São Paulo medical journal = Revista paulista de medicina
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Review Case Reports
Sudden sensorineural hearing loss and vertigo associated with arterial occlusive disease: three case reports and literature review.
Sudden sensorineural hearing loss and vertigo (SSNHLV) has multifactorial causes, of which viral, autoimmune and vascular insufficiency are the most common. The therapeutic management for SSNHLV includes antiviral drugs, corticosteroids, vasodilators, normovolemic hemodilution therapy and hyperbaric oxygen therapy. ⋯ Here, we present our experience with three cases managed with interventional treatment and conduct a review and discussion on the relevant literature. We conclude that investigation of vertebrobasilar and carotid occlusive diseases is necessary in patients over 50 years of age who present SSNHLV, mild neurological symptoms and a history of arteriosclerosis, high blood pressure or thrombosis.
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Comparative Study
Evaluation of early hospital discharge after allogeneic bone marrow transplantation for chronic myeloid leukemia.
The increasing number of patients waiting for bone marrow transplantation in our service led to the implement of an early hospital discharge program with the intention of reducing the interval between diagnosis and transplantation. In this study we analyzed the results from early discharge, with outpatient care for patients with chronic myeloid leukemia who underwent allogeneic bone marrow transplantation. ⋯ This partially outpatient-based hematopoietic stem cell transplantation program allowed an increased number of transplantations in our institution, in cases of CML and other diseases, since it reduced the median length of hospital stay without increasing morbidity and mortality.
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Metabolic syndrome (MS) is recognized worldwide as an important public health concern. However, little information is available for rural populations in Brazil. The aim was to determine the prevalence and risk factors associated with MS in a rural village in Brazil in 2004. ⋯ BMI and age were independently associated factors for MS in this rural community. These findings provide important evidence on the prevalence of MS as a public health problem, particularly for women and overweight individuals.
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Many children with acute lower respiratory tract infections (ALRI) present to the emergency ward with concurrent wheezing. A chest x-ray is often requested to rule out pneumonia. We assessed inter-observer agreement in interpreting x-rays on such children. DESIGNS AND SETTING: Prospective consecutive case study at Instituto de Salud del Niño, Lima, Peru. ⋯ There was poor inter-observer agreement for chest x-ray interpretation on children with ALRI and concurrent wheezing seen at the emergency ward. This may preclude reliable diagnosing of pneumonia in settings where residents make management decisions regarding sick children. The effects of training on inter-observer variation need further studies.
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Neonatal resuscitation should be part of medical school curriculums. We aimed to evaluate medical school graduates' knowledge of neonatal resuscitation. ⋯ Medical school graduates' knowledge of neonate resuscitation in the delivery room is quite precarious. Emphasis on neonatal resuscitation training is urgently needed in medical schools.