Alterações cutâneas com ziprasidona

Os antipsicóticos podem estar associados a alterações cutâneas adversas. Relatamos o caso de uma paciente do sexo feminino, 47 anos, em acompanhamento ambulatorial com o diagnóstico de esquizofrenia. Estava em uso de ziprasidona há sete semanas. Prescrita inicialmente na dose de 80 mg ao dia, a medicação foi aumentada para 120 mg após seis semanas. Sete dias após o aumento da dose, a paciente apresentou quadro de prurido associado a lesões eritematosas em alvo, acometendo tronco, membros superiores e inferiores. Após a suspensão do antipsicótico, houve remissão do quadro dermatológico. Embora haja menção prévia a efeitos colaterais de natureza cutânea durante o uso desta medicação, não encontrou-se na literatura relatos de associação entre eritema multiforme e ziprasidona.There are descriptions of skin reactions secondary to antipsychotic use. We reported a case of erythema multiform associated with ziprasidone use in a 47-year-old female patient diagnosed with schizophrenia. The patient was receiving the medication (80 mg/day) for seven weeks, and the dose was increased to 120 mg/day. Seven days after the dose change, the patient presented pruritus and erythematosus lesions in trunk, upper and lower members. The medication was discontinued and there was a complete improvement of the lesions. We were unable to find previous reports of association between erythema multiform and ziprasidone

Lack of association between the 5-HTTLPR and positive screening for mental disorders among children exposed to urban violence and maltreatment

Objective: To ascertain whether genetic variations in the serotonin transporter gene (5-HTTLPR 44-bp insertion/deletion polymorphism) influence an increase in depressive and anxiety symptoms in children and adolescents exposed to high levels of violence. Methods: Saliva samples were collected from a group of children who were working on the streets and from their siblings who did not work on the streets. DNA was extracted from the saliva samples and analyzed for 5-HTTLPR polymorphism genotypes. Results: One hundred and seventy-seven children between the ages of 7 and 14 years were analyzed (114 child workers and 63 siblings). Data on socioeconomic conditions, mental symptoms, and presence and severity of maltreatment and urban violence were collected using a sociodemographic inventory and clinical instruments. There was no positive correlation between the 5-HTTLPR polymorphism and presence of mental symptoms in our sample, although the children were exposed to high levels of abuse, neglect, and urban violence. Conclusions: Despite previous studies that associated adult psychiatric disorders with the 5-HTTLPR polymorphism and a history of childhood maltreatment, no such association was found in this sample of children at risk.Universidade Federal de São Paulo (UNIFESP) Department of PsychiatryOcular Genetic InstituteCollege of Public Health, USPUniversidade de São Paulo (USP) Institute of Mathematics and StatisticsKing's College London Institute of Psychiatry Health Service and Population Research DepartmentUNIFESP, Department of PsychiatrySciEL

Exposure to maltreatment and urban violence in children working on the streets in São Paulo, Brazil: factors associated with street work

Objective: To quantitatively study the exposure to childhood maltreatment and urban violence in children from families with at least one child working on the streets and to investigate the relationship between these factors and street work. Methods: Families who participated in a nongovernmental organization (NGO) program to eliminate child labor were included. Data concerning sociodemographic characteristics, punishment methods used in the family environment against the children, five types of abuse and neglect perpetrated by the caregivers, urban violence exposure and family functioning were collected. Results: The sample included 126 children who were working on the streets and 65 siblings who were not working on the streets. Caregivers reported high levels of severe physical punishment. The children reported high levels of abuse and neglect, and high levels of urban violence exposure. The families showed a predominance of dysfunctional and unsatisfactory relationships. A multiple logistic regression model showed that age older than 12 years and severe physical punishment at home were associated with street work. Conclusion: Interventions to decrease the risk of child street work should be family-focused and should aim to reduce violence in the family environment.Universidade Federal de São Paulo (UNIFESP) Department of PsychiatryUniversidade Estadual de São Paulo (UNESP) Mathematics and Statistics InstituteUniversidade Presbiteriana Mackenzie Graduate Program in Developmental DisordersPontifícia Universidade Católica do Rio Grande do Sul (PUCRS) Graduate Department of PsychologyRUKHA Institute and Center for Studies and Research in Neuropsychoanalysis (CEINP)UNIFESP, Department of PsychiatrySciEL

Traqueobroncomegalia (síndrome de Mounier-Kuhn): relato de caso e revisão da literatura Tracheobronchomegaly (Mounier-Kuhn syndrome): case report and review of the literature

A traqueobroncomegalia é uma rara entidade de etiologia incerta, caracterizada por dilatação marcante da traquéia e brônquios principais, bronquiectasias e infecções recorrentes do trato respiratório inferior. Sua apresentação clínica é inespecífica, sendo o diagnóstico realizado por métodos de imagem. Relata-se, neste trabalho, um caso de tal enfermidade, cujo diagnóstico confirmou-se por radiografia simples do tórax e por tomografia computadorizada.<br>Tracheobronchomegaly is a rare condition of uncertain etiology characterized by marked dilatation of the trachea and main bronchi, bronchiectasis and recurrent respiratory tract infections. Clinical presentation is nonspecific and the diagnosis is usually made by imaging methods. We report a case of a patient with tracheobronchomegaly. Diagnosis was confirmed by plain x-ray films and computed tomography of the chest