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- ItemAcesso aberto (Open Access)Abordagem estereotáxica guiada por imagem de lesões do sistema nervoso central: precisão diagnóstica, morbidade, mortalidade(Academia Brasileira de Neurologia - ABNEURO, 1999-09-01) Hisatugo, Marcelo Ken-iti; Stávale, João Norberto [UNIFESP]; Bidó, José Orlando; Ferraz, Fernando Patriani [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)We studied seventy-five patients with brain lesions biopsied by stereotaxis from March 1993 to December 1998 at Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina. The three most frequent lesions were: metastasis, low grade astrocytomas and glioblastoma multiforme. The morbidity rate was 2.66% due to: one case of scalp infection in a patient with thalamic cyst; and a partial seizure during surgery in a patient with lynphoma. The mortality rate was 1.33% due to increasing of cerebral edema after biopsy and the patient died after one week. The diagnostic accuracy was 89.33%.
- ItemAcesso aberto (Open Access)Crescimento de lactentes não-anêmicos suplementados com diferentes doses profiláticas de ferro(Sociedade Brasileira de Pediatria, 2008-08-01) Silva, Danielle Goes da [UNIFESP]; Franceschini, Sylvia do Carmo Castro [UNIFESP]; Sigulem, Dirce Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Viçosa Departamento de Nutrição e Saúde Programa de Pós-Graduação em Ciência da NutriçãoOBJECTIVE: To compare the effects of different prophylactic iron doses on the growth and nutritional status of non-anemic infants. METHODS: Prospective randomized study. Infants aged 5.0 to 6.9 months who met the inclusion criteria and showed capillary hemoglobin ≥ 11 g/dL were randomly allocated into three groups who received the following prophylactic doses of iron supplement (ferrous sulfate): 1 mg/kg/day (n = 39); 2 mg/kg/day (n = 36); and 25 mg/week (n = 39). This supplementation was given during 16 weeks. Both weight and length were measured. The nutritional status was evaluated by comparing z scores for weight/age, length/age and weight/length based on the World Health Organization (2006) references. Morbidity information was collected during monthly visits. RESULTS: The groups showed similar nutritional status before supplementation. There were no differences in daily nutrient intake among groups. During the study, weight and length gain, and increments in anthropometric indices did not differ statistically among supplemented groups either. The occurrence and duration of morbidity episodes did not differ statistically among groups. In general, improvements were observed in both weight/age and weight/length indices in the population under study, whereas length/age showed no differences before and after supplementation. CONCLUSION: Different prophylactic iron doses had no different effects on the growth and nutritional status of non-anemic infants.
- ItemAcesso aberto (Open Access)Diarreia persistente: ainda um importante desafio para o pediatra(Sociedade Brasileira de Pediatria, 2011-06-01) Andrade, Jacy Alves Braga de [UNIFESP]; Fagundes-Neto, Ulysses [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To provide recent guidelines to reduce the incidence of diarrheal diseases. We discuss the definition, clinical aspects, pathophysiology, diagnosis, management, and prevention of persistent diarrhea. SOURCES: Electronic search of the MEDLINE database, Google search. SUMMARY OF THE FINDINGS: Acute diarrhea may be caused by a variety of agents, including bacterial, viral, and protozoan pathogens. The top priority in treatment of diarrhea is replacement of fluid and electrolytes losses, particularly at the acute stage, and, under certain circumstances, eradication of the enteropathogenic agent. On the other hand, treatment of persistent diarrhea should focus on prevention and management of food intolerance and malnutrition. CONCLUSIONS: Promotion of breastfeeding, adequate interventions in the treatment of acute diarrheal episodes, introduction of safe dietary strategies for prevention of malnutrition, and improvements in sanitation and hygiene conditions, including sewage and clean water, are essential measures for the reduction of diarrheal morbidity and mortality rates in children under 5 years of age.
- ItemSomente MetadadadosDieta hipoproteica, cetoácidos e redução da morbidade por acessos para diálise(Universidade Federal de São Paulo (UNIFESP), 2013-08-28) Cobello, Marta Rene Duenhas [UNIFESP]; Schor, Nestor Schor [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Dieta hipoprotéica, cetoácidos e redução da morbidade por acessos para diálise Objetivo: Retardar o início da terapia dialítica até a confecção e maturação da fístula artério-venosa (FAV) ou treinamento para diálise peritoneal (DP) em pacientes com encaminhamento tardio ao nefrologista com necessidade imediata de diálise. Casuística e Métodos: Estudo prospectivo. Vinte e um pacientes com doença renal crônica (DRC) foram acompanhados. Foi prescrita por 30 dias uma dieta muito restrita em proteínas suplementada com aminoácidos essenciais ou cetoácidos (DMRP+CA) até a confecção da FAV ou treinamento para DP. Os pacientes foram avaliados antes do início da DMRP+CA, no 7o, 15o e 30o dia com exames clínicos e laboratoriais, e urina de 24h. Resultados: 47,6% (10/21) dos pacientes iniciaram diálise com FAV confeccionada em 30 dias; 33,3% (7/21) dos pacientes não estavam aptos para iniciar diálise mesmo com tempo suficiente (42 a 1011 dias) para confecção de FAV ou treinamento para DP, cinco devido a trombose de FAV confeccionada e dois não aceitarem a confecção da mesma; 14,3% (3/21) dos pacientes permaneceram no estudo sem necessidade de diálise e 4,8% (1/21) foi excluído por falta de aderência a DMRP+CA. Os parâmetros antropométricos e de consumo alimentar não diferiram entre os períodos. Conclusão: A DMRP+CA é segura para manter o estado nutricional de pacientes com DRC até a confecção FAV ou treinamento para DP.
- ItemAcesso aberto (Open Access)Manejo do paciente no período perioperatório em neurocirurgia pediátrica(Associação Médica Brasileira, 2012-06-01) Mekitarian Filho, Eduardo [UNIFESP]; Carvalho, Werther Brunow de [UNIFESP]; Cavalheiro, Sergio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); UPA Hospital Israelita Albert Einstein; Hospital Santa Catarina; Hospital Santa Catarina Unidade de Terapia Intensiva PediátricaOBJECTIVES: To describe the main pathophysiological differences in neurosurgical procedures between children and adults; the main complications and adverse events resulting from pediatric neurosurgery reported in studies; the singularities in anesthetic and intraoperative management in several neurosurgical diseases; the more specific and common complications and their management in the most frequent pediatric neurosurgical procedures, as well as causes and treatment for the main complications found in children undergoing neurosurgery. METHODS: A non-systematic review in literature databases PubMed, EMBASE, and SciELO was performed by using the keywords pediatrics, children, neurosurgery, risk factors, intraoperative complications, and postoperative period, as well as their matches in Portuguese and Spanish from January 2001 to January 2011, in addition to using important references from the selected material over any period of time. RESULTS: The three procedures most commonly performed in children are hydrocephalus, craniostenosis repair, and brain tumor resection. Complications as fever, bleeding, metabolic disturbances (hyponatremia and hyperglycemia), brain swelling, and transient focal deficits (limb weakness, speech and swallowing disorders) are frequent, but their course is often towards prompt improvement. Up to 50% of children may have an uneventful evolution over the postoperative period. Special attention must be given to the prevention of postoperative infections and seizures with the use of a drug therapy that suits each case. CONCLUSION: The complexity of neurosurgical procedures in children is increasing, and observation and recognition of complications in pediatric intensive care units are fundamental. Anticipating complications in order to achieve an early treatment and adverse event prophylaxis can contribute to reduced morbidity and mortality and increased patients' safety.
- ItemAcesso aberto (Open Access)União interétnica de nipo-brasileiros associada a hábitos alimentares menos saudáveis e ao pior perfil de risco cardiometabólico(Sociedade Brasileira de Endocrinologia e Metabologia, 2009-07-01) Yamashita, Carla; Damião, Renata; Chaim, Rita; Harima, Helena Aiko [UNIFESP]; Kikuchi, Mário [UNIFESP]; Franco, Laercio Joel [UNIFESP]; Ferreira, Sandra Roberta Gouvea [UNIFESP]; Universidade de São Paulo (USP); Universidade Federal do Triângulo Mineiro; Universidade do Sagrado Coração Faculdade de Nutrição; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: Interethnic marriage between nikkey Brazilians and non-nikkey Brazilians may favor the westernization of diet. Dietary consumption, clinical data and frequencies of metabolic diseases were compared in a Japanese-Brazilian population, with intraethnic or interethnic marriage. METHODS: T test, Mann-Whitney, chi-square and Person coefficient were used. RESULTS: Among 1009 Japanese-Brazilians there were 18.9% of interethnic marriage, being more frequent among nikkey men. These showed higher means of BMI, waist, blood pressure, glycemia and triglyceridemia than women. Overall frequencies of obesity, hypertrigliceridemia and metabolic syndrome were 47.7%, 68.1% and 45.2%, being higher in interethnic than intraethnic marriage. Comparing individuals with interethnic marriages, hypertriglyceridemia was more common among men while low-HDL among women. Energy, fat, groups of alcohol, sweets and oils were higher in interethnic marriage. Individuals with intraethnic marriage consumed more carbohydrate, proteins, fibers, vitamins, minerals, vegetables, fruits/juice, cereals and missoshiru. Comparing individuals with interethnic marriages, nikkey men showed a more westernized dietary pattern than nikkey women. CONCLUSION: Interethnic marriage was associated with less healthy food habits and worse cardiometabolic profile.