Ethnobotanical knowledge of herbalists about medicinal plants from the semiarid region in northeastern Brazil / Conocimiento etnobotánico de herbolarios sobre plantas medicinales de la región semiárida del noreste de Brasil

Medicinal plants have been used since ancient times to treat illnesses. This study aimed to identify through questionnaire the medicinal plants most frequently sold on public and street markets in some municipalities of Paraíba state, northeastern Brazil, and the knowledge of herbalists about their therapeutic indications and forms of use. The sample consisted of 28 herbalists. Fifteen plants with a dental indication were identified, including barbatimão (Stryphnodendron adstringens), aroeira (Myracrodruon urundeuva), gengibre (Zingiber officinale), romã (Punica granatum), cajueiro-roxo (Anacardium occidentale), mulungu (Erythrina velutina) and quixaba (Sideroxylon obtusfolium), as well as 21 plants used for the treatment of general diseases, including barbatimão (S. adstringens), aroeira (M. urundeuva), cajueiro-roxo (A. occidentale), quixaba (S. obtusfolium), boldo (Peumus boldus) and erva doce (Pimpinella anisum). Bottled preparations ("garrafadas")and teas were the most frequently indicated forms of use. The results suggest that herbalists have a vast traditional knowledge of the therapeutic potential of commercialized plants.

Las plantas medicinales se han utilizado desde la antigüedad para tratar enfermedades. Este estudio tuvo como objetivo identificar a través de cuestionario las plantas medicinales más vendidas en mercados públicos y callejeros en algunos municipios del estado de Paraíba, noreste de Brasil, y el conocimiento de los herbolarios sobre sus indicaciones terapéuticas y formas de uso. La muestra estuvo formada por 28 herbolarios. Se identificaron quince plantas con indicación dental, entre las que se encuentran barbatimão (Stryphnodendron adstringens), aroeira (Myracrodruon urundeuva), jenjibre (Zingiber officinale), romã (Punica granatum), cajueiro-roxo (Anacardium occidentale), mulungu (Erythrina velutina) y quixaba (Sideroxylon obtusfolium), así como 21 plantas utilizadas para el tratamiento de enfermedades generales, incluidas barbatimão (S. adstringens), aroeira (M. urundeuva), cajueiro-roxo (A. occidentale), quixaba (S. obtusfolium), boldo (Peumus boldus) y erva doce (Pimpinella anisum). Las preparaciones embotelladas ("garrafadas") y los tés fueron las formas de uso más frecuentemente indicadas. Los resultados sugieren que los herbolarios tienen un vasto conocimiento tradicional del potencial terapéutico de las plantas comercializadas.

Fatores associados a anormalidades na cintilografia de perfusão miocárdica de pacientes diabéticos / Factors associated with abnormalities on myocardial perfusion scintigraphy in diabetic patients

O diabetes melito é o maior fator de risco para doença arterial coronariana. Além da longa duração de diabetes, outros fatores, como presença de doença arterial periférica e tabagismo são fortes preditores para anormalidades na cintilografia de perfusão do miocárdio. O objetivo deste estudo foi avaliar o impacto dos fatores de risco de pacientes diabéticos nos resultados da cintilografia de perfusão do miocárdio e comparar com os resultados de pacientes não diabéticos em uma clínica de medicina nuclear. Foi realizado um estudo transversal retrospectivo por meio da análise de prontuários de pacientes que realizaram cintilografia miocárdica no período de 2010 a 2019. Foram avaliados 34.736 prontuários. Analisando a fase de estresse da cintilografia de perfusão do miocárdio, os portadores de diabetes melito precisaram receber estímulo farmacológico duas vezes mais que os não diabéticos para sua realização. Também foram avaliados fatores que tivessem impacto negativo no resultado da cintilografia de perfusão do miocárdio, e foi visto que o diabetes melito (33,6%), a insulinoterapia (18,1%), a hipertensão arterial sistêmica (69,9%), a dislipidemia (53%), o sedentarismo (83,1%), o uso de estresse farmacológico (50,6%), a dor torácica típica (8,5%) e a angina limitante durante o teste (1,7%) estiveram associados significativamente (p<0,001) a anormalidades neste exame. (AU)

Diabetes mellitus (DM) is the greatest risk factor for coronary artery disease. In addition to a long duration of diabetes, the presence of peripheral arterial disease and smoking are strong predictors of abnormalities on myocardial perfusion scintigraphy (MPS). This study aimed to assess the impact of risk factors in diabetic patients on MPS results and compare them with those of non-diabetic patients in a nuclear medicine clinic. A retrospective cross-sectional study was performed through the analysis of the medical records of patients who underwent MPS in 2010­2019. A total of 34,736 medical records were evaluated. Analyzing the stress phase of MPS, DM patients required two-fold more pharmacological stimulation than non-diabetic patients for MPS. Factors that negatively impact the MPS results were also evaluated, and DM (33.6%), insulin therapy (18.1%), systemic arterial hypertension (69.9%), dyslipidemia (53%), sedentary lifestyle (83.1%), use of pharmacological stress (50.6%), typical chest pain (8.5%), and limiting angina during the test (1.7%) were significantly associated (p < 0.001) with test abnormalities. (AU)

Dental age assessment: Which is the most applicable method?

To evaluate which method is the most applicable for estimating estimate dental age in Brazilian children, Nolla or Demirjian. For this purpose, both methods were reviewed and the differences between them brought to light. A total of 403 healthy children between the ages of 7 and 13 years with satisfactory panoramic radiographs, similar socio-economic background and ethnic origin were included. Panoramic radiographs were examined by the Nolla and Demirjian methods. Dental age was calculated for both methods, and the differences between the dental age and the chronological age were compared with analysis of variance with post hoc Dunnett. The Nolla method showed no significant difference in relation to chronological age in the majority of age groups for boys and girls, except for 12-year-old boys (over-estimation of 1.00) and between 11- and 12-year-old girls (over-estimation of 0.51 and 0.59, respectively). An over-estimation of the dental age was observed by using the Demirjian method (for boys 0.89-1.84 and for girls 0.69-1.97) for all age groups. The Nolla method is suitable for Brazilian children when it comes to age estimate with care to growth spurt beginning (around 11 and 12 years). However, the Dermijian method should not be used, because it over-estimated the age in both sexes.

Dosimetry in CBCT with Different Protocols: Emphasis on Small FOVs Including Exams for TMJ.

This study aimed to estimate the absorbed dose in cone beam computed tomography (CBCT) exams according to different exposure parameters and size and position of the field of view (FOV). In addition was compared the absorbed dose of two smaller FOV scans with that of a larger FOV scan for evaluation of temporomandibular joint (TMJ), as it is a bilateral structure. CBCT scans were obtained on OP300 Maxio unit varying scanning mode (standard, high and endo) as well as size (5x5, 6x8 and 8x15 cm) and positioning of FOV. With a small FOV, different areas were scanned (maxilla or mandible, anterior or posterior and TMJ). Absorbed doses were determined using thermoluminescent dosimeters on the skin surface of sensitive organs of an anthropomorphic phantom. Endo mode showed the highest dose, followed by the high and standard modes in all FOV positions. With small FOV, doses were higher in the posterior region, especially in the mandible. Dose reduction occurred when small FOVs were used, but it was not proportional to FOV size reduction. For TMJ, the dose in a single acquisition with large FOV was greater than two acquisitions with small FOV, but lower than two acquisitions with medium FOV (6x8 cm). In conclusion, scanning mode, size and FOV position have great influence on the absorbed dose. Small FOV decreases the dose, but there is no linear relation between FOV size and dose. For bilateral exams of TMJ, double acquisition with small FOVs produces decrease in absorbed dose relative to a large FOV.

Dosimetry in CBCT with Different Protocols: Emphasis on Small FOVs Including Exams for TMJ

Abstract This study aimed to estimate the absorbed dose in cone beam computed tomography (CBCT) exams according to different exposure parameters and size and position of the field of view (FOV). In addition was compared the absorbed dose of two smaller FOV scans with that of a larger FOV scan for evaluation of temporomandibular joint (TMJ), as it is a bilateral structure. CBCT scans were obtained on OP300 Maxio unit varying scanning mode (standard, high and endo) as well as size (5x5, 6x8 and 8x15 cm) and positioning of FOV. With a small FOV, different areas were scanned (maxilla or mandible, anterior or posterior and TMJ). Absorbed doses were determined using thermoluminescent dosimeters on the skin surface of sensitive organs of an anthropomorphic phantom. Endo mode showed the highest dose, followed by the high and standard modes in all FOV positions. With small FOV, doses were higher in the posterior region, especially in the mandible. Dose reduction occurred when small FOVs were used, but it was not proportional to FOV size reduction. For TMJ, the dose in a single acquisition with large FOV was greater than two acquisitions with small FOV, but lower than two acquisitions with medium FOV (6x8 cm). In conclusion, scanning mode, size and FOV position have great influence on the absorbed dose. Small FOV decreases the dose, but there is no linear relation between FOV size and dose. For bilateral exams of TMJ, double acquisition with small FOVs produces decrease in absorbed dose relative to a large FOV.

Resumo O objetivo deste estudo foi estimar a dose absorvida em exames de tomografia computorizada de feixe cônico (TCFC) de acordo com diferentes parâmetros de exposição, tamanho e posição do campo de visão (FOV, do inglês field of view). Além disso, comparou-se a dose absorvida em uma única aquisição com FOV grande com aquela em duas aquisições com FOVs menores para avaliação de estruturas bilaterais como a articulação temporomandibular (ATM). As aquisições de TCFC foram obtidas no aparelho OP300 Maxio, variando o modo de aquisição (standard, high e endo), bem como o tamanho (5x5, 6x8 e 8x15 cm) e o posicionamento do FOV. Com o FOV pequeno, foram escaneadas diferentes áreas (maxila ou mandíbula, anterior ou posterior e ATM). As doses absorvidas foram determinadas por meio da utilização de dosímetros termoluminescentes na superfície da pele em órgãos sensíveis de um phantom antropomórfico. O modo endo mostrou a dose mais alta, seguido pelos modos high e standard em todas as posições dos FOVs. Com um FOV pequeno, as doses foram maiores na região posterior, especialmente na mandíbula. A redução da dose ocorreu quando foram utilizados pequenos FOVs; contudo, essa redução não foi proporcional à redução do tamanho do FOV. Para a ATM, a dose em uma única aquisição com FOV grande foi maior que duas aquisições com FOV pequeno, porém inferior à dose de duas aquisições com FOV médio (6x8 cm). Em conclusão, o modo de aquisição, o tamanho e a posição do FOV têm grande influência na dose absorvida. FOVs pequenos apresentaram doses mais baixas em relação aos FOVs grandes, entretanto não há uma relação linear entre o tamanho do FOV e a dose absorvida. Para estruturas bilaterais como a ATM, a dupla aquisição com FOV pequeno representa uma diminuição na dose absorvida em relação a uma aquisição com FOV grande.

Prevalence of suggestive images of carotid artery calcifications on panoramic radiographs and its relationship with predisposing factors.

Panoramic radiographs (PR) can display radiopaque images suggestive of calcified atheroma in the carotid artery in asymptomatic patients. The aim of this study was to evaluate the prevalence of these images on PR and their linkage with hypertension, obesity, age, gender and smoking habits. PR of 505 patients were evaluated. They were older than 30 years old and their PR had been taken for different clinical reasons. Their body mass index was calculated; their waist circumference was also taken into consideration. Information about smoking habits and hypertension was obtained. The observers analyzed the presence of radiopaque mass in the region of the cervical vertebrae C3-C4 through the PR, confirmed by an antero-posterior (AP) radiograph. The results showed a 7.92% prevalence of suggestive images of calcifications on PR and on AP radiograph. The adjusted Odds Ratio showed association with age and smoking habits. The calcification process is almost nine times higher for the elderly when compared to the young. As far as smokers are concerned, this process is twice worse when compared to no smokers. In conclusion, 7.92% of the group studied presented suggestive images of carotid atherosclerosis on PR, which is directly associated with the age and smoking habits.

Prevalence of suggestive images of carotid artery calcifications on panoramic radiographs and its relationship with predisposing factors / Prevalência de imagens sugestivas de calcificações da artéria carótida em radiografias panorâmicas e sua relação com fatores predisponentes

Abstract Panoramic radiographs (PR) can display radiopaque images suggestive of calcified atheroma in the carotid artery in asymptomatic patients. The aim of this study was to evaluate the prevalence of these images on PR and their linkage with hypertension, obesity, age, gender and smoking habits. PR of 505 patients were evaluated. They were older than 30 years old and their PR had been taken for different clinical reasons. Their body mass index was calculated; their waist circumference was also taken into consideration. Information about smoking habits and hypertension was obtained. The observers analyzed the presence of radiopaque mass in the region of the cervical vertebrae C3-C4 through the PR, confirmed by an antero-posterior (AP) radiograph. The results showed a 7.92% prevalence of suggestive images of calcifications on PR and on AP radiograph. The adjusted Odds Ratio showed association with age and smoking habits. The calcification process is almost nine times higher for the elderly when compared to the young. As far as smokers are concerned, this process is twice worse when compared to no smokers. In conclusion, 7.92% of the group studied presented suggestive images of carotid atherosclerosis on PR, which is directly associated with the age and smoking habits.

Resumo As radiografias panorâmicas (RP) podem exibir imagens radiopacas sugestivas de ateromas calcificados na artéria carótida em pacientes assintomáticos. O objetivo deste estudo foi avaliar a prevalência destas imagens na RP e sua relação com hipertensão, obesidade, idade, sexo e tabagismo. Foram avaliadas RP de 505 pacientes acima de trinta anos, que realizaram esse exame por diversos motivos clínicos. Seu índice de massa corpórea foi calculado; sua circunferência abdominal também foi considerada. Informações sobre hipertensão e tabagismo foram obtidas. Os observadores avaliaram as RP para a presença de massas radiopacas na região das vértebras cervicais C3-C4, confirmadas por meio de uma radiografia ântero-posterior (AP). Os resultados mostraram prevalência de 7,92% de imagens sugestivas de calcificações em RP e na radiografia AP. A razão de probabilidade (OR) ajustada mostrou associação com idade e tabagismo. O risco para as pessoas mais velhas aumenta até cerca de nove vezes quando comparado com aqueles mais jovens, enquanto para os fumantes, o risco é o dobro, quando comparado com não fumantes. Na população estudada, 7,92% de todos os sujeitos apresentaram imagens sugestivas de aterosclerose carotídea em RP e houve associação com idade e tabagismo.

Accuracy of Digital Subtraction Radiography in the Detection of Vertical Root Fractures.

INTRODUCTION: The objective of this study was to evaluate the accuracy of digital subtraction radiography in the diagnosis of vertical root fractures (VRFs). METHODS: Twenty decoronated uniradicular human teeth were placed in the alveoli of a dry mandible and radiographed twice, first without (unfilled roots) and then with (filled roots) a gutta-percha cone placed into the root canal. Roots were then removed from the dry mandible, and vertical fractures were created with the aid of a universal testing machine. The fractured roots were repositioned in the mandibular alveoli and again radiographed twice. Radiographic images were subtracted by using the Regeemy software in 3 test situations: group 1, initial radiographic images of unfilled roots and images of fractured or non-fractured unfilled roots; group 2, initial radiographic images of unfilled roots and images of fractured or non-fractured filled roots; and group 3, initial radiographic images of filled roots and images of fractured or non-fractured filled roots. Three examiners evaluated all the original digital radiographs, as well as the subtracted images, for the presence or absence of VRFs. Numerical data were subject to statistical analysis with the use of receiver operator characteristic (ROC) curves. RESULTS: The areas under the ROC curve for groups 1, 2, and 3 were 0.86, 0.73, and 0.66, respectively. For the original digital radiographs, areas under the ROC curve were 0.80 (without gutta-percha) and 0.73 (with gutta-percha). No statistically significant differences were found between subtracted and original images. CONCLUSIONS: Digital subtraction radiography could be considered as an alternative tool for the investigation of VRFs because of its comparable diagnostic accuracy to existing methods.

Evaluation of the zygomatic bone by cone beam computed tomography.

PURPOSE: The zygomatic bone (ZB) has been an effective option in the rehabilitation of the atrophic edentulous maxilla, in restoration of the low projection of the maxilla and in insertion of miniplates in maxillofacial fracture; it is situated near to air cells. In this way, the aim of this study was to evaluate the ZB by means of cone beam computed tomography (CBCT) images to determine if this bone can present characteristics similar to pneumatizations (CSPZB) and, in affirmative case, to determine its distribution concerning the age, gender, laterality and type. MATERIALS AND METHODS: CBCT of 698 patients (1.396 ZB) were evaluated to determine the presence of CSPZB. The age and gender were recorded for all patients and, for the cases of CSPZB, laterality and type (unilocular or multilocular) were noted. Its prevalence was correlated with gender, age and laterality by statistical analyses (Chi-squared test). RESULTS: 3.3% of individuals presented CSPZB. If we consider all zygomatic bones, CSPZB was in 2.8%. Of these cases, 30.5% were unilateral and 69.5% bilateral; all presented multilocular pattern. There was no statistical correlation between CSPZB and gender or age (p = 0.15 and 0.63, respectively), neither between CSPZB and laterality (p = 0.39). CONCLUSION: It was found an altered pattern similar to pneumatization in ZB; however, its prevalence was low (3.3% of the studied population). Our results indicate that the ZB should be evaluated in tomographic images prior to surgical treatments carefully.

Estimation of toothpaste fluoride intake in preschool children.

The objective of this study was to estimate the intake of toothpaste fluoride used by children aged 2 to 6 years (n=87) treated at a hospital of a medium-sized city (Campina Grande, PB) in the Northeastern region of Brazil. Data regarding sociodemographic characteristics of families and children's toothbrushing were collected from questionnaire-based interviews with parents/guardians, and the amount of fluoride used during toothbrushing was estimated using a precision scale for assessment of the risk of dental fluorosis, considering a cutoff value of 0.07 mgF/kg body weight/day. Fluoride content in the toothpastes was analyzed using a specific fluoride electrode. Data were analyzed using descriptive and inferential statistics using the chi-square and Fisher's exact tests (α=0.05). Considering the use of the derice, the risk of fluorosis in the children was 19.5%. There was significant association (p<0.05) between the risk of fluorosis, brushing frequency, type of derice and who performed the child's oral hygiene. It was concluded that a high percentage of children in the studied sample used toothpaste inappropriately and were at risk of developing dental fluorosis.

Estimation of Toothpaste Fluoride Intake in Preschool Children

The objective of this study was to estimate the intake of toothpaste fluoride used by children aged 2 to 6 years (n=87) treated at a hospital of a medium-sized city (Campina Grande, PB) in the Northeastern region of Brazil. Data regarding sociodemographic characteristics of families and children's toothbrushing were collected from questionnaire-based interviews with parents/guardians, and the amount of fluoride used during toothbrushing was estimated using a precision scale for assessment of the risk of dental fluorosis, considering a cutoff value of 0.07 mgF/kg body weight/day. Fluoride content in the toothpastes was analyzed using a specific fluoride electrode. Data were analyzed using descriptive and inferential statistics using the chi-square and Fisher's exact tests (α=0.05). Considering the use of the derice, the risk of fluorosis in the children was 19.5%. There was significant association (p<0.05) between the risk of fluorosis, brushing frequency, type of derice and who performed the child's oral hygiene. It was concluded that a high percentage of children in the studied sample used toothpaste inappropriately and were at risk of developing dental fluorosis.

Resumo O objetivo do presente trabalho foi estimar a ingestão de flúor de derícios utilizados por crianças de 2 a 6 anos de idade (n=87) atendidas em um hospital de médio porte (Campina Grande, PB) na região nordeste do Brasil. Os dados envolveram características sócio-demográficas e escovação dentária das crianças através de uma entrevista com formulário específico, aplicado aos pais/responsáveis, e a quantidade de flúor utilizada na escovação da criança, por meio de balança de precisão, para avaliação do risco de fluorose dentária, considerando o ponto de corte 0,07 mgF/kg peso corporal/dia. O conteúdo de flúor nos cremes dentais foi analisado utilizando eletrodo específico. Os dados foram trabalhados sob a forma de estatística descritiva e inferencial usando o testes do Qui-quadrado de Pearson e Exato de Fisher (α= 0,05). Levando-se em consideração o uso do derício, o risco de fluorose das crianças pesquisadas foi 19,5%. Houve associação significativa entre o risco de fluorose, a frequência de escovação, o tipo de derício e quem realiza a higiene bucal da criança (p<0,05). Concluiu-se que elevada parcela das crianças usavam o derício de forma inadequada e apresentaram risco de fluorose. .

Características bucais da perimólise e episódios recorrentes de vômitos: relato de caso / Features Oral of Perimolysis Recurrent Vomiting: Case Report

O presente trabalho teve o propósito de abordar, por meio de relato de caso clínico, aspectos relevantes sobre o diagnóstico, tratamento e acompanhamento de uma criança de 10 anos de idade portadora de perimólise. Ao exame clínico, a paciente apresentou IHO-S igual a 0,16 e ISG de 26,0%. Foram verificadas alterações do esmalte em vários elementos dentários (superfície palatina dos dentes anteriores superiores). O tratamento consistiu de 08 aplicações em intervalos semanais de verniz fluoretado a 5% NaF. Orientações de higiene e dieta também foram condutas adotadas. Após a realização das intervenções, foi constatada a redução da sensibilidade dentária.

This paper aims to address, through clinical case, the relevant aspects on the diagnosis, treatment and monitoring of a 10 year old carrier perimolysis. On clinical examination, the patient had OHI-S equal to 0.16 and 26.0% of ISG. Enamel alterations were noted in several dental elements (palatal surface of maxillary anterior teeth). Treatment consisted of 08 weekly applications at intervals of 5% NaF fluoride varnish. Guidelines hygiene and diet behaviors were also adopted. After completion of the interventions, was found to reduce tooth sensitivity.

An impedimetric biosensor for detection of dengue serotype at picomolar concentration based on gold nanoparticles-polyaniline hybrid composites.

In this work, we describe the preparation and characterization of a novel gold nanoparticles-polyaniline hybrid composite (AuNpPANI) with SH-terminal groups that, due to its ability of immobilizing dengue serotype-specific primers 1, 2 and 3 (ST1, ST2 and ST3), can be used for the development of biosensors. Electrochemical impedance spectroscopy (EIS) and cyclic voltammetry (CV) were performed. CV and EIS results demonstrated that the AuNpPANI can immobilize ST1, ST2 and ST3, forming AuNpPANI-ST complexes. Well-defined cyclic voltammograms characteristic of a diffusion-limited redox process were observed both for the bare gold electrode and after these electrodes have been modified by the adsorption of AuNpPANI or AuNpPANI-ST. The AuNpPANI-ST(1-3) systems were able to recognize the dengue serotype of different patients at picomolar concentrations. Even when small volumes and low concentrations of the analyte were used, the CV and EIS results showed unequivocal evidence of an existing interaction between dengue serotype-specific primers and their complementary genomic DNA targets.

Aplicabilidade clínica de antimicrobianos locais e sistêmicos no tratamento periodontal básico: uma abordagem conceitual / Clinical feasibility of local and systemic antimicrobial for initial periodontal treatment: a conceptual approach

Este artigo apresenta uma revisão de literatura que aborda a ação dos antimicrobianos locais e sistêmicos como coadjuvantes ao tratamento mecânico básico (raspagem e alisamento radicular) das doenças periodontais. Além disso, engloba o correto conhecimento das drogas no tratamento dessas patologias, principalmente, nos casos agudos com envolvimento sistêmico, em pacientes com comprometimento do sistema imune e em periodontites agressivas, com ênfase em seus mecanismos de ação e aplicabilidade clínica...

This literature review addressed the action of local and systemic antibiotics as adjuncts to the basic mechanical (scaling and root planing) treatment of periodontal diseases. The correct knowledge of drugs for the treatment of such disorders, especially in acute cases with systemic involvement in patients with impaired immune systems and highly aggressive periodontitis is described, focusing on their mechanisms of action and its clinical applicability...

Tratamento não-farmacológico das dislipidemias: o que os estudos ensinaram? / Non pharmacological dyslipidemias treatment: What did we learn from clinical studies?

Neste artigo os autores versam sobre o tratamento não-farmacológico das dislipidemias, em que as mudanças de estilo de vida são apreciadas, tanto aquelas relacionadas à dieta e as advindas dos exercícios físicos como as relacionadas ao abandono do hábito de fumar e às medidas antiestresse. Relatam o que os estudos internacionais demonstrarame, e, nosso meio, os trabalhos de Moraes, que avaliaram parâmetros clínicos e laboratoriais em 279 pacientes submetidos a intervenção aguda no estilo de vida (média 14,27 dias), as modificações produzidas por esse tratamento e a presença e a reversão da síndrome metabólica. Os parâmetros bioquímicos utilizados foram: colesterol total, frações HDL-colesterol e LDL-colesterol, triglicérides, glicose e ácido úrico plasmático. Houve melhora significante dos padrões bioquímicos de entrada, com destaque para os pacientes com síndrome metabólica, entre os quais aproximadamente 36 por cento deixaram de apresentar essa condição. A intervenção aguda de estilo de vida reduziu ou reverteu os fatores de risco para doença arterial coronariana.

Periodicidade e escolha de exames laboratoriais na terapia hipolipemiante / Special recommendations for lipid-lowering treatment: efficacy and safety

Intervenções farmacológicas com hipolipemiantes devem ser monitoradas periodicamente para avaliar eficácia e parâmetros de segurança. As estatinas são drogas normalmente bem toleradas e os seus principais efeitos colaterais incluem aumento das enzimas hepáticas (AST e ALT) e muscular (CK). O tratamento deve ser interrompido ou diminuído no caso de um aumento significativo das AST ou ALT (> 3x LSN), ou CK (> 10x LSN). Outros agentes hipolipemiantes também podem produzir hepatotoxicidade ou miosite, fibratos e ácido nicotínico, especialmente em associação com as estatinas ou na presença de anormalidades metabólicas (tireoidite, hepatopatia e nefropatia). Acido nicotínico pode também aumentar os níveis plasmáticos de glicose e ácido úrico. Testes laboratoriais podem ser utilizados no seguimento da terapia hipolipemiante e devem ser repetidos a cada três meses durante o primeiro ano e então em intervalos de seis meses. Intervalos menores são recomendados para casos especiais.

[Special recommendations for lipid-lowering treatment: efficacy and safety]. / Periodicidade e escolha de exames laboratoriais na terapia hipolipemiante.

Pharmacologic lipid-lowering interventions should be monitored periodically to assess efficacy and safety parameters. Statins are usually well-tolerated drugs and major side effects include increased serum liver and muscle enzymes (AST, ALT, CK). Treatment should be stopped or diminished in case of significant increase of AST or ALT (> 3x ULN), or CK (> 10x ULN). Other lipid lowering agents may also produce hepatotoxicity or myositis, especially in association with statins (fibrates and nicotinic acid) or in presence of metabolic abnormalities (thyroid, liver or renal disorders). Nicotinic acid can also increase glucose and uric acid plasma levels. Laboratory tests might be performed prior to hypolipidemic drug treatment and should be repeated every three months during the first year and then at 6-mo intervals. Shorter intervals should be recommended in individual cases.

Abuso sexual na infância / Sexual abuse in childhood

Dissertaçäo expositiva sobre o abuso sexual infantil. Descrevem-se todos os aspectos relacionados ao tema,incluindo: definiçäo, histórico, epidemiologia, classificaçäo, curso, entrevista, identificaçäo, sinais e sintomas, exame físico, evidências forenses, notificaçäo, tratamento, prognóstico, prevençäo, legislaçäo, finalizando com dois estudos estatísticos sobre a epidemiologia do abuso sexual infantil no município de Belém capital do estado do Pará. O primeiro foi realizado no Instituto Médico Legal Renato Chaves no período de 1§ de janeiro de 1995 a 31 de dezembro de 1995 e o segundo foi realizado na Delegacia de Proteçäo a Crianças e Adolescentes no período de 1§ de novembro de 1995 a 30 de junho de 1996