SYLVIA COSTA LIMA FARHAT
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina
LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina
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- Elevated C-Reactive Protein and Spontaneous Bacterial Peritonitis in Children With Chronic Liver Disease and Ascites(2014) PRETO-ZAMPERLINI, Marcela; FARHAT, Sylvia Costa Lima; PERONDI, Maria Beatriz Moliterno; PESTANA, Adriana Pozzi; CUNHA, Patricia Salles; PUGLIESE, Renata Pereira Sustovich; SCHVARTSMAN, ClaudioObjectives:The aims of this study were to compare laboratory indices of spontaneous bacterial peritonitis (SBP) and noninfected ascites in children with chronic liver disease and to determine the infectious agents involved in SBP.Methods:The medical records of 90 children with chronic liver disease and ascites studied between January 2005 and August 2011 were reviewed for laboratory data of diagnostic significance in SBP. Standard laboratory tests included blood cell count, coagulation indices, liver and renal function tests, C-reactive protein (CRP), serum sodium concentration, serum albumin, and serum cultures. Ascitic fluid obtained from 152 paracentesis procedures was assayed for cytology, Gram stains, neutrophil counts, and bacteriological cultures.Results:The SBP group manifested significantly lower albumin levels and elevated CRP levels, prothrombin times, international normalized ratios, and leukocyte number (P<0.05 in each case). CRP was shown to be an independent variable in the prediction of SBP. Values of serum creatinine, sodium concentration, urea, total bilirubin and differential leukocyte shift were comparable in SBP and noninfected ascites. Streptococcus pneumoniae was the most prevalent infectious agent in the ascitic fluid (44%).Conclusions:CRP may be useful in early detection and monitoring of SBP in children with liver disease.
- Hypotonic solution decreases serum sodium in infants with moderate bronchiolitis(2014) RODRIGUES, Regina M.; SCHVARTSMAN, Benita G. S.; FARHAT, Sylvia C. L.; SCHVARTSMAN, ClaudioAimTo investigate the influence of hypotonic parenteral hydration on serum and urinary sodium and osmolality in infants with moderate bronchiolitis. MethodsWe studied 36 infants (mean age 3.72.3months), with a diagnosis of moderate bronchiolitis admitted to a paediatric emergency unit in SAo Paulo, Brazil. Patients received a standard parenteral hypotonic solution, according to Holliday and Segar, during the first 24h, due to respiratory distress. The disease was monitored by a respiratory severity score (RDAI-Respiratory Distress Assessment Instrument), respiratory rate and oxygen saturation. Serum and urinary sodium and osmolality were monitored at admission, 24 and 48h after admission. ResultsAll respiratory parameters improved during hospitalisation. Serum sodium and osmolality dropped after 24h (136.8 +/- 2.8 and 135.8 +/- 2.6mEq/L, p=0.031; 283.4 +/- 4.1 and 281.6 +/- 3.9 mOsm/kg, p=0.004 respectively) as well as urinary osmolality (486.8 +/- 243.4 mOsm/kg and 355.7 +/- 205.0 mOsm/kg, p<0.001) when compared to admission. ConclusionThis study reinforces the occurrence of hyponatraemia in bronchiolitis even in patients with moderate disease and highlights the risk of serum sodium drop caused by hypotonic parenteral hydration.
- Elevated C-Reactive Protein and Spontaneous Bacterial Peritonitis in Chronic Liver Disease and Ascites Response(2014) PRETO-ZAMPERLINI, Marcela; FARHAT, Sylvia C. L.; SCHVARTSMAN, Claudio
- Risk Factors for Juvenile Dermatomyositis: Exposure to Tobacco and Air Pollutants During Pregnancy(2014) ORIONE, Maria Angelica M.; SILVA, Clovis A.; SALLUM, Adriana M. E.; CAMPOS, Lucia M. A.; OMORI, Clarissa H.; BRAGA, Alfesio L. F.; FARHAT, Sylvia C. L.Objective, To evaluate the influence of exposure to inhaled environmental factors during pregnancy on the diagnosis of juvenile dermatomyositis (DM). Methods. We performed a case control study comprising 20 juvenile DM patients and 56 healthy controls matched by age and sex who were residents in the metropolitan region of a large city. A questionnaire assessed demographic data and environmental inhalation exposure during pregnancy (occupational exposure to demolition, chalk, construction and/or quarry dust, paints, varnish, gasoline vapor, and/or battery fluids; stationary sources of inhaled pollution near the mother's home; and maternal tobacco exposure). Daily concentrations of inhaled particulate matter, SO2, NO2, O-3, and carbon monoxide (CO) were evaluated throughout the gestational period. Results. Maternal occupational exposure to school chalk dust/gasoline vapor in the juvenile DM group was significantly higher compared with controls (50% versus 4.6%; P = 0.001). Smoking mothers and secondhand smoke exposure at home during pregnancy were significantly higher in the juvenile DM group versus controls (smoking mothers: 20% versus 1.7%; P = 0.01, and secondhand smoke: 35% versus 19%; P = 0.07). In univariate logistic regression models, maternal smoking, occupational exposure to inhaled agents, and the highest tertile of tropospheric CO (3.2-5.4 parts per million) in the third trimester were significantly associated with juvenile DM (P <= 0.05). In the multivariate analysis, smoking mother (odds ratio [OR] 13.26 [95% confidence interval (95% CI) 1.21-144.291, P = 0.03), occupational exposure (OR 35.39 [95% CI 1.97-632.80], P = 0.01), and CO (third tertile) exposure in the tird rimester of gestation (OR 12.21 [95% CI 1.28-115.96], P = 0.03) remained risk factors for juvenile DM. Conclusion. Inhaled pollutants and tobacco smoking during fetal development may contribute to juvenile DM.