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BACKGROUND: Lung or head and neck cancers are known for their high prevalence and mortality rates. Chemotherapy and radiotherapy are usually recommended as cancer treatment for these malignancies; however, they can negatively impact both the physical and mental status of patients. Hence, it is reasonable to consider resistance and aerobic exercise training to prevent these negative health outcomes. Further, several factors prevent patients from attending outpatient exercise training programs, and, therefore, a semisupervised home-based exercise training program may be seen as a well-accepted alternative. OBJECTIVE: The aim of this study will be to investigate the effects of a semisupervised home-based exercise training program on physical performance, body composition, and self-reported outcomes; changes in the initial cancer treatment dose prescribed; number of hospitalizations at 3, 6, and 9 months; and 12-month survival in people with primary lung or head and neck cancer. METHODS: Participants will be randomly allocated to the training group (TG) or control group (CG). The TG will undergo semisupervised home-based resistance and aerobic exercise training throughout their cancer treatment. The resistance training will be performed using elastic bands (TheraBand) twice a week. The aerobic training (ie, brisk walk) will be performed for at least 20 minutes per day outdoors. The equipment and tools used during the training sessions will be provided. This intervention will start the week before treatment commencement, will be performed throughout the duration of the treatment, and will continue for 2 weeks after treatment completion. The CG will undergo usual care (ie, cancer treatment with no formal exercise prescription). Assessments will take place 2 weeks before the beginning of the usual cancer treatment and 2 weeks after treatment completion. The measures of physical function (peripheral muscle strength, functional exercise capacity, and physical activity), body composition, and self-reported outcomes (symptoms of anxiety and depression, health-related quality of life, and symptoms related to the disease and treatment) will be collected. We will report on any change in the initial cancer treatment dose prescribed; number of hospitalizations at 3, 6, and 9 months; and 12-month survival. RESULTS: In February 2021, the clinical trial registration was approved. Recruitment and data collection for the trial are ongoing (as of April 2023, 20 participants had already been randomized), and findings of this study are likely to be published late in 2024. CONCLUSIONS: This exercise training as a complementary treatment for patients with cancer is likely to promote positive effects on the health outcomes assessed, over and above any change in the CG, and prevent the reduction of initial cancer treatment dose prescribed. If these positive effects are shown, they will likely impact long-term outcomes such as hospitalizations and 12-month survival. TRIAL REGISTRATION: Brazilian Clinical Trials Registry (ReBEC) RBR-5cyvzh9; https://ensaiosclinicos.gov.br/rg/RBR-5cyvzh9. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/43547.

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The hyperhomocysteinemia (HHcy) is toxic to the cells and associated with several diseases. Clinical studies have shown changes in plasma concentrations of Hcy after physical exercise. This study aimed to assess the effect of HHcy on testis, epididymis and sperm quality and to investigate whether voluntary exercise training protects this system against damage caused by HHcy in Swiss mice. In this study, 48 mice were randomly distributed in the control, HHcy, physical exercise, and HHcy combined with physical exercise groups. HHcy was induced by daily administration of dl-homocysteine thiolactone via gavage throughout the experimental period. Physical exercise was performed through voluntary running on the exercise wheels. The plasma concentrations of homocysteine (Hcy) and testosterone were determined. The testes and epididymis were used to assess the sperm count, histopathology, lipoperoxidation, cytokine levels, testicular cholesterol, myeloperoxidase, and catalase activity. Spermatozoa were analyzed for morphology, acrosome integrity, mitochondrial activity, and motility. In the testes, HHcy increased the number of abnormal seminiferous tubules, reduced the tubular diameter and the height of the germinal epithelium. In the epididymis, there was tissue remodeling in the head region. Ultimately, voluntary physical exercise training reduced plasma Hcy concentration but did not attenuate HHcy-induced testicular and epididymal disturbances.

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O melanoma de mucosa oral (MMO) representa de 0,2 a 8% dos casos de melanoma. Acomete, principalmente, palato e gengiva de pacientes entre 40 e 70 anos. Inicialmente é assintomático, contribuindo para o diagnóstico tardio e prognóstico reservado. O tratamento de escolha consiste na ressecção cirúrgica, podendo ser utilizadas radioterapia e quimioterapia adjuvantes. Relatamos um caso em paciente de 80 anos do sexo masculino, com melanoma primário na gengiva e palato duro, que foi submetido à ressecção tumoral seguida de reconstrução de palato. Ressaltamos a importância do exame físico completo e da busca ativa por lesões na mucosa oral para diagnóstico precoce

Oral mucosa melanoma (OMM) represents 0.2% to 8% of melanoma cases. It mainly affects the palate and gums of patients between 40 and 70 years old. It is initially asymptomatic, contributing to late diagnosis and poor prognosis. The treatment of choice consists of surgical resection, and adjuvant radiotherapy and chemotherapy may be used. We report a case in an 80-year-old male patient with primary gingival and hard palate melanoma who underwent tumor resection followed by palate reconstruction. We emphasize the importance of a complete physical examination and active search for lesions in the oral mucosa for early diagnosis.

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PURPOSE: The aim of this study was to investigate the effects of creatine supplementation on muscle wasting in Walker-256 tumor-bearing rats. METHODS: Wistar rats were randomly assigned into three groups (n = 10/group): control (C), tumor bearing (T), and tumor bearing supplemented with creatine (TCr). Creatine was provided in drinking water for a total of 21 days. After 11 days of supplementation, tumor cells were implanted subcutaneously into T and TCr groups. The animals' weight, food and water intake were evaluated along the experimental protocol. After 10 days of tumor implantation (21 total), animals were euthanized for inflammatory state and skeletal muscle cross-sectional area measurements. Skeletal muscle components of ubiquitin-proteasome pathways were also evaluated using real-time PCR and immunoblotting. RESULTS: The results showed that creatine supplementation protected tumor-bearing rats against body weight loss and skeletal muscle atrophy. Creatine intake promoted lower levels of plasma TNF-α and IL-6 and smaller spleen morphology changes such as reduced size of white pulp and lymphoid follicle compared to tumor-bearing rats. In addition, creatine prevented increased levels of skeletal muscle Atrogin-1 and MuRF-1, key regulators of muscle atrophy. CONCLUSION: Creatine supplementation prevents skeletal muscle atrophy by attenuating tumor-induced pro-inflammatory environment, a condition that minimizes Atrogin-1 and MuRF-1-dependent proteolysis.

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Skin injuries constitute a gateway for pathogenic bacteria that can be either part of tissue microbiota or acquired from the environmental. These microorganisms (such as Acinetobacter baumannii, Enterococcus faecalis,Pseudomonas aeruginosa, and Staphylococcus aureus) produce virulence factors that impair tissue integrity and sustain the inflammatory phase leading for establishment of chronic wounds. The high levels of antimicrobial resistance have limited the therapeutic arsenal for combatting skin infections. Thus, the treatment of non-healing chronic wounds is a huge challenge for health services worldwide, imposing great socio-economic damage to the affected individuals. This scenario has encouraged the use of natural polymers, such as polysaccharide, in order to develop new formulations (membranes, nanoparticles, hydrogels, scaffolds) to be applied in the treatment of skin infections. In this non-exhaustive review, we discuss the applications of polysaccharide-based formulations in the healing of infected wounds in animal models and clinical trials. The formulations discussed in this review were prepared using alginate, cellulose, chitosan, and hyaluronic acid. In addition to have healing actions per se, these polysaccharide formulations can act as transdermal drug delivery systems, controlling the release of active ingredients (such as antimicrobial and healing agents). The papers show that these polysaccharides-based formulations are efficient in controlling infection and improve the healing, even in chronic infected wounds. These data should positively impact the design of new dressings to treat skin infections.

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ABSTRACT Introduction: Ileocolic resection (ICR) is the most common surgical procedure performed for Crohn's disease (CD). Similarly, right-sided Colorectal cancer (CRC) is treated by the same operation. The primary aim of this study was to analyze and compare the frequency and profile of early postoperative complications of ICR between patients with CD and CRC. Methods: Retrospective and observational study with patients submitted to ICR from two Brazilian tertiary referral units in colorectal surgery. We included patients with diagnosis of CD or CRC, treated with ICR, at any stage of follow-up. Variables analyzed: age at surgery, gender, diagnosis, surgical approach (open or laparoscopy), type of anastomosis (hand-sewn/stapled; end-to-end/side-to-side), presence and type of early postoperative complications (30 days) and mortality, among others. Results: 109 patients were included, 73 with CD (67%) and 36 with CRC (33%). CD patients were younger (42.44 ± 12.73 years vs. 66.14 ± 11.02 years in the CRC groups, p < 0.0001) and had more previous resections (20 ± 27.4 in CD and 0 in CCR, p = 0.001). There were no significant differences between the groups in terms of overall early postoperative complications [17/73 (23.3%) in the CD and 5/36 (13.9%) in the CRC groups (p = 0.250)]. There was no significant difference between the groups in relation to anastomotic leakage (p = 0.185), surgical site infections (p = 0.883), other complications (0.829) and deaths (p = 0.069). Conclusions: There was no significant difference in early postoperative complications in patients with CD or CRC submitted to ICR.

RESUMO Introdução: A ileocolectomia direita (ICD) é a operação mais realizada no manejo cirúrgico da doença de Crohn (DC). Da mesma forma, é o procedimento de escolha no tratamento do câncer colorretal (CCR) quando localizado à direita. O objetivo deste estudo foi analisar e comparar as complicações cirúrgicas em pacientes submetidos a ICD por DC e CCR em uma coorte de pacientes. Método: Estudo longitudinal, retrospectivo e observacional, de uma coorte de pacientes submetidos a ICD provenientes de 2 centros de referência em coloproctologia. Os critérios de inclusão foram pacientes com DC ou CCR, submetidos a ICD, em qualquer estágio de acompanhamento. As variáveis analisadas foram: idade à cirurgia, gênero, diagnóstico, abordagem (aberta ou laparoscópica), tipo de anastomose, presença e tipo de complicações pós-operatórias precoces (até 30 dias) e óbito. Resultados: Foram incluidos 109 pacientes, 73 com DC (67%) e 36 com CCR (33%). Os grupos foram homogêneos em todas as variáveis, à exceção da idade (42,44 ± 12,73 na DC e 66,14 ± 11,02 no CCR, p < 0,0001). Não houve diferença entre os grupos em relação às complicações precoces, com 17/67 (23,3%) na DC e 5/36 (13,9%) no CCR, p = 0,250. Da mesma forma, não houve diferença entre os grupos em relação a deiscência de anastomose (p = 0,185), infecções do sítio cirúrgico (p = 0,883), outras complicações (0,829) e óbitos (p = 0,069). Conclusões: Não houve diferença nas complicações pós-operatórias em pacientes submetidos a ICD entre portadores de DC e CCR.

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ABSTRACT BACKGROUND: Infliximab and adalimumab are considered effective drugs in the management of Crohn's disease. However, due to significant immunossupression, they can cause important adverse events, mostly infections. OBJECTIVE: The aim of this study was to quantify and describe adverse events derived from adalimumab and infliximab use in Crohn's disease patients, and to compare the safety profile between these two agents. METHODS: This was an observational, single-center, longitudinal, retrospective study with Crohn's disease patients under infliximab or adalimumab therapy. Variables analyzed: demographic characteristics (including the Montreal classification), type of agent used, concomitant immunomodulators, presence and types of adverse events observed. Patients were allocated in two groups (infliximab and adalimumab) and had their adverse events accessed and subsequently compared. RESULTS: A total of 130 patients were included (68 in infliximab and 62 in adalimumab groups, respectively). The groups were fully homogeneous in all baseline characteristics, with a median follow-up of 47.21±36.52 months in the infliximab group and 47.79±35.09 in the adalimumab group (P=0.512). Adverse events were found in 43/68 (63.2%) and 40/62 (64.5%) in each group, respectively (P=0.879). There were no differences between the groups regarding infections (P=0.094) or treatment interruption (P=0.091). There were higher rates of infusion reactions in the infliximab group (P=0.016). Cephalea and injection site reactions were more prevalent in adalimumab patients. CONCLUSION: Adverse events were found in approximately two thirds of Crohn's disease patients under anti-TNF therapy, and there were no significant differences between infliximab or adalimumab.

RESUMO CONTEXTO: A utilização de inibidores do fator de necrose tumoral (TNF) alfa no manejo da doença de Crohn é cada vez mais frequente. Tanto o infliximabe quanto o adalimumabe são considerados medicamentos efetivos no controle da doença. Entretanto, por serem potentes imunossupressores, podem causar efeitos adversos importantes, principalmente infecções. OBJETIVO: O objetivo primário deste estudo foi analisar a presença de efeitos adversos dos anti-TNFs em portadores de doença de Crohn, comparando-se infliximabe e adalimumabe e individualizando-se o perfil de segurança de cada droga. MÉTODOS: Estudo observacional, longitudinal e retrospectivo, que incluiu portadores de doença de Crohn com uso de infliximabe ou adalimumabe de uma coorte de pacientes tratados em um único centro. Analisou-se características demográficas (incluindo-se a classificação de Montreal), tipo de agente utilizado, presença e tipo dos eventos adversos observados, entre outras variáveis. Os pacientes foram alocados em dois grupos (infliximabe e adalimumabe) e tiveram os efeitos adversos anotados e posteriormente comparados. RESULTADOS: Um total de 130 pacientes foram incluídos (68 com infliximabe e 62 com adalimumabe). Os grupos foram homogêneos em todas as variáveis analisadas, com tempo de seguimento médio de 47,21±36,52 meses no grupo infliximabe e 47,79±35,09 no grupo adalimumabe (P=0,512). Efeitos adversos foram encontrados em 43/68 (63,2%) e 40/62 (64,5%) nos dois grupos, respectivamente (P=0,879). Não houve diferença entre os grupos em relação a infecções (P=0,094) ou interrupção do tratamento (P=0,091). Houve maiores índices de reações infusionais no grupo infliximabe (P=0,016). Cefaleia e reações no local das injeções foram mais frequentes no grupo adalimumabe. CONCLUSÃO: Efeitos adversos foram encontrados em cerca de dois terços dos pacientes com doença de Crohn em uso de anti-TNF, não havendo maiores diferenças em relação ao uso de infliximabe ou adalimumabe.

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Muscle wasting has been emerging as one of the principal components of cancer cachexia, leading to progressive impairment of work capacity. Despite early stages melanomas rarely promotes weight loss, the appearance of metastatic and/or solid tumor melanoma can leads to cachexia development. Here, we investigated the B16F10 tumor-induced cachexia and its contribution to muscle strength and locomotor-like activity impairment. C57BL/6 mice were subcutaneously injected with 5 × 104 B16F10 melanoma cells or PBS as a Sham negative control. Tumor growth was monitored during a period of 28 days. Compared to Sham mice, tumor group depicts a loss of skeletal muscle, as well as significantly reduced muscle grip strength and epididymal fat mass. This data are in agreement with mild to severe catabolic host response promoted by elevated serum tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and lactate dehydrogenase (LDH) activity. Tumor implantation has also compromised general locomotor activity and decreased exploratory behavior. Likewise, muscle loss, and elevated inflammatory interleukin were associated to muscle strength loss and locomotor activity impairment. In conclusion, our data demonstrated that subcutaneous B16F10 melanoma tumor-driven catabolic state in response to a pro-inflammatory environment that is associated with impaired skeletal muscle strength and decreased locomotor activity in tumor-bearing mice.

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BACKGROUND: Infliximab and adalimumab are considered effective drugs in the management of Crohn's disease. However, due to significant immunossupression, they can cause important adverse events, mostly infections. OBJECTIVE: The aim of this study was to quantify and describe adverse events derived from adalimumab and infliximab use in Crohn's disease patients, and to compare the safety profile between these two agents. METHODS: This was an observational, single-center, longitudinal, retrospective study with Crohn's disease patients under infliximab or adalimumab therapy. Variables analyzed: demographic characteristics (including the Montreal classification), type of agent used, concomitant immunomodulators, presence and types of adverse events observed. Patients were allocated in two groups (infliximab and adalimumab) and had their adverse events accessed and subsequently compared. RESULTS: A total of 130 patients were included (68 in infliximab and 62 in adalimumab groups, respectively). The groups were fully homogeneous in all baseline characteristics, with a median follow-up of 47.21±36.52 months in the infliximab group and 47.79±35.09 in the adalimumab group (P=0.512). Adverse events were found in 43/68 (63.2%) and 40/62 (64.5%) in each group, respectively (P=0.879). There were no differences between the groups regarding infections (P=0.094) or treatment interruption (P=0.091). There were higher rates of infusion reactions in the infliximab group (P=0.016). Cephalea and injection site reactions were more prevalent in adalimumab patients. CONCLUSION: Adverse events were found in approximately two thirds of Crohn's disease patients under anti-TNF therapy, and there were no significant differences between infliximab or adalimumab.

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BACKGROUND: Odontogenic myxoma is a rare benign neoplasm that originates from odontogenic ectomesenchyme. There is no standard of care and recurrences are frequent after conservative surgical procedures. MATERIAL AND METHODS: A retrospective study conducted at a single cancer center, with analysis of medical records of all patients diagnosed with odontogenic myxoma from 1980 to 2010, along with a literature review. RESULTS: There were 14 patients with diagnosis of odontogenic myxoma (OM). Most patients were female (78.6%) and Caucasian (100%), with ages ranging from 7 to 51 years (21.6 ± 11.6 years). The time period between the first symptom and first consultation ranged from 0 to 60 months (19.4 ± 19.97 months). The most frequent complaints were increased local volume or failure to tooth eruption. The most common tumor site was the mandible (11 cases, 78.5%). About radiological findings, most lesions were multilocular (9 cases, 64.3%) and with imprecise limits (12 cases, 85.7%). Surgery was performed in all cases and curettage was the most applied technique (10 cases, 71.4%). Three patients underwent mandibulectomy and complex reconstructions including iliac crest microvascular flap. Three patients had postoperative complications and 4 had local recurrences of the tumor. The follow up time ranged from 12 to 216 months (112 ± 70.8 months). All patients are without clinical and radiographic evidence of disease. CONCLUSIONS: OM is a locally aggressive and rare tumor. There is no gold standard surgical management and the therapeutic decision should be individualized taking into account the characteristics and extension of the tumor. Key words:Mandible, myxoma, odontogenic, odontogenic tumor.

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BACKGROUND: Although studies have demonstrated that physical exercise alters homocysteine levels in the blood, meta-analyses of the effects of acute exercise and exercise training on homocysteine blood concentration have not been performed, especially regarding the duration and intensity of exercise, which could affect homocysteine levels differently. OBJECTIVE: The aim of this meta-analysis was to ascertain the effects of acute exercise and exercise training on homocysteine levels in the blood. METHOD: A review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses using the online databases PubMed, SPORTDiscus, and SciELO to identify relevant studies published through June 2015. Review Manager was used to calculate the effect size of acute exercise and exercise training using the change in Hcy plasmaserum concentration from baseline to post-acute exercise and trained vs. sedentary control groups, respectively. Weighted mean differences were calculated using random effect models. RESULTS: Given the abundance of studies, acute exercise trials were divided into two subgroups according to exercise volume and intensity, whereas the effects of exercise training were analyzed together. Overall, 22 studies with a total of 520 participants indicated increased plasma homocysteine concentration after acute exercise (1.18 µmol/L, 95% CI: 0.71 to 1.65, p < .01). Results of a subgroup analysis indicated that either long-term exercise of low-to-moderate intensity (1.39 µmol/L, 95% CI: 0.9 to 1.89, p < .01) or short-term exercise of high intensity (0.83 µmol/L, 95% CI: 0.19 to 1.40, p < .01) elevated homocysteine levels in the blood. Increased homocysteine induced by exercise was significantly associated with volume of exercise, but not intensity. By contrast, resistance training reduced plasma homocysteine concentration (-1.53 µmol/L, 95% CI: -2.77 to -0.28, p = .02), though aerobic training did not. The cumulative results of the seven studies with a total of 230 participants in exercise training analysis did not demonstrate a significant impact on homocysteine levels in the blood (-0.56 µmol/L, 95% CI: -1.61 to 0.50, p = .23). CONCLUSIONS: Current evidence demonstrates that acute exercise increases homocysteine levels in the blood independent of exercise duration and intensity. Resistance, but not aerobic training decreases plasma homocysteine levels.

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O presente estudo avaliou a qualidade bromatológica, em termos de umidade, cinzas, proteínas, lipídios e valor calórico, da carne de Lula (Loligo spp.), animal introduzido na comercialização e consumo da população de São Luís, MA em quase duas décadas. As amostras foram coletadas em cinco supermercados (totalizando 20 amostras). As análises foram realizadas em triplicata seguindo-se as recomendações metodológicas para Análises de Alimentos do instituto Adolfo Lutz (2005). Na análise de proteína os resultados (entre 14,37 e 16,72%) demonstraram que, para uma dieta alimentar saudável, a carne de Lula apresenta-se como um alimento bastante nutricional. Os teores de lipídios (entre 0,37 e 0,48%) e o valor calórico (entre 61,02 e 71,2 Kcal/100g) foram baixos. Este alimento, portanto, é considerado saudável para o consumo humano por apresentar baixo índice de gordura.

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O presente estudo avaliou a qualidade bromatológica, em termos de umidade, cinzas, proteínas, lipídios e valor calórico, da carne de Lula (Loligo spp.), animal introduzido na comercialização e consumo da população de São Luís, MA em quase duas décadas. As amostras foram coletadas em cinco supermercados (totalizando 20 amostras). As análises foram realizadas em triplicata seguindo-se as recomendações metodológicas para Análises de Alimentos do instituto Adolfo Lutz (2005). Na análise de proteína os resultados (entre 14,37 e 16,72%) demonstraram que, para uma dieta alimentar saudável, a carne de Lula apresenta-se como um alimento bastante nutricional. Os teores de lipídios (entre 0,37 e 0,48%) e o valor calórico (entre 61,02 e 71,2 Kcal/100g) foram baixos. Este alimento, portanto, é considerado saudável para o consumo humano por apresentar baixo índice de gordura.(AU)

Samples of Squids Loligo spp.,introduced for food in the city of SãoLuis, MA population in the last two decades,were qualitatively studied usingphysical chemistry quality analysisin terms of moisture, ash, proteins,lipids, and the caloric value of thisspecies meat. Samples were collectedat five supermarkets (20 samples intotal). The analysis was conducted intriplicate following the Adolfo Lut;Institute Food Analysis Recommendations(2005). Results showed highmoisture content (varying from 80.45to 82.02%), and consequently low ashcontent (between 0.67 and 0.88%),which means a meet easier to digest.Results of protein analysis (between14.37 and 16.72%) showed that, fora healthy feeding diet, Loligo spp.meat is rather nutritive. Lipid content(close to 0.37 and 0.48%) and thecaloric value (close to 61.02 and 71.2Kcal/100g) were low. This food, thus,is considered apt for human consumptiondue to its low fat content. (AU)

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O presente estudo avaliou a qualidade bromatológica, em termos de umidade, cinzas, proteínas, lipídios e valor calórico, da carne de Lula (Loligo spp.), animal introduzido na comercialização e consumo da população de São Luís, MA em quase duas décadas. As amostras foram coletadas em cinco supermercados (totalizando 20 amostras). As análises foram realizadas em triplicata seguindo-se as recomendações metodológicas para Análises de Alimentos do instituto Adolfo Lutz (2005). Na análise de proteína os resultados (entre 14,37 e 16,72%) demonstraram que, para uma dieta alimentar saudável, a carne de Lula apresenta-se como um alimento bastante nutricional. Os teores de lipídios (entre 0,37 e 0,48%) e o valor calórico (entre 61,02 e 71,2 Kcal/100g) foram baixos. Este alimento, portanto, é considerado saudável para o consumo humano por apresentar baixo índice de gordura.(AU)

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INTRODUCTION: Respiratory impairment may be the main clinical manifestation of human leptospirosis. METHODS: With the aim of describing the respiratory functional characteristics of this disease, 21 patients were evaluated using pulse oximetry and spirometry at two times: an initial evaluation and after around 28 days. RESULTS: Two (9.5%) patients presented peripheral oxygen saturation of less than 95%. Normal spirometric patterns were observed in eight (38.1%); cases restrictive ventilatory disorders were inferred in seven (33.3%), obstructive disorders with reduced forced vital capacity in four (19%), and nonspecific disorders in two (9.5%). Abnormal spirometry findings were associated with worse APACHE II scores (p = 0.02) and abnormalities on chest x-ray (p = 0.05). After clinical resolution, significant functional gain was observed (p < 0.05) in the group of patients with abnormal spirometry findings. CONCLUSIONS: It was concluded that respiratory functional abnormalities were detected during the course of the disease and were associated with greater clinical severity and higher frequency of chest radiographic abnormalities.

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INTRODUÇÃO: O comprometimento respiratório da leptospirose humana pode ser sua principal manifestação clínica e comumente está associado a maior morbimortalidade. MÉTODOS: Objetivando descrever aspectos funcionais respiratórios nessa doença, foram analisados 21 pacientes com oximetrias de pulso e espirometrias em dois momentos: em avaliação inicial e após cerca de 28 dias. RESULTADOS: Dois (9,5 por cento) doentes tinham saturação periférica de oxigênio menor que 95 por cento. Padrões espirométricos normais foram observados em 8 (38,1 por cento) casos; distúrbios ventilatórios restritivos foram inferidos em 7 (33,3 por cento), obstrutivos com capacidade vital forçada reduzida em 4 (19 por cento), e inespecíficos em 2 (9,5 por cento). Espirometrias anormais se associaram a pior escore APACHE II (p=0,02) e anormalidades na radiografia de tórax (p=0,05). Após resolução clínica, verificou-se ganho funcional significativo (p<0,05) no grupo de pacientes com espirometria alterada. CONCLUSÕES: Alterações espirométricas foram detectadas no curso da enfermidade e estiveram associadas a pior gravidade clínica e maior freqüência de anormalidades radiológicas torácicas.

INTRODUCTION: Respiratory impairment may be the main clinical manifestation of human leptospirosis. METHODS: With the aim of describing the respiratory functional characteristics of this disease, 21 patients were evaluated using pulse oximetry and spirometry at two times: an initial evaluation and after around 28 days. RESULTS: Two (9.5 percent) patients presented peripheral oxygen saturation of less than 95 percent. Normal spirometric patterns were observed in eight (38.1 percent); cases restrictive ventilatory disorders were inferred in seven (33.3 percent), obstructive disorders with reduced forced vital capacity in four (19 percent), and nonspecific disorders in two (9.5 percent). Abnormal spirometry findings were associated with worse APACHE II scores (p = 0.02) and abnormalities on chest x-ray (p = 0.05). After clinical resolution, significant functional gain was observed (p < 0.05) in the group of patients with abnormal spirometry findings. CONCLUSIONS: It was concluded that respiratory functional abnormalities were detected during the course of the disease and were associated with greater clinical severity and higher frequency of chest radiographic abnormalities.

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O autor discute, ante um enfoque medico-social, o papel dos Neurolepticos de Acao Prolongada (NAP), no tratamento de manutencao de psicoticos cronicos em geral e de esquizofrenicos em particular, a partir das especialidades farmaceuticas disponiveis no mercado e de estudos comparativos dos efeitos colaterais dos mesmos, sua acao farmacologica e suas indicacoes. Conclui que existe vantagens na utilizacao dos NAP, especialmente nos casos onde o abandono do tratamento e frequente, ou nos casos onde existe a possibilidade de um controle periodico desses pacientes por pessoal de enfermagem psiquiatrica, em ambulatorios de servicos publicos de saude mental, favorecendo a reintegracao socio-familiar e profissional do paciente psicotico, estabilizado, egresso de instituicoes psiquiatricas ou nao.

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Os autores estudaram a atividade terapêutica e as reaçöes adversas do decanoato de haloperidol em 50 pacientes esquizofrênicos estabilizados, 30 ambulatoriais e 20 hospitalizados. A posologia inicial foi de 18 a 20 vezes a dose oral de haloperidol ou o equivalente de outro neuroléptico, com ajuste mensal da dose nos primeiros 2 ou 3 meses de tratamento, cuja duraçäo foi de 6 meses. A avaliaçäo clínica foi feita pela BPRS e Avaliaçäo Clínica Global, empregando-se a escala de Bordeleau para efeitos secundários. Concluíram que o decanoato de haloperidol I.M., a cada 4 semanas, oferece eficaz e segura alternativa na terapêutica de manutençäo da esquizofrenia, permitindo adequado controle da sintomatologia psicótica, com reaçöes adversas comparáveis às observadas com a terapêutica neuroléptica por via oral

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RESUMO

Os autores estudaram a atividade terapeutica e as reacoes adversas do DECANOATO DE HALOPERIDOL em 50 pacientes esquizofrenicos estabilizados, 30 ambulatoriais e 20 hospitalizados. A posologia inicial foi de 18 a 20 vezes a dose oral de haloperidol ou o equivalente de outro neuroleptico, com ajuste mensal da dose nos primeiros 2 ou 3 meses de tratamento, cuja duracao total foi de 6 meses. A avaliacao clinica foi feita pela BPRS e Avaliacao Clinica Global, empregando-se a escala de Bordeleau para efeitos secundarios. Concluiram que o DECANOATO DE HALOPERIDOL I. M., a cada 4 semanas, oferece eficaz e segura alternativa na terapeutica de manutencao da esquizofrenia, permitindo adequado controle da sintomatologia psicotica, com reacoes adversas comparaveis as observadas com a terapeutica neuroleptica por via oral.

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