EDITORIAL
In th april 2006 issue of clinics
Mauricio Rocha-e-Silva, Editor
Hospital das Clínicas, São Paulo University Medical School São Paulo/SP, Brazil. Email: mrsilva36@hcnet.usp.br
In this issue of Clinics we publish 10 original papers, 1 review and 5 letters to the editor, an all time high for the journal.
Guerra et al are highlighted for an extensive study which retrospectively evaluated early signs and symptoms of osteosarcoma and Ewing's sarcoma in 365 patients, in a quest for diagnostic and differentiation markers. Onset of signs and symptoms preceded definitive diagnosis by 5.3 months in osteosarcoma and 8.1 months in Ewing's sarcoma. These values are higher than those reported for USA and Europe. The most frequent early symptom was local pain, but local volume increase and fever discriminate between the 2 entities. Education of the lay public and medical professionals regarding suspicious early signs and symptoms might shorten the delay.
Dias et al studied the Roux-en-Y gastric bypass surgery in 40 female patients treated for morbid obesity by means of a 1-year follow-up on its nutritional consequences. A 24-hour dietary recall procedure was applied every 3 months. Weight loss at 1 year was 67% of the initial excess weight. Mean daily energy intake was 529 kcal/day at 3 months and 866 kcal/day at 1 year; the average intake never met recommendations for calories, proteins, iron or zinc. Nutrition was thus compromised for 1 year, with slow and inefficient food intake improvement. Specific protocols to improve nutrition and health during the postoperative phase is recommended.
Wakassa et al described the evolution of popliteal artery aneurismatic sac after exclusion and bypass surgery in 16 patients treated between 1996 and 2004. Follow-up time ranged from 1 month to 7 years: 50% of the aneurysms were reduced in size, 35% had increased and 15% remained unchanged; blood flow was present in 25% of cases, but no ruptures were registered. A strict follow-up of these patients is strongly recommended.
Nunes et al reviewed autopsies performed in Uberaba, a high standard Brazilian provincial city hospital between 1976 and 2000, and selected 10 cases of patients deceased over the age of 60 with hearts free of cardiopathies, with negative serology for Chagas' Disease, and with brains free of morphological changes associated to encephalopaties. Amyloidosis was detected in 4 of the cases; in all of them amyloidosis was present in the brain, and in 1 it was also detected in the heart.
Corbett et al determined species and the genotype of Cryptosporidium sp in 29 positive samples from a diarrhea outbreak diagnosed in children attending a daycare center in São Paulo, Brazil. Identification and typing of isolates were obtained by DNA sequencing analysis of fragments from three different Cryptosporidium loci. A single genotype of Cryptosporidium hominis was found in every sample. This analysis reinforced the hypothesis that transmission of Cryptosporidium hominis occurred in an outbreak pattern, possibly by person to person, through fecal or oral route.
Rebello and Ramos evaluated the effects of maternal-fetal genetic histocompatibility and of maternal malnutrition in mice. Syngeneic and allogeneic fetuses compared to their mothers were analyzed. Maternal-fetal genetic histocompatibility alone had no effect on fetal growth, or litter size; in contrast, undernourished mothers produced litters with reduced placental and brain weight, and diminished numbers of viable fetuses. The association of maternal fetal compatibility with malnutrition, accentuated the effects of the latter on fetal and placental weight.
Camanho et al retrospectively investigated the results of the treatment of patients with isolated meniscal injuries of different etiologies in 435 patients. Most patients achieved good results and were able to return to their customary activities, without major limitations. Meniscectomy for traumatic injuries provides better results than for degenerative injuries. Meniscectomy for the treatment of meniscal injury due to fatigue produces results which are similar to those obtained with traumatic meniscal injury, although the risk of osteonecrosis development is higher.
Bretanha et al evaluated clinical aspects, diagnosis, prognostic factors and percent progression of plasmacytoma to multiple myeloma in 30 medical records covering the period between 1950 and 1998. Patients who progressed to multiple myeloma were younger than those who did not. No significant differences were found between the 2 groups regarding sex, disease period and survival time. In both groups, the most affected anatomical location was the vertebral column, and the most affected patients were males. The average time of progression to multiple myeloma was 41 months. It was not possible to determine the factors that influenced the survival of patients with plasmacytoma and of patients who progressed to multiple myeloma.
Bricks et al describe morbidity, complications, and sequelae associated to varicella in 664 affected children attending day care centers in Taubaté (a high standard Brazilian provincial city), by means of a descriptive study carried out through inquiries with their parents or tutors. The median age of the affected children was 36 months and their main symptoms were: exanthema (100.0%), fever (85.4%), anorexia (39.6%), and headache (15.3%). At least one medical visit was described for 87% of the children, and 80.6% received at least one medication; complications occurred in 5.7% of the children, hospitalization in 1.2% and 0.7% had sequelae. More than half of the children and their working parents were absent for more than a week from their regular activities. The population should be warned about the risks, most commonly used medicine, and the benefits of vaccination against varicella should be considered.
Precioso et al described the production of a porcine pulmonary surfactant preparation by the Butantan Institute (Brazil) by organic extraction coupled with adsorption on a cellulose derivative and compared it to commercially available surfactants. Immunogenicity was evaluated in an adult rabbit model. Stability and safety were tested by comparing the effects of surfactants stored in adverse conditions in a premature rabbit model. No significant differences were observed in antibodies titers between surfactants, which did not trigger immune response against their components. The surfactants had similar stability and efficacy after adverse storage, as shown by improvement in pulmonary function of prematurely hatched rabbits. The Butantan surfactant may represent a competitive alternative for surfactant replacement therapy.
Leão et al reviewed oral manifestations of syphilis and three of our letters are case reports.
Publication Dates
-
Publication in this collection
26 Apr 2006 -
Date of issue
Apr 2006
