São Paulo medical journal = Revista paulista de medicina
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Comparative Study
Clinical versus computed tomography evaluation in the diagnosis and management of deep neck infection.
Deep neck infections have high potential for severe complications and even death, if not properly managed. The difference between clinical and computed tomography findings may demonstrate that clinical evaluation alone underestimates disease extent, which may lead to conservative treatment with worse prognosis. ⋯ The most frequent clinical findings were cervical mass, neck pain, local erythema and locally increased temperature. Computed tomography demonstrated that the lateropharyngeal space was the most affected neck space. More than one deep neck space was compromised in 90% of cases. Clinical evaluation underestimated the extent of deep neck infection in 70% of patients.
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Multicenter Study Comparative Study Clinical Trial Controlled Clinical Trial
Comparison between cardiac output values measured by thermodilution and partial carbon dioxide rebreathing in patients with acute lung injury.
Thermodilution, which is considered to be a standard technique for measuring the cardiac output in critically ill patients, is not free from relevant risks. There is a need to find alternative, noninvasive, automatic, simple and accurate methods for monitoring cardiac output at the bedside. ⋯ Under the conditions of this study, the results obtained allow us to conclude that, in patients with acute lung injury, the cardiac output determined by partial rebreathing of CO2 differs from the measurements obtained by thermodilution. This difference becomes greater, the more critical the lung injury is.
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Fibromyalgia is a syndrome characterized by chronic, diffuse musculoskeletal pain, and by a low pain threshold at specific anatomical points. The syndrome is associated with other symptoms such as fatigue, sleep disturbance, morning stiffness and anxiety. Because of its chronic nature, it often has a negative impact on patients' quality of life. ⋯ The three instruments utilized showed efficiency in evaluating fibromyalgia patients. FIQ was found to be the most efficient instrument for discriminating and assessing the impact of fibromyalgia on their quality of life. It can be concluded that such patients have a worse quality of life and higher levels of anxiety.
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Review Case Reports
Leber's hereditary optic neuropathy--case report and literature review.
Leber's hereditary optic neuropathy is an important cause of progressive painless visual loss among young male patients. ⋯ We describe a 17-year-old male with progressive bilateral visual loss. Two maternal uncles had had similar patterns of visual loss. The patient had a history of smoking and alcohol abuse. Neuro-ophthalmological examination revealed visual acuity of 20/800 in both eyes, with decreased direct and consensual pupillary light reflexes. Fundus examination demonstrated pale optic discs. The visual evoked potential test showed signs of conduction disturbances in both optic nerves and campimetric study showed complete visual loss in all fields of both eyes. A diagnosis of bilateral optic neuropathy with a clinical suspicion of Leber's hereditary optic neuropathy was made. A blood sample was submitted to genetic analysis in relation to the principal mutations of this disorder, and homoplasmic mutation in 11778 was detected, thereby confirming the diagnosis of Leber's hereditary optic neuropathy.
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Comparative Study
Insight into schizophrenia: a comparative study between patients and family members.
Despite the recognition of the role that sociocultural factors play in the process of acquiring insight, recent research on this issue is scarce. ⋯ Different dimensions of insight are not equally influenced by disease and sociocultural factors. The recognition of illness is more strongly influenced by sociocultural factors than the ability to relabel psychotic phenomena as abnormal.