Assessing the Effect of Piperacillin/Tazobactam on Hematological Parameters in Patients Admitted with Moderate or Severe Foot Infections

Introduction: Piperacillin/tazobactam is a commonly used antibiotic for the empirical treatment of severe diabetic foot infections. One of the most feared complications of this drug is the development of pancytopenia. The aim of this study was to determine whether the use of piperacillin/tazobactam caused any hematological changes in patients admitted with severe diabetes-related foot infections from a specialist multidisciplinary foot clinic. Specifically, looking at whether it caused anemia, leukopenia, neutropenia, or thrombocytopenia. Methods: A 1-year retrospective analysis of patients admitted to a tertiary care center for treatment of diabetes-related foot infection using piperacillin/tazobactam. Hematological indices, urea and electrolytes, and C-reactive protein (CRP) were recorded pretreatment, during treatment, and posttreatment. HbA1c, vitamin B12, folate, thyroid-stimulating hormone, and free thyroxin were also analyzed to exclude any potential confounders as a cause of pancytopenia. Results: A total of 154 patients were admitted between 1 January 2016 and 31 December 2016 who received piperacillin/tazobactam for severe diabetes-related foot infection. On admission, white cell count and CRP were raised and fell significantly within the first 48 h. Other hematological factors did not change. Five patients developed a mild pancytopenia, of which three were unexplained. Conclusion: In this relatively small cohort, pancytopenia did not occur. As such, piperacillin/tazobactam appeared to have a low risk of adverse hematological outcomes and remains the treatment of choice for severe diabetes-related foot infections

Colesterolemia, trigliceridemia e excesso de peso em escolares de Santa Maria, RS, Brasil Blood lipids abnormalities and overweight prevalence in students of Santa Maria, RS, Brazil

INTRODUÇÃO: O nível de colesterol na infância é um preditor do nível de colesterol na vida adulta. As consequências do colesterol elevado, somadas a outros fatores de risco constituem problema mundial de saúde pública. OBJETIVO: Estimar a prevalência de hipercolesterolemia, hipertrigliceridemia e excesso de peso em estudantes do município de Santa Maria-RS. Métodos: Estudo transversal com 374 crianças de 10 a 12 anos de idade, de escolas das redes pública e privada, realizado no segundo semestre de 2005 na cidade de Santa Maria-RS. Foram determinados os níveis de colesterol total, triglicerídeos e estado nutricional. RESULTADOS: As prevalências de hipercolesterolemia, hipertrigliceridemia e excesso de peso encontradas foram de 4,7%, 8,9% e 20,7%, respectivamente. Não houve diferença significante entre sexo e rede pública e privada. As crianças com excesso de peso apresentaram maior prevalência de alterações lipídicas. CONCLUSÕES: A prevalência de alterações lipídicas pode ser considerada baixa, mas a prevalência de excesso de peso dos estudantes de Santa Maria mostrou-se relativamente alta, alertando à importância de políticas públicas e à necessidade de assistência pediátrica nessa faixa etária, visando o seu diagnóstico precoce e, principalmente, o aconselhamento nutricional e incentivo à prática esportiva, uma vez que as dislipidemias e o excesso de peso têm sido apontados como fatores de risco para as doenças cardiovasculares.<br>INTRODUCTION: Cholesterol level in childhood is a predictor of cholesterol level in adult life. The consequences of high cholesterol levels summed to other risk factors constitute a worldwide public health problem. OBJECTIVE: To estimate the prevalence of blood lipid abnormalities and overweight among school students of the city of Santa Maria, RS, Brazil. Methods: A cross-sectional study with 374 children, aged between 10 and 12 years, from public and private schools of the city of Santa Maria, RS, conducted on the second semester of 2005. Total cholesterol levels (TC), fractions of cholesterol (HDL- C and LDL- C), triglycerides (TG) and nutritional status were determined. RESULTS: The prevalence of hypercholesterolemia, hypertriglicemia and overweight found were 4.7%, 8.9% and 20.7%, respectively. There was no significant difference between sexes or public and private schools. The overweight children presented higher prevalence of lipid alterations. CONCLUSION: The prevalence of lipid alterations may be considered low, but the prevalence of overweight among the students of Santa Maria was high, demonstrating hence the importance of public policies and the need for pediatric assistance at this age group. The aims here would be early diagnosis, especially for nutritional advising and stimulus for physical activities, since overweight and blood lipid abnormalities have been pointed out as risk factors for cardiovascular diseases

Vitaminas antioxidantes e prevenção da arteriosclerose na infância Antioxidant vitamins and prevention of atherosclerosis in childhood

OBJETIVO: Revisar os potenciais efeitos antioxidantes das vitaminas A, C e E na prevenção do desenvolvimento da arteriosclerose na infância, com ênfase na prevenção da dislipidemia. FONTES DE DADOS: Pesquisa bibliográfica em revistas científicas, livros técnicos e publicações de órgãos oficiais dos últimos 20 anos. Utilizaram-se as bases de dados Lilacs, SciELo e Medline em português, inglês e espanhol, com as palavras-chave: "antioxidantes", "arteriosclerose", "dislipidemias", "peroxidação de lipídeos", "infância", "vitamina A", "vitamina C" e "vitamina E". SÍNTESE DE DADOS: A prevalência de dislipidemia na infância e na adolescência mostra frequência crescente, provavelmente relacionada às mudanças dos hábitos alimentares e à redução na prática de atividades físicas. O elevado nível plasmático da lipoproteína de baixa densidade (LDL-c) é fator de risco para o desenvolvimento da arteriosclerose. O consumo de frutas, verduras e legumes, ricos em antioxidantes, é um dos fatores de maior importância na prevenção da peroxidação lipídica. A baixa ingestão dessas fontes naturais de antioxidantes sugere a necessidade de intervenção nutricional para atingir as metas diárias de consumo de vitaminas A, C e E, não sendo preconizada a sua suplementação medicamentosa. CONCLUSÕES: O pediatra e o nutricionista devem orientar as famílias sobre o consumo de alimentos saudáveis, principalmente frutas, verduras e legumes, por seu potencial efeito antioxidante, especialmente nos primeiros anos de vida.<br>OBJECTIVE: To review the potential antioxidant effects of vitamins A, C and E in the prevention of atherosclerosis development during childhood, emphasizing the prevention of dyslipidemia. DATA SOURCES: Bibliographic search in scientific journals, technical books and official publications of the last 20 years. Lilacs, SciElo and Medline databases were searched for articles in Portuguese, Spanish and English using a combination of the following terms: "antioxidants", "atherosclerosis", "dyslipidemia", "lipid peroxidation", "childhood", "vitamin A", "vitamin C" and "vitamin E". DATA SYNTHESIS: There is an increasing prevalence of dyslipidemia in children and adolescents, probably related to changes in dietary habits and to the reduced practice of physical activities. The high plasma concentration of low-density lipoprotein (LDL-c) is a risk factor for atherosclerosis development. The consumption of nutrients rich in antioxidants, such as fruits and vegetables, is very important to prevent lipid peroxidation. The low intake of these natural antioxidants sources suggests the need for nutritional intervention to achieve the daily ingestion targets of vitamins A, C and E. Vitamin supplementation is not recommended. CONCLUSIONS: Children should be encouraged to increase ingestion of fruits and vegetables due to their potential antioxidant effect, especially in the first years of life