São Paulo medical journal = Revista paulista de medicina
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Neonatal alloimmune thrombocytopenic purpura (NAITP) is a neonatal disorder characterized by maternal alloimmunization against fetal platelet antigens inherited from the father. Intracranial hemorrhage leading to death or permanent neurological disability may occur in the fetus. ⋯ A healthy 30-year-old woman gave birth to her first baby by cesarean after an uneventful 36-week pregnancy. Ten hours after birth, the infant presented severe petechiae, with platelet count of 8 x 10(3)/microl. The mother's platelet count was normal (180 x 10(3)/microl). The infant re ceived intravenous immunoglobulin and was discharged 18 days later, with platelet count of 100 x 10(3)/microl. The cause of thrombocytopenia was not elucidated at that time. One year later, the infant died of neuroblastoma. Since the parents wanted another child, they were referred for investigation of this thrombocytopenia. Platelet genotyping and platelet antibody screening were performed, showing total HPA-1 system mismatch between mother (HPA-1b1b) and father (HPA-1a1a), with anti-HPA-1a antibodies in the mother's serum. We concluded that the first baby was born with NAITP. Thus, in the second pregnancy, the mother was treated with several infusions of intravenous immunoglobulin. Careful ultrasound monitoring was performed, with normal results for mother and fetus throughout the pregnancy. The second baby was born by cesarean at 39 weeks, presenting 92 x 10(3) platelets/microl six hours after birth. The baby's platelets were genotyped as HPA-1a1b and the mother's serum again showed anti-HPA-1a antibodies. No clinical bleeding was observed. Intravenous immunoglobulin therapy was an effective treatment for preventing NAITP in the second baby.
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Smooth muscle fiber has fundamental importance in erection. Alterations in its function or quantity may be associated with erectile dysfunction. The study objective was to assess the proportion of penile smooth muscle fiber in patients with severe erectile dysfunction. ⋯ Among patients with severe erectile dysfunction, the arterial flow on its own does not present interference in the proportion of smooth muscle fiber. The diminution of the proportion of smooth muscle fiber may result from chronic diseases and vascular risk factors.
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Nurses are one of the largest groups of healthcare professionals sharing in patient care responsibilities, including caring for those who use and abuse psychoactive substances. The objective was to evaluate the theoretical-practical knowledge acquired by nurses in undergraduate and postgraduate studies and their perceptions about alcohol users. ⋯ Formal education regarding the use of alcohol and its consequences is limited, especially with regard to offering adequate care management for patients who have problems with or are addicted to alcohol.