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2.
Med. segur. trab ; 62(244): 241-262, jul.-sept. 2016. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-158402

RESUMO

Antecedentes: Los bomberos, en el ejercicio de su actividad laboral, están expuestos en forma aguda y crónica a sustancias peligrosas que conllevan un riesgo para la salud; dichas sustancias (varias de ellas clasificadas como cancerígenas) están presentes en el escenario de extinción del fuego y fuera de éste. Los equipos de protección personal han ido evolucionado con el fin de minimizar los daños. En este artículo revisamos la evidencia existente en cuanto a contaminación a través de equipos de trabajo y si la profesión de bombero supone un riesgo para el desarrollo de cáncer de testículo y próstata. Objetivos: Conocer la implicación de los equipos de trabajo como fuente adicional de contaminación en bomberos. Ver la asociación de esta profesión con cáncer de testículo y próstata. Métodos: Búsqueda bibliográfica en Pubmed, Toxnet, Scopus y OSH Update, Google scholar y webs institucionales; recopilamos 20 artículos (11 de exposición y 9 relacionados con cáncer testicular y próstata). Resultados: Se encontraron hidrocarburos aromáticos policíclicos (HAP), compuestos orgánicos volátiles (COV), algunos cancerígenos, que se adhieren a los EP. Los cánceres testicular y prostático tuvieron asociación estadísticamente significativa en 4 y 5 estudios, que valoraban incidencia y mortalidad, respectivamente; dentro de los que se incluye un metaanálisis. Conclusiones: Parece existir contaminación, a través de los equipos de protección, bien por sustancias liberadas en forma de gas, transferencia cutánea y/o desarrollo de un microambiente tóxico entre el traje y la piel. Se encontró asociación estadística significativa para cáncer de próstata y testículo (AU)


Background: Firefighters, in the exercise of their work, are exposed to acute and chronically hazardous substances that pose a health risk; these substances (some classified as carcinogenic) are present in the scene extinguishing the fire and out of this. Personal protective equipment (PPE), have evolved in order to minimize damage. In this paper, we review the actual evidence about contamination through EP and if firefighters are in risk about prostate and testis cancer. Objectives: To know the involvement of PPE as an additional source of pollution in fire. To see the association with testicular cancer and prostate cancer. Methods: Research in PubMed, Toxnet, Scopus and OSH Update, Google scholar and institutional websites; we collect 20 articles (11 and 9 related to exposure testicular cancer and prostate). Results: Polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs), some carcinogens, adhering to the EP. Testicular and prostate cancer had a statistically significant association in studies 4 and 5 respectively that assessed incidence and mortality; this included a meta-analysis. Conclusions: It seems that there’s contamination through PPE, as some substances released as a gas, by dermal contamination or by creation of toxic microenvironment between suit and skin. Different substances released during or after the fire stick to the EP, creating a «toxic microenvironment» between the suit and the skin, promoting systemic absorption. We found statistically significant association to prostate and testicular cancer (AU)


Assuntos
Humanos , Masculino , Doenças Profissionais/epidemiologia , Exposição Ocupacional/análise , Neoplasias da Próstata/epidemiologia , Neoplasias Testiculares/epidemiologia , Bombeiros/estatística & dados numéricos , Equipamento de Proteção Individual , Perigos Teratogênicos
3.
Repert. med. cir ; 25(1): 33-39, 2016. Cuadro
Artigo em Espanhol | LILACS, COLNAL | ID: lil-795744

RESUMO

La esclerosis múltiple es una enfermedad neurodegenerativa común en poblaciones jóvenes en edad reproductiva; el embarazo ha sido motivo de controversia, dada la necesidad de manejo farmacológico, el riesgo de recaídas y la discapacidad resultante. Los estudios son escasos, aunque la mayoría aporta datos confiables.Objetivos: Ofrecer al médico una adecuada orientación preconcepcional y durante el embarazo en pacientes con esta enfermedad, así como una adecuada información acerca del uso de medicamentos y sus efectos a corto y largo plazo, tanto en la madre como en el feto.Materiales y métodos: Para la revisión de la literatura se estructuró una estrategia de búsqueda utilizando los términos embarazo, esclerosis múltiple, tratamientos inmunomoduladores y efectos teratogénicos (MeSH y no MeSH), los cuales se articularon con operadores booleanos en las siguientes bases de datos: Pubmed, Ebscohost y Embase, filtrando los resultados por artículos de revisión.Discusión: Se analizan el efecto protector del embarazo en esclerosis múltiple y la administración de vitamina D.Conclusión: Aunque no hay evidencia suficiente sobre el efecto nocivo del tratamiento en el recién nacido, se recomienda suspenderlo... (AU)


Multiple sclerosis is a neurodegenerative disease commonly affecting young adults of fertile age. Pregnancy has been a subject of controversy given that pharmacological management is required, there is a risk of relapses, and it may be disabling. Studies on the topic are scarce, although most of them report reliable data.Objective: To provide the physician with adequate preconception and pregnancy care guidelines for this disease, as well as, adequate information about medications and their effects in the short and long-term, for the mother and the foetus.Materials and methods: A search strategy was created for reviewing the literature, using the terms, pregnancy, multiple sclerosis, immunomodulatory therapies and teratogenic effects (MeSH and not MeSH), which were articulated with Boolean operators in the following databases: Pubmed, Ebscohost and Embase, filtering the results by review article.Discussion: The protective effects of pregnancy on multiple sclerosis were evaluated, as well as, vitamin D administration.Conclusion: Although there is not enough evidence on the harmful effects of treatment on the newborn, discontinuing the treatment is recommended...(AU)


Assuntos
Humanos , Esclerose Múltipla , Complicações na Gravidez , Fatores Imunológicos , Perigos Teratogênicos
4.
Rev. bras. saúde matern. infant ; 14(4): 393-399, Oct-Dec/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-736223

RESUMO

To evaluate the agreement between Visual Analogue Scales (VAS) and numerical questions as a way of assessing the perception of teratogenic risk of treatment with drugs and radiotherapy. Methods: the sample comprised 144 pregnant and 143 non-pregnant women consecutively recruited at public health centers in Porto Alegre, in the State of Rio Grande do Sul, from February to August 2011. The perception of risk for congenital malformations in the general population and the perceptions of teratogenic risk for exposure to acetaminophen, meto-clopramide, misoprostol and radiotherapy were measured using VAS and numerical questions. The agreement between the results of the two techniques was tested using a Bland-Altman plot. Results: the medians for the perceptions measured using VAS were higher than those obtained using numerical questions for all variables. The perception of risk for acetaminophen showed the lower bias of the two techniques (bias=13.17; p<0.001) and exposure to radiotherapy, the higher (bias=25.02; p<0.001). Conclusion: there was no agreement between the measurements obtained using the two techniques for any of the risk perceptions under study. Risk perceptions were higher using VAS, for all kinds of exposure. Studies should be conducted to assess whether there is overestimation in other situations and social contexts owing to the use of VAS...


Avaliar a concordância entre Escalas Visuais Analógicas (EVA) e perguntas numéricas para aferir a percepção de risco teratogênico de medicamentos e radioterapia. Métodos: a amostra foi constituída por 144 gestantes e 143 não gestantes recrutadas consecutivamente em centros públicos de saúde de Porto Alegre, RS, entre fevereiro e agosto de 2011. A percepção de risco de malformações congênitas na população geral e as percepções de risco teratogênico das exposições a paracetamol, metoclo-pramida, misoprostol e radioterapia na gestação foram aferidas por EVA e perguntas numéricas. A concordância entre as duas técnicas foi avaliada pela análise gráfica de Bland-Altman Resultados: as medianas das percepções de risco teratogênico medidas por EVA foram superiores às obtidas através da pergunta numérica, para todas as variáveis. A percepção de risco ao paracetamol apresentou o menor viés entre as duas técnicas de aferição (viés=13,17; p<0,001) e a exposição à radioterapia, o maior (viés=25,02;p<0,001). Conclusões: não houve concordância entre as duas técnicas, para nenhuma das percepções de risco estudadas. As percepções de risco foram maiores para EVA, para todas as exposições. Sugerimos a realização de estudos que avaliem se também ocorre superestimação em outras situações e contextos sociais, em função do uso de EVA...


Assuntos
Humanos , Feminino , Gravidez , Acetaminofen/efeitos adversos , Metoclopramida/efeitos adversos , Misoprostol/efeitos adversos , Radioterapia/efeitos adversos , Perigos Teratogênicos , Teratogênios , Escala Visual Analógica , Anormalidades Induzidas por Medicamentos , Anormalidades Induzidas por Radiação
5.
Med. segur. trab ; 59(233): 426-443, oct.-dic. 2013. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-121368

RESUMO

Introducción: La utilización de agentes citostáticos ha mostrado suficiente evidencia científica en el origen de efectos carcinogénicos, mutagénicos y teratogénicos en seres humanos. El riesgo de exposición a estos agentes no se limita esencialmente a las personas que reciben dosis terapéuticas, también existe importante riesgo de exposición sobre la salud de los trabajadores que participan en la preparación, manipulación, administración y almacenamiento de estos medicamentos. Objetivo general: Revisar la literatura científica para establecer la relación entre el manejo de citostáticos por el personal sanitario y los posibles efectos sobre la salud reproductiva. Material y Métodos: Se realizó una revisión de la literatura existente a partir del año 2005 hasta el año 2012. La búsqueda se realizó por consulta directa y acceso por internet a la literatura recogida en las bases de datos de MEDLINE. Al introducir los filtros se obtuvo un total de 5 publicaciones de evidencia científica, las cuales fueron analizadas. Resultados: En un meta-análisis de 2005 se encontraron datos de abortos espontáneos, fetos muertos, malformaciones congénitas, embarazos ectópicos y cáncer. En un estudio posterior de casos y control se encontraron datos de partos prematuros, bajo peso al nacer y dificultades para conseguir la concepción. En los estudios de cohortes se encontró evidencia de: en uno, de abortos espontáneos; en otro de malformaciones congénitas y cáncer y en otro se encontraron datos de bajo peso al nacer y anomalías congénitas, pero con menores cifras de lo esperado. Discusión/Conclusiones: Los resultados encontrados no muestran una asociación estadística significativa, y por lo tanto sería de utilidad realizar estudios más potentes. A pesar de la existencia de Guías y Protocolos desde 2004, estudios posteriores a 2005 siguen evidenciando riesgos y efectos relacionados con la exposición, por lo tanto existe un margen para mejorar la evaluación del cumplimiento de dichos protocolos. A su vez existe rango de mejora en el campo de Vigilancia de la Salud (AU)


Introduction: The use of cytostatic agents has shown enough scientific evidence in the origin of mutagenic and cancer effects, as well as teratogenicity in human beings. The risk of exposure to these agents is not only confined to patients receiving therapeutic doses, but also there is an important exposure risk on the health of workers participating in the preparation, handling, administration and storage of these agents. General Objective: To review current literature in order to establish the relationship between cytostatic handling by health workers, and the possible effects on reproductive health. Material and Methods: A literature review between 2005 to 2012 was carried out. The search was done by direct consultation and internet access to MEDLINE data. After screening, a total of 5 publications of scientific evidence were found and analyzed. Results: In a meta-analysis in 2005, data on the following effects was found: spontaneous abortions, congenital deformities, ectopic pregnancies and cancer. Thereafter, in a case-control study, data on the following effects was found: premature childbirth, low weight at birth and difficulties in achieving conception. Cohort studies showed the following evidence: spontaneous abortions in one of them, congenital deformities and cancer in the second one, and low weight at birth and congenital deformities in the third one, but with lower figures than expected. Discussion: The results of this study don't show a strong statistical association, and therefore more powerful studies would be recommended. Despite existing Guidelines from 2004, studies from 2005 still show risks and effects related to exposure; so there is a long way to go in improving adherence and evaluation of these Guidelines. Also there is place for improvement in the field of Health Surveillance (AU)


Assuntos
Humanos , Citostáticos/efeitos adversos , Exposição Ocupacional/efeitos adversos , Anormalidades Congênitas/epidemiologia , Perigos Carcinogênicos , Carcinógenos/análise , Teratogênios/análise , Perigos Teratogênicos , Perigos Mutagênicos , Mutagênicos/análise
6.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 40(2): 55-57, mar.-abr. 2013.
Artigo em Espanhol | IBECS | ID: ibc-110847

RESUMO

El cáncer de mama durante el embarazo es una circunstancia clínica infrecuente. Esta asociación plantea interrogantes en lo referente al manejo de la madre en su condición fisiológica especial y la seguridad del feto. El primer trimestre del embarazo es el periodo más crítico en el cual pueden ocurrir daños severos en el feto que pueden provocar aborto espontáneo o daños subletales que inducen malformaciones, teratogénesis, mutaciones, carcinogénesis, toxicidad de órganos o retraso mental. Se analiza la experiencia en 5 casos de cáncer mamario durante la gestación y el posible efecto de los agentes quimioterápicos. Se concluye sin evidencia de riesgo teratogénico (AU)


Breast cancer during pregnancy is uncommon. This association raises questions on the management of the mother and the safety of the fetus. The first trimester of pregnancy is the most critical period, in which severe fetal damage can occur, causing miscarriage or sublethal damage leading to malformations, teratogenesis, mutations, carcinogenesis, toxicity of organs or mental retardation. We discuss our experience of five cases of breast cancer during pregnancy and the possible impact of chemotherapy agents. We conclude that there is no evidence of a risk of teratogenesis (AU)


Assuntos
Humanos , Feminino , Gravidez , Perigos Teratogênicos , Neoplasias da Mama/tratamento farmacológico , Antineoplásicos/efeitos adversos , Complicações Neoplásicas na Gravidez , Fatores de Risco
7.
Pesqui. vet. bras ; 32(10): 987-989, out. 2012. tab
Artigo em Português | LILACS | ID: lil-654386

RESUMO

Sinais nervosos associados à ingestão de vagens de Prosopis julilora tem sido descritos em aprinos adultos pastejando continuamente em áreas invadidas por esta planta. A doença não tem sido constatada em ovinos, mas nesta espécie o pastejo em áreas invadidas por P. julilora tem sido associado à ocorrência de malformações. O presente trabalho objetivou estudar a toxicidade sobre o sistema nervoso e o efeito teratogênico de vagens de P. julilora (algaroba) em ovinos e avaliar a sua toxicidade em caprinos. Para isso foram realizados três experimentos. No Experimento 1, grupos de quatro ovinos receberam vagens na concentração de 0, 60% e 90% da alimentação durante um ano. No Experimento 2, sete ovelhas ingeriram vagens, em quantidades equivalente a 2,1% do peso corporal (pc) durante toda a gestação. No Experimento 3, três caprinos receberam vagens em quantidade equivalente a 1,5% do pc por periodos de 264, 474 e 506 dias. Nenhum animal experimental apresentou sinais nervosos e no Experimento 2 todas as ovelhas pariram cordeiros normais. Esses resultados sugerem que as vagens de algaroba podem ser utilizadas sem restrição na alimentação de ovinos. Em um trabalho anterior as vagens de algaroba, nas concentrações de 60% e 90% da alimentação, causaram intoxicação em caprinos apos 210 dias de ingestão o que sugere que ocorrem variações na toxicidade das vagens. Recomenda-se que caprinos não permaneçam em áreas invadidas por algaroba por mais de um periodo de frutificação da planta.


In Brazil, nervous signs caused by the ingestion of Prosopis juliflora pods have been reported in goats grazing in areas invaded by this plant. The disease has not been reported in sheep, but in this species, grazing in areas invaded by P. juliflora has been associated with the occurrence of malformations in lambs. The objective of this research was to study the toxicity for the central nervous system and the teratogenicity of P. juliflora pods in sheep, and to determine their toxicity to goats. Three experiments were performed. In Experiment 1, groups of four sheep were fed with ration containing 0, 60% or 90% of pods. In Experiment 2, seven sheep were fed with pods in amount equivalent to 2.1% body weight (bw) during the whole gestation. In Experiment 3, three goats were fed with pods in amounts equivalent to 1.5% of their bw during 264, 474, and 506 days. None of the experimental animals showed nervous signs and the seven pregnant sheep delivered normal lambs. These results suggest that P. juliflora pods can be used without restrictions in the food of sheep. Because in a previous paper P. juliflora pods, in the concentratiosn of 60% and 90% of the food, caused nervous signs in goats after 210 days of ingestion, it is suggested that there are variation in the toxicity of the pods. It is recommended that goats may be kept in areas invaded by P. juliflora for no more than one fructification period.


Assuntos
Animais , Cabras/metabolismo , Ovinos/metabolismo , Prosopis/envenenamento , Perigos Teratogênicos , Pastagens/métodos , Sistema Nervoso/fisiopatologia
8.
Rev. cuba. obstet. ginecol ; 38(3): 313-321, jul.-set. 2012.
Artigo em Espanhol | CUMED | ID: cum-52853

RESUMO

Las cardiopatías congénitas constituyen defectos estructurales y/o funcionales del corazón y los grandes vasos, están relacionadas con la primera causa de muerte en niños menores de 1 año. Se realizó un estudio observacional, analítico, de casos y controles con el objetivo de identificar los factores de riesgo prenatales relacionados con la aparición de las cardiopatías congénitas en el territorio San Antonio de los Baños, La Habana, Cuba, de enero del 2000 a diciembre del 2009. El universo estuvo constituido por 89 gestantes cuyo producto de concepción tuvo cardiopatías congénitas. El 66,3 porciento de los casos con cardiopatías congénitas tenían algún familiar con esta patología, se identificó asociación entre la ingestión de medicamentos teratogenos y la presencia de las cardiopatías congénitas. Las edades extremas de la vida no constituyen factor de riesgo para tener hijos con cardiopatías congénitas(AU)


Congenital heart defects are structural and / or functional defects of the heart and great vessels; they are related to the first cause of death in children younger than 1 year old. We performed an observational, analytical, case-control study with to identify prenatal risk factors related to the occurrence of congenital heart disease in the territory of San Antonio de los Baños, Havana, Cuba from December 2009 to January 2000. The sample consisted of 89 pregnant women whose product of conception had congenital heart disease. 66.3 percent of cases with congenital heart disease had a relative with this disease; association was found between teratogens- medication intake and the presence of congenital heart disease. Extreme life ages are not a risk factor for having children with congenital heart disease(AU)


Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Cuidado Pré-Natal/métodos , Cardiopatias Congênitas/complicações , Perigos Teratogênicos , Fatores de Risco , Estudos de Casos e Controles , Estudos Observacionais como Assunto , Estudos Populacionais em Saúde Pública
9.
Braz. j. pharm. sci ; 48(3): 427-433, July-Sept. 2012. tab
Artigo em Inglês | LILACS | ID: lil-653456

RESUMO

The aim of this study was to present the implications of the use of herbs during pregnancy, pointing out those that should be avoided during this condition because of their abortifacient and/or teratogenic potential. We carried out searches in the databases ScienceDirect, Scielo and Google Scholar, adopting as criteria for inclusion: book chapters and/or complete articles (with abstract), available in English, Portuguese or Spanish, published from 1996 to in 2011. After a pre-selection of 83 articles, 49 bibliographies were used in the manufacturing end of the article, where 25 were from the Scielo database, 18 from ScienceDirect and 6 from Google Scholar. From the articles studied, we identified the four most commonly used plants as emmenagogue/abortifacient agents by patients of the Department of Prenatal SUS: senne, arruda, boldo and buchinha-do-norte or cabacinha. Thus, we conclude that people often adhere to the maxim "if it's natural, it does no harm" in their rational use of natural products, without the right guidance, believing that these products are safe to use. This usage is even more worrisome among the elderly, pregnant women and children. Regarding the safety of these products, some information and reliable data are scarce or contradictory.


Este trabalho busca as implicações atuais sobre o uso de plantas medicinais durante a gravidez, alertando sobre aquelas que devem ser evitadas nesse período por serem potencialmente abortivas e/ou teratogênicas. Para tanto, foram realizadas buscas nas bases de dados Sciencedirect, Scielo e Google scholar, adotando-se como critérios de inclusão capítulos de livros e/ou artigos completos (com abstract) e disponíveis, em português, inglês ou espanhol, publicados de 1996 a 2011. Após uma pré-seleção de 83 artigos, 49 bibliografias foram utilizadas na confecção final do artigo, sendo 25 provenientes da base de dados Scielo, 18 do Sciencedirect e 06 do Google scholar. A partir dos artigos estudados, identificaram-se as quatro plantas mais utilizadas como emenagogas/abortivas por pacientes do Serviço de Pré-Natal do SUS: senne, arruda, boldo e buchinha-do-norte ou cabacinha. Assim, é possível concluir que, muitas vezes, a população se utiliza da máxima "se é natural, não faz mal" para fazer uso irracional de produtos naturais, sem a correta orientação, acreditando que esses produtos sejam incapazes de provocar qualquer dano. Esse uso é ainda mais preocupante quando realizado por idosos, gestantes e crianças. Em relação à segurança do uso desses produtos, algumas informações e dados confiáveis ainda são escassos ou contraditórios.


Assuntos
Plantas Medicinais/toxicidade , Gravidez , Perigos Teratogênicos , Produtos Biológicos/análise , Indutores da Menstruação/análise
10.
Rev. cuba. obstet. ginecol ; 38(3): 313-321, jul.-set. 2012.
Artigo em Espanhol | LILACS | ID: lil-649869

RESUMO

Las cardiopatías congénitas constituyen defectos estructurales y/o funcionales del corazón y los grandes vasos, están relacionadas con la primera causa de muerte en niños menores de 1 año. Se realizó un estudio observacional, analítico, de casos y controles con el objetivo de identificar los factores de riesgo prenatales relacionados con la aparición de las cardiopatías congénitas en el territorio San Antonio de los Baños, La Habana, Cuba, de enero del 2000 a diciembre del 2009. El universo estuvo constituido por 89 gestantes cuyo producto de concepción tuvo cardiopatías congénitas. El 66,3 porciento de los casos con cardiopatías congénitas tenían algún familiar con esta patología, se identificó asociación entre la ingestión de medicamentos teratogenos y la presencia de las cardiopatías congénitas. Las edades extremas de la vida no constituyen factor de riesgo para tener hijos con cardiopatías congénitas


Congenital heart defects are structural and / or functional defects of the heart and great vessels; they are related to the first cause of death in children younger than 1 year old. We performed an observational, analytical, case-control study with to identify prenatal risk factors related to the occurrence of congenital heart disease in the territory of San Antonio de los Baños, Havana, Cuba from December 2009 to January 2000. The sample consisted of 89 pregnant women whose product of conception had congenital heart disease. 66.3 percent of cases with congenital heart disease had a relative with this disease; association was found between teratogens- medication intake and the presence of congenital heart disease. Extreme life ages are not a risk factor for having children with congenital heart disease


Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Cuidado Pré-Natal/métodos , Cardiopatias Congênitas/complicações , Perigos Teratogênicos , Estudos de Casos e Controles , Estudos Observacionais como Assunto , Estudos Populacionais em Saúde Pública , Fatores de Risco
11.
Int. j. morphol ; 30(1): 119-124, mar. 2012. ilus
Artigo em Inglês | LILACS | ID: lil-638771

RESUMO

Lead is one of the heavy metals most used in industry. Poisoning due to long-term lead exposure is known as saturnism, and is an occupational illness that has been known for many years. Lead is highly toxic and can compromise the structural and functional patterns of organs and systems. The aim of this study was to examine the lungs and kidneys of fetuses from female Wistar rats exposed to lead acetate. In this study, the lungs and kidneys of 20 fetuses from female rats that had previously been treated with lead acetate were dissected, fixed, embedded in paraffin and stained with hematoxylin and eosin. Macroscopic changes to the shape, color and consistency of organs from fetuses treated with this heavy metal were observed, in comparison with organs from control fetuses. Microscopic lesions characterized by vascular sclerosis, cell atrophy or hyperplasia, progressive interstitial fibrosis, inclusion bodies containing lead acetate and glomerular sclerosis were found in the kidneys. The lesions found in the lungs consisted of destructuring of the parenchyma, impregnation with lead acetate, formation of fibrosis, extravasation of vascular fluids, reduction of the alveolar spaces and formation of alveolar edema. These changes were correlated with the level of lead acetate absorption, as determined using atomic spectrophotometry.


El plomo es un metal pesado utilizado en la industria. El envenenamiento debido a la exposición prolongada por plomo es una enfermedad profesional conocida por muchos años. La toxicidad del plomo es muy expresiva y puede poner en peligro el modelo estructural y funcional de los órganos y sistemas. El objetivo de este estudio fue examinar los pulmones y riñones de fetos de ratas Wistar expuestos al acetato de plomo. En este estudio, 20 fetos de ratas Wistar previamente tratados con acetato de plomo durante la gestación, tuvieron sus órganos disecados, fijados, incluidos en parafina y teñidos con hematoxilina y eosina. Macroscópicamente, los órganos fetales tratados por este metal fueron comparados con los órganos de fetos controles en relación a forma, color y consistencia. Microscópicamente, se encontraron lesiones en el riñón que se caracterizaron por esclerosis vascular, atrofia o hiperplasia de células, fibrosis intersticial progresiva, presencia de cuerpos de inclusión que contenían acetato de plomo y esclerosis glomerular. En el pulmón se observó desorganización del parénquima impregnado con acetato de plomo, formación de fibrosis, líquido intersticial, reducción de los espacios alveolares y edema alveolar. Estos cambios se correlacionaron con el nivel de absorción de acetato de plomo, determinado por espectrometría atómica.


Assuntos
Ratos , Chumbo/toxicidade , Pulmão/anatomia & histologia , Pulmão , Rim/anatomia & histologia , Rim , Anormalidades Induzidas por Medicamentos/veterinária , Ratos Wistar/anatomia & histologia , Ratos Wistar/sangue , Perigos Teratogênicos
12.
Rev. esp. enferm. dig ; 104(2): 59-64, feb. 2012. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-97745

RESUMO

Introducción: la enfermedad inflamatoria intestinal (EII) es un trastorno crónico que debuta en la mayoría de los casos durante la edad reproductiva. Existen pocos datos sobre la seguridad durante el embarazo de los tratamientos disponibles, entre ellos los denominados biológicos, y estos están basados en resultados de casos esporádicos. Objetivos: determinar la seguridad del tratamiento con infliximab (IFX) durante el embarazo en mujeres con EII. Un segundo objetivo es observar el efecto que sobre la actividad de la enfermedad tiene el abandono del tratamiento. Material y métodos: se trata de un estudio retrospectivo en el que se incluyeron mujeres con EII embarazadas y que estaban en tratamiento con IFX durante el embarazo. Se incluyeron en el estudio a 5 hospitales de España. La actividad de la enfermedad se midió según el CDAI en la enfermedad de Crohn (EC) y la de la colitis ulcerosa (CU) según el índice de Truelove-Witts en cada trimestre del embarazo. La edad gestacional, el peso y las enfermedades del feto se determinaron al nacimiento. Resultados: se incluyeron doce mujeres con una edad media de 29 años, 4 diagnosticadas de CU y 8 de EC, con una duración media de la enfermedad de 7 años. Todas salvo una, que se diagnosticó durante el embarazo estaban siendo tratadas con IFX en el momento de la concepción. Seis pacientes recibieron el tratamiento de forma ininterrumpida durante todo el embarazo, 2 suspendieron el tratamiento de forma voluntaria y a tres se les suspendió el tratamiento en el tercer trimestre. Recibieron una dosis media de IFX de 400 mg cada 8 semanas. De las 6 pacientes que recibieron tratamiento continuo, el 50% se mantuvo en remisión. De las pacientes que abandonaron el tratamiento, un 83,3% (todas menos una) presentaron un brote de su enfermedad. Ocho partos fueron por vía vaginal y cuatro por cesárea. Ningún recién nacido presentó malformaciones congénitas, retraso del crecimiento intrauterino ni bajo peso y sólo hubo un parto prematuro. Conclusiones: aunque los casos incluidos en el estudio son pocos, según nuestra experiencia IFX es un fármaco seguro durante el embarazo para la madre y el feto. De hecho, parece que su suspensión puede conducir a un empeoramiento de la enfermedad. No obstante, son necesarios más estudios y con más pacientes para obtener resultados con mayor evidencia científica(AU)


Background: in most cases, inflammatory bowel disease (IBD) debuts at reproductive age. The data available in the literature show infliximab (IFX) to be a safe drug during pregnancy but there is very little evidence about the activity of the disease following drug withdrawal during pregnancy. Aims: determine the drug’s safety in pregnant women in our setting and assess its effect on the foetus, drawing on the experience of several hospitals. Secondly, observe the effect of treatment withdrawal on disease activity during pregnancy. Material and methods: a retrospective study was conducted of women with IBD who had received IFX treatment during pregnancy in five hospitals in Spain. Disease activity was assessed using Crohn’s Disease Activity Index, while UC was assessed using the Truelove-Witts Index in each trimester of pregnancy. Gestational age, weight and diseases in the foetus were determined at birth. Results: the study included 12 women with a mean age of 29 years; 4 had ulcerative colitis and 8 Crohn’s disease, with mean disease duration of 7 years. All but one, who was diagnosed during pregnancy, was receiving IFX treatment at conception. Six patients received uninterrupted treatment throughout the pregnancy, 2 requested voluntary interruption and in 3 cases treatment was interrupted in the third trimester as a precaution. They received a mean IFX dose of 400 mg every 8 weeks. Of the 6 patients who received continuous treatment, in 50% disease was held in remission. The 6 remaining patients suspended treatment for different reasons, presenting disease recurrence in all but one case (83.3%). Eight deliveries were vaginal and 4 by caesarean section. Newborns presented no congenital anomalies, intrauterine growth retardation or low birth weight and there was only one premature delivery. Conclusions: although cases included in the stduy are not significant, in our experience, IFX during pregnancy is a safe treatment for the mother and the foetus. In fact, in our study and in some cases, its withdrawal may lead to a worsening of the disease. How - ever, further control studies are required with larger samples to obtain more representative findings(AU)


Assuntos
Humanos , Feminino , Gravidez , Adulto , Doenças Inflamatórias Intestinais/tratamento farmacológico , Colite Ulcerativa/complicações , Colite Ulcerativa/tratamento farmacológico , Idade Gestacional , Colectomia/métodos , Corticosteroides/uso terapêutico , Fatores de Risco , Doença de Crohn/complicações , Doença de Crohn/tratamento farmacológico , Estudos Retrospectivos , Sinais e Sintomas , Coleta de Dados , Perigos Teratogênicos
14.
Pesqui. vet. bras ; 30(3): 277-288, mar. 2010. ilus
Artigo em Português | LILACS | ID: lil-545171

RESUMO

São descritos aspectos toxicológicos, clínico-patológicos e ultraestruturais de coelhos intoxicados iatrogênica e experimentalmente por vitamina D por via subcutânea. Clinicamente, os animais evidenciaram sinais de insuficiência cardiovascular como ascite e edema pulmonar, hiporexia, anorexia, diarréia mucosa, emagrecimento e apatia. As clássicas alterações de mineralização e, por vezes, osseificação, do sistema cardiovascular, bem como as alterações de rins, pulmões, estômago, entre outros órgãos, foram reproduzidas com administrações subcutâneas de solução oleosa de colecalciferol (vitamina D3 não-ativada).


Toxicological, clinic-pathological and ultrastructural aspects of iatrogenic and experimental subcutaneous poisoning in rabbits by vitamin D are described. Clinically the animals showed signs of cardiovascular insufficiency, as ascite and lung edema, hyporexia, anorexia, mucous diarrhoea, loss of weight and apathy. The classical alterations of minera-lization and, occasionally, ossification of the cardiovascular system, as well the lesions of kidneys, lungs, stomach, among other organs, were reproduced by the subcutaneous administration of an oily solution of cholecalciferol (non-activated vitamin D3).


Assuntos
Animais , Masculino , Feminino , Coelhos , Calcinose/complicações , Calcinose/veterinária , Colecalciferol/administração & dosagem , Colecalciferol/envenenamento , Colecalciferol , Doença Iatrogênica/epidemiologia , Doença Iatrogênica/veterinária , Receptores de Calcitriol/ultraestrutura , Epidemiologia Experimental , Injeções Subcutâneas/métodos , Injeções Subcutâneas/veterinária , Patologia Clínica/métodos , Perigos Teratogênicos , Sintomas Toxicológicos
15.
Actas dermo-sifiliogr. (Ed. impr.) ; 100(6): 445-455, ago. 2009.
Artigo em Espanhol | IBECS | ID: ibc-60362

RESUMO

Tanto los síndromes de androgenización y las enfermedades que empeoran con el embarazo, como la medicación de riesgo para el feto de uso habitual en Dermatología precisan la prescripción de contraceptivos por parte del dermatólogo. En mujeres sanas, no fumadoras, la anticoncepción oral no aumenta el riesgo de enfermedad cardiovascular (cerebral o cardiaca), y está asociada a grandes beneficios no anticonceptivos, incluidos la importante prevención del carcinoma de ovario y de endometrio, de la gestación ectópica, la enfermedad inflamatoria pélvica, el dolor ovulatorio y los trastornos del ciclo menstrual. Se revisan el mecanismo de acción, los efectos secundarios, los riesgos para la salud, las contraindicaciones, el inicio y el seguimiento del uso de los anticonceptivos orales, así como las interacciones de los anticonceptivos con otros fármacos (AU)


Patients with hyperandrogenic syndromes and diseases exacerbated by pregnancy and those taking common dermatologic drugs associated with risk to the fetus require prescription of contraceptives by the dermatologist. In healthy, nonsmoking women, oral contraception does not increase the risk of cerebral or cardiac vascular disease and is associated with major benefits besides avoiding pregnancy. These include prevention of ovarian and endometrial carcinoma, ectopic pregnancy, pelvic inflammatory disease, ovulation pain, and menstrual cycle disorders. This article will review the mechanism of action, side effects, health risks, contraindications, initiation of the oral contraceptive regimen, and patient follow-up, as well as interactions between contraceptives and other drugs (AU)


Assuntos
Humanos , Feminino , Anticoncepcionais Orais Hormonais/farmacocinética , Dermatopatias/induzido quimicamente , Virilismo/induzido quimicamente , Perigos Teratogênicos , Interações de Medicamentos , Anticoncepcionais Orais Hormonais/farmacologia
16.
Pharm. pract. (Granada, Internet) ; 6(1): 15-19, ene.-mar. 2008. tab
Artigo em Inglês | IBECS | ID: ibc-64347

RESUMO

Counselling or prescribing drugs during pregnancy requires health professionals to assess risk/benefit ratio for women and their baby. A misperception of the risk may lead to inappropriate decisions for pregnancy outcomes. The aim of the present study was to assess teratogenic and/or foetotoxic risk perception of common medications by general practitioners (GPs) and community pharmacists (CPs) from the Midi-Pyrenees area. Methods: 103 GPs and 104 CPs were interviewed. For 21 given drugs, a visual-analogue scale was used to evaluate the risk to give birth to a malformed infant if the mother had taken the drug during first trimester of pregnancy. For 9 drugs, health professionals had to say if they thought there was a potential foetotoxic and/or neonatal risk when drugs were administered during late pregnancy. Results: 97% and 91% of GPs and CPs respectively thought that isotretinoin and thalidomide are teratogenic and more than 80% thought that amoxicillin and acetaminophen are safe in early pregnancy. However, 19% of the GPs and 33% of CPs answered there were no teratogenic risk for valproate. Around 11% of both GPs and CPs said that warfarin was safe during pregnancy. For 22% of GPs and for 13% and 27% of CPs respectively, ibuprofen and enalapril were safe on late pregnancy. For each drug, mean value of perceived teratogenic risk by health professionals was higher than values that can be found in scientific references. Concerning isotretinoin, thalidomide and metoclopramide, perceived teratogenic risk was higher for CPs. Conclusion: These data show that the potential teratogenic and foetotoxic risk of several commonly used drugs is unknown by health professionals. Conversely, GPs and CPs who think that a risk exists, overestimate it. This misperception can lead to inappropriate decisions for pregnancy outcomes (AU)


Aconsejar o prescribir medicamentos durante el embarazo requiere que los profesionales de la salud evalúen la relación riesgo/beneficio para la mujer y su bebé. Una mala percepción del riesgo, puede llevar a decisiones inapropiadas para los resultados del embarazo. El objetivo del presente estudio fue evaluar la percepción del riesgo teratogénico y/o fetotóxico de medicamentos frecuentes por médicos generales (MG) y farmacéuticos comunitarios (FC) de la región de Midi-Pyrenees. Métodos: Se entrevistó a 103 MG y 104 FC. Se utilizó una escala visual analógica EVA para evaluar el riesgo de dar a luz un niño malformado si la madre había usado el medicamento durante el primer trimestre de embarazo. Para 9 medicamentos, los profesionales tenían que decir si pensaban que había un riesgo teratogéncio y/o fetotóxico cuando se administraban los medicamentos al final del embarazo. Resultados: el 97% y el 91% de los MG y FC respectivamente pensaron que la isotretinoína y la talidomida eran teratogénicos y más del 80% pensó que la amoxicilina y el paracetamol eran seguros al principio del embarazo. Sin embargo, el 19% de los MG y el 33 de los FC respondió que no había riesgo teratogénico en el valproato. Cerca del 11% tanto de MG y de FC dijo que la warfarina era segura durante el embarazo. Para el 22% de los MG y para 13% y 27% de FC el ibuprofeno y el enalaprilo eran seguros al final del embarazo, respectivamente. Para cada medicamento, el valor medio del riesgo teratogénico para los profesionales era superior a los valores encontrados en la literatura. Relativamente a la isotretinoína, talidomina y metoclopramida, el riesgo percibido era superior para los FC. Conclusión: Estos datos muestran que el posible riesgo teratogénico y fetotóxico de varios medicamentos frecuentemente utilizados no es conocido por los profesionales de la salud. Por el contrario, los MG y FC que piensan que existe riesgo, lo sobre-estiman. Esta mala interpretación puede conducir a decisiones inapropiadas en el embarazo (AU)


Assuntos
Humanos , Feminino , Gravidez , Teratogênios/análise , Perigos Teratogênicos , Complicações na Gravidez/tratamento farmacológico , Prescrições de Medicamentos , Fatores de Risco , França , Conhecimentos, Atitudes e Prática em Saúde
17.
Rev. esp. pediatr. (Ed. impr.) ; 64(1): 74-88, ene.-feb. 2008. tab
Artigo em Espanhol | IBECS | ID: ibc-59808

RESUMO

En este trabajo se describen estudios preclínicos y clínicos del ácido linoleico conjugado (CLA). En 2 ensayos de mutagénesis el CLA demuestra efectos negativos. En un estudio de toxicidad subcrónica en ratas alimentadas con CLA (1,5 ó 15%) se identificó un NOAEL de 2.433 y 2.728 mg/kg pc/día para machos y hembras. Dos estudios de toxicidad crónica en ratas alimentadas con CLA (1 y 1.5%) no presentaron signos de toxicidad. Un estudio de teratogénesis y toxicidad post-natal en ratas alimentadas con CLA (0,25 y 0,5%) no evidenció efectos adversos. Estudio clínico con CLA a dosis de 3,4 g/día durante 2 años en sujetos adultos fue seguro y bien tolerado. Otros estudios en que se administró CLA a dosis de 6g/día durante 12 meses y 3g/día durante 12 semanas demostraron ser bien tolerados. Un meta-análisis efectuado concluyó que el CLA a dosis de 3,2 g/día produce una modesta pérdida de la masa de grasa corporal (MGC). Estudios clínicos en niños y adolescentes obesos a los que se administró CLA a una dosis de 3g/día durante 6 a 12 meses no produjo alteraciones en los patrones habituales de crecimiento. En otro estudio realizado en la edad pediátrica y adulta en obesos que recibieron durante 16 semanas dos envases de 100 g de yogur suplementado con CLA se observó en base a los parámetros de seguridad evaluados y la clínica de los pacientes que este compuesto era seguro. Se presenta, por último, un Post Launch Monitoring de productos Naturlínea conteniendo CLA como Tonalin y conclusiones sobre la seguridad del CLA (AU)


This paper presents pre-clinical y clinical studies of conjugated linoleic acid (CLA). Two mutagenicity studies have evidence CLA negative effects. A subchronic study in rats fed with CLA (1,5 or 15%) concluded a NOAEL of 2.433 and 2.728 mg/kg bw/day for male and female, respectively. Two chronic toxicity studies in rats fed with CLA (1 and 1,5%) no signs of toxicity were showed. A teratogenic and post-natal toxicity study in the rat fed with CLA (0.25% or 0.5%) did not evidence adverse effects. A clinical study with CLA at dose of 3.4 g/day for 2 years in obese adult subjects was safe and tolerated. In other studies in which CLA was administed at doses of 6g/day during 12 months and 3g/day for 12 weeds showed to be well tolerated. A meta-analysis of human studies in which CLA was provided as a dietary supplement concluded that CLA was provide as a dietary supplement concluded that CLA given at a dose of 3.2 g/day produced a modest loss in body fat. Obese children and adolescent clinical studies in which CLA was provided as a dietary supplement concluded that CLA given at a dose of 3.2 g/day produced a modest loss in body fat. Obese children and adolescent clinical studies in which CLA was administered at a dose of 3g/day for 6 to 12 months did not produce changes in usual pattern of growth. Other study performed with obese adolescents during 16 weeks receiving a daily amount of 200 g of yogurt supplemented with CLA was safe. Finally a “Post Launch Monitoring” of Naturlinea products containing CLA as Tonalin and general conclusions on safety of CLA were presented (AU)


Assuntos
Humanos , Animais , Ácidos Linoleicos Conjugados/efeitos adversos , Obesidade/dietoterapia , Mutagênese , Genotoxicidade , Perigos Teratogênicos
18.
Braz. j. vet. res. anim. sci ; 45(1): 67-75, 2008. graf, ilus, tab
Artigo em Português | LILACS | ID: lil-488557

RESUMO

The embryotoxic effects of prenatal daily exposure to 0.0, 0.7, 3.0 or 15.0 mg/kg of the aqueous extract (AQE) from Ipomoea carnea (I. carnea) dried leaves on gestational days 5û21 were studied in rats. Maternal reproductive performance, skeletal and visceral abnormalities, and malformations were evaluated. Moreover, anatomopathological findings in dams following the treatment were recorded. Regarding the dams, our results show that body weight, weight gain, food and water consumption, and reproductive performance were all unaffectedby exposure to the different doses of the AQE. Nonetheless, dams treated with AQE presented a dose-dependent cytoplasmic vacuolation in the liver, kidneys, thyroid and adrenal glands. Fetal examination did not show external abnormalities or malformations. Evidences of several skeletal and visceral abnormalities were found, particularly after the higher dose of AQE. A reduced ossification centers were also detected. The present data show that prenatal ingestion of the I. carnea AQE in rats induces embryotoxicity. These effects are attributed to an active principle from I. carnea acting on maternal homeostasis, or directly in the conception.


Os efeitos embriotóxicos da exposição diária pré-natal a 0,0, 0,7, 3,0 ou 15,0mg/kg do extrato aquoso da I. carnea nos dias 5 a 21 de gestação foram estudados. Foram avaliados a performance reprodutiva materna, anormalidades esqueléticas e viscerais e malformações. Além disso, após o tratamento foram encontrados achados anatomopatológicos. Em relação às ratas mães, nossos resultados mostraram que a exposição às diferentes doses não afetou o peso corporal, ganho de peso, consumos de água e ração e performance reprodutiva. Apesar disso, apresentaram vacuolização citoplasmática de forma dose-dependente em fígado, rins, tireóide e glândula adrenal. Exames fetais não mostraram anormalidades externas ou malformações, sendo somente encontradas evidências de anormalidades esqueléticas e viscerais após altas doses do extrato. Foi observada redução dos centros de ossificação. Os presentes dados mostram que a ingestão prenatal do extrato de I. carnea induz embriotoxicidade. Estes efeitos são atribuídos à ação na homeostase maternal ou diretamente na concepção.


Assuntos
Animais , Estruturas Embrionárias/anatomia & histologia , Ipomoea/toxicidade , Ratos , Perigos Teratogênicos
20.
Med. intensiva (Madr., Ed. impr.) ; 31(1): 29-35, ene. 2007. ilus
Artigo em Espanhol | IBECS | ID: ibc-64368

RESUMO

El síndrome coronario agudo con elevación de ST (SCACEST) es una entidad clínica que rara vez se observa en mujeres embarazadas, pero cuya manifestación constituye una situación de alto riesgo materno-fetal. El manejo farmacoterapéutico de estas pacientes es difícil y requiere una atención individualizada por parte de un equipo multidisciplinar, puesto que muchos de los tratamientos estándar se incluyen dentro de las categorías de teratogenicidad C o D de la Food and Drug Administration, y es escasa la experiencia con técnicas como la angioplastia coronaria con colocación de stent. Se describe el caso de una mujer de 32 años, gestante de 11 semanas y diagnosticada de SCACEST, así como el abordaje terapéutico de la misma. Además se revisa la información disponible sobre la epidemiología, etiología y fisiopatología del SCACEST durante el embarazo y el papel específico de las opciones de tratamiento disponibles actualmente


ST segment elevation acute coronary syndrome is a clinical condition that is rarely observed in pregnant women. However, its manifestation is a situation of high maternal-fetal risk. Pharmacotherapeutical management of these patients is difficult and requires individualized care by a multidisciplinary team since many of the standard treatments are included within the categories of teratogencity C or D of the Food and Drug Administration and experience with techniques such as coronary angioplasty with stent placement is scarce. The case of a 32-year woman who was 11 weeks pregnant and diagnosed of acute coronary syndrome with ST segment and its therapeutic approach are described. Furthermore, the information available on epidemiology, etiology and pathophysiology of acute coronary syndrome with ST segment during pregnancy and the specific role of the currently available treatment options are reviewed


Assuntos
Humanos , Feminino , Gravidez , Doença das Coronárias/tratamento farmacológico , Complicações Cardiovasculares na Gravidez/tratamento farmacológico , Gravidez de Alto Risco , Angiografia Coronária , Perigos Teratogênicos , Fibrinólise , Terapia Trombolítica , Arritmias Cardíacas/complicações , Fatores de Risco
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