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Eficácia e toxicidade da hidroxiuréia em crian?as com anemia falciforme
Silva, Michelle C.;Shimauti, Eliana L. T.;
Revista Brasileira de Hematologia e Hemoterapia , 2006, DOI: 10.1590/S1516-84842006000200016
Abstract: sickle cell anemia is a genetic disease characterized by a high morbimortality rate, it is considered as the most serious among all sickle cell diseases. the most effective therapeutic options available nowadays for the treatment of this hemoglobinopathy are bone morrow transplantation (bmt) and hydroxyurea (hu). bmt is considered a high risk procedure due to the different complications and significant mortality rates. the use of hu for children with sickle cell anemia has reduced the clinical complications and given a significant increase in life expectancy by augmenting the fetal hemoglobin levels and hemoglobin concentrations and reducing cytomegalovirus, as well as reducing hemolysis and vaso-occlusive events. thus, hu is considered the best therapeutic option currently available. however, as hu has been identified as a potentially carcinogenic drug, there are questions related to the benefits and toxicities when it is used over long periods of time. this work aimed at evaluating, through a review of the literature, the risks, benefits and adverse effects of the use of hydroxyurea in children.
Mini mental state examination and evaluation of factors associated with cognitive decline in HIV/AIDS-infected people = Miniexame do estado mental e avalia o de fatores que se associam à presen a de declínio cognitivo em pessoas vivendo com HIV/AIDS
Ana Luiza Sereia,Miguel Spack Junior,Talita Perdig?o Domiciano,Eliana Shimauti
Acta Scientiarum : Health Sciences , 2012,
Abstract: Neuropsychiatric complications are present in almost one third of patients diagnosed with AIDS who show wide variations in their clinical symptoms, featuring a spectrum of disorders ranging from minor cognitive-motor impairments to profound dementia. The Mini Mental State Examination (MMSE) is one of the most used and studied cognitive tests around the world and evaluates cognitive function and screening of dementia. Current experiment applies the MMSE to HIV/AIDS patients to screen possible dementia factors in the sample and to evaluate the association of scores that are positively associated with the emergence of cognitive impairment and possible dementia. The study population consisted of 100 HIV/AIDS patients attended at the 15 th and 17th Regional Health Centers covering 50 municipalities in the northwestern region of the state of Paraná, Brazil. Whereas patients were classified with cognitive impairment and patients without cognitive impairment, the factors assessed included depression, body mass index, haematocrit, hemoglobin levels, rate of lymphocytes T CD4+, viral load and gender. Twenty-seven (27%) patients had scores lower than expected and were considered cognitively impaired. There was a significant positive association between cognitive impairment and changes in blood hemoglobin and haematocrit, age and depression. Complica es neuropsiquiátricas est o presentes em quase um ter o dos pacientes com diagnóstico de AIDS e apresentam grande varia o na sua evolu o clínica, exibindo um espectro de sintomas que vai de disfun es cognitivo-motoras leves a demência profunda. O Miniexame do Estado Mental (MEEM) é um dos testes mais empregados e mais estudados em todo o mundo, e permite a avalia o da fun o cognitiva e o rastreamento de quadros demenciais. O objetivo deste trabalho foi aplicar o MEEM em pacientes portadores de HIV/AIDS de modo a rastrear possíveis quadros demenciais na amostra, bem como avaliar a associa o desses escores com os fatores carga viral plasmática maior que 50000 cópias mL-1, concentra o de hemoglobina menos de 15 mg dl-1, níveis de linfócitos CD4 inferiores a 200 células mL-1, baixo índice de massa corpórea, baixo hematócrito, idade avan ada, sexo feminino e depress o. A popula o estudada constituiu-se de 100 pacientes com HIV/AIDS atendidos na 15 e na 17a Regional de Saúde, abrangendo 50 municípios da Regi o Noroeste do Paraná, classificados em pacientes com comprometimento cognitivo e pacientes sem comprometimento cognitivo mediante a aplica o do MEEM. Foram avaliados os fatores depress o, índice de massa corpor
Estrabismo: detec??o em uma amostra populacional e fatores demográficos associados
Shimauti, Augusto Tomimatsu;Pesci, Leonardo de Toledo;Sousa, Roberta Lilian Fernandez de;Padovani, Carlos Roberto;Schellini, Silvana Artioli;
Arquivos Brasileiros de Oftalmologia , 2012, DOI: 10.1590/S0004-27492012000200004
Abstract: purposes: to identify the frequency of occurrence of ocular deviation and the carriers characteristics in a population sample. methods: observational cross-sectional study, evolving a probabilistic sampling, between the years 2004 and 2005, including 11 cities of the s?o paulo state. 10,994 individuals were examined. a sub-sample of this population identified as strabismus clinical diagnosis was the subject of the present study. the population was addressed by a trained team and standardized to the research procedures. the results were submitted to statistical tests through descriptive analysis, frequency of occurrence evaluation, contingency analysis and association tests (p<0.05). results: strabismus frequency of occurrence in the population studied was on average 1.4% (148 strabismus carriers), with no difference between gender. depending on the type of strabismus detected, 46.3% presented et, 38.2% cases of xt and 15.4% of deviations were associated with vertical or horizontal syndromes. contingency analysis showed three ocular deviation carriers (2.3%) with blindness (both eyes affected) and seven (5.4%) had low vision in only one eye. according to the association of the ocular deviation and refractive error, et and also xt can be present in individuals with varying degrees of myopia (up to -5.75 for xt and -2.50 for et) or hyperopia (up to +9.00 for xt and +8.00 for et). the association between strabismus and static spherical equivalent showed no significant difference between the types of eye deviation (p>0.05). conclusion: the frequency of occurrence of strabismus in the population studied was 1,4%, with no difference between gender or ocular deviation type. the presence of blindness and low vision associated to ocular deviation reinforce the need for early treatment.
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