Rev Assoc Med Bras
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Case Reports
[Toxic epidermal necrolysis after the use of intermediate dose of cytosine arabinoside].
Toxic epidermal necrolysis is a drug-induced dermatologic disease related to Lyell syndrome, erythema multiforme and Stevens-Johnson syndrome. ⋯ Cytarabine is frequently associated with dermatologic toxicity but, until now, there is no other case of toxic epidermal necrolysis described.
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Clinical Trial
[Continuous positive airway pressure (CPAP) with face mask to treat acute respiratory failure].
To evaluate the efficacy of continuous positive airway pressure (CPAP) administered by face mask in patients with acute respiratory failure with indication of mechanical ventilation. ⋯ These data allow the conclusion that CPAP administered by face mask improves gas exchange and decreases respiratory rate in patients with acute respiratory failure and may reduce the need for invasive mechanical ventilation.
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Clinical Trial
[Diagnostic limitations of the physical examination in the identification of children with anemia].
A total of 143 children was randomly selected from a Pediatric out-patients clinic in order to evaluate the accuracy and reproductibility of the clinical signs of anemia. The patients, who ranged from 6 to 68 months old, were assessed on the basis of 2 clinical examinations performed independently by 2 physicians. Clinical diagnosis of anemia relied upon the examination for the presence of pallor through an inspection of the skin, conjunctivaes, lips, tongue and palms. ⋯ Almost all the children with hemoglobin concentration lower than 9.0 g/dL presented at least one suggestive clinical sign of anemia. The Kappa coefficient (K) demonstrated a mild agreement between the 2 examinations for the assessment of cutaneous pallor (K = +0.32) and moderate agreement for the evaluation of the conjunctivaes, lips-tongue and palms (K from +0.55 to +0.59). In view of limitation of the accuracy and reproductibility of the clinical signs of anemia, we may state that the determination of hemoglobin concentration should be introduced as a routine procedure of major importance in health care services.