Manifestações clínicas em crianças infectadas pelo HIV na era HAART: um estudo seccional

The number of HIV infected children still grows gradually, becoming one of the five leading causes of pediatric death in the world. This study described HIV clinical manifestations in children from ages of 4 to 12 years who are in use of antiretroviral treatment or not. This was a descriptive, cross-sectional, observational and quantitative study performed with HIV positive children patients of the Gafrée and Guinle Hospital (HUGG) and the Previdenciary Center of Niteroi (CPN), in the state of Rio de Janeiro – Brazil, during the year of 2005. After collecting data from medical charts, a descriptive statistical analysis was conducted, using simple frequency and χ² test. Sixty-three percent of the patients from HUGG and CPN were on HAART, and 48% showed no clinical manifestations (p=0.1376). The most frequently observed clinical manifestations were upper respiratory tract infection (6%) and herpes simplex (2%). The antiretroviral treatment (HAART) was successful in diminishing HIV related disease, contributing greatly to a better life style of patients in use of this therapy.O número de crianças infectadas pelo HIV ainda cresce progressivamente, tornando-se uma das cinco principais causas de óbito pediátrico no mundo. Este trabalho teve como objetivo escrever as manifestações clínicas da infecção pelo HIV em crianças de 4 a 12 anos com o uso ou não de tratamento anti-retroviral. O estudo foi descritivo, seccional, observacional e quantitativo, realizado com pacientes pediátricos HIV+, dos Hospitais Gafrée e Guinle (HUGG) e Centro Previdenciário de Niterói (CPN), no Rio de Janeiro, em 2005. Após coleta de dados por ficha clínica e consulta dos prontuários, realizou-se análise estatística descritiva por frequência simples, com o uso do teste χ². 63% dos pacientes do HUGG e CPN faziam uso de HAART, com 48% sem manifestação clínica (p=0,1376). As manifestações clínicas mais frequentes foram infecções das vias aéreas superiores (6%) e herpes simples (2%). Concluiu-se que a terapia anti-retroviral (HAART) fez as manifestações clinicas da infecção pelo HIV diminuírem, gerando uma melhoria na qualidade de vida desses pacientes

Dupilumab Treatment Reduces Hospitalizations in Adults with Moderate-to-Severe Atopic Dermatitis

BACKGROUND: Refractory disease, flares, or infections in atopic dermatitis (AD) can lead to hospitalizations. OBJECTIVE: To compare hospitalization rates among adults with moderate-to-severe AD treated with dupilumab versus control. METHODS: Data from 7 randomized, placebo-controlled trials of dupilumab (300 mg every 2 weeks [q2w] and/or weekly [qw]; with or without topical corticosteroids) were analyzed. RESULTS: Patients in the dupilumab 300 mg q2w, qw, and combined dupilumab (q2w and qw; n = 1,841) groups compared with patients in the control group (n = 1,091) had lower rates of all-cause hospitalizations (5.8, 2.7, and 3.8 events, respectively, vs 9.0 events per 100 patient-years [PY]; all P \u3c .05 [49%, 71%, and 62% risk reduction, respectively]); AD-related hospitalizations (2.0, 0.4, 1.0 events vs 4.1 events per 100 PY; P \u3c .05 for qw and dupilumab combined [91% and 79% risk reduction, respectively]); as well as reduced overall duration of AD-related hospitalization (10.9, 7.3, and 8.6 d vs 38.9 d per 100 PY). CONCLUSIONS: Among adults with moderate-to-severe AD, treatment with dupilumab versus control was associated with significant reductions in all-cause and AD-related hospitalization rates, and shorter duration of AD-related hospitalization

O conhecimento de pediatras sobre alergia alimentar: estudo piloto Pediatricians' knowledge on food allergy: pilot study

OBJETIVO: Avaliar o conhecimento de pediatras sobre alergia alimentar. MÉTODOS: Dados obtidos de questionário padronizado, postado e respondido por pediatras filiados à Sociedade Brasileira de Pediatria (SBP). Digitação dos dados em planilha Excel e análise de freqüência de respostas afirmativas em porcentagem. RESULTADOS: Foram analisados 895 questionários preenchidos por pediatras de todo o país, com predomínio da região Sudeste (61,6%). Segundo os pediatras entrevistados, as manifestações diagnósticas de alergia alimentar são: respiratórias, cutâneas e sistêmicas, em iguais proporções. Ainda segundo estes pediatras, leite de vaca (98,9%), clara de ovo (58,7%) e amendoim (50,9%) são os principais alimentos associados a essas manifestações. Embora 74,8% dos respondedores tivessem identificados os corantes e aditivos alimentares como responsáveis pela alergia alimentar, apenas 19,4% conheciam o código de identificação da tartrazina. CONCLUSÕES: Os dados apresentados reforçam a necessidade de ampliação dos conhecimentos dos profissionais de saúde sobre o diagnóstico e tratamento da alergia alimentar, com o objetivo de garantir o uso de critérios diagnósticos e terapêuticos mais adequados.<br>OBJECTIVE: To evaluate the knowledge of Brazilian pediatricians about food allergy. METHODS: Data was obtained from a sent back posted written questionnaire. It was filled in by Brazilian pediatricians, affiliated to the Brazilian Society of Pediatrics. Data was transcript to an Excel spread sheet and the frequency of affirmative responses was reported as percentages. RESULTS: Data from 895 written questionnaire of pediatricians from all over Brazil, (mainly from the southeastern region - 61.6%), were analyzed. The main clinical expressions of food allergy determined by the pediatricians were: respiratory, cutaneous and systemic symptoms (equal proportions). According to these pediatricians, cow's milk (98.9%), egg white (58.7%) and peanuts (50.9%) were the main allergens related to food allergy symptoms. Although 74.8% of the responders have indicated food dyes and food additives as associated to food allergies, only 19.4% of them knew the identification code of tartrarzine. CONCLUSIONS: The presented data reinforce the need to improve the pediatricians' knowledge about the diagnosis and treatment of food allergy, in order to assure the use of appropriate diagnostic and treatment criteria

Epidemiology of adult patients with atopic dermatitis in AWARE 1: A second international survey

Background: There are gaps in our understanding of the epidemiology of atopic dermatitis (AD) in adults. Objective: To evaluate the prevalence and severity of AD in adults from countries/regions within Asia, Eurasia, Latin America, Middle East, and Russia. Methods: This international, web-based survey was performed in Argentina, Brazil, China, Colombia, Egypt, Hong Kong, Israel, Malaysia, Mexico, Russia, Kingdom of Saudi Arabia (KSA), Singapore, Taiwan, Thailand, Turkey, and United Arab Emirates. Questionnaires were sent to adult members of online respondent panels for determination of AD and assessment of severity. A diagnosis of AD required respondents to meet the modified United Kingdom (UK) Working Party criteria and to self-report they had a physician diagnosis of AD. Severity of AD was determined using Patient-Oriented Scoring of Atopic Dermatitis (PO-SCORAD), Patient-Oriented Eczema Measure (POEM), and Patient Global Assessment (PGA). Results: Among respondents by country/region the prevalence of AD ranged from 3.4% in Israel to 33.7% in Thailand. The prevalence was generally higher in females versus males. Severity varied by scale, although regardless of scale the proportion of respondents with mild and moderate disease was higher than severe disease. PGA consistently resulted in the lowest proportion of severe AD (range 2.4% China – 10.8% Turkey) relative to PO-SCORAD (range 13.4% China – 41.6% KSA) and POEM (range 5.1% China – 16.6% Israel). Conclusions: This survey highlights the importance of AD in adults, with high prevalence and high morbidity among respondents and emphasizes that AD is not just a disease of childhood—there is disease persistence and chronicity in adults