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BACKGROUND: Although G6PDd individuals are generally asymptomatic throughout their life, the clinical burden of this genetic condition includes a range of haematological conditions, including acute haemolytic anaemia (AHA), neonatal jaundice (NNJ) and chronic non-sphaerocytic anaemia (CNSA). In Latin America (LA), the huge knowledge gap regarding G6PDd is related to the scarce understanding of the burden of clinical manifestation underlying G6PDd carriage. The aim of this work was to study the clinical significance of G6PDd in LA and the Caribbean region through a systematic review. METHODS: A systematic search of the published literature was undertaken in August 2013. Bibliographies of manuscripts were also searched and additional references were identified. Only original research was included. All study designs were included, as long as any clinical information was present. Studies were eligible for inclusion if they reported clinical information from populations living in LA or Caribbean countries or about migrants from these countries living in countries outside this continent. RESULTS: The Medline search generated 487 papers, and the LILACS search identified 140 papers. After applying the inclusion criteria, 100 original papers with any clinical information on G6PDd in LA were retrieved. Additionally, 16 articles were included after reading the references from these papers. These 116 articles reported data from 18 LA and Caribbean countries. The major clinical manifestations reported from LA countries were those related to AHA, namely drug-induced haemolysis. Most of the published works regarding drug-induced haemolysis in LA referred to haemolytic crises in P. vivax malaria patients during the course of the treatment with primaquine (PQ). Favism, infection-induced haemolysis, NNJ and CNSA appear to play only a minor public health role in this continent. CONCLUSION: Haemolysis in patients using PQ seems to be the major clinical manifestation of G6PDd in LA and contributes to the morbidity of P. vivax infection in this continent, although the low number of reported cases, which could be linked to under-reporting of complications. These results support the need for better strategies to diagnose and manage G6PDd in malaria field conditions. Additionally, Malaria Control Programmes in LA should not overlook this condition in their national guidelines.
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Erradicação de Doenças , Deficiência de Glucosefosfato Desidrogenase/epidemiologia , Hemólise , Malária Vivax/tratamento farmacológico , Malária Vivax/epidemiologia , Primaquina/efeitos adversos , Região do Caribe/epidemiologia , Humanos , América Latina/epidemiologia , Malária Vivax/patologia , Primaquina/uso terapêuticoRESUMO
Peperomia pellucida (PP) belongs to the Peperomia genus, which has a pantropic distribution. PP is used to treat a wide range of symptoms and diseases, such as pain, inflammation, and hypertension. Intriguingly, PP extract is used by different tropical countries for its anti-inflammatory and antinociceptive effects. In fact, these outcomes have been shown in animal models, though the exact bioactive products of PP that exert such results are yet to be discovered. To determine and elucidate the mechanism of action of one of these compounds, we evaluated the antinociceptive effect of the novel dimeric ArC2 compound, Pellucidin A by using in vivo and in silico models. Animals were then subjected to chemical, biphasic and thermal models of pain. Pellucidin A induced an antinociceptive effect against chemical-induced pain in mice, demonstrated by the decrease of the number of writhes, reaching a reduction of 43% and 65% in animals treated with 1 and 5 mg/kg of Pellucidin A, respectively. In the biphasic response (central and peripheral), animals treated with Pellucidin A showed a significant reduction of the licking time exclusively during the second phase (inflammatory phase). In the hot-plate test, Pellucidin A did not have any impact on the latency time of the treated animals. Moreover, in vivo and in silico results show that Pellucidin A's mechanism of action in the inflammatory pain occurs most likely through interaction with the nitric oxide (NO) pathway. Our results demonstrate that the antinociceptive activities of Pellucidin A operate under mechanism(s) of peripheral action, involving inflammatory mediators. This work provides insightful novel evidence of the biological properties of Pellucidin A, and leads to a better understanding of its mechanism of action, pointing to potential pharmacological use.
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Analgésicos/farmacologia , Ciclobutanos/farmacologia , Animais , Anti-Inflamatórios/farmacologia , Ciclo-Oxigenase 2/efeitos dos fármacos , Ciclo-Oxigenase 2/metabolismo , Inflamação/tratamento farmacológico , Camundongos , Simulação de Acoplamento Molecular , Óxido Nítrico/metabolismo , Dor/tratamento farmacológico , Dor/fisiopatologia , Medição da Dor , Peperomia , Extratos Vegetais/farmacologiaRESUMO
ABSTRACT Insects are fundamental to biodiversity conservation in almost all ecosystems, and their population decline, and extinction directly result from environmental impacts. These facts are aggravated by the lack of knowledge of insect biodiversity, the so-called biodiversity deficits, especially the Linnean and Wallacean shortfalls. In freshwater ecosystems, biodiversity loss is higher among aquatic insects, and caddisflies comprise one of the most vulnerable orders. In this way, research focusing on describing new caddisfly species and understanding their distribution ranges will increase knowledge of caddisfly biodiversity. In the past 14 years, the team from the Laboratório de Entomologia Aquática "Prof. Dr. Claudio Gilberto Froehlich" (LEAq, Universidade Federal da Bahia, Brazil) and collaborators have been addressing these issues, resulting in 55 described species of caddisflies. Taxa in other insect orders have also received attention and an additional 16 species have been described (eight mayflies, four stoneflies, four neuropteran spongillaflies, and antlions). Here, eight caddisfly species are described and illustrated (Atopsyche froehlichi sp. nov., Austrotinodes zeferina sp. nov., Cernotina kariri sp. nov., Neoathripsodes froehlichi sp. nov., Notalina claudiofroehlichi sp. nov., Oecetis marcus sp. nov., Phylloicus froehlichi sp. nov., and Polycentropus claudioi sp. nov.), five of them in honor of LEAq's patron. In addition, new distributional data are presented for 10 known species. A checklist of the caddisfly fauna of Bahia state is also presented, with 138 species, around 75% and 30% of them recorded and described by the LEAq team, respectively. Currently, for caddisflies, Bahia is the fifth most species-rich state in Brazil, and the first in the Brazilian Northeast region.
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INTRODUCTION: During and after coronary artery bypass grafting, a decline in multifactor lung function is observed. Due to this fact, some patients may benefit from non-invasive ventilation after extubation targeting lung expansion and consequently improved oxygenation. OBJECTIVE: To test the hypothesis that higher levels of positive end expiration pressure during non-invasive ventilation improves oxygenation in patients undergoing coronary artery bypass grafting. METHODS: A randomized clinical trial was conducted at Instituto Nobre de Cardiologia in Feira de Santana. On the first day after surgery, the patients were randomized: Group PEEP 10, Group PEEP 12 and Group PEEP 15 who underwent non-invasive ventilation with positive end expiration pressure level. All patients were submitted to analysis blood pressure oxygen (PaO2), arterial oxygen saturation (SaO2) and oxygenation index (PaO2/FiO2). RESULTS: Thirty patients were analyzed, 10 in each group, with 63.3% men with a mean age of 61.1±12.2 years. Mean pulmonary expansion pre-therapy PaO2 was generally 121.9±21.6 to 136.1±17.6 without statistical significance in the evaluation among the groups. This was also present in PaO2/FiO2 and SaO2. Statistical significance was only present in pre and post PEEP 15 when assessing the PaO2 and SaO2 (P=0.02). CONCLUSION: Based on the findings of this study, non-invasive ventilation with PEEP 15 represented an improvement in oxygenation levels of patients undergoing coronary artery bypass grafting.
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Ponte de Artéria Coronária , Ventilação não Invasiva/métodos , Oxigênio/sangue , Respiração com Pressão Positiva/métodos , Troca Gasosa Pulmonar/fisiologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Fatores de TempoRESUMO
RESUMO Objetivo verificar as evidências disponíveis sobre o efeito dos exercícios vocais no tratamento da disfagia. Estratégia de pesquisa foi realizado levantamento bibliográfico nas bases de dados PubMed, LILACS, SciELO e MEDLINE, sem restrições quanto ao período de publicação. Critérios de seleção artigos originais, estudos de caso e/ou revisões de literatura publicados nos idiomas português e/ou inglês, disponíveis eletronicamente na íntegra e que abordassem o tratamento clínico com exercícios vocais em adultos e idosos com disfagia. Foram excluídas publicações repetidas nas bases de dados, com população de crianças, com indivíduos que não apresentassem o diagnóstico de disfagia, com exercícios vocais sem especificação, com exercícios exclusivos de deglutição, artigos e/ou resumos sem possibilidade de acesso pelas plataformas institucionais e estudos com modelo animal. Resultados foram encontrados 2.356 artigos, dos quais, após aplicados os critérios de elegibilidade, foram selecionados 8 para a amostra final. Para avaliar os efeitos dos exercícios vocais, os estudos utilizaram avaliação clínica, videofluoroscopia, videoendoscopia e eletromiografia. Quanto aos efeitos dos exercícios vocais na deglutição, observou-se que as técnicas de som plosivo, empuxo, trato vocal semiocluído, som basal, modulação vocal, sobrearticulação, o método Lee Silverman Voice Treatment® e o uso de exercícios de treino de força muscular expiratória apresentaram efeitos positivos na reabilitação da disfagia. Conclusão os estudos com treino de força muscular expiratória, o método Lee Silverman e os exercícios vocais tradicionais demonstraram efeitos positivos no tratamento da disfagia. No entanto, ainda não foi possível comprovar o nível de evidências de todos os estudos.
ABSTRACT Purpose To verify the available evidence on the effect of vocal exercises on the treatment of dysphagia. Research strategy A bibliographic survey was carried out in the PubMed, LILACS, SciELO and MEDLINE databases, with no restrictions on the publication period. Selection criteria Original articles, case studies and/or literature reviews published in Portuguese and/or English, available electronically in full and addressing clinical treatment with vocal exercises in adults and elderly with dysphagia. Publications repeated by the databases, with a population of children, individuals who did not present the diagnosis of dysphagia, with vocal exercises without specification, with exclusive swallowing exercises, articles and/or abstracts without the possibility of access by institutional platforms, and studies with animal model were excluded. Results A total of 2,356 articles were found, of which, after the eligibility criteria were applied, 08 were selected for the final sample. To evaluate the effects of vocal exercises, the studies used clinical evaluation, videofluoroscopy, videoendoscopy and electromyography. Regarding the effects of vocal exercises on swallowing, it was observed that the techniques of plosive sound, buoyancy, semi-occluded vocal tract, basal sound, vocal modulation, overarticulation, the Lee Silverman Voice Treatment method® and the use of expiratory muscle strength training exercises showed positive effects in the rehabilitation of dysphagia. Conclusion It was observed that studies with expiratory muscle strength training (EMST), Lee Silverman method (LSVT®) and traditional vocal exercises demonstrated positive effects in the treatment of dysphagia. However, it has not yet been possible to prove the level of evidence in all studies.
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Humanos , Fonoterapia/métodos , Treinamento da Voz , Exercícios Respiratórios , Transtornos de Deglutição/fisiopatologia , Transtornos de Deglutição/terapia , Terapia Miofuncional , Eletromiografia , Força Muscular/fisiologiaRESUMO
Resumo Introdução A tuberculose drogarresistente (TBDR) é um dos grandes desafios para a saúde pública. Objetivo Este estudo analisou a tendência temporal da TBDR e a razão da proporção dos tipos de resistência no estado de Pernambuco, no período de 2002 a 2014. Método Trata-se de um estudo observacional do tipo tendência temporal de série histórica utilizando dados do Sistema de Informação de Tratamentos Especiais da Tuberculose e análise pelo modelo autorregressivo de médias móveis de ordem 2. Resultados Foram notificados 298 novos casos de TBDR, com incidência variando entre 0,06 e 0,71/100 mil habitantes. Pelo menos 1 caso foi notificado em 40 dos 185 municípios do estado. A tendência temporal da TBDR e da proporção entre os tipos de resistência não apresentou comportamento linear. Nos últimos cinco anos, houve uma tendência ascendente, concentrando 71,1% dos casos da série histórica. Em 2014, foi observado um crescimento expressivo tanto da TBDR primária como da secundária, quando comparado ao ano de 2002. Conclusão Apesar da baixa incidência e de a tendência da TBDR não ter comportamento linear, o aumento de casos nos últimos anos da série histórica pode ser considerado um sinal de alerta para os programas de controle da doença em Pernambuco.
Abstract Background Drug-Resistant Tuberculosis (DRTB) is one of the most relevant challenge to public health. Objective This study analyzed the temporal trend of the DRTB and resistance types in the state of Pernambuco, from 2002 to 2014. Method This was an observational study of the temporal trend type of a historical series using data from the Special Treatment Information System of Tuberculosis (SITE-TB) and also analysis by the autoregressive moving average models of order 2. Results A total of 298 new DRTB cases were reported, ranging from 0.06 to 0.71 per 100,000 inhabitants. At least one case was reported in 40 of the 185 municipalities in the state. The temporal trend of DRTB and the proportion between resistance types did not present a linear behavior. In the last 5 years, there has been an upward trend, concentrating 71.1% of the historical series. In 2014, there was an expressive growth of both primary and secondary DRTB, when compared to the year 2002. Conclusion Despite the low incidence and tendency of DRTB not to be linear, the increase in cases in the last years of the historical series can be considered as a warning sign for the disease control programs of Pernambuco.
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BACKGROUND: Scorpion stings are a major public health problem in Brazil, with an increasing number of registered cases every year. Affecting mostly vulnerable populations, the phenomenon is not well described and is considered a neglected disease. In Brazil, the use of anti-venom formulations is provided free of charge. The associate scorpion sting case is subject to compulsory reporting. This paper describes the epidemiology and identifies factors associated with severity of scorpions stings in the state of Amazonas, in the Western Brazilian Amazon. METHODOLOGY/PRINCIPAL FINDINGS: This study included all cases of scorpion stings in the state of Amazonas reported to the Brazilian Diseases Surveillance System from January 1, 2007 to December 31, 2014. A case-control study was conducted to identify factors associated with scorpions sting severity. A total of 2,120 cases were reported during this period. The mean incidence rate in the Amazonas was 7.6 per 100,000 inhabitants/year. Scorpion stings showed a large spatial distribution in the state and represent a potential occupational health problem for rural populations. There was a positive correlation between the absolute number of cases and the altimetric river levels in the Central (p<0.001; Rs = 0.479 linear) and Southwest (p = 0.032; linear Rs = 0.261) regions of the state. Cases were mostly classified as mild (68.6%), followed by moderate (26.8%), and severe (4.6%). The overall lethality rate was 0.3%. Lethality rate among children ≤10 years was 1.3%. Age <10 years [OR = 2.58 (95%CI = 1.47-4.55; p = 0.001)], stings occurring in the rural area [OR = 1.97 (95%CI = 1.18-3.29; p = 0.033) and in the South region of the state [OR = 1.85 (95%CI = 1.17-2.93; p = 0.008)] were independently associated with the risk of developing severity. CONCLUSIONS/SIGNIFICANCE: Scorpion stings show an extensive distribution in the Western Brazilian Amazon threatening especially rural populations, children ≤10 in particular. Thus, the mapping of scorpions fauna in different Amazon localities is essential and must be accompanied by the characterization of the main biological activities of the venoms. Urban and farming planning, in parallel with awareness of workers at risk for scorpion stings on the need for personal protective equipment use should be considered as public policies for preventing scorpionism.
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População Rural/estatística & dados numéricos , Picadas de Escorpião/epidemiologia , População Urbana/estatística & dados numéricos , Adolescente , Brasil/epidemiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Masculino , Fatores de Risco , Picadas de Escorpião/mortalidadeRESUMO
Objetivo: narrar as manifestações clínicas das vítimas da COVID-19 com base em evidências científicas e propor os principais diagnósticos de enfermagem de acordo com a Taxonomia da NANDA Internacional. Método: A pesquisa foi realizada com base em estudos que revelaram os sinais e os sintomas das vítimas positivas para COVID-19 que evoluíram de forma leve a grave. A busca dos estudos foi realizada nas bases de dados MEDLINE, LILACS e BDENF, nos idiomas: inglês e português, com recorte temporal de dezembro de 2019 a abril de 2020, por meio da associação dos DeCs "coronavírus", "pandemia", "enfermagem" e COVID-19, utilizando o operador booleano "AND", "OR" e "NOT". Resultados: Após a leitura e o refinamento, foram selecionados 13 estudos segundo o objetivo e a proposta do tema. Foram abordados, ao longo do artigo, os principais sinais e sintomas, as medidas de segurança perante o vírus, os fatores de risco, diagnósticos e as intervenções de enfermagem, sendo expostos 15 diagnósticos de enfermagem segundo a NANDA. Conclusões: este estudo possui relevâncias esclarecedoras concernentes às condutas nos casos de confirmação ou suspeita da infecção pelo novo Coronavírus, a fim de estabelecer a sistematização da assistência, auxiliando o profissional enfermeiro a manejar, de forma satisfatória, sua prática clínica e gerencial perante os eventos relacionados à COVID-19.
Objective: to narrate the clinical manifestations of COVID-19 victims based on scientific evidence and propose the main nursing diagnoses according to NANDA International Taxonomy. Method: The research was conducted based on studies that revealed the signs and symptoms of victims positives for COVID-19 that evolved mild to severe. The studies were searched in the MEDLINE, LILACS and BDENF databases, in the following languages: English and Portuguese, with a time frame from December 2019 to April 2020, through the association of the DeCs "coronavirus", "pandemic", "nursing" and COVID-19, using the Boolean operator "AND", "OR" and "NOT". Results: After reading and refinement, 13 studies were selected according to the objective and proposal of the theme. Throughout the article, the main signs and symptoms, safety measures against the virus, risk factors, diagnoses and nursing interventions were addressed, and 15 nursing diagnoses were exposed according to NANDA. Conclusions: This study has clarifying relevances regarding the conducts in cases of confirmation or suspicion of infection by the new Coronavirus, in order to establish the systematization of the care, helping the professional nurse to satisfactorily manage their clinical and managerial practice in the face of the events related to COVID -19.
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Coronavirus , Enfermagem , Infecções por Coronavirus , PandemiasRESUMO
Elephant grass silages have high moisture content, causing nutrient loss, mainly by effluent production. The use of moisture absorbent additives, such as patauá, Oenocarpus bataua meal, can be a strategy to reduce losses in these silages. The aim of this study was to determine the fermentation losses, microbiological composition, fermentative characteristics, and chemical composition of elephant grass silage with increasing levels of inclusion of patauá meal. The experiment was conducted in a completely randomized design, with four concentrations of patauá meal (7%, 14%, 21%, and 28%, based on fresh matter) and a control without patauá, and five replicates. The elephant grass was collected manually after 60 days of growth. After chopping, the grass was homogenized, mixed with the patauá meal according to the established treatments, and ensiled in experimental silos of 15 L. The inclusion of patauá meal in elephant grass silage had positive effects on the chemical composition and effluent loss. It significantly increased dry matter, organic matter, crude protein, nitrogen insoluble in neutral detergent and acid, ethereal extract, lignin, and non-fibrous carbohydrates of the silages. It also reduced effluent losses, neutral and acid detergent fiber contents, and cellulose. Our findings contribute towards reducing the environmental impact caused by the production of effluents during ensilage of tropical grasses and providing a potential use for the residue from the production of patauá oil, thus avoiding disposal in the environment. (AU)
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Excipientes Farmacêuticos , Esgotos , Pennisetum , UmidadeRESUMO
The Amazon region reports the highest incidence of snakebite envenomings in Brazil. We aimed to describe the epidemiology of snakebites in the state of Amazonas and to investigate factors associated with disease severity and lethality. We used a nested case-control study, in order to identify factors associated with snakebite severity and mortality using official Brazilian reporting systems, from 2007 to 2012. Patients evolving to severity or death were considered cases and those with non-severe bites were included in the control group. During the study period, 9,191 snakebites were recorded, resulting in an incidence rate of 52.8 cases per 100,000 person/years. Snakebites mostly occurred in males (79.0%) and in rural areas (70.2%). The most affected age group was between 16 and 45 years old (54.6%). Fifty five percent of the snakebites were related to work activities. Age ≤15 years [OR=1.26 (95% CI=1.03-1.52); (p=0.018)], age ≥65 years [OR=1.53 (95% CI=1.09-2.13); (p=0.012)], work related bites [OR=1.39 (95% CI=1.17-1.63); (p<0.001)] and time to medical assistance >6 hours [OR=1.73 (95% CI=1.45-2.07); (p<0.001)] were independently associated with the risk of severity. Age ≥65 years [OR=3.19 (95% CI=1.40-7.25); (p=0.006)] and time to medical assistance >6 hours [OR=2.01 (95% CI=1.15-3.50); (p=0.013)] were independently associated with the risk of death. Snakebites represent an occupational health problem for rural populations in the Brazilian Amazon with a wide distribution. These results highlight the need for public health strategies aiming to reduce occupational injuries. Most cases of severe disease occurred in the extremes of age, in those with delays in medical attention and those caused by Micrurus bites. These features of victims of snakebite demand adequate management according to well-defined protocols, including prompt referral to tertiary centres when necessary, as well as an effective response from surveillance systems and policy makers for these vulnerable groups.
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Mordeduras de Serpentes/mortalidade , Adolescente , Adulto , Fatores Etários , Idoso , Animais , Bothrops , Brasil/epidemiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Mordeduras de Serpentes/epidemiologia , Mordeduras de Serpentes/terapia , Fatores de Tempo , Viperidae , Adulto JovemRESUMO
Abstract Introduction: During and after coronary artery bypass grafting, a decline in multifactor lung function is observed. Due to this fact, some patients may benefit from non-invasive ventilation after extubation targeting lung expansion and consequently improved oxygenation. Objective: To test the hypothesis that higher levels of positive end expiration pressure during non-invasive ventilation improves oxygenation in patients undergoing coronary artery bypass grafting. Methods: A randomized clinical trial was conducted at Instituto Nobre de Cardiologia in Feira de Santana. On the first day after surgery, the patients were randomized: Group PEEP 10, Group PEEP 12 and Group PEEP 15 who underwent non-invasive ventilation with positive end expiration pressure level. All patients were submitted to analysis blood pressure oxygen (PaO2), arterial oxygen saturation (SaO2) and oxygenation index (PaO2/FiO2). Results: Thirty patients were analyzed, 10 in each group, with 63.3% men with a mean age of 61.1±12.2 years. Mean pulmonary expansion pre-therapy PaO2 was generally 121.9±21.6 to 136.1±17.6 without statistical significance in the evaluation among the groups. This was also present in PaO2/FiO2 and SaO2. Statistical significance was only present in pre and post PEEP 15 when assessing the PaO2 and SaO2 (P=0.02). Conclusion: Based on the findings of this study, non-invasive ventilation with PEEP 15 represented an improvement in oxygenation levels of patients undergoing coronary artery bypass grafting.
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Oxigênio/sangue , Troca Gasosa Pulmonar/fisiologia , Ponte de Artéria Coronária , Respiração com Pressão Positiva/métodos , Ventilação não Invasiva/métodos , Período Pós-Operatório , Fatores de TempoRESUMO
Modificações no teor de vários componentes da secreção pancreática e alterações histopatológicas desse órgão são verificadas após injeção de veneno do escorpião Tityus serrulatus em ratos. Entre essas alterações, podem ser citadas pancreatite aguda e crônica após uma única injeção de veneno. Os achados compatíveis com pancreatite aguda foram encontrados a partir de 10 minutos após a intoxicação e, 20 dias após, a maioria dos animais exibiu achados histológicos típicos de pancreatite crônica. O objetivo do presente trabalho foi determinar a cinética das alterações pancreáticas que ocorrem ao longo do tempo, após injeção endovenosa de veneno bruto de escorpião em ratos. Os animais, após jejum de 24-48 horas, receberam uma injeção venosa, pela veia peniana, de 0,2 ml de uma solução de cloreto de sódio (grupo controle) ou de 0,2 ml de uma solução contendo 300 mg/ml de veneno bruto do escorpião Tityus serrulatus (60 mg/animal). Os animais foram sacrificados em grupos de 5 a 10 cada, aos 10, 20 e 40 minutos e 1, 2, 3, 4, 6, 8, 10, 12, 14, 16, 18 e 20 dias após a injeção. O pâncreas foi retirado e processado para estudo histológico. Pancreatite aguda (PA) foi observada nos grupos sacrificados após 10, 20 e 40 minutos, 24 e 48 horas após a injeção. Achados compatíveis com pancreatite crônica (PC) foram detectados nos animais sacrificados entre 4 a 20 dias após a injeção. No grupo de animais sacrificados 3 dias após, observaram-se, no mesmo animal e, às vezes, no mesmo corte histológico, alterações características de PA (degranulação, vacuolização acinar, infiltração difusa de linfócitos e lesões granulomatosas) e, surpreendentemente, de PC (dilatação ductal com rolhas protéicas, hiperplasia ductal e hiperplasia dos linfonodos peripancreáticos), caracterizando a fase de transição da pancreatite aguda para pancreatite crônica. Todos os grupos apresentaram mobilização e degranulação de mastócitos, sugerindo a participação dessas células na etiopatogênese dessas lesões...
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Animais , Ratos , Pancreatite Necrosante Aguda , Pâncreas/patologia , Venenos de Escorpião , HiperplasiaRESUMO
A sulfassalazina (SSZ) é amplamente utilizada para tratamento da retocolite ulcerativa idiopática. Estudos relatam frequência de efeitos colaterais em torno de 20-45%, os quais em geral são dose-dependentes e relacionados com altos n¡veis séricos de sulfapiridina, ocorrendo principalmente nos pacientes com baixa capacidade genética de acetilação hepática da medicação. Embora seja droga utilizada há muito tempo, a escassez de dados em nosso meio motivou a realização de um levantamento da tolerância desse medicamento em pacientes do Programa Estadual de Medicamentos de Alto Custo da Secretaria de Saúde da Bahia. Métodos: Estudo retrospectivo com avaliação de prontuários de pacientes em acompanhamento ambulatorial que fizeram uso de SSZ. Foram levantados dados epidemiológicos, dados sobre a extensão da doença, exames laboratoriais, dose, tempo de uso e suspensão da SSZ, relatos de queixas espontâneas dos pacientes com relação a eventos adversos gastrointestinais, hematológicos, dermatológicos, neurológicos e urinários. Resultados: Foram avaliados 100 pacientes com média de idade de 44,1 anos (13-87), sendo 73% do sexo feminino. Apresentaram efeitos colaterais 37% dos pacientes, havendo necessidade de suspensão da medicação em 47,4% (18/37) dos casos, redução da dose em 18,4% (7/37) e hospitalização em 7,8% (3/37). Os efeitos colaterais mais frequentes nos pacientes com colite distal, predominando cefaléia (11 %), epigastralgia (11 %) e náuseas em 9% dos pacientes. Conclusões: A frequência de eventos adversos foi semelhante relatada em outros estudos, com baixa frequência de reações adversas graves. Não foi observada relação entre a frequência e gravidade dos efeitos colaterais e a extensão da doença.