ABSTRACT
A sífilis é uma doença infectocontagiosa, tendo a via sexual como a principal via de transmissão, mas podendo ser por via sanguínea e transplacentária. Apresenta-se, também, como gestacional e congênita, além das suas formas clínicas primária, secundária, terciária, latente recente e latente tardia que auxiliam no tratamento. Objetivo: analisar a relação entre o diagnóstico e adesão do tratamento adequado na sífilis gestacional. Metodologia: Tratou-se de uma pesquisa descritiva, exploratória e retrospectiva com uma abordagem quantitativa. As variáveis foram obtidas através das fichas do Sistema de Informação de Agravos de Notificação (SINAN) da sífilis gestacional e congênita e dos prontuários da Unidade Básica de Saúde (UBS) Central no município de Caçador-SC no do período de 2018 a 2022. Os dados foram dispostos em tabelas e a análise realizada por meio da frequência relativa e absoluta. Resultados: Foram analisadas 61 mulheres com sífilis gestacional e 4 recém-nascidos com sífilis congênita. Destas,58 realizaram o tratamento, sendo os casos mais frequentes em mães de 21 a 25 anos. Observou-se que 93,10% das crianças notificadas tiverem o teste não treponêmico não reagente. Conclusão: houve baixa incidência de sífilis congênita, porém, elevado número de parceiros não tratados, o que reforça a importância da assistência no pré-natal para prevenção e seguimento do tratamento correto.
Syphilis is an infectious and contagious disease, having the sexual route as the main route of transmission, but it can also be via blood and transplacental. It is also presented as gestational and congenital, in addition to its clinical forms primary, secondary, tertiary, recent latent and late latent which help in the treatment. Objective: to analyze the relationship between diagnosis and adherence to adequate treatment in gestational syphilis. Methodology: It was a descriptive, exploratory, and retrospective research with a quantitative approach. The variables were recorded through the records of the Notifiable Diseases Information System (SINAN) of gestational and congenital syphilis and the medical records of the Central Basic Health Unit (UBS) in the municipality of Caçador-SC in the period from 2018 to 2022. The data were prescribed in tables and the analysis performed through relative and absolute frequency. Results: 61 women with gestational syphilis and 4 newborns with congenital syphilis were pregnant. Of these, 58 underwent treatment, with the most frequent cases in mothers aged 21 to 25 years. Note that 93.10% of the notified children had non-reactive non-treponemal test. Conclusion: there was a low incidence of congenital syphilis, however, a high number of untreated partners, which reinforces the importance of prenatal care for prevention and following the correct treatment.
La sífilis es una enfermedad infectocontagiosa, teniendo la vía sexual como principal vía de transmisión, pero también puede ser vía sanguínea y transplacentaria. También se presenta como gestacional y congénita, además de sus formas clínicas - primaria, secundaria, terciaria, latente reciente y latente tardía- que ayudan en el tratamiento. Objetivo: analizar la relación entre el diagnóstico y la adherencia al tratamiento adecuado en la sífilis gestacional. Metodología: Fue una investigación descriptiva, exploratoria y retrospectiva con enfoque cuantitativo. Las variables fueron obtenidas a través de los registros del Sistema de Información de Enfermedades de Declaración Obligatoria (SINAN) de sífilis gestacional y congénita y de las historias clínicas de la Unidad Básica Central de Salud (UBS) del municipio de Caçador-SC en el período de 2018 a 2022. datos se organizaron en tablas y el análisis se realizó mediante frecuencia relativa y absoluta. Resultados: Se analizaron 61 mujeres con sífilis gestacional y 4 recién nacidos con sífilis congénita. De estos, 58 recibieron tratamiento, siendo los casos más frecuentes en madres de 21 a 25 años. Se observó que el 93,10% de los niños notificados tenían prueba no treponémica no reactiva. Conclusión: hubo baja incidencia de sífilis congénita, sin embargo, alto número de parejas no tratadas, lo que refuerza la importancia del control prenatal para la prevención y seguimiento del correcto tratamiento.
ABSTRACT
We report a case of massive unilateral hydrothorax diagnosed in an 18-weeks-old fetus with a normal karyotype. The fetus was severely affected by hydrops and bradycardia since week 24. Initially, we performed pleurodesis, but the hydrothorax worsened and evolved into hydrops, so we proceeded to insert a transplacental thoracoamniotic shunt. Improvement was evident one week after the procedure, and the hydrothorax resolved during the remainder of the pregnancy. Following cesarean delivery at 37 weeks, the neonate required prolonged NICU stay. He was discharged after two months and remains stable until the present time.
Presentamos un caso de hidrotórax masivo unilateral diagnosticado a las 18 semanas de gestación en un feto con cariotipo normal. El feto fue afectado severamente por hydrops y bradicardia desde las 24 semanas. Inicialmente realizamos una pleurodesis, pero debido al empeoramiento del hidrotórax que evolucionó a hidropesía, procedimos con la inserción de una derivación toracoamniótica transplacentaria. La mejoría fue evidente una semana después del procedimiento, seguido por la resolución del hidrotórax durante el resto del embarazo. Después de una cesárea a las 37 semanas, el neonato requirió una estancia prolongada en la UCIN. Fue dado de alta a los 2 meses de edad y se ha mantenido estable hasta el momento actual.
ABSTRACT
Gastroschisis (GS) is an abdominal wall defect that results in histological and morphological changes leading to intestinal motility perturbation and impaired absorption of nutrients. Due to its anti-inflammatory, antioxidant, and neuroprotective effects, cannabidiol (CBD) has been used as a therapeutic agent in many diseases. Our aim was to test the effect of maternal CBD in the intestine of an experimental model of GS. Pregnant rats were treated over 3 days with CBD (30 mg/kg) after the surgical induction of GS (day 18.5 of gestation) and compared to controls. Fetuses were divided into 4 groups: 1) control (C); 2) C+CBD (CCBD); 3) gastroschisis (G), and 4) G+CBD (GCBD). On day 21.5 of gestation, the fetuses were harvested and evaluated for: a) body weight (BW), intestinal weight (IW), and IW/BW ratio; b) histometric analysis of the intestinal wall; c) immunohistochemically analysis of inflammation (iNOS) and nitrite/nitrate level. BW: GCBD was lower than CCBD (P<0.005), IW and IW/BW ratio: GCBD was smaller than G (P<0.005), GCBD presented lower thickness in all parameters compared to G (P<0.005), iNOS and nitrite/nitrate were lower concentration in GCBD than to G (P<0.005). Maternal use of CBD had a beneficial effect on the intestinal loops of GS with decreased nitrite/nitrate and iNOS expression.
Subject(s)
Animals , Female , Pregnancy , Rats , Cannabidiol/therapeutic use , Gastroschisis/metabolism , Enteritis/prevention & control , Fetal Diseases/metabolism , Intestines/drug effects , Anti-Inflammatory Agents/therapeutic use , Immunohistochemistry , Rats, Sprague-Dawley , Gastroschisis/pathology , Disease Models, Animal , Nitric Oxide Synthase Type II/analysis , Fetal Diseases/pathology , Nitrates/metabolism , Nitrites/metabolismABSTRACT
Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders.Clinical manifestations can be hermaphroditism,pseudo-precocious puberty or acute infant adrenal crisis.The wide range of CAH symptom spectrums may lead to miss or misdiagnosis in those who had atypical clinical features.The common forms of CAH are caused by deficiency in 21-hydroxylase enzymes,11 β-hydroxylase,3β-steroid dehydrogenase,17α-hydroxylase and so on,while the most common form of CAH is 21-Hydroxylase deficiency (＞ 90％).The basic principal clinical management of CAH is lifelong therapy using corticosteroids.This paper review and summarize the recent progress on the diagnosis,principles of treatment and long-term prognosis of CAH.