Abstracts · Scientific Abstracts

Um estudo da Abstinência Neonatal de Narcóticos com duração de quatro anos: Avaliação e Tratamento

Matityahu Lifshitz MD1, Vladimir Gavrilov MD1, Aharon Galil MD2 and Daniella Landau MD3
1Unidade toxicológica, 2Centro de Desenvolvimento Infantil de Zusman, e 3Departamento de Neonatalogia, Centro Médico da Universidade de Soroka e Faculdade de Ciências da Saúde da Universidade de Ben-Gurion do Negev, Beer Sheva, Israel

Palavras-chave: neonato, narcótico, síndrome de abstinência, dependência

RESUMO

Enquadramento: O abuso de narcóticos tem-se vindo a tornar mais prevalente em Israel e poderá resultar num aumento do número de bebés expostos a narcóticos na gestação, tendo como consequência o aumento  do número de neonatos com a SAN (Síndrome de Abstinência Neonatal).

Objetivo: Divulgar a nossa experiência com bebés nascidos de mulheres dependentes de narcóticos entre 1995 e 1998, no Soroka University Medical Center.

Metodologia: Foram analisados retrospetivamente os registos médicos de 24 recém-nascidos e das suas progenitoras toxicodependentes, que haviam sido admitidas no nosso Centro Médico para parturientes. Foi estabelecido um diagnóstico da SAN na base da apresentação clínica e na anamnese. A Escala de Avaliação de Finnegan de Abstinência Neonatal foi utilizada para avaliar a abstinência às drogas. Só se fez a análise toxicológica da urina para analisar a presença de narcóticos  no ano de 1998.

Resultados: Dos 24 recém-nascidos expostos no período pré-natal a narcóticos, 23 (96%) desenvolveram SAN e desses 23, 18 (78%) obtiveram uma pontuação de Finnegan igual ou superior a 8. Estes 18 bebés foram tratados farmacologicamente (tintura de ópio e/ou fenorbarbital) até a pontuação ter sido reduzida para menos de 8, tendo recebido tratamento de seguimento posteriormente. A medicação foi interrompida numa criança que se tornou letárgica após receber a primeira dose de tintura de ópio, tendo recebido apenas tratamento de seguimento. Quatro dos cinco neonatos com pontuações iguais ou inferiores a 7 receberam tratamento de seguimento. Um dos cinco bebés que havia obtido uma pontuação de Finnegan baixa após o parto, todavia, foi tratado farmacologicamente para prevenir a deterioração posterior do seu estado físico, visto este ter nascido com dispneia grave. Dez das 24 crianças (42%) foram seguidas por períodos de tempo de 6 a 22 meses após a alta hospitalar, nos quais todos apresentaram um desenvolvimento normal.

Conclusões: Cerca de três quartos dos recém-nascidos que apresentaram Síndrome de Abstinência necessitaram de tratamento farmacológico. Informação prévia referente ao abuso de drogas pela mãe é um critério crucial para um diagnóstico e tratamento precoce.

Source: A Four Year Survey of Neonatal Narcotic Withdrawal

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Abstracts · Scientific Abstracts

Abstinência neonatal causada por dependência materna de substâncias voláteis

RESUMO
Objetivo: Determinar se neonatos nascidos de progenitoras dependentes de substâncias voláteis estão em risco de ter SAN (Síndrome de Abstinência Neonatal).

Metodologia: Uma amostra consecutiva de bebés nascidos de progenitoras dependentes de substâncias voláteis foi estudada durante quatro anos, num centro médico associado a uma universidade, com uma combinação variável de cuidados primários, secundários e terciários de doentes. Os bebés foram avaliados clinicamente com a Escala de Avaliação de Finnegan de Abstinência Neonatal. Aqueles que preencheram os critérios de pontuação a priori foram tratados com fenobarbital e a avaliação foi continuada.

Resultados: Dos 48 bebés, 32 preencheram os critérios para farmacoterapia. Os oito bebés com o odor característico e 15 dos 21 bebés nascidos de progenitoras com esse mesmo odor preencheram este critério. Os sintomas mais característicos foram o choro gritado e excessivamente gritado, insónias, reflexo de Moro aumentado, tremores, hipotonia, e dificuldade alimentar. A média de idades de início do tratamento foi de 27,1 horas e a duração média foi de 5 a 8 dias. O tratamento foi considerado eficaz em 17 de 27, enquanto os benefícios foram medianos em 3 e ausentes em 7.

Conclusões: Verifica-se que existe uma Síndrome de Abstinência Neonatal identificável causada por dependência de substâncias voláteis. O odor químico característico no neonato ou na progenitora é uma marca da sua ocorrência e o tratamento com fenobarbital aparenta ser eficaz. A Escala de Avaliação de Finnegan parece ser útil para classificar a sua gravidade.

Source: Neonatal withdrawal from maternal volatile substance abuse

Abstracts · Scientific Abstracts

Response to a Monovalent 2009 Influenza A (H1N1) Vaccine

Greenberg, M, et al.

ABSTRACT

Background

A novel 2009 influenza A (H1N1) virus is responsible for the first influenza pandemic in 41 years and a safe and effective vaccine is needed. A randomized, observer-blind, parallel-group trial evaluating two doses of an inactivated, split-virus 2009 H1N1 vaccine in healthy adults between the ages of 18 and 64 years is being held/conducted at a single site in Australia.

Methodology

The immunogenicity and safety of the vaccine after each of two scheduled doses, administered 21 days apart were evaluated. A total of 240 subjects, equally divided into two age groups (<50 years and 50 years), were enrolled and underwent randomisation to receive either 15 µg or 30 µg of hemagglutinin antigen by intramuscular injection. The antibody titers using hemagglutination-inhibition and microneutralization assays at baseline and 21 days after vaccination were measured. The co-primary immunogenicity endpoints were the proportion of subjects with antibody titers of 1:40 or more on hemagglutination-inhibition assay, the proportion of subjects with either seroconversion or a significant increase in antibody titer, and the factor increase in the geometric mean titer.

Findings

By day 21 after the first dose, antibody titers of 1:40 or more were observed in 114 of 120 subjects (95.0%) who received the 15-µg dose and in 106 of 119 subjects (89.1%) who received the 30-µg dose. A similar result was observed after the second dose of vaccine. No deaths, serious adverse reactions, or adverse events of special interest were reported. Local discomfort (e.g., injection-site tenderness or pain) was reported by 56.3% of subjects, and systemic symptoms (e.g., headache) by 53.8% of subjects after each dose. Nearly all reactions were mild to moderate in intensity.

Conclusions

A single 15-µg dose of 2009 H1N1 vaccine was immunogenic in adults, with mild-to-moderate vaccine-associated reactions.

Source: Resposta a uma Vacina Monovalente para a Gripe A (H1N1) 2009

Abstracts · Humanities Abstracts

Education of deaf and hard of hearing children

ABSTRACT

The aim of this study is the education of deaf and hard of hearing children and adolescents, who are often victims of exclusion and failure at school.

The first part looks at increasingly larger samples of deaf and hard of hearing students who fail at school and who are often associated with poor linguistic performance.

The following part focuses on identifying the causes of exclusion and failure and whether they are due to the condition itself or linked to the school or home environment. The deaf or hard of hearing are often perceived as being impaired, both by popular belief and by the medical community, indicating endogenous exclusion. However, recent studies have shown that the brains of the deaf and hard of hearing are biologically identical to those that hear and that they have the same linguistic competence. The fact is that sign languages have an identical structure to spoken ones, demonstrating that exclusion is exogenous, stemming from the school or home.

The third part deals with education and school, showing that exclusion is still ubiquitous, more recently as a result of providing so-called equal opportunities. It also refers to countries which have reverted this trend and adopted a theoretical educational model for the deaf and hard of hearing.

The final part analyses two Portuguese schools in which there is both ideological and oralist exclusion. However, the positive educational experience of a deaf child in a Sign Language environment is also presented.

Source: Educação de crianças e jovens surdos

Abstracts · Scientific Abstracts

Prevention of Thromboembolism by using Recombinant Hirudin

Prevention of Thromboembolism by using Recombinant Hirudin – Findings of a double-blind and multicentric assay comparing the effectiveness of Desirudin (Revasc) with non-fractioned Heparin in patients with total hip replacement

Eriksson, P. et al

 

ABSTRACT

Introduction: The specific inhibition of thrombin is a new method used to prevent deep vein thrombosis during the post-surgery period. The aim of this multicentric, randomized and double-blind study was the comparison of the effectiveness and safety of Desirudin (Revasc, 30 µg two times a day) with non-fractioned Heparin (5.000 international units three times a day) in patients, who have opted for total hip replacement.

Methodology: The drugs were administered subcutaneously for 9 to 12 days, starting in the post-surgery period. The primary end point was an adverse thromboembolic reaction throughout the treatment period. The presence of deep vein thrombosis was evaluated using bilateral venograms, which had been centrally assessed by two independent radiologists. A total of 890 eligible subjects were randomized: 440 underwent tests using Heparin and 450 underwent tests using Desirudin. The effectiveness analysis was tested in a total of 702 subjects (78.9%), who had been evaluated through suitable bilateral venography for 9 to 12 days after the surgery or who had had an attested thrombotic event.

Findings: The prevalence of attested deep vein thrombosis was observed in 26 (7.5%) of the 348 subjects, who had been treated using Desirudin, and in 82 (23.2%) of the 354 subjects, who had been treated using Heparin, which shows a significant difference (p <0.0001). The prevalence of proximal deep vein thrombosis was also significantly lower (p <0.0001) in 78.9% in the group that had been treated using Desidurin (12 [3.4%] of the 348 subjects), when compared to the group that had been treated using Heparin (58 [16.4%] of the 354 subjects). No deaths or attested pulmonary embolisms were confirmed during the prophylaxis period. The presence of pulmonary embolisms in 4 patients, who had been treated with Heparin, was confirmed during a period of 8 follow-up weeks.

Conclusion: With this study, we were able to show that a 30mg dose of Desidurin, administered subcutaneously twice a day during the post-surgery for a period of at least 9 days results in an efficient and safe prevention against thrombotic events, with no specific requirements for laboratory follow-up, in patients who had total hip replacement.

Source: Prevenção do Tromboembolismo com o uso de Hirudina Recombinante

 

Abstracts · Humanities Abstracts

From Dictatorship to Freedom

From Dictatorship to Freedom

– children’s literature and contemporary Portuguese history

ABSTRACT

In April 1974, after almost half a century under the control of a political dictatorship, Portugal regained its freedom and a democracy was established. A colonial war, which lasted for more than one decade and was closely related to the fall of a fascist regime, also came to an end. It was the closing of a historical cycle with the independence of the African countries, ending the five-century lasting colonial “empire”.

This crucial moment of Portugal’s contemporary history has been revisited and recreated by some of the most relevant names of contemporary literature, namely José Saramago, António Lobo Antunes, José Cardoso Pires (and many others). However, this subject has not been forgotten by/has also been included in/has also been published in children’s literature. With commemorative, educational, interventional and other objectives/goals, the Revolução dos Cravos – the Carnation Revolution (and the time immediately before and after) has been dealt with, in both poetry and prose, and the works on the matter are published on a daily basis. Therefore, the aim of this study is to look into some of the most important Portuguese works on this subject, carried out within this subject area, highlighting/emphasising the recurrence of different themes and forms.

Source: Da Ditadura à Liberdade

Abstracts · Humanities Abstracts

Greenspeak and manipulation

ABSTRACT

Nowadays, greenspeak is ubiquitous in daily interactions, literature, the media and in the foundations of human action. It is expressed through multiple discursive types, some of which have considerably different characteristics. Nonetheless, it may be possible to identify several common features/traits of structure or function, as well as several strategies, which include discourses on the paradigm of environmentalism.

This paper analyses those characteristics, focusing its attention on the processes, which usually manipulate public opinion. This manipulation occurs through the explicit or implicit evocation of well-being, as well as through its teleological nature, its social contraction of the concept of crisis, the mimesis of scientific discourse, the hiper mediatisation of environmental issues or democratic censorship.

Source: Discurso verde e manipulação