Navegando por Palavras-chave "child"

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    2018 International Olympic Committee Consensus Statement on Prevention, Diagnosis, and Management of Pediatric Anterior Cruciate Ligament Injuries
    (Sage Publications Inc, 2018) Ardern, Clare L.; Ekas, Guri; Grindem, Hege; Moksnes, Havard; Anderson, Allen F.; Chotel, Franck; Cohen, Moises [UNIFESP]; Forssblad, Magnus; Ganley, Theodore J.; Feller, Julian A.; Karlsson, Jon; Kocher, Mininder S.; LaPrade, Robert F.; McNamee, Mike; Mandelbaum, Bert; Micheli, Lyle; Mohtadi, Nicholas G. H.; Reider, Bruce; Roe, Justin P.; Seil, Romain; Siebold, Rainer; Silvers-Granelli, Holly J.; Soligard, Torbjorn; Witvrouw, Erik; Engebretsen, Lars
    In October 2017, the International Olympic Committee hosted an international expert group of physical therapists and orthopaedic surgeons who specialize in treating and researching pediatric anterior cruciate ligament (ACL) injuries. The purpose of this meeting was to provide a comprehensive, evidence-informed summary to support the clinician and help children with ACL injury and their parents/guardians make the best possible decisions. Representatives from the following societies attended: American Orthopaedic Society for Sports Medicine
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    Analgesia com laser terapêutico após tonsilectomia
    (Sociedade de Pediatria de São Paulo, 2010-09-01) Neiva, Felipe Costa [UNIFESP]; Vieira, Fernando Mirage Jardim [UNIFESP]; Figueiredo, Claudia Regina [UNIFESP]; Stamm, Aldo Eden Cassol [UNIFESP]; Weckx, Luc Louis Maurice [UNIFESP]; Pignatari, Shirley Shizue Nagata [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: The postoperative period of a tonsillectomy is usually very painful, requiring the use of pain-relieving drugs. The aim of this study was to evaluate the efficacy of low-level laser therapy in post-tonsillectomy pain control. METHODS: 18 children aged 5 to 15 years undergoing adenotonsillectomy between June 2005 and October 2006 were randomized to receive either local application of therapeutic laser immediately after surgery and 24 hours postoperatively (n=9) or routine analgesic drug therapy, if necessary. Pain was assessed by visual analog scale scores, need for analgesics, and acceptance of diet during the postoperative period. RESULTS: Patients undergoing laser applications had lower median pain scores and required less analgesic medication postoperatively than the control group. Acceptance of diet was similar in both groups. CONCLUSIONS: Preliminary results showed that low-level laser therapy is effective in the reduction of post-tonsillectomy pain, minimizing the need of analgesic medication in children and adolescents.
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    Análise da densidade mineral óssea através da absorciometria por dupla emissão de raios x na avaliação dos efeitos ósseos tardios de pacientes tratados de acordo com os protocolos gbtli lla-93 e lla- 99 do grupo cooperativo brasileiro para tratamento da l
    (Universidade Federal de São Paulo (UNIFESP), 2013-08-28) Molinari, Poliana Cristina Carmona [UNIFESP]; Caran, Eliana Maria Monteiro Caran [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objectives: To evaluate the impact of therapy on bone mineral density in acute lymphoblastic leukemia survivors treated according to the Brazilian Cooperative Childhood protocols – GBTLI LLA-93 and 99. Methods: Bone mineral density (BMD) by dual energy X-ray absorptiometry was performed in 101 treated patients in a crosssectional study. Bone densitometry were interpreted according to the age group and they were compared with reference population. BMD values were evaluated according to clinical and treatment characteristics and body composition. Correlations between BMD values and all variables were tested using χ2 test , Fisher’s exact test, likelihood ratio and t-Student test with significancy level of 5%. Results: Sixty patients were female and 78% were white, mean age was 17 ± 4,7 years, 94% had common ALL and 8,9% had central nervous system leukemia. The mean initial white blood cells (WBC)was 38.305μ/L and 79% of patient had less than 50.000 μ/L WBC. Fourty-four patients were treated according to GBTLI LLA-93 protocol and 54,5% were classified as low risk. Fifty seven patients were treated according to GBTLI LLA-99 protocol and 54% were classified as low risk. Twenty patients (19,8%) received cranial radiotherapy: 17 received prophylatic dose of 18 Gy and three received therapeutic dose of 24 Gy. The distribuition of nutritional diagnosis was 22,8% overweight and 15,8% obesity. There was no relationship between these diagnosis and radiotherapy exposure. There were 2% of fractures and 2% of osteonecrosis. In group younger than 20 years of age, three patients had low BMD: two patients had low lumbar spine BMD and one had low total body BMD. In the risk group for low BMD (Z-score between -1,1 and -1,9), 20,3% had risk values for lumbar spine BMD and 8,9% had risk values for total body BMD. In the group older than 20 years of age, ten patients (45,5%) had osteopenia: 31,8% in the lumbar spine and 13,6% in the proximal femur. The risk group had lower lumbar spine (p=0,01) and total body (p=0,005) BMD compared to the group wih normal values. Moreover that group had lower lean body mass (p=0,03). Patients with lumbar spine osteopenia had lower BMD compared to patients with normal values (p=0,000) and those with proximal femur osteopenia were older than patients with normal values (p=0,001). Conclusion: Bone late effect were represented by 2% of fracture, 2% of osteonecroses and 2,9% of low BMD in survivors of acute lymphoblastic leukemia treated with Brazilian protocols. It was characterized a risk group for low BMD comprising 15,8% that presented significant low values of BMD. The study suggest that this group needs a better attention in monitoring bone loss and they may be benefit through preventive actions to avoid bone loss and to promote good habits of life. Furthermore it encourages the development of protocols for longitudinal monitoring of these patients.
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    Anatomic study of the tricuspid valve in children
    (Springer, 2001-06-01) Gerola, L. R.; Wafae, N.; Vieira, M. C.; Juliano, Y.; Smith, R.; Prates, J. C.; Universidade Federal de São Paulo (UNIFESP)
    We performed an anatomic study of the right atrioventricular valve in children under one year of age using a conservative method of dissection of the heart valve. the main aspects studied were the number of cusps and their morphometric characteristics, such as the width of the base and the depth of the cusps. Other parameters studied were the number of papillary muscles, number of tendinous cords, and diameter of the fibrous ring and the last one were divided in three regions, anterior, posterior and septal for localization of cusps. Our results showed that the number of cusps varied from two to four. Three cusps was the commonest finding and the fourth cusp, if present, was classified as anterolateral in location. the anterior and septal cusps had bases bigger than those of the posterior and anterolateral cusps; the septal cusp was deeper than the others; and the number of tendinous cords was greater for the anterior and septal cusps than for the posterior and anterolateral cusps. in addition, the posterior region showed great variability: in 35.7% it was occupied by undeveloped valve tissue and the posterior valve in these cases was located anteriorly.
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    Anemia falciforme: perfil epidemiológico das crianças atendidas no hemocentro regional de montes claros - mg
    (Universidade Federal de São Paulo (UNIFESP), 2013-08-28) Dourado Sobrinha, Ernestina [UNIFESP]; Peterlini, Maria Angelica Sorgini Peterlini [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Descriptive reminiscent, census and documentary study using secondary data which focused the demographic features and the main clinical signs of the Sickle Cell Disease (SCD) in pediatric patients at the Regional Hemocenter in Montes Claros – Minas Gerais. All the medical notes of the SCD carried children, who were submitted to the treatment at the outpatient care of coagulopathies and hemoglobinopathies in the Hemocenter, and who were 11 year - 11 month - 29 day old, between February 1998 and December 2010. In order to list the collected data a spreadsheet based on the statistic program SPSS® 17.0 was used. The results were shown according to the absolute and relative frequency and the analysis of the association among the variables was done by the chi-square test. The study sample were 168 children, most of them (89.9%) were not from Montes Claros, mainly male (51.8%), 32.1% of them in the age group from 0 to 3 years old and 57.7% were part of the afro descendant group. In 75.5%, diagnosis was made until the age of one month, 78.6% did not develop symptoms at diagnosis and in 73.8% there was no family history of the disease. 66.7% of the patients were submitted to blood transfusion and 75.9% of these received from one to 10 transfusions; half of the sample has had from one to five pain episodes; 61.3% have already been admitted to hospital and more than a half of these have already been admitted to hospital once or twice; and 85.7% have shown some kind of infection, mainly URTI (upper respiratory tract infection). 5.4% of the children were submitted to splenectomy and 5.4% have had cerebrovascular accident. Every three months, 35.1% of the children returned to the practice and death occurred in 2.4% of the children. Afro descendant children were submitted to blood transfusion in a higher frequency (p=0.012), as well as those who showed splenic sequestration (p=0.000). The inpatients have had one or more pain episodes (p=0,000), splenic sequestration (p=0,000) and some infection (p=0,000).
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    Associations between oral health-related quality of life and emotional statuses in children and preadolescents
    (Wiley-Blackwell, 2012-10-01) Barbosa, T. S.; Castelo, P. M. [UNIFESP]; Leme, M. S.; Gaviao, M. B. D.; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP)
    Oral Diseases (2012) 18, 639647 Objectives: To evaluate the associations between oral health-related quality of life (OHRQoL) and emotional statuses in children and preadolescents. Methods: One hundred and forty-five Brazilian students (814 years) were clinically examined for caries, gingivitis, fluorosis, malocclusions, and temporomandibular disorders (TMD). OHRQoL was measured using two global ratings of oral health (OH) and overall well-being (OWB). the Revised Childrens Manifest Anxiety Scale (R-CMAS) and Childrens Depression Inventory (CDI) were used to assess anxiety and depression, respectively. SalivCezannea was collected 30 min after waking and at night to determine the diurnal decline in salivary cortisol (DDSC). the results were analyzed using non-paired t test/one-way ANOVA, Pearsons correlation test, and multiple linear regression analyses. Results: 1114-year-old participants had higher CDI scores (P < 0.01) and DDSC concentrations (P < 0.001). Participants with fewer caries and without gingivitis had higher DDSC concentrations (P < 0.05). TMD patients had higher DDSC concentrations and OWB ratings (P < 0.001). Girls had higher Revised Childrens Manifest Anxiety Scale (RCMAS) scores (P < 0.01). There was positive correlation between RCMAS and CDI scores and OWB ratings (P < 0.05). the OH model retained age (beta =0.312; P < 0.001) and the OWB model retained TMD (beta = 0.271; P < 0.001) and CDI scores (beta=0.175; P < 0.05). Conclusions: Children and preadolescents with poor emotional well-being are more sensitive to the impacts of OH and its effects on OWB.
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    Associations between orbicularis oris thickness and skeletal and dental variables in mixed dentition
    (Universidade Estadual Paulista Júlio de Mesquita Filho, 2012-12-01) Barbosa, Taís De Souza; Gavião, Maria Beatriz Duarte; Pupo, Luciana Silveira; Castelo, Paula Midori [UNIFESP]; Pereira, Luciano José; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Lavras Departamento de Medicina Veterinária
    AIM: To evaluate the association between orbicularis oris thickness and skeletal and dental variables in children with mixed dentition. MATERIAL AND METHOD: A convenience sample of 22 children, aged 7 to 12 years, with skeletal Class I and Class II malocclusion and subdivisions were selected. The upper and lower fascicles of the orbicularis oris thicknesses were measured using ultrasound (US) by one calibrated examiner, at rest and in the contracted state. Cephalometric radiograph measurements of the hard and soft tissues were calculated by one trained examiner. The results were analyzed by the Pearson and Spearman coefficients. RESULT: The upper and lower fascicles of the orbicularis oris in the contracted state showed a negative correlation with the distance between Ricketts' E-line and the labrale superius (E ┴ Ls). There were positive correlations between the lower face height and the distance between the AB plane and the labrale superius (AB-Ls) and between the ANB angle and the distance between E ┴ Ls and Ricketts' E-line and the labrale inferius (E ┴ Li). The lower-incisor distance from the N-Pg plane correlated positively with the distance between AB-Ls and the distance between the E ┴ Ls and E ┴ Li. Overbite and interincisal angle were negatively correlated with the distance between the pogonion and the soft tissue pogonion and the distance between E ┴ Li, respectively. CONCLUSION: Skeletal and dental variables were associated with upper and lower lip position and pogonion thickness, while the upper and lower fascicles of the orbicularis oris thicknesses in the contracted state were associated only with upper lip retrusion.
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    Asthma in children and adolescents in Brazil: contribution of the International Study of Asthma and Allergies in Childhood (ISAAC)
    (Sociedade de Pediatria de São Paulo, 2014-03-01) Solé, Dirceu [UNIFESP]; Camelo-Nunes, Ines Cristina; Wandalsen, Gustavo Falbo [UNIFESP]; Mallozi, Marcia Carvalho [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective:To assess asthma among Brazilian pediatric population applying the International Study of Asthma and Allergies in Childhood (ISAAC), an internationally standardized and validated protocol.Data sources:ISAAC was conceived to maximize the value of epidemiologic studies on asthma and allergic diseases, establishing a standardized method (self-applicable written questionnaire and/or video questionnaire) capable to facilitate the international collaboration. Designed to be carried out in three successive and dependent phases, the ISAAC gathered a casuistic hitherto unimaginable in the world and in Brazil. This review included data gathered from ISAAC official Brazilian centers and others who used this method.Data synthesis:At the end of the first phase, it has been documented that the prevalence of asthma among Brazilian schoolchildren was the eighth among all centers participating all over the world. Few centers participated in the second phase and investigated possible etiological factors, especially those suggested by the first phase, and brought forth many conjectures. The third phase, repeated seven years later, assessed the evolutionary trend of asthma and allergic diseases prevalence in centers that participated simultaneously in phases I and III and in other centers not involved in phase I.Conclusions:In Brazil, the ISAAC study showed that asthma is a disease of high prevalence and impact in children and adolescents and should be seen as a Public Health problem. Important regional variations, not well understood yet, and several risk factors were found, which makes us wonder: is there only one or many asthmas in Brazil?
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    Asthmatic children and their feelings about the disease: action of Pediatric Program of asthma prevention (PIPA), Uruguaiana, Brazil
    (Wiley-Blackwell, 2016) Urrutia-Pereira, M.; Lopez, M. C.; Bulhosa, M.; Martins, J.; Sole, D. [UNIFESP]
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    Atenção seletiva: PSI em crianças com distúrbio de aprendizagem
    (ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2007-06-01) Garcia, Vera Lúcia; Pereira, Liliane Desgualdo [UNIFESP]; Fukuda, Yotaka [UNIFESP]; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
    Selective attention is essential for learning how to write and read. AIM: The objective of this study was to examine the process of selective auditory attention in children with learning disabilities. MATERIAL AND METHOD: Group I included forty subjects aged between 9 years and six months and 10 years and eleven months, who had a low risk of altered hearing, language and learning development. Group II included 20 subjects aged between 9 years and five months and 11 years and ten months, who presented learning disabilities. A prospective study was done using the Pediatric Speech Intelligibility Test (PSI). RESULT: Right ear PSI with an ipsilateral competing message at speech/noise ratios of 0 and -10 was sufficient to differentiate Group I and Group II. Special attention should be given to the performance of Group II on the first tested ear, which may substantiate important signs of improvements in performance and rehabilitation. CONCLUSION: The PSI - MCI of the right ear at speech/noise ratios of 0 and -10 was appropriate to differentiate Groups I and II. There was an association with the group that presented learning disabilities: this group showed problems in selective attention.
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    Auditory processing in dysphonic children
    (Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2011-06-01) Arnaut, Mirian Aratangy; Agostinho, Caroline Vieira; Pereira, Liliane Desgualdo [UNIFESP]; Weckx, Luc Louis Maurice [UNIFESP]; Ávila, Clara Regina Brandão de [UNIFESP]; University of São Paulo Speech and Hearing Department Graduate Program in Human Communication Disorders; Universidade Federal de São Paulo (UNIFESP)
    Contemporary cross-sectional cohort study. There is evidence of the auditory perception influence on the development of oral and written language, as well as on the self-perception of vocal conditions. The auditory system maturation can impact on this process. OBJECTIVE: To characterize the auditory skills of temporal ordering and localization in dysphonic children. MATERIALS AND METHODS: We assessed 42 children (4 to 8 years). Study group: 31 dysphonic children; Comparison group: 11 children without vocal change complaints. They all had normal auditory thresholds and also normal cochleo-eyelid reflexes. They were submitted to a Simplified assessment of the auditory process (Pereira, 1993). In order to compare the groups, we used the Mann-Whitney and Kruskal-Wallis statistical tests. Level of significance: 0.05 (5%). RESULTS: Upon simplified assessment, 100% of the Control Group and 61.29% of the Study Group had normal results. The groups were similar in the localization and verbal sequential memory tests. The nonverbal sequential memory showed worse results on dysphonic children. In this group, the performance was worse among the four to six years. CONCLUSION: The dysphonic children showed changes on the localization or temporal ordering skills, the skill of non-verbal temporal ordering differentiated the dysphonic group. In this group, the Sound Location improved with age.
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    Avaliação da força muscular respiratória em crianças e adolescentes com sobrepeso/obesos
    (Sociedade de Pediatria de São Paulo, 2008-06-01) Santiago, Sandra Quintino; Silva, Maria De Lourdes P. Da; Davidson, Josy [UNIFESP]; Aristóteles, Luciana Ritha De C. R. B.; Universidade Federal de São Paulo (UNIFESP); Universidade Guarulhos Unidade de Terapia Intensiva Adulto; Hospital Alemão Oswaldo Cruz
    OBJECTIVE: Evaluate respiratory muscle strength in overweight/obese children and adolescents. METHODS: This cross-sectional study enrolled patients between four and 15 years old, classified according to the National Center for Health Statistics curve for body mass index (BMI): Overweight/Obese Group (OG, BMI> 85th percentile) and Normal Weight Group (NG, BMI between 5th and 85th percentile). Manuvacuometer was used to measure maximal inspiratory pressure (MaxInspP) and maximal expiratory pressure (MaxExpP). Three measurements were obtained using the maximum pulmonary effort and the higher value was considered. Variables were compared by t test chi-square test. Adjustment of possible covariants was made by analysis of covariance, being significant p<0.05. RESULTS: 69 children were included: 37 (54%) in the OG and 32 (46%) in the NG. Obese patients were younger: 9.8±2.3 versus 10.9±1.9 years (p=0.031). MaxInspP was 71.4±24.9cmH2O in the OG and 89.6±19.6cmH2O (p=0.002). MaxExpP was 71.9±24.8cmH2O in the OG and 95.6±19.6cmH2O in the NG (p<0.001). There was no difference between groups regarding gender and physical activity. After adjustment for age, only the MaxExpP was significantly different between groups (p=0.003). CONCLUSIONS: Maximal expiratory pressure was lower in overweight/obese patients, indicating that obesity may alter pulmonary mechanics.
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    Avaliação do estado nutricional e da composição corporal das crianças índias do Alto Xingu e da etnia Ikpeng
    (Sociedade Brasileira de Pediatria, 2004-12-01) Fagundes, Ulysses [UNIFESP]; Kopelman, Benjamin Israel [UNIFESP]; Oliva, Carlos Alberto Garcia [UNIFESP]; Baruzzi, Roberto Geraldo [UNIFESP]; Fagundes-Neto, Ulysses [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVES: To assess the nutritional and body composition of two Brazilian indigenous populations by comparing their nutritional status. METHODS: 95 children from Alto Xingu and 69 from Ikpeng were evaluated, ages ranged from 24 to 117 months. The study was performed in the Xingu Indigenous Park. Data collected were: age, weight, height, skin folds, arm circumference, resistance and reactance. The z-scores were calculated and classified according to the parameters defined by the National Center for Health Statistics (NCHS 2000). Shortness was defined as length or stature below -2, underweight as body mass index below -2, and overweight as body mass index above 2. RESULTS: Among children from Alto Xingu, the prevalence of shortness was 8.4%, while among Ikpengs the prevalence was 37.7% (p < 0.001). Underweight was diagnosed in 12.5% of Ikpeng's children. Values of fat-free mass were greater for children from Alto Xingu and no case of obesity was found. CONCLUSION: In this study, Ikpeng's children showed higher incidences of short stature and low weight than the Altoxingu's children. Data regarding body composition have greater values among children from Alto Xingu, thus we conclude that nutritional status among children from Alto Xingu is better than the one found among the Ikpeng's children.
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    Avaliação nutricional de crianças com doença renal crônica
    (Sociedade de Pediatria de São Paulo, 2009-06-01) Brecheret, Ana Paula [UNIFESP]; Fagundes, Ulysses [UNIFESP]; Lazaretti-Castro, Marise [UNIFESP]; Andrade, Maria Cristina de [UNIFESP]; Carvalhaes, João Tomás de Abreu [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE:Malnutrition is a frequent complication among children with renal diseases. Short stature is the main clinical sign. The aim of this study is to analyze the nutritional status of children with renal disease using anthropometry. METHODS: This cross sectional study enrolled 21 (43%) boys and 28 (57%) girls with age ranging from 5.3 to 19.5 years. They were divided in three groups based on their creatinine clearance (mL/min/1.73m²): Group 1, >37 (n=19); Group 2, between 15 and 37 (n=9) and Group 3, <15 (n=21). Weight and height were obtained in order to calculate the following indexes: Weight/age (W/A), height/age (H/A) and body mass index (BMI); then, Z scores were obtained. Malnutrition was defined as Z scores below -2. ANOVA test was used to compare groups. RESULTS: There were no differences among the groups for anthropometric data. 19 patients (38.8%) presented short-stature and 22 (44.8%) low-weight. Z scores were similar among groups relative to W/A, H/A and BMI values. W/A Z score values were: Group 1: -1.9±1.8; Group 2: -2.6±3.1 and Group 3: -2.5±1.4 (p=0.47). H/A Z scores values were: Group 1: -1.5±1.2; Group 2: -2.3±1.8 and Group 3: -2.1±1.1 (p=0.18). The calculated BMI Z scores were: Group 1: -1.2±1.4; Group 2: -1.7±3.9 and Group 3: -1.6±1.3 (p=0.82). 19 children presented short stature and 22 presented low weight. There were no differences between the studied groups. CONCLUSIONS: The sample presented high prevalence of malnutrition. Even considering the disease stage, there were no nutritional differences between the studied groups.
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    Bronchioloalveolar carcinoma arising in a congenital pulmonary airway malformation in a child: case report with an update of this association
    (Elsevier B.V., 2007-05-01) Ramos, Simone G.; Barbosa, Gustavo H.; Tavora, Fabio Rocha Fernandes [UNIFESP]; Jeudy, Jean; Torres, Lidia A. G. M.; Tone, Luiz Gonzaga; Trad, Clovis S.; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Univ Maryland
    An 9-year-old girl was evaluated for a mass in the left pulmonary lobe. Her clinical history was remarkable for an intermittent dry cough since the age of 2, with recurrent episodes of purulent sputum and fever. She underwent left lower lobectomy, which was found to be a bronchioloalveolar carcinoma arising in a type 1 congenital pulmonary airway malformation at pathologic examination. No additional therapies were undertaken. Two years after resection, imaging studies showed 5 contralateral pulmonary nodules suggestive of disseminated disease with a poor outcome. A review of presentation, treatment, and outcome of this association was made. (C) 2007 Elsevier Inc. All rights reserved.
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    Calcifying panniculitis in a child after renal transplantation
    (Oxford Univ Press, 1997-01-01) Nogueira, Paulo Cesar Koch [UNIFESP]; Giuliani, C.; Rey, N.; Said, M. H.; Cochat, P.; HOP EDOUARD HERRIOT; UNIV LYON 1; Universidade Federal de São Paulo (UNIFESP); FAC ROCKEFELLER
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    Capilaroscopia periungueal em crianças e adolescentes com doenças reumáticas
    (Sociedade Brasileira de Reumatologia, 2012-10-01) Piotto, Daniela Gerent Petry [UNIFESP]; Len, Claudio Arnaldo [UNIFESP]; Hilário, Maria Odete Esteves [UNIFESP]; Terreri, Maria Teresa Ramos Ascensão [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Albert-Ludwigs Universität Freiburg
    OBJECTIVE: To assess nailfold capillaroscopy in children and adolescents with autoimmune rheumatic diseases (juvenile idiopathic arthritis, systemic lupus erythematosus, juvenile dermatomyositis, scleroderma and mixed connective tissue disease) and relate it to clinical and laboratory findings and disease activity. METHODS: Cross-sectional study assessing 147 patients by use of nailfold capillaroscopy as follows: 60 with juvenile idiopathic arthritis; 30 with systemic lupus erythematosus; 30 with juvenile dermatomyositis; 20 with localized scleroderma; four with systemic sclerosis; and three with mixed connective tissue disease. Clinical and laboratory tests and nailfold capillaroscopy were performed in all patients. The nailfold capillaroscopy was performed with an optical microscope (at 10- and 16-time magnifications) by the same observer. RESULTS: Most patients (76.2%) had normal nailfold capillaroscopy. The major changes in nailfold capillaroscopy, characterizing the scleroderma pattern, were observed in patients with juvenile dermatomyositis, systemic scleroderma and mixed connective tissue disease. There was no association between nailfold capillaroscopy and disease activity in patients with juvenile idiopathic arthritis, systemic lupus erythematosus and localized scleroderma. Disease activity and capillaroscopy were associated in patients with juvenile dermatomyositis. CONCLUSION: Nailfold capillaroscopy is a useful method to diagnose autoimmune rheumatic diseases and monitor disease activity.
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    Características da violência física e sexual contra crianças e adolescentes atendidos no IML de Maceió
    (Universidade Federal de São Paulo (UNIFESP), 2009) Guimarães, João Alfredo Tenório Lins [UNIFESP]; Villela, Wilza Vieira [UNIFESP]
    Contexto: A violência contra crianças e adolescentes é um fenômeno histórico-cultural com desdobramentos que tem se revelado problemas crescentes para a saúde pública. Objetivo: Descrever as principais características epidemiológicas da violência física e sexual contra crianças e adolescentes na população atendida no IML/Maceió. Método: Foram incluídos 303 casos consecutivos de crianças e adolescentes vítimas de violência física e sexual, submetidos a exame de corpo de delito no IML/Maceió no período de setembro/2008 a março/2009. Para estas, foram coletados dados referentes ao tipo de violência, sexo, idade, estado civil, procedência, ocupação, escolaridade e classificação econômica da vítima; escolaridade da mãe; identificação do agressor e do denunciante, local da prática e reincidência da violência. Os dados foram tabulados e analisados por meio do programa SPSS® (Microsoft corporation). Resultados: Os resultados demonstraram predomínio de vítimas do sexo feminino, de cor parda, classificação econômica D, baixa escolaridade da vítima e sua mãe. Os agressores foram, na maioria, pessoas conhecidas fora da família. Predominaram casos de violência sexual entre as crianças e, física entre os adolescentes. A casa da vítima e via pública foram os locais mais comuns para a prática da violência contra crianças e adolescentes respectivamente. Conclusão: A análise dos dados mostrou que a violência contra crianças e adolescentes que chegam ao IML está concentrada nas camadas sociais mais baixas e tem nas meninas e jovens do sexo feminino as principais vítimas. Estudos adicionais devem ser realizados no sentido de identificar se a violência contra crianças e adolescentes nos demais segmentos sociais de fato não existe ou apenas não demanda exames de corpo de delito, o que contribui para sua invisibilidade. Adicionalmente, o estudo mostra que devem ser elaboradas políticas específicas de prevenção da violência no sentido de proteger meninas e adolescentes – sobretudo nos segmentos mais vulneráveis.
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    Case report. Histoplasmosis in an AIDS paediatric patient
    (Blackwell Wissenschafts-verlag Gmbh, 1999-11-01) Cimerman, S.; Sokolowski, W.; Goncalves, SEC; Lins, MSD; Colombo, A. L.; Universidade Federal de São Paulo (UNIFESP)
    Histoplasmosis has been little reported among HIV-infected children. We report a case of a 4-year old boy with AIDS who presented with disseminated histoplasmosis diagnosed by lung biopsy. the patient had a good clinical response to amphotericin B followed by itraconazole oral solution.
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    Cerebral sinovenous thrombosis in a nephrotic child
    (Academia Brasileira de Neurologia - ABNEURO, 2003-12-01) Masruha, Marcelo Rodrigues [UNIFESP]; Zardini, Lilian Rocha [UNIFESP]; Andrade, Maria Cristina de [UNIFESP]; Mangia, Cristina Malzoni Ferreira [UNIFESP]; Carvalhaes, João Tomás de Abreu [UNIFESP]; Vilanova, Luiz Celso Pereira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Nephrotic syndrome in infancy and childhood is known to be associated with a hypercoagulable state and thromboembolic complications, but cerebral sinovenous thrombosis (CST) is a very rare and serious one, with only a few isolated reports in the literature. A case is presented of a 9-year-old boy with nephrotic syndrome that acutely developed signs and symptoms of intracranial hypertension syndrome. CST was diagnosed on cranial CT and MRI and he gradually recovered after treatment with anticoagulants. The diagnosis of CST should be considered in any patient with nephrotic syndrome who develops neurologic symptoms. The discussion of this case, coupled with a review of the literature, emphasizes that early diagnosis is essential for institution of anticoagulation therapy and a successful outcome. This report also illustrates the difficulties that may be encountered in managing such a patient.