São Paulo medical journal = Revista paulista de medicina
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Totally implantable devices are increasingly being utilized for chemotherapy treatment of oncological patients, although few studies have been done in our environment to analyze the results obtained from the implantation and utilization of such catheters. ⋯ The low rate of complications obtained in this study confirms the safety and convenience of the use of totally implantable accesses in patients undergoing prolonged chemotherapy regimes.
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Despite the advances in the cure rate for acute lymphoblastic leukemia, approximately 25% of affected children suffer relapses. Expression of genes for the multiple drug resistance protein (MDR-1), multidrug resistance-related protein (MRP), and lung resistance protein (LRP) may confer the phenotype of resistance to the treatment of neoplasias. ⋯ Evaluation of the expression of genes for resistance to antineoplastic drugs in childhood acute lymphoblastic leukemia upon diagnosis, and particularly the expression of the LRP gene, may be of clinical relevance, and should be the object of prospective studies.
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Non-specific lymphocytic infiltrates of the skin pose difficulties in daily practice in pathology. There is still a lack of pathognomonic signs for the differential diagnosis between benign and malignant lymphocytic infiltrates. ⋯ A combination of clinical and histological features remains the most reliable approach for establishing a definite diagnosis in cases of lymphoid skin infiltrates.
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Clinical Trial
Hemodynamics and renal function during administration of low-dose dopamine in severely ill patients.
Although a large number of studies have been performed regarding the renal and hemodynamic effects of the infusion of low-dose dopamine (LDD) in severely ill patients, there is still controversy on this subject. ⋯ Infusion of 2 microg/kg/min of dopamine for 2 hours increases diuresis. At the doses studied, dopamine does not induce significant alterations in MAP, HR, CVP, CLcr and FENa+.
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Abdominal aortic aneurysm is an asymptomatic but potentially fatal condition. Elective surgery can prevent death from rupture, and is indicated for aneurysms larger than 45 mm. Because aneurysms tend to grow with time, detection of small ones (> 29 mm) may lead to a closer follow-up of patients at risk. ⋯ In Sao Paulo, Brazil, 1.8 to 3 % of persons aged 50 years or more are expected to have abdominal aortic aneurysms. In the subgroup of men aged 60 or more, the expected prevalence is between 4.3 and 8%.