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- ItemAcesso aberto (Open Access)Efeito de fármacos ototóxicos na audição de recém-nascidos de alto risco(Sociedade Brasileira de Fonoaudiologia, 2010-01-01) Camara, Marília Fontenele e Silva; Azevedo, Marisa Frasson de [UNIFESP]; Lima, José Wellington de Oliveira; Sartorato, Edi Lúcia; Universidade de Fortaleza; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual do Ceará; Universidade Estadual de Campinas (UNICAMP)PURPOSE: To calculate the incidence of sensorineural hearing loss (SNHL), to verify if there is a causal association between the use of ototoxic drugs and SNHL, and to establish the frequency of genetic mutations related to SNHL in high risk newborns. METHODS: The study was a retrospective and prospective cohort research with 250 children. Data was gathered from subjects' charts and with their caregivers. Moreover, subjects were submitted to auditory evaluation with distortion product otoacoustic emissions, timpanometry, visual reinforcement audiometry, auditory brainstem response and transient otoacoustic emissions. The study of the genetic mutation 35delG, and the mitochondrial mutations A1555G and A7445G was essential to evaluate the possibility that SNHL had a non-syndromic genetic origin. The association between the medicine use and the occurrence of hearing loss had been analyzed. RESULTS: The incidence of SNHL in high risk newborns was 11.6%, and causal associations between SNHL and the drugs administered were: amikacin and cefotaxime (OR=5.35), cefotaxime and furosemide (OR=7.02), ceftazidime and vancomycin (OR=9.12). The frequencies of the mutation 35deIG and mitochondrial mutations A1555G and A7445G were, respectively, 0.8% and 0%. CONCLUSION: The incidence of SNHL in high risk newborns was high, showing an important causal relation with the use of ototoxic drugs and a small relation with genetic mutations.
- ItemAcesso aberto (Open Access)Late-onset persistent retinal microvascular changes after bone marrow transplantation: 3-year follow-up(Conselho Brasileiro de Oftalmologia, 2002-06-01) Muccioli, Cristina [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Jorge, Rodrigo; Farah, Michel Eid [UNIFESP]; Pereira, Mauricio B.; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Universidade Federal do Rio de Janeiro Faculdade de Medicina Setor de RetinaPurpose: To describe a case of persistent retinopathy after bone marrow transplantation in the absence of radiation therapy. Methods: Case Report. Results: A 42 year-old man developed bilateral visual loss 15 months after receiving a bone marrow transplant for acute leukemia. The patient was treated with a high dose of cyclosporin A and oral corticosteroids. No radiation therapy was given. Late-onset, multiple, bilateral cotton-wool spots developed 15 months after the bone marrow transplantation and still persist. After three years other cotton-wool spots arose in the absence of any immunosuppressive therapy. Conclusions: Bone marrow transplantation microvasculopathy of the retina may be related to certain combinations of chemotherapy drugs or immunosuppression itself and may persist in the absence of these immunosuppressive drugs.