A S Petrilli, R Melaragno, A Bianchi, E Kusano, K V Barros, A A Silva
{"title":"[Fever and neutropenia in children with cancer: a new therapeutic proposal].","authors":"A S Petrilli, R Melaragno, A Bianchi, E Kusano, K V Barros, A A Silva","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Based on our previous experience treating children with cancer, fever and neutropenia we selected two different empirical regimens: Ceftriaxone once a day, for patients with solid tumors and lymphomas I-II (Low Risk group--LR) and Imipenem for patients with leukemias and lymphomas III-IV (High Risk group--HR). From Oct 1988 to Nov 1989, 121 episodes of fever (F+) and granulocytopenia (G+) in LR Group and 119 in HR Group were studied: the HR had 51.3% documented infections and the LR 58.7%. In the HR Group the following organisms were isolated from the blood cultures: Gram + 52%, Gram - 20% and fungal 28%. In the LR Group 78% of the organisms were Gram+. Positive blood cultures was 21% for the HR Group and 8.3% for the LR Group. There were 23.5% superinfections in the HR Group vs 5.7% in the LR. The mean time and the median time of granulocytopenia was 11.5 and 8 days (HR) and 6.9 and 6.0 days (LR), respectively. There were 14.5% (LR) and 45.4% (HR) modifications to the initial empirical antibiotic regimen (Amphotericin B, Vancomycin and Amikacin). The overall success rate was 97.6% (LR) and 94.2% (HR) and for documented infection the success rate was 95.7% (LR) and 91.8% (HR). We conclude that: a) The allocation of patients to two risk groups aiming to use distinguished therapy, allowed us to delineate two different populations, predominantly based on time of granulocytopenia, disappearance of fever, rate of superinfection, causative organisms and need of additional drugs to the initial scheme.(ABSTRACT TRUNCATED AT 250 WORDS)</p>","PeriodicalId":75471,"journal":{"name":"AMB : revista da Associacao Medica Brasileira","volume":"37 4","pages":"173-80"},"PeriodicalIF":0.0,"publicationDate":"1991-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12833633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Graduate course at the Faculdade de Medicina de Botucatu-UNESP: survey among former students].","authors":"T Ruiz, I Morita","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>With the objective of evaluating teaching at the Faculdade de Medicina de Botucatu, UNESP, questionnaires were sent to 605 ex students and with return of 245 answers. The medical course was considered good, Pediatrics and Medicine obtaining the best marks, the evaluation of Medicine, however decreased among the more recently graduated. Surgery, gynecology-obstetrics and public health had a medium evaluation. Ex students were secure in diagnosis, therapeutics and evaluation of laboratory and other subsidiary texts and techniques but criticized the training in more elaborate medical procedures, essential for medical practice. The fragmentation of the curriculum into specialties was also criticized. Many of the ex students suggested as necessary measures of improvement: integration of specialties in the five basic areas of medicine and utilization of the different health services of the city for teaching.</p>","PeriodicalId":75471,"journal":{"name":"AMB : revista da Associacao Medica Brasileira","volume":"37 4","pages":"200-4"},"PeriodicalIF":0.0,"publicationDate":"1991-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12834248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E Barros, R C Manfro, A Saick, V dos S Ramos, A C Mustafá, L F Gonçalves, J V Morales, C A Prompt
{"title":"[Cyclosporin A: drug interactions].","authors":"E Barros, R C Manfro, A Saick, V dos S Ramos, A C Mustafá, L F Gonçalves, J V Morales, C A Prompt","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75471,"journal":{"name":"AMB : revista da Associacao Medica Brasileira","volume":"37 4","pages":"205-10"},"PeriodicalIF":0.0,"publicationDate":"1991-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12833637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D M Simonatto, M de D Dias, R L Machado, H Abensur, J Cruz
{"title":"[Arterial hypertension in students of the great São Paulo area].","authors":"D M Simonatto, M de D Dias, R L Machado, H Abensur, J Cruz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In 1,000 students from Great São Paulo First Degree Schools, from 6 to 18 years old, we studied: age, sex, race, weight, height, left arm circumference, blood pressure, pulse and family history of hypertension. Of these 550 were female and 450 male, with predominance of caucasians in both sexes (83.7%). The conclusions of this study were: until 9 years old the blood pressure was similar in both sexes. As the school girls grow up earlier, their blood pressure rose first, but after 16 years this fact changed: 126 +/- 3.5 x 76 +/- 2.8 in males and 115 +/- 2.0 x 74 +/- 1.9 in females. Students with a family history of hypertension had higher blood pressure than students without and the prevalence of systolic and diastolic hypertension was higher in the first group: 12.2 and 13.8 to 4.7 and 3.8% respectively. Diastolic blood pressure was dominant in only in males Negros. The prevalence of systolic and diastolic hypertension was 6.9% in these 1,000 students.</p>","PeriodicalId":75471,"journal":{"name":"AMB : revista da Associacao Medica Brasileira","volume":"37 3","pages":"109-14"},"PeriodicalIF":0.0,"publicationDate":"1991-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12834378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Learning and teaching medicine. Brazilian experiences and the new pathways at Harvard].","authors":"J E de Oliveira","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A few Brazilian medical teaching programs carried out during the last 40 years, in which the author has participated or has been a witness, are presented and discussed. The examples of the Medical School of Ribeirão Preto, the Medical School of Botucatu and the Catholic University Medical School of Campinas are cited. The \"new pathway\" to teach and learn medicine, introduced at the Harvard Medical School, is described as a model of the collaborative and cooperative teaching methodology, implanted in the United States and in a few other countries. The need and possibility of introducing new methods of learning and teaching of medicine in Brazil is presented and debated.</p>","PeriodicalId":75471,"journal":{"name":"AMB : revista da Associacao Medica Brasileira","volume":"37 3","pages":"127-31"},"PeriodicalIF":0.0,"publicationDate":"1991-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12834381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M Cinelli Júnior, P Kauffman, R Sacilotto, B Muraco
{"title":"[Unusual complication of surgery of popliteal artery aneurysm: report of a case and considerations on the surgical technique].","authors":"M Cinelli Júnior, P Kauffman, R Sacilotto, B Muraco","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A popliteal artery aneurysm was submitted to an exclusion surgery and autologous reversed saphenous vein bypass. The proximal ligation of the popliteal artery was performed 3cm above the aneurysm. A large branch of the artery below this point remained patent maintaining a communication with a branch of deep femoral artery. Due to this fact residual circulation inside the aneurysm was observed. The patient was reoperated in order to ligate the collateral branch and resect part of the aneurysm. This kind of complication of the technique proposed by Edwards is not common and does not invalidate this technique preferred by most surgeons.</p>","PeriodicalId":75471,"journal":{"name":"AMB : revista da Associacao Medica Brasileira","volume":"37 3","pages":"157-9"},"PeriodicalIF":0.0,"publicationDate":"1991-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12833620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Usefulness of the CAGE questionnaire for the detection of alcohol-related problems among the causes of death in women from Diadema (SP) in the years 1985-1986].","authors":"L A Vianna, M G Monteiro","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The present study was aimed to evaluate problems related to alcohol abuse among the characteristics of mortality of women decreased in Diadema between July 1985 and June 1986. The CAGE questionnaire was used to detect possible cases of alcoholism or alcohol related problems, and it was applied to a relative or close friend of the deceased. From 327 women dead during that period, 7.3% were CAGE positives. Alcoholism was direct or indirectly related to death of women specially between 30-49 years of age, although through the original death certificate, alcoholism was not indicated of diagnosis. The questionnaire CAGE was useful as a tool to detect alcohol problems even when the questions were answered by a resource person, thus identifying alcoholism as an important risk factor of mortality among young women.</p>","PeriodicalId":75471,"journal":{"name":"AMB : revista da Associacao Medica Brasileira","volume":"37 3","pages":"139-42"},"PeriodicalIF":0.0,"publicationDate":"1991-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12834385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Cough induced by angiotensin converting enzyme inhibitors: report of a case by lysinopril].","authors":"D Feder, H Romaldini","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75471,"journal":{"name":"AMB : revista da Associacao Medica Brasileira","volume":"37 3","pages":"160"},"PeriodicalIF":0.0,"publicationDate":"1991-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12833623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Standardization and clinical applications of the rapid and prolonged ACTH stimulation tests in patients with primary and secondary adrenal insufficiency].","authors":"S Faiçal, C E Kater","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Some methodological aspects of the rapid ACTH stimulation test (RST) and the prolonged ACTH stimulation test (PST) remain heterogeneous, e.g. administration routes, time of the day, duration, interpretation criteria and clinical indications. To standardize both tests we studied the serum cortisol responses to ACTH in 16 normal subjects, 16 patients with Addison's disease (AD), 14 with hypopituitarism (HP) of different etiologies and 13 patients on chronic glucocorticoid (CG) treatment (doses equivalent to 5-20 mg/d of prednisone for at least 6 months). For the RST, 250mcg of Cortrosina Organon were injected as an IV bolus and blood collected before and 60 minutes later, whereas for the PST, 250mcg of Cortrosina-Depot Organon were injected IM, every 8 hours for 3 days, and blood drawn daily between 8 and 9 o'clock AM. The post-ACTH cortisol value was the single parameter chosen to interpret both tests (the absolute or percent increase was of no further value). The 95% lower confidence limits (mean minus 1.64 SD) for the RST and the 3rd day of PST were 19.1 and 49.0mcg/dL, respectively. AD patients did not increase cortisol in response to both the RST (1.1 +/- 1.2 to 1.2 +/- 1.1mcg/dL) or the PST (1.2 +/- 1.3 to 2.0 +/- 1.7mcg/dL). However, whereas 22 out of 27 patients with HP and CG showed a modest cortisol increase to the RST (1.6 +/- 2.3 to 5.6 +/- 4.7 mcg/dL), all had a gradual and nearly normal response on the 3rd day of the PST (1.6 +/- 2.1 to 29.6 +/- 16.6mcg/dL).(ABSTRACT TRUNCATED AT 250 WORDS)</p>","PeriodicalId":75471,"journal":{"name":"AMB : revista da Associacao Medica Brasileira","volume":"37 3","pages":"132-8"},"PeriodicalIF":0.0,"publicationDate":"1991-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12834383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L F Zantut, P E Zantut, A J Rodrigues Júnior, D Birolini
{"title":"[Comparative analysis of the diagnostic value of ultrasonography and laparoscopy in acute abdomen].","authors":"L F Zantut, P E Zantut, A J Rodrigues Júnior, D Birolini","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Patients with traumatic or non-traumatic acute abdomen, often exhibit difficulties in the assessment of the real intra-abdominal visceral compromise. This study intends to compare laparoscopy and ultrasonography in patients with non-traumatic or traumatic acute abdomen, in whom there is a doubt on the actual visceral compromise. Forty-five patients were studied in this protocol. Both procedures were performed in 28 and in 17 patients with non-traumatic or traumatic acute abdomen, respectively. The laparoscopic examination was shown to be superior to the ultrasound even when one subtracts from the ultrasound data all pathologies that involved bowel transit and the bowel wall such as the acute appendicitis and cases of pelvic inflammatory disease. The laparoscopic and ultrasound accuracy were 97.8% and 53%, respectively.</p>","PeriodicalId":75471,"journal":{"name":"AMB : revista da Associacao Medica Brasileira","volume":"37 3","pages":"143-9"},"PeriodicalIF":0.0,"publicationDate":"1991-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12834382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}