Surveillance of nasopharyngeal pneumococcus has proven to be a valuable tool for the monitoring of antibiotic resistance. We reviewed the latest information on colonization rate and penicillin resistance by making a MEDLINE search, using the terms "nasopharyngeal carriage" and "Streptococcus pneumoniae". Out of 225 articles found, data from 109 recent publications (89% from 1996-2003) were analyzed. Data were reported from 41 countries of six continents. Individuals under the age of five (64.3%) or 10 years (85.7%) were enrolled, including children attending day-care centers (32.1%) or orphanages (3.6%), and healthy individuals (78.6%) or sick patients (43.6%); biological samples were collected mainly by nasopharyngeal swabs (89.3%). The highest colonization rates were reported from Africa (85-87.2%), where several authors did not find high rates of penicillin resistance. On the other hand, studies conducted in North and Central America reported high-level penicillin resistance at rates of approximately 20-30%. Great variation in the rates of pneumococcal colonization and penicillin resistance were observed within regions or continents. There were also considerable differences in similar populations located in different areas of the same country. Data regarding pneumococcal colonization and penicillin resistance are not available from most countries. We also examined the use of antibiotics to treat pneumococcal infections.

The aim of this study was to describe the frequency of antimicrobial-resistance and serotypes of nasopharyngeal pneumococcal isolates from adolescents. Clinical data and nasopharyngeal specimens for culture were collected from 1,013 adolescents as a part of a population-based study. A total of 83 isolates of Streptococcus pneumoniae were identified (8.2%). Seventy-four of the 83 isolates were serotyped. The median age of the 83 adolescents colonized by pneumococci was 14 years (mean 14 +/- 2.2 yrs); 55.4% were males. Intermediate resistance to penicillin was detected in 7.2% (6/83). No strain showed high resistance to penicillin. All isolates were susceptible to clindamycin, chloramphenicol, rifampin, and vancomycin; 37.3%, 18.1%, and 4.8% were resistant to trimethoprim-sulfamethoxazole, tetracycline, and erythromycin, respectively. The most frequent serotypes (5-10% of strains each) were 6B, 6A, 23F, and 18C among 28 serotypes/serogroups identified; 18.9% of the strains were nontypeable (NT). Intermediate resistance to penicillin was detected in serotypes 6B, 14, and NT. The rate of resistance to penicillin of nasopharyngeal isolates is low considering data from other studies about invasive strains recovered from children in Brazil. Serotype patterns are similar, except for type 14, which was unusually infrequent.

<span class="texto">Os contraceptivos orais vêm sendo cada vez mais prescritos na prática médica para o tratamento de várias patologias, dentre elas a dismenorréia e a Síndrome do Ovário Policístico (SOP), essa última bastante freqüente nas mulheres em idade fértil. Entretanto, o principal emprego dessa droga é, indubitavelmente, na prevenção da gravidez indesejada, através da supressão do hormônio do folículo estimulante (FSH) no ciclo ovariano. Esse bloqueio hormonal pode sofrer interferência pelo uso concomitante de outros fármacos - fato esse denominado interação medicamentosa. Dentre eles destacam-se os antibióticos, medicamentos progressivamente mais utilizados no tratamento das infecções. O objetivo deste trabalho é, portanto, discutir e esclarecer os mecanismos de ocorrência das interações medicamentosas entre anticoncepcionais orais e antibióticos, salientando-se as drogas mais envolvidas na redução do efeito contraceptivo.</span>

Os distúrbios do sono são importantes alterações do funcionamento do ciclo sono-vigília que culminam em prejuízos significativos às atividades diárias e afetam o bem-estar biopsicossocial do indivíduo, frequentemente são associados a transtornos mentais, enfermidades neurológicas e diagnósticos em outras especialidades médicas. O que repercute na necessidade deste estudo em direcionar um olhar sobre a identificação de sintomas depressivos e ansiosos em pessoas diagnosticadas com distúrbio do sono, retomando elementos determinantes para que se realize uma adequada associação. Desse modo foi elaborada uma revisão bibliográfica sobre a temática e foi efetivada uma pesquisa de campo em contexto ambulatorial para avaliação de 76 pacientes, utilizando-se das seguintes escalas: Escala Hospitalar de Depressão e Ansiedade; Escala de sonolência Epworth; Índice de qualidade de sono Pittsburgh e Questionário clínico de Berlim. Através dos dados obtidos a pesquisa constatou que há uma significativa ocorrência na correlação entre distúrbios do sono e sintomas emocionais.