In the September, 2010 issue of CLINICS

Rocha e Silva, Mauricio

doi:10.1590/S1807-59322010000900001

EDITORIAL

With this new issue of CLINICS, we are opening our site www.clinics.org.br where we will eventually be able to offer our entire collection, from 2005 to this date. Article PDFs will be freely downloadable and we expect to be able to insert an e-book for every issue in a few weeks from now.

This issue of CLINICS contains 10 clinical science articles, two basic research papers, two reviews, one technical note, and tree case reports.

Franco et al. determined the frequency of metallo-β-lactamases among imipenem-resistant Pseudomonas aeruginosa isolates and compared methods of phenotypic and molecular detection and conclude that Metallo-β-lactamases among imipenem-resistant Pseudomonas aeruginosa were detected in 30.4% of imipenem-resistant Pseudomonas aeruginosa isolates. They claim that this number might have been higher if other genes were included. SPM-1 was described as the predominant enzyme found and PCR detection remains the gold standard.

Arslan et al. studied reg1onal 1ntravenous anesthes1a procedure in knee arthroscopy to evaluate the effects of adding ketamine over the anesthesia block charactery and tourniquet pain in 40 American Society of Anesthesiologists (ASA) II patients who received knee arthroscopy. Patients were randomly split into two groups, receiving either 80 ml 0.5% prilocaine, or 0.15 mg/kg ketamine (80 ml in total) via the dorsum of the foot. They conclude that Reg1onal 1ntravenous anesthes1a using the doses and volumes commonly used in knee arthroscopy may be an inadequate block among patients with high BMI values. Moreover, the addition of ketamine to the local anesthetic solution may produce a partial solution by shortening the onset of sensory block and prolonging the time until the first analgesic is required.

Orlando et al. analyzed the results of treating deep venous malformations patients with low doses of ethanol. Thirty-nine patients treated between July 1995 and June 2007 were followed up prospectively over a median period of 18 months. They conclude that outpatient treatment for Deep venous malformations patients using ethanol at low doses was effective, with a low complication rate.

Pimenta et al. introduce the new concept of Desaturation - distance ratio for the functional assessment of interstitial lung diseases. This is a new composite index (desaturation distance ratio using continuous peripheral oxygen saturation (SpO₂) and the distance walked as a more reliable tool for doing a functional evaluation of these patients. They conclude that this is a promising concept and a more reliable physiologic tool to assess pulmonary diseases characterized by involvement of the alveolar-capillary membrane, such as interstitial lung diseases.

Guimarães et al. performed a retrospective study to determine the predictive complication factors for ct-guided fine needle aspiration biopsy of pulmonary lesions, examining variables such as the radiological characteristics of the lesions, secondary pulmonary radiological findings, co-morbidities, and aspects concerning the procedure. They conclude that CT-guided percutaneous fine needle aspiration biopsy of lung lesions had a lower rate of complications in our study and presented more rates of complications on lesions that lack pleural contact.

Mancusi and Festa-Neto conducted a prospective study that recorded data from inpatient dermatology consultation request forms over a period of four months. They produced a report on 313 requests that led to 566 visits, 86 biopsies, 35 laboratory exams, 41 direct microscopic studies, 18 direct immunofluorescence analyses, 14 skin cultures and a few other exams.

Ortega et al. evaluated the importance of providing guidelines to patients via active telephone calls for blood pressure control and for preventing the discontinuation of treatment among 354 hypertensive patients and conclude that guidance to patients via active telephone calls is an efficient strategy for preventing the discontinuation of antihypertensive treatment.

Fomin et al. describe clinical and laboratorial data and phenotypic characteristics of patients with DiGeorge Syndrome and point out the need of considering the syndrome in all patient presenting with heart defects, facial abnormalities (associated or not with hypocalcemia), and immunological disorders, because although frequency of occurrence of DiGeorge Syndrome is high, few patients with a confirmed diagnosis are adequately followed.

Sardenberg et al. performed a retrospective review of 122 patients admitted to the Thoracic Surgery Department with lung metastases and who underwent thoracotomy for resection, after following treatment of the primary tumor. Data were collected regarding primary tumor features, demographics, treatment, and outcome were collected. They found a total 122 thoracotomies and 273 nodules resected from 77 patients with previously treated soft tissue sarcomas. The median follow-up time of all patients was 36.7 months (range: 10-138 months), the postoperative complication rate was 9.1%, and the 30-day mortality rate was 0%. The 90-month overall survival rate for all patients was 34.7%. Multivariate analysis identified the following independent prognostic factors for overall survival: the number of metastases resected, the disease-free interval, and the number of complete resections as independent prognostic factors for overall survival. They conclude that these results confirm that lung metastasectomy is a safe and potentially curative procedure for patients with treated primary tumors. A select group of patients can achieve long-term survival after lung resection.

Rodrigues et al. investigated the effect of carnitine supplementation on alcoholic malnourished rats' hepatic nitrogen content and found i) no difference between the alcohol/no alcohol groups, with or without carnitine, regarding body weight gain, diet consumption, urinary nitrogen excretion, plasma free fatty acids, lysine, methionine, and glycine. ii) Liver nitrogen content was highest in the carnitine recovery non-alcoholic group and lowest in alcoholic animals. iii) Hepatic fat content was highest in the alcoholic animals. They conclude that carnitine supplementation did not induce better nutritional recovery.

von Wilmsdorff et al. investigated the of typical and atypical antipsychotic drugs on leptin concentration in blood and changes in the receptor expression in the hypothalamus of male Wistar rats. and conclude that during the treatment period, the tested drugs did not act directly on the leptin regulatory system. They recommend further studies using long-term treatment of different rat strains.

We also publish two review articles, one by Bloch et al. on Episodes of falling among elderly people and one by Giavina-Bianchi et al. on difficult-to-control asthma management cases.