Objective: To analyze the frequency of unlicensed (UL) and offlabel (OL) prescriptions in neonates admitted to the neonatal intensive care unit of a tertiary care hospital and to determine their association with patients' severity. Methods:Observational cohort study including drugs prescribed during hospitalization of neonates over a 6-week period between July and August 2011. The drugs were classified as UL and OL for dose, frequency, presentation, age group, or indication, according to an electronic list of drugs approved by the Food and Drug Administration. Patients were followed until hospital discharge or 31 days of hospitalization, with daily records of the Neonatal Therapeutic Intervention Scoring System (NTISS). Results:We identified 318 prescription items for 61 patients (average of five items/patient); there were only 13 patients with appropriate use of medications (21%). A prevalence of 7.5% was identified for UL prescriptions and 27.7% for OL, and the most prevalent OL use was that related to age group -19.5%. Fifty-seven medications were computedone patient received 10 UL/OL drugs during hospitalization. The prevalence of OL uses was higher in preterm infants < 35 weeks and in those with higher severity scores (p = 0.00). Conclusions:The prevalence of neonates exposed to UL/OL drugs during hospitalization was high, especially for those with higher NTISS scores. Although there is general appreciation that neonates, especially preterm infants, have a high rate of drug use, an assessment including different cultures and countries is still needed to prioritize areas for future research in the pharmacotherapy of this vulnerable population.J Pediatr (Rio J). 2012;88(6):465-70: Drugs, drug labeling, injury severity score, neonatology. ResumoObjetivo: Avaliar a frequência da prescrição de medicamentos de uso não licenciado (UL) e off-label (OL) em recém-nascidos internados em unidade de tratamento intensivo neonatal de hospital de nível terciário e verificar a associação do seu uso com a gravidade dos pacientes.Métodos: Estudo observacional de coorte dos medicamentos prescritos no período de 6 semanas da internação de neonatos, entre julho e agosto de 2011. Os medicamentos foram classificados em UL e OL para dose, frequência, apresentação, faixa etária e indicação, de acordo com bulário eletrônico aprovado pela Food and Drug Administration. Os pacientes foram acompanhados até alta hospitalar ou 31 dias de internação, com registro diário do Neonatal Therapeutic Intervention Scoring System. Resultados:Foram identificados 318 itens de prescrição para 61 pacientes (média de cinco itens/paciente) e apenas 13 pacientes com uso de medicamentos adequados (21%). Identificaram-se prevalên-cias de 7,5% para prescrições UL e de 27,7% para OL. O uso OL mais prevalente foi para medicamentos não padronizados para faixa etária -19,5%. Computaram-se 57 medicações -um paciente recebeu 10 fármacos UL/OL na internação. A prevalência de usos OL foi maior em prematuros < 35 semanas e nos com escores de gravidade mais ele...

ABSTRACT ABSTRACTObjective Objective Objective Objective Objective: To identify the incidence of pelvic infection after miscarriage undergoing uterine evacuation in a tertiary hospital in southern Brazil and to compare with the international literature. MethodsMethods Methods Methods Methods: we reviewed electronic medical records of the Hospital de Clinicas de Porto Alegre of all patients who underwent uterine evacuation for miscarriage between August 2008 and January 2012 were reviewed. We included all patients submitted to uterine curettage due to abortion and who had outpatient visits for review after the procedure. We calculated emographic and laboratory data of the study population, number needed for treatment (NNT) and number needed to harm (NNH). Results Results ResultsResults Results: of the 857 revised electronic medical records, 377 patients were subjected to uterine evacuation for miscarriage; 55 cases were lost to follow-up, leaving 322 cases that were classified as not infected abortion on admission. The majority of the population was white (79%); HIV prevalence and positive VDRL was 0.3% and 2%, respectively. By following these 322 cases for a minimum of seven days, it was found that the incidence of post-procedure infection was 1.8% (95% CI 0.8 to 4). The NNT and NNH calculated for 42 months were 63 and 39, respectively. Conclusion Conclusion Conclusion Conclusion Conclusion: The incidence of post-abortion infection between August 2008 to January 2012 was 1.8% (0.8 to 4).

Abstracts newborns (10 with sepsis, 10 with perinatal asphyxia, and 10 with surgical abdominal malformations). That has always been given intravenously except for 10 septic newborns receiving oral administration. In our studies, melatonin treatment was able to reduce the level of proinflammatory cytokines, lipid peroxidation products and clinical parameters of inflammation and sepsis, and to improve the clinical outcome in terms of reduction of bronchodysplasia in preterm infants with RDS. None adverse event has been observed in our population of newborns treated with melatonin. Conclusions To our knowledge, studies related to the toxicity of melatonin have not uncovered evidence of toxicity in humans even when given in very high doses. Our studies confirmed the potential role of melatonin as a treatment in different neonatal pathologies and the safety of its use in neonates at relatively high doses for short term and in various formulations. Background and Aims Sulfonylureas inhibit the ATP-sensitive potassium (K ATP ) channel, are insulinogenic, and close the fetal ductus arteriosus. Diazoxide, a K ATP channel opener, is used for neonatal hyperinsulinemic hypoglycemia, and has been associated with the reopening of the ductus arteriosus. The aim of this study is to clarify ductus-opening effect of diazoxide. Methods Neonatal rats were delivered by caesarian section nearterm and incubated at 34°C. Diazoxide and pinacidil, another K ATP channel opener, were injected intraperitoneally immediately, or at one hour, or at four hours postnatally, and the ductus was studied 0.5, and 1 hour later, with a rapid whole-body freezing method. Results Diazoxide and pinacidil both induced hyperglycemia. Diazoxide and pinacidil delayed neonatal ductus closure following injection immediately after birth. At 2 hours, the control ductus was closed, whereas the ductus treated with 100 mg/kg of diazoxide at birth was widely patent with a diameter 40% of the fetal ductus. Ductus diameter at 60 minutes postnatally dilated from 10% to 40% with diazoxide. Diazoxide given to the closed ductus at 4 hours after birth did not open reopen it. The ductus was more sensitive to pinacidil than to diazoxide. Conclusions Diazoxide and pinacidil open the closing ductus arteriosus of the neonatal rat. This study demonstrates that opening of K ATP channels results in opening of the ductus arteriosus, indicating that the K ATP channel is physiologically and pharmacologically important in ductus opening. The ductus should be checked in the neonate before and after treatment with diazoxide. DIAZOXIDE OPENS THE CLOSING NEONATAL DUCTUS ARTERIOSUS