São Paulo medical journal = Revista paulista de medicina
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Randomized Controlled Trial
Intra-articular morphine versus bupivacaine for knee motion among patients with osteoarthritis: randomized double-blind clinical trial.
Osteoarthritis causes pain and disability in a high percentage of elderly people. The aim of the present study was to assess the efficacy of intra-articular morphine and bupivacaine on the joint flexion and extension angles of patients with knee osteoarthritis. ⋯ The analgesic effects of 1 mg of morphine and 25 mg of 0.25% bupivacaine were similar among patients with osteoarthritis of the knee.
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Randomized Controlled Trial Comparative Study
Effectiveness of two programs of intermittent ferrous supplementation for treating iron-deficiency anemia in infants: randomized clinical trial.
Low compliance among mothers regarding the treatment of anemic children using daily doses of ferrous sulfate administered at home has been reported. This study aimed to establish the effectiveness of weekly doses administered by mothers at home compared with weekly supplements administered directly by healthcare professionals, to reduce the prevalence of anemia. ⋯ Weekly supplementation of 25 mg of iron was proven to be efficient in reducing anemia, using interventions both at home and in healthcare clinics. Compliance among the mothers was achieved because weekly supplementation was easy to administer and had few side effects. The results showed that the treatment presented low cost and fast benefits.
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Significant controversy exists regarding the best surgical treatment for complex duodenal injuries. The aims of this study were to report on a series of eight cases of duodenal repairs using pyloric exclusion and to describe reported complications or improvements in clinical outcomes among patients with complex duodenal trauma. ⋯ Pyloric exclusion was associated with multiple complications and a high mortality rate. This surgical technique is indicated for rare cases of complex injury to the duodenum and the surgeon should be aware that treatment with a minimalistic approach, with only primary repair, may be ideal.
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Long-term totally implantable catheters (e.g. Port-a-Cath) are frequently used for long-term venous access in children with cancer. The use of this type of catheter is associated with complications such as infection, extrusion, extravasation and thrombosis. Embolism of catheter fragments is a rare complication, but has potential for morbidity. The aim here was to report on two cases in which embolism of fragments of a long-term totally implantable catheter occurred. ⋯ Embolism of fragments of totally implantable catheters is a rare complication that needs to be recognized even in asymptomatic patients.