São Paulo medical journal = Revista paulista de medicina
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Review Meta Analysis
Diagnostic accuracy of sonography for pleural effusion: systematic review.
The initial method for evaluating the presence of pleural effusion was chest radiography. Isolated studies have shown that sonography has greater accuracy than radiography for this diagnosis; however, no systematic reviews on this matter are available in the literature. Thus, the aim of this study was to evaluate the accuracy of sonography in detecting pleural effusion, by means of a systematic review of the literature. ⋯ In different populations and clinical settings, sonography showed consistently high sensitivity, specificity and accuracy for detecting fluid in the pleural space.
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The association between fibular dimelia and mirror polydactyly of the foot is considered to be a very rare lower-limb abnormality. On the other hand, VACTERL is an acronym for a nonrandom association of congenital anomalies for which the etiology is still poorly understood. ⋯ The patient was a seven-month-old white girl whose mother had used misoprostol in the second month of pregnancy to induce abortion. On clinical evaluation, she was small for her age and presented hypotonia, anteverted nares, long philtrum and carp-like mouth. Her left hand had a reduction defect, with absence of the extremities of the second, third and fifth fingers and camptodactyly of the fourth finger. The ipsilateral lower limb presented significant shortening, especially rhizomelic shortening. Her left foot had a mirror configuration with seven toes and no identifiable hallux. The pelvis was hypoplastic. Esophageal atresia with tracheoesophageal fistula and imperforate anus were detected during the neonatal period. Abdominal ultrasound identified agenesis of the right kidney and left pyelocaliceal duplication. Radiographic evaluation on the left side showed iliac and femoral hypoplasia, absence of the tibia with a duplicated fibula and seven metatarsals and toes with no identifiable hallux on the foot. Echocardiography demonstrated an atrial septal defect. Based on the literature, we believe that the spectrum of malformations presented by our patient may be related to the vascular disruptive effect of the misoprostol. However, we cannot rule out the possibility that this association might simply be a coincidence.
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child development is negatively influenced by multiple risk factors associated with poverty, thus indicating the importance of identifying the most vulnerable groups within populations that are apparently homogeneous regarding their state of socioeconomic deprivation. This study aimed to identify different levels of poverty in a population of low socioeconomic condition and to ascertain their influence on infants' neuropsychomotor development. ⋯ infants of more precarious socioeconomic status more frequently present suspected developmental delay. Development monitoring and intervention programs should be encouraged for this subgroup, thereby providing these children with a better chance of becoming productive citizens in the future.
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magnesium ion concentration is directly related and phosphorus ion concentration is inversely related to calcemia. The aim of this study was to evaluate the evolution of magnesium and phosphorus ion levels in patients undergoing thyroidectomy and correlate these with changes to calcium concentration. ⋯ despite the postoperative changes, neither magnesium nor phosphorus ion levels had any role in post-thyroidectomy calcemia.
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It has been suggested that there has been a large increase in breast cancer incidence among young women over the last decade. The aim of this study was to describe the incidence of breast cancer among young women up to 39 years of age in Goiânia, between 1988 and 2003, and to compare this with other age groups. ⋯ The incidence of breast cancer among young women in Goiânia has been increasing significantly, although this change was similar to the increase in other age groups.