Objective: To assess health-related quality of life and associated factors in patients treated with atypical antipsychotics, as well as to determine utility values using the EuroQol-5D-3L instrument. Methods: A cross-sectional study was conducted at a state-run pharmacy in the Brazilian National Health System. Individuals were included if they were using a single atypical antipsychotic and completed the EuroQol-5D-3L. Sociodemographic, behavioral, and clinical data were collected. The dependent variable was the EuroQol-5D-3L utility score. Associations between the independent variables and the dependent variable were analyzed in a multiple linear regression model. Results: A total of 394 patients were included, and their mean utility score was 0.664±0.232. Patients treated with clozapine had the highest mean score (0.762 [0.202]), followed by olanzapine (0.687 [0.230]), risperidone (0.630 [0.252]), ziprasidone (0.622 [0.234]), and quetiapine (0.620 [0.243]). The following variables were related to higher utility scores: income, employment, clozapine use, no illicit psychoactive substance use, no suicide attempts, and no comorbidities. Conclusion: Evaluating health-related quality of life differences in the available atypical antipsychotics can facilitate the choice of treatment, improve health outcomes, and ensure rational prescriptions.

RESUMO Avanços significativos na compreensão e no manejo da Distrofia Muscular de Duchenne (DMD) ocorreram desde a publicação de diretrizes internacionais para o cuidado destes pacientes em 2010. Nosso objetivo foi elaborar um consenso nacional baseado em evidências para o cuidado multidisciplinar dos pacientes com DMD no Brasil. Utilizamos uma combinação da técnica de Delphi com uma revisão sistemática da literatura de 2010 a 2016 para classificarmos os níveis de evidência e graus de recomendação para o consenso. Nossas recomendações foram divididas em duas partes. A metodologia utilizada na elaboração do consenso e conceitos gerais da doença encontram-se na parte 1. Neste artigo fornecemos os resultados e recomendações sobre reabilitação e cuidados sistêmicos para DMD.

ABSTRACT Significant advances in the understanding and management of Duchenne muscular dystrophy (DMD) have occurred since the publication of international guidelines for DMD care in 2010. Our objective was to provide an evidence-based national consensus statement for multidisciplinary care of DMD in Brazil. A combination of the Delphi technique with a systematic review of studies from 2010 to 2016 was employed to classify evidence levels and grade of recommendations for the guideline. Our recommendations were divided in two parts. Guideline methodology and overall disease concept descriptions are found in Part 1. Here we present Part 2, where we provide the results and recommendations on rehabilitation and systemic care for DMD.

ABSTRACT Laetia suaveolens (Poepp.) Benth., Salicaceae, popularly known as "casinga-cheirosa", "caferana", or "laranjinha", is native to Brazil but not endemic to this country. A crude organic extract was obtained from the leaves and stem and intraperitoneally administered in male Balb-c mice. Its behavioral effects were evaluated in the open field and elevated plus maze in a two-stage experiment that assessed ten different parameters related to behavior as locomotion, emotionality, and anxiety. In the first stage of the experiment, intraperitoneal the crude organic extract administration dose-dependently impaired locomotion and emotionality 30–120 min after administration. A significant decrease in defecation was observed, which was related to emotionality. No alterations in the elevated plus maze were found; thus, this apparatus was not used in the next stage of the experiment. In the second stage, the previously determined non-lethal dose of 0.1563 g/kg was intraperitoneally administered, which impaired locomotion and rearing frequency and increased immobility time. Necropsy revealed smooth intestine hemorrhage. Rutin, leucoside, nicotiflorin, guaijaverin, and astragalin were isolated from the crude organic extract. This is the first time that these compounds have been identified in L. suaveolens. In conclusion, the crude organic extract impaired locomotion and emotionality and caused hemorrhage in male Balb-c mice, indicating that its consumption can be harmful to humans and animals. The present results provide a basis for further studies on the pharmacology, toxicology, and natural product chemistry of the crude organic extract.

The organic extract EB689, obtained from the stem of Abarema auriculata (Benth.) Barneby & J.W.Grimes, Fabaceae, commonly known as "saboeiro-ferro", was chemically studied, as well as its influence over behavioral effects such as locomotion, emotionality and anxiety, after intra-peritonial administration were assessed. The open-field and elevated-plus maze were used in experiments divided into two stages. The first stage aimed for the identification of the main effects over behavior using a reduced number of animals against half-fold diluted doses of EB689. The same variables were also tested in a second stage of the experiment using the non-lethal intra-peritoneal dose of 4.8 mg/kg in a larger number of animals. It was observed that EB689 clearly decreased locomotion, which was probably caused by internal hemorrhage causing hypovolemic shock. Although it is the first time lupeol and eucryphin are described in A. auriculata, it is still not clear if they are involved in the toxicology of A. auriculata. The undesirable effects of EB689 are better understood, the basis for further pharmacological assays aiming antitumor activity are supported.

OBJETIVOS: Determinar a prevalência de infecção do trato respiratório inferior (ITRI) por Chlamydia trachomatis em lactentes internados e descrever as características clínicas, laboratoriais e radiológicas da doença. MÉTODOS: Este foi um estudo do tipo corte transversal, realizado durante um período de 12 meses. Foram incluídos todos os lactentes de até 6 meses internados consecutivamente no Centro Pediátrico Professor Hosannah de Oliveira da Universidade Federal da Bahia, em Salvador, BA, com diagnóstico clínico ou clínico-radiológico de ITRI. O diagnóstico de infecção por C. trachomatis foi realizado através da pesquisa de anticorpos da classe IgM, utilizando-se o ensaio imunoenzimático (ELISA). A prevalência de ITRI por C. trachomatis foi determinada, e foram calculadas as razões de prevalência para essa infecção e variáveis clínicas e laboratoriais. RESULTADOS: Cento e cinquenta e um lactentes realizaram sorologia para C. trachomatis, das quais 15 (9,9%) foram positivas. A infecção por C. trachomatis ocorreu unicamente entre os menores de 5 meses, principalmente naqueles menores de 2 meses. Três crianças com infecção por C. trachomatis nasceram de parto cesáreo. Conjuntivite e eosinofilia ocorreram em 33,3% dos casos. As radiografias de tórax se mostraram alteradas em 92% dos casos. Demonstrou-se associação da infecção por C. trachomatis com duração de internação superior a 15 dias (p = 0,0398) e com oxigenoterapia (p = 0,0484). CONCLUSÕES: Houve alta prevalência de ITRI por C. trachomatis na população estudada. A infecção por esta bactéria foi associada a uma forma mais grave da doença, demonstrando a importância de se investigar essa infecção na gestante de forma a evitar o adoecimento de recém-nascidos.

OBJECTIVES: To determine the prevalence of lower respiratory tract infection (LRTI) due to Chlamydia trachomatis in newborn infants and to describe the clinical, laboratory, and radiological characteristics of the disease. METHODS: A cross-sectional study carried out over a 12-month period. All infants up to 6 months of age admitted consecutively at the Centro Pediátrico Professor Hosannah de Oliveira of the Universidade Federal da Bahia in Salvador, Brazil, and diagnosed with LRTI according to clinical and/or radiological criteria were included in the study. C. trachomatis infection was diagnosed by the enzyme-linked immunosorbent assay (ELISA) for the detection of IgM-class antibodies. The prevalence of LRTI by C. trachomatis was determined and the prevalence ratios for the infection and clinical or laboratory variables were calculated. RESULTS: One hundred and fifty-one infants were submitted to serology for C. trachomatis and 15 (9.9%) tested positive. Chlamydial infection was found only in infants under 5 months of age, mainly in those aged under 2 months. Three of the infants with C. trachomatis infection were born by cesarean section. Conjunctivitis and eosinophilia had occurred in 33.3% of the cases. Chest X rays were abnormal in 92.0% of cases. There was an association between C. trachomatis infection and the duration of hospitalization exceeding 15 days (p = 0.0398) and oxygen therapy (p = 0.0484). CONCLUSIONS: There was a high prevalence of C. trachomatis respiratory infection in the population studied. The infection was associated with a more severe form of the disease, emphasizing the importance of testing pregnant women for this infection to avoid infection in the newborn infant.

Objetivo: a reação cutânea na revacinação BCG tem sido motivo de questionamentos dado à sua magnitude. Seria ela intensa o suficiente para desencorajar seu uso na idade escolar? O objetivo deste estudo é descrever o aspecto evolutivo da lesão vacinal entre 48 horas e a décima semana pós-revacinação. Métodos: estudo de coorte descritivo em que foram revacinadas 484 crianças entre seis e 11 anos de idade, com 0,1ml da vacina BCG Moreau, e aferidos eritema, enduração, pústula, úlcera, crosta e cicatriz em 48h, 72h e, semanalmente, até a décima semana de evolução, acompanhadas no período de julho a dezembro de 1997. Os dados foram informatizados em programa Epi-Info 6.0, avaliando-se freqüências, médias, medianas e desvios-padrões. Resultados: enduração estava presente em 99,1%, e eritema em 91,6% das 438 crianças avaliadas com 48h. Pústulas foram observadas na primeira semana em 26,1% de 479 crianças. Na segunda semana, já apareceram as primeiras úlceras. Na décima semana, 69,8% das 463 crianças presentes exibiam crostas, mas apenas 29,2% havia completado o processo de cicatrização. Conclusão: a revacinação BCG em escolares produz intensa e precoce reação, que pode ser atribuível ao fenômeno de Koch, mas sem a esperada redução no tempo de cicatrização. Se por um lado a magnitude da reação não chega a comprometer sua indicação na idade escolar, a pronta resposta inflamatória aponta para a ativa resposta imune possivelmente remanescente da primo-vacinação.

Objective: cutaneous reaction after BCG revaccination has been cause of concerns due its magnitude. Would it be intense enough to discourage its use in school-age children? The objective of this study is to describe the evolution of BCG vaccination site between 48 hours and 10 weeks post-revaccination. Methods: a descriptive cohort study was carried out involving 484 children between six and 11 years. The subjects were vaccinated with 0.1 mL of BCG-Moreau. Erythema, induration, pustule, ulcer, crust and final scar were measured within 48h, 72h and weekly until the tenth week, evaluated between July and December 1987. Epi Info 6.0 software was utilized to analyze frequencies, means, median and standard deviations. Results: induration was present in 99.1% and erythema in 91.6% of 438 children evaluated within 48h. Pustules were observed in the first week in 26.1% of 479 children. The first ulcers were seen during the second week. In the tenth week, 69.8% of 463 children showed crusts but only 29.2% completed the healing process. Conclusions: BCG revaccination in school-age children causes intense and early reaction that can be related to Koch phenomenon, even though it does not present the expected reduction in the healing period. The magnitude of the reaction is not enough to discourage its recommendation for school-age children. On the other hand, it is possible that the rapid inflammatory response is an indication of active immune response from the first vaccination.