PROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE MATERNO-INFANTIL - PPG Saúde Materno Infantil

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    EXPRESSÃO DOS MARCADORES CD56, CD16 E CD57 NA AVALIAÇÃO PROGNÓSTICA DE PACIENTES COM LEUCEMIA LINFÓIDE AGUDA NO ESTADO DO MARANHÃO
    (Universidade Federal do Maranhão, 2012-09-28) Andrade, Karla Nadinne de Sousa; OLIVEIRA, Raimundo Antonio Gomes; CPF:40727343300; http://lattes.cnpq.br/1633053684617759; Silva, Raimundo Antonio da; CPF:0237799368
    The acute lymphoblastic leukemia (ALL) is characterized by abnormal proliferation of immature lymphoid cells and represents the most common cancer in children. The evaluation of prognostic factors in patients with ALL enables the implantation of different therapeutic approaches. The aberrant expression of markers CD56, CD57 and CD16 may be a way to assess this prognosis. The objective of this study was to characterize patients with ALL and to evaluate the prognostic influence of aberrant expression of markers CD56, CD16 and CD57 in ALL. 44 patients treated at the Maranhense Oncology Institute Aldenora Bello in Sao Luis - MA were evaluated, from March 2010 to October 2011. Patients were diagnosed with ALL according to the morpho-cytochemical and immunophenotype criteria. The expression of markers was determined by flow cytometry and clinical data were obtained through chart review. Two groups were divided as the expression or not of these markers and compared in relation to prognostic variables. The average of age in the sample was 6,28 years, with a predominance of males (60,0%). The average of blasts counted in bone marrow (BM) and peripheral blood (PB) was 77,0 and 39,6, respectively. The L1 morphology of the blasts from BM was the most frequent (80,0%). The profile of the blood count at diagnosis indicated: 24.061 leukocytes/mm3; 56.510 platelets/mm3 and 8,0 g/dL hemoglobin. According to the classification GBTLI-99, 60,0% of the patients were in low risk of recurrence group and in the end of the induction phase of treatment (D29), 70,0% of the patients had remission. The patients with ALL T had mean of age (10,6 years; p = 0,0204) and leukometry (48.200/mm3; p = 0,0167) significantly higher than patients with ALL B. 80,0% of the patients expressed the CD56 marker and no patient expressed CD16 and/or CD57 markers. Patients who did not express the marker CD56 had age significantly higher those who expressed (9,3 years; p = 0,0353). For patients with ALL B, the average of blasts from PB of patients who expressed the CD56 marker was higher than those not expressed (41,1; p = 0,0226). It is concluded that CD56 expression characterizes a worse prognosis for patients with ALL B, due to a significantly higher average of blasts counted in PB found in our study. However, a greater number of cases and a longer observation time would be needed to better emphasize this evidence.
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    INTERNAÇÕES PEDIÁTRICAS POR CONDIÇÕES SENSÍVEIS À ATENÇÃO PRIMÁRIA EM HOSPITAL DE REFERÊNCIA TERCIÁRIA NO MARANHÃO
    (Universidade Federal do Maranhão, 2014-11-18) Lima, Raquel Castro Desterro e Silva Moreira; GAMA, Mônica Elinor Alves; CPF:45297207304; Coimbra, Liberata Campos; CPF:0111101200; http://lattes.cnpq.br/9128715784318958; Silva, Raimundo Antonio da; CPF:0237799368; Chein, Maria Bethânia da Costa; CPF:71725431734; http://lattes.cnpq.br/6140088004101694
    Access and effectiveness of Primary Health Care are decisive to avoid hospitalizations. Therefore, Ambulatory Care Sensitive Conditions (ACSC) is an excellent indicator to evaluate Primary Health Care. In view of the relevance of this indicator to propose strategies of organization and consolidation of Sistema Único de Saúde, this study has the main purpose to analyze pediatric hospitalizations by ACSC in a tertiary referral hospital in Maranhão. It was made a descriptive and retrospective study of the epidemiological data and diagnostics collected in University Hospital of Federal University of Maranhão. The data were transferred to a database, using the IBM SPSS Statistics 20 software (2011) to do statistical analysis. The crossing of diagnostics register systems and age groups was analyzed by non parametric test of independence; when it was not possible to use test, it was used the exact Fisher test or the G independence test. To analyze frequencies of hospitalizations by ACSC among age groups within each register system was applied test of adherence. The crossings of hospitalized patients by ACSC, within each register system, and the presence or not of Unidade Básica de Saúde da Família (UBSF) near their residence, were analyzed by test of adherence, and the comparison between the register systems about the presence or not of UBSF, by the test of independence. The level of significance in all tests was 5%. The diagnostics were classified according to Brazilian List of ACSC. There were 17% of hospitalizations by ACSC. The predominant age group was 1 to 4 years old (36%), male (51,2%) and brown-skinned (60,5%). The patients came from São Luís (50%) and from interior of Maranhão (50%), and the majority was from the urban zone (65,1%) and did not have UBSF near your residence (57%). Within the ACSC groups of the Brazilian List, the most frequent was pneumonias bacterianas (25,5%), followed by the group of infecção no rim e trato urinário (19,7%). Considering the classification of ACSC Brazilian List, almost one fifth of admissions in this high complexity reference hospital in the state could have had, plausibly, resolution in Primary Health Care.