Avaliação, diagnóstico e tratamento da surdez: conhecimento e conduta de médicos com atuação em neonatologia e/ou pediatria de um hospital-escola terciário

CONTEXT AND OBJECTIVE: Infant hearing deficiency is a human disorder with devastating effects and serious implications for the development of speech and language. Early diagnosis of hearing loss should be the objective of a multidisciplinary team, and early-intervention programs should immediately follow this. The aim of this study was to investigate the knowledge and conduct of pediatricians and pediatric residents in a tertiary teaching hospital regarding deafness. DESIGN AND SETTING: Cross-sectional study in a tertiary hospital in the state of São Paulo, Brazil. METHODS: Eighty-eight questionnaires were randomly distributed to pediatricians and pediatric residents. RESULTS: Thirty-six questionnaires were analyzed. Most respondents (61.1%) were residents in pediatrics and/or neonatology. Eighty-three percent of them performed special procedures on babies presenting a high risk of deafness, and 55% reported that they had no knowledge of techniques for screening hearing. Most of them were unaware of the classifications of level and type of hearing loss. According to 47.2% of them, infants could begin to use a hearing aid at six months of age. Most of them reported that infants could undergo hearing rehabilitation during the first six months of life, and all respondents stated 's responsibilities. CONCLUSIONS: Even though most of the participants followed special procedures with babies presenting a high risk of deafness, they did not routinely investigate hearing. All respondents believed that it is a doctor's responsibility to be concerned about child communication.CONTEXTO E OBJETIVO: A deficiência auditiva na criança é uma das desordens humanas cujo impacto tem efeito devastador produzindo sérias conseqüências no desenvolvimento da fala e linguagem. O diagnóstico precoce da perda auditiva deve ser objetivo de uma equipe interdisciplinar e ser seguido imediatamente por programas de intervenção precoce. O objetivo foi investigar o conhecimento e condutas de pediatras e residentes em pediatria de um hospital-escola terciário em relação à surdez. TIPO DE ESTUDO E LOCAL: Estudo transversal, hospital terciário do Estado de São Paulo. MÉTODOS: Oitenta e oito questionários distribuídos para pediatras e residentes em pediatria. RESULTADOS: Analisados 36 questionários. A maioria dos entrevistados (61,1%) foi de residentes em pediatria e/ou neonatologia. Oitenta e três por cento realizavam alguma conduta especial com bebês de alto risco para surdez, e 55% referiram não ter conhecimento sobre técnicas de triagem auditiva. A maioria desconhecia as classificações de grau e tipo de perda auditiva. Para 47,2%, a criança poderia utilizar o aparelho auditivo a partir de seis meses. A maioria referiu que a criança poderia realizar reabilitação auditiva nos primeiros seis meses de vida e todos os entrevistados responderam que é função do médico ter preocupação com a comunicação da criança. CONCLUSÕES: Mesmo a maioria adotando condutas especiais com bebês de alto risco para surdez, não se investigava rotineiramente a audição. Todos os entrevistados julgaram ser função do médico se preocupar com a comunicação da criança

Plasma lipidomic signature of rectal adenocarcinoma reveals potential biomarkers

FAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCAPES - COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIORCNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICORectal adenocarcinoma (RAC) is a common malignant tumor of the digestive tract and survival is highly dependent upon stage of disease at diagnosis. Lipidomic strategy can be used to identify potential biomarkers for establishing early diagnosis or therape7FAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCAPES - COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIORCNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOFAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCAPES - COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIORCNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO2016/11905-2sem informação2015/162191-4The authors wish to thank their colleagues of the Unidade Integrada de Farmacologia e Gastroenterologia (UNIFAG) and Laboratório de Análises Clínicas São José from Hospital Universitário São Francisco na Providência de Deus and FAPESP (2016/11905-2) for

Screening, diagnosing and treating deafness: the knowledge and conduct of doctors serving in neonatology and/or pediatrics in a tertiary teaching hospital

CONTEXT AND OBJECTIVE: Infant hearing deficiency is a human disorder with devastating effects and serious implications for the development of speech and language. Early diagnosis of hearing loss should be the objective of a multidisciplinary team, and early-intervention programs should immediately follow this. The aim of this study was to investigate the knowledge and conduct of pediatricians and pediatric residents in a tertiary teaching hospital regarding deafness. DESIGN AND SETTING: Cross-sectional study in a tertiary hospital in the state of São Paulo, Brazil. METHODS: Eighty-eight questionnaires were randomly distributed to pediatricians and pediatric residents. RESULTS: Thirty-six questionnaires were analyzed. Most respondents (61.1%) were residents in pediatrics and/or neonatology. Eighty-three percent of them performed special procedures on babies presenting a high risk of deafness, and 55% reported that they had no knowledge of techniques for screening hearing. Most of them were unaware of the classifications of level and type of hearing loss. According to 47.2% of them, infants could begin to use a hearing aid at six months of age. Most of them reported that infants could undergo hearing rehabilitation during the first six months of life, and all respondents stated 's responsibilities. CONCLUSIONS: Even though most of the participants followed special procedures with babies presenting a high risk of deafness, they did not routinely investigate hearing. All respondents believed that it is a doctor's responsibility to be concerned about child communication

Plasmalogen lipids: functional mechanism and their involvement in gastrointestinal cancer

Abstract The plasmalogens are a class of glycerophospholipids which contain a vinyl-ether and an ester bond at the sn-1 and sn-2 positions, respectively, in the glycerol backbone. They constitute 10 mol% of the total mass of phospholipids in humans, mainly as membrane structure components. Plasmalogens are important for the organization and stability of lipid raft microdomains and cholesterol-rich membrane regions involved in cellular signaling. In addition to their structural roles, a subset of ether lipids are thought to function as endogenous antioxidants and emerging studies suggest that they are involved in cell differentiation and signaling pathways. Although the clinical significance of plasmalogens is linked to peroxisomal disorders, the pathophysiological roles and their possible metabolic pathways are not fully understood since they present unique structural attributes for the different tissue types. Studies suggest that changes in plasmalogen metabolism may contribute to the development of various types of cancer. Here, we review the molecular characteristics of plasmalogens in order to significantly increase our understanding of the plasmalogen molecule and its involvement in gastrointestinal cancers as well as other types of cancers

Plasma Lipidomic Signature of Rectal Adenocarcinoma Reveals Potential Biomarkers

BackgroundRectal adenocarcinoma (RAC) is a common malignant tumor of the digestive tract and survival is highly dependent upon stage of disease at diagnosis. Lipidomic strategy can be used to identify potential biomarkers for establishing early diagnosis or therapeutic programs for RAC.ObjectiveTo evaluate the lipoperoxidation biomarkers and lipidomic signature in the plasma of patients with RAC (n = 23) and healthy controls (n = 18).MethodsLipoperoxidation was evaluated based on malondialdehyde (MDA) and F2-isoprostane levels and the lipidomic profile obtained by gas chromatography and high resolution mass spectrometry (ESI-q-TOF) associated with a multivariate statistical technique.ResultsThe most abundant ions identified in the RAC patients were those of protonated phosphatidylcholine and phosphatidylethanolamine. It was found that a lisophosphatidylcholine (LPC) plasmalogen containing palmitoleic acid [LPC (P-16:1)], with highest variable importance projection score, showed a tendency to be lower in the cancer patients. A reduction of n − 3 polyunsaturated fatty acids was observed in the plasma of these patients. MDA levels were higher in patients with advanced cancer (stages III/IV) than in the early stages groups and the healthy group (p < 0.05). No differences in F2-isoprostane levels were observed among these groups.ConclusionThis study shows that the reduction in plasma levels of LPC plasmalogens associated with an increase in MDA levels may indicate increased oxidative stress in these patients and identify the metabolite LPC (P-16:1) as a putatively novel lipid signature for RAC

Potential Lipid Signatures for Diagnosis and Prognosis of Sepsis and Systemic Inflammatory Response Syndrome

Systemic inflammatory response syndrome (SIRS) and sepsis are two conditions which are difficult to differentiate clinically and which are strongly impacted for prompt intervention. This study identified potential lipid signatures that are able to differentiate SIRS from sepsis and to predict prognosis. Forty-two patients, including 21 patients with sepsis and 21 patients with SIRS, were involved in the study. Liquid chromatography coupled to mass spectrometry and multivariate statistical methods were used to determine lipids present in patient plasma. The obtained lipid signatures revealed 355 features for the negative ion mode and 297 for the positive ion mode, which were relevant for differential diagnosis of sepsis and SIRS. These lipids were also tested as prognosis predictors. Lastly, L-octanoylcarnitine was found to be the most promising lipid signature for both the diagnosis and prognosis of critically ill patients, with accuracies of 75% for both purposes. In short, we presented the determination of lipid signatures as a potential tool for differential diagnosis of sepsis and SIRS and prognosis of these patients