuos (59,8%) y, con el uso de la investigación de estreptococos del grupo A se los prescribieron a 286 pacientes (44,0%). De los 261 niños que no recibirían antibióticos por el cuadro clínico, 111 (42,5%) tuvieron investigación de estreptococos del grupo A positiva. El diagnóstico basado en el cuadro clínico presentó sensibilidad del 61,1%, especificidad del 47,7%, valor predictivo positivo del 44,9% y valor predictivo negativo del 57,5%, CONCLUSIONES: En este estudio, el diagnóstico clínico de la faringotonsilitis estreptocócica mostró baja sensibilidad y especificidad. El uso de rutina de la prueba rápida para investigación de estreptococos permitió la reducción del uso de antibióticos y la identificación de un grupo de riesgo para las complicaciones de la infección estreptocócica, pues el 42,5% de los pacientes con prueba rápida positiva no recibirían antibióticos si se llevara en consideración solamente el diagnóstico clínico.

Cessação de tabagismo em fumantes com periodontite crônica / Tabacco use cessation in chronic periodontitis smokers

O tabagismo é o mais importante fator de risco de diversas doenças crônicas, incluindo a periodontite. Embora cirurgiões-dentistas apresentem potencial para ajudar seus pacientes fumantes a abandonar o vicio, o papel do dentista na cessação do tabagismo ainda não está totalmente esclarecido. O objetivo deste estudo prospectivo de 12 meses foi verificar o efeito de um programa antitabágico multidisciplinar na cessação de tabagismo em fumantes com periodontite. Duzentos e um (201) sujeitos foram triados e 93 foram incluídos e receberam tratamento periodontal não-cirúrgico e terapia antitabágica. Durante o tratamento periodontal, os dentistas motivaram ativamente os participantes a pararem de fumar, usando técnicas de entrevista motivacional. Aconselhamento e suporte adicionais foram fornecidos durante as visitas de manutenção após 3, 6 e 12 meses do término do tratamento periodontal. A condição de tabagista foi avaliada por meio de um questionário estruturado e foi validada pela mensuração de monóxido de carbono expirado (CO). Dentre os 52 indivíduos que permaneceram até o exame de 12 meses, 22 (42,31%), 17 (32,69%) e 17 (32,69%) não estavam fumando após 3, 6 e 12 meses, respectivamente. Concluiu-se que a terapia antitabágica realizada por uma equipe multidisciplinar que inclui dentistas resultou em alta taxa de cessação de tabagismo

Smoking is the leading risk factor of several chronic diseases, including periodontitis. Although it is acknowledged that dentists have potential to help smoking patients to quit, their role in tobacco control is not completely defined. The aim of this prospective 12-month study was to evaluate the effect of a multidisciplinary smoking cessation program in quitting smoking in subjects with periodontal disease. Two-hundred and one (201) subjects were screened, and 93 were included and received non-surgical periodontal treatment and smoking cessation therapy. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists during periodontal maintenance sessions at 3, 6 and 12 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and it was validated by exhaled carbon monoxide (CO) measurements. Among the 52 individuals that remained up to the 12-months examination, 22 (42.31%), 17 (32.69%) and 17 (32.69%) were not smoking at 3, 6 and 12 months, respectively. It is concluded that smoking cessation therapy performed by a multidisciplinary team including dentists resulted in high quit rates

Maternal smoking during pregnancy: impact on otoacoustic emissions in neonates.

OBJECTIVES: To determine the effect of maternal smoking during pregnancy on transient evoked otoacoustic emissions levels in neonates. METHODS: This was a cross-sectional study investigating neonates in the maternity ward of a university hospital in the city of São Paulo, Brazil. A total of 418 term neonates without prenatal or perinatal complications were evaluated. The neonates were divided into two groups: a study group, which comprised 98 neonates born to mothers who had smoked during pregnancy; and a control group, which comprised 320 neonates born to mothers who had not. In order to compare the two ears and the two groups in terms of the mean overall response and the mean transient evoked otoacoustic emissions in response to acoustic stimuli delivered at different frequencies, we used analysis of variance with repeated measures. RESULTS: The mean overall response and the mean frequency-specific response levels were lower in the neonates in the study group (p<0.001). The mean difference between the groups was 2.47 dB sound pressure level (95% confidence interval: 1.47-3.48). CONCLUSIONS: Maternal smoking during pregnancy had a negative effect on cochlear function, as determined by otoacoustic emissions testing. Therefore, pregnant women should be warned of this additional hazard of smoking. It is important that smoking control be viewed as a public health priority and that strategies for treating tobacco dependence be devised.

A prospective 12-month study of the effect of smoking cessation on periodontal clinical parameters.

AIM: The aim of this 12-month prospective study was to assess the adjunctive effect of smoking cessation in non-surgical periodontal therapy of subjects with severe chronic periodontitis. MATERIALS AND METHODS: Of the 201 subjects enrolled from a smoking cessation clinic, 93 were eligible and received non-surgical periodontal treatment and concurrent smoking cessation treatment. Periodontal maintenance was performed every 3 months. Full-mouth periodontal examination in six sites per tooth was performed by a calibrated examiner, blinded to smoking status, at baseline, 3, 6 and 12 months after non-surgical periodontal treatment. Furthermore, expired air carbon monoxide concentration measurements and interviews based on a structured questionnaire were performed in order to collect demographic and smoking data. RESULTS: Of the 93 eligible subjects, 52 remained in the study after 1 year. Of these, 17 quit smoking and 35 continued smoking or oscillated. After 1 year, only quitters presented significant clinical attachment gain (p=0.04). However, there were no differences between the groups regarding clinical attachment level, probing depth, bleeding on probing and plaque index after 1 year (p>0.05). CONCLUSION: Smoking cessation promoted clinical attachment gain in chronic periodontitis subjects from a smoking cessation clinic after 1 year of follow-up.

Faringoamidalite estreptocócica: comparação entre diagnóstico clínico e microbiológico / Streptococcal pharyngitis: comparison between the clinical and microbiological diagnosis

Introdução: Faringoamidalite é queixa frequente nos pronto-socorros pediátricos, com presença do Streptococcus pyogenes em 20 por cento dos casos. Os sinais e sintomas clínicos são insuficientes para diferenciar quadros virais dos bacterianos. Os métodos microbiológicos, teste rápido(TR) e cultura orofaringe(CO) são indispensáveis para diagnóstico e redução de antibióticos...

Introductions: Pharyngitis is a common complaint in the emergency room for children, with the presence of Streptococcus pyogenes in 20 per cent of the cases. The clinical signs and symptoms are insufficient to differentiate viral from bacterial infections. The microbiological methods, rapid test (RT) and oropharynx cultura (OC), are essential for diagnosis and for reducing the use of antibiotics...

Orquite em dois meninos com púrpura de Henoch-Schonlein / Orchitis in two boys with Henoch-Schonlein purpura

Objetivo: descrever dois casos de orquite da púrpura de Henoch-Schonlein. Descrição de casos: duas crianças apresentaram orquite durante a evolução da púrpura de Henoch-Schonlein. Foram acompanhadas evolutivamente com ultrassonografia com Doppler colorido, para avaliar uma possível torção testicular, que não ocorreu / Objective: to describe two cases of Henoch-Schonlein purpura. They were accompanied according to the evolution with Doppler coloured ultraonography to evaluate a testicular torsion occurrence, which did not happen. The cases werre treated wich prednisone with improvement in one week...

Abordagem do trauma abdominal fechado em duas crianças / Abdominal blunt trauma management in two children

Objetivo: relatar dois casos de trauma abdominal fechado em crianças com sinais clínicos frustros nos quais foram detectadas lesões hepáticas através de exame tomográfico; o tratamento foi conservador. Descrição: os casos foram atendidos em pronto socorro de pediatria, o primeiro era um menino de quatro anos de idade, que sofreu queda de 12 degraus de escada e trauma do abdome / Objective: two cases are reported of abdominal blunt trauma in children with mild clinical signs and in which tomography detected hepatic lesions; the treatment was clinical. Description: the cases were attended at the pediatric emergency room, the first was a 4-year-old boy who fell down 12 stairs and suffered abdominal trauma. he presented normal physical condition, except for abdominal pain on palpation in the hypochondrium and right flank...

Doença de Kawasaki simulando quadro séptico: relato de caso / Kawasaki disease simulating sepsis: case report

Objetivo: apresentar um caso de doença de Kawasaki (DK) onde a apresentação inicial foi sugestiva de quadro séptico com comprometimento da função miocárdica. Relato de Caso: uma lactente de um ano foi atendida em pronto socorro infantil com febre há 4 dias, em tratamento de otite com amoxacilina. Após o início do antibiótico houve aparecimento de exantema pruriginoso pelo corpo. Ao exame físico foi constatado: regular estado geral, febre elevada, taquicardia, exantema maculopapular generalizado, edema de mãos e pés, hipoperfusão periférica, hepatomegalia, e roncos pulmonares / Objective: to present a case of the Kawasaki syndrome (DK) where the clinical presentation suggested septic manifestation with myocardial function compromised. Case report: an one year old girl was admitted to a children emergency room with a complaint of fever lasting for 4 days, while receiving amoxacilin for an otitis treatment. After the antibiotic therapy start a pruriginous exanthem appeared over the body...

Taquicardia supraventricular revertida por manobra vagal: relato de caso / Supraventricular tachycardia treated trough vagal maneuver: a case report

Objetivo: descrever um episódio de taquicardia paroxísticasupraventricular (TSVP) revertido por manobra vagal. Relato de caso: uma menina de 4 anos apresentava episódios de TSVP desde o primeiro mês de vida. Era acompanhada em serviço cardiológico com escapes ocasionais tratados nese serviço. Em um episódio, buscou serviço pediátrico de urgência, com febre e dor abdominal, com duração de um dia / Objective: to describe a case of supraventricular paroxysmal tachycardia (TSVP) reverted through vagal maneuver. Case report: a four-year-old girl presented TSVP episodes since the first month of life...

Utilidade de radiografias simples no pronto atendimento de pediatria / Utility of simple radiographs in the pediatric emergency room

Estamos em meio a um programa de redução no número de radiografias simples no Pronto Atendimento do Hospital Universitário da USP, que, aparentemente, logrou êxito sem perda da qualidade do atendimento. Centramos nosso programa em três tipos de exames: as radiografias para avaliação de pneumonia, para o diagnóstico de derrame pleural, e para a avaliação de sinusite aguda...