RESUMO
Ginkgo biloba is a herbal medication that is often used worldwide. Although side effects are uncommon, G. biloba has been associated with serious bleeding complications, especially intracranial hemorrhage. We report the case of a young woman who made chronic use of G. biloba and suffered from cerebral bleeding without any structural abnormalities. Several studies have pointed to the association between G. biloba and intracranial hemorrhage.
Assuntos
Hemorragia Cerebral/induzido quimicamente , Ginkgo biloba/efeitos adversos , Extratos Vegetais/efeitos adversos , Adulto , Hemorragia Cerebral/patologia , Feminino , Medicina Herbária , HumanosRESUMO
BACKGROUND: Serum autoantibodies such as antinuclear antibody (ANA) are frequently detected in patients with chronic hepatitis C virus (HCV) infection, but its relevance is a matter of discussion. AIM: To assess the association of ANA positivity with clinical and histological features, and with the outcome of antiviral therapy in patients with HCV infection. METHODS: Baseline samples from patients with hepatitis C treated with interferon and ribavirin were tested for ANA positivity by indirect immunofluorescence. RESULTS: The mean age was 48.3+/-11.1 years and 56% were men. Among 234 included patients, 22 patients (9.4%) were positive for ANA. These patients showed significantly higher median alanine aminotransferase level (3.52 vs. 2.39 x upper limit of normal, P=0.009) when compared with ANA-negative patients. Fibrosis stage and necroinflammatory grading were not influenced by ANA positivity. Sustained virological response (SVR) rates were similar between ANA-positive and ANA-negative patients (27 vs. 29%, P=0.882). Alanine aminotransferase flares (> or =1.5-fold the baseline) during treatment were observed in 28 patients (12%), irrespective of the presence of ANA and without any clinical significance. CONCLUSION: Among HCV patients, ANA positivity seems to represent an immunological epiphenomenon. It neither influences clinical, biochemical, and histological features of chronic hepatitis C nor predicts response to antiviral treatment.
Assuntos
Anticorpos Antinucleares/sangue , Hepatite C Crônica/imunologia , Adulto , Alanina Transaminase/sangue , Antivirais/uso terapêutico , Biomarcadores/sangue , Estudos Transversais , Quimioterapia Combinada , Feminino , Técnica Indireta de Fluorescência para Anticorpo/métodos , Hepatite C Crônica/tratamento farmacológico , Humanos , Interferon-alfa/uso terapêutico , Masculino , Pessoa de Meia-Idade , Ribavirina/uso terapêutico , Falha de Tratamento , Resultado do TratamentoRESUMO
BACKGROUND: Serum autoantibodies such as antinuclear antibody (ANA) are frequently detected in patients with chronic hepatitis C virus (HCV) infection, but its relevance is a matter of discussion. AIM: To assess the association of ANA positivity with clinical and histological features, and with the outcome of antiviral therapy in patients with HCV infection. METHODS: Baseline samples from patients with hepatitis C treated with interferon and ribavirin were tested for ANA positivity by indirect immunofluorescence. RESULTS: The mean age was 48.3+/-11.1 years and 56% were men. Among 234 included patients, 22 patients (9.4%) were positive for ANA. These patients showed significantly higher median alanine aminotransferase level (3.52 vs. 2.39 x upper limit of normal, P=0.009) when compared with ANA-negative patients. Fibrosis stage and necroinflammatory grading were not influenced by ANA positivity. Sustained virological response (SVR) rates were similar between ANA-positive and ANA-negative patients (27 vs. 29%, P=0.882). Alanine aminotransferase flares (> or = 1.5-fold the baseline) during treatment were observed in 28 patients (12%), irrespective of the presence of ANA and without any clinical significance. CONCLUSION: Among HCV patients, ANA positivity seems to represent an immunological epiphenomenon. It neither influences clinical, biochemical, and histological features of chronic hepatitis C nor predicts response to antiviral treatment.
Assuntos
Anticorpos Antinucleares/sangue , Hepatite C Crônica/sangue , Hepatite C Crônica/imunologia , Adulto , Alanina Transaminase/sangue , Anticorpos Antinucleares/imunologia , Antivirais/uso terapêutico , Biópsia , Estudos Transversais , Feminino , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/patologia , Humanos , Interferons/uso terapêutico , Cirrose Hepática/tratamento farmacológico , Cirrose Hepática/imunologia , Cirrose Hepática/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ribavirina/uso terapêuticoRESUMO
Este artigo pretende levantar questões sobre o atendimento à violência na área da saúde, particularmente à "violência sexual", com base em dados de uma pesquisa etnográfica em andamento num hospital municipal de emergências na cidade de São Paulo. Busca-se discutir esse atendimento como uma construção que responde a formulações sociais sobre o que são violência e sexualidade, que transcendem o campo da saúde e que têm impacto decisivo sobre suas ações. Atentaremos para as formas como se identificam as figuras de vítima e de agressor, que dão ao fenômeno uma configuração própria, delimitando a violência e a forma específica de atenção que a ela corresponde.
This paper aims to raise questions on assistance to violence in the health area, especially "sexual violence", based on data from an ethnographic research being carried out in a municipal emergency hospital in São Paulo City, Brazil. It tries to discuss such assistance as a construction which responds to social formulations on the meanings of violence and sexuality, which transcend the health area and have decisive impact on its actions. We will point out the ways victim and aggressor are identified, which gives a particular configuration to the phenomenon, thus delimiting violence and its corresponding specific type of assistance.