São Paulo medical journal = Revista paulista de medicina
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Randomized Controlled Trial Multicenter Study Clinical Trial
Inhaled budesonide for adults with mild-to-moderate asthma: a randomized placebo-controlled, double-blind clinical trial.
Budesonide is an inhaled corticosteroid with high topical potency and low systemic activity recommended in the treatment of chronic asthma. ⋯ Budesonide via a breath-activated, multi-dose, dry-powder inhaler results in a rapid onset of asthma control, which is maintained over time and is well tolerated in adults with mild-to-moderate asthma.
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The CDR-3 region of heavy-chain immunoglobulin has been used as a clonal marker in the study of minimal residual disease in children with acute lymphoblastic leukemia. Southern blot and polymerase chain reaction studies have demonstrated the occurrence of bi/oligoclonality in a variable number of cases of B-lineage acute lymphoblastic leukemia, a fact that may strongly interfere with the detection of minimal residual disease. Oligoclonality has also been associated with a poorer prognosis and a higher chance of relapse. ⋯ We conclude that bi/oligoclonality was not associated with the factors investigated in the present study and that its detection in 31.9% of the patients may be important for the study and monitoring of minimal residual disease.
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Inborn Errors of Metabolism are hereditary affections resulting from incompetence in enzymatic reactions of intermediary metabolism. At present, several hundred hereditary metabolic disturbances are known, many of which correspond to severe life-threatening disorders. ⋯ The high positivity observed in the tests reflects the newborn's own metabolic immaturity. The selection of 9% of the studied cases for outpatient follow-up confirms that Inborn Errors of Metabolism must be suspected whenever a patient presents metabolic disturbances or neurological manifestations without a determined cause. They should be researched in parallel with the other diagnostic possibilities and not just taken to be exceptional diagnoses.
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There is still controversy as to the use and dosage of antimicrobial prophylaxis of the urinary infection associated with urethral catheterization in the post renal transplant period. ⋯ Infection urinary does not occur during the period of urethral catheterization in kidney post-transplant patients. Thus, antimicrobial prophylaxis is not recommended for these patients to prevent urinary infection.
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Case Reports
Complete atrioventricular block during renal transplantation in a patient with Alport's syndrome: case report.
Patients with Alport's syndrome (causing 5% of end-stage renal disease) have a higher risk of heart conduction abnormalities. ⋯ A 21-year-old man with chronic renal failure due to Alport's syndrome was submitted to a renal transplantation under epidural anesthesia and, during the intraoperative period, a complete atrioventricular block was diagnosed and promptly treated with a transcutaneous pacemaker. This extensive sympathetic block can contribute towards disturbances in the heart conduction system, particularly in patients with chronic renal disease in hemodialysis. Even in patients with a normal preoperative electrocardiogram or no conduction system disturbances, some degree of atrioventricular block, including complete atrioventricular block, can occur. In this situation, a transcutaneous pacemaker provides rapid and effective treatment in the operating room, thereby permitting the planning of a definitive treatment.