São Paulo medical journal = Revista paulista de medicina
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Case Reports
Azacitidine and lenalidomide as an alternative treatment for refractory acute myeloid leukemia: a case report.
Refractory acute myeloid leukemia (AML) is a difficult disease to control with second or third-line chemotherapy regimens. In this report, we describe using azacitidine in combination with lenalidomide as salvage therapy. ⋯ Azacitidine plus lenalidomide can be a therapeutic option for patients with refractory AML, as illustrated in this case.
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Chronic obstructive pulmonary disease (COPD) is a respiratory disease of high prevalence and socioeconomic impact worldwide. It affects approximately 16% of the population of São Paulo. The incidence of COPD is still unknown in Brazil. The aim of this study was to estimate new cases of COPD in a population-based sample in São Paulo, Brazil, using three different spirometric diagnostic criteria, and to assess the concordance between these criteria. ⋯ The incidence of COPD after a nine-year follow-up was high, but varied according to the spirometric criterion used. The agreement between the criteria for identifying new cases of the disease ranged from 35% to 60%.
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This research project arose from a proposal made to the teachers by the students of a medical course at a federal university in Brazil, from their personal experiences regarding the skills and competencies that should be developed during the obstetrics and gynecology (OBG) stage of the internship. The objective here was to develop the matrix of skills necessary for training good general physicians in the medical course. ⋯ A competency matrix that standardizes the minimum requirements that interns should be capable of putting into practice after concluding the OBG stage is a valuable tool for ensuring student performance and a fair and rigorous assessment for them, thereby seeking to train good general physicians who meet the community's needs.
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Testicular torsion is a medical and urological emergency because it can lead to loss of the organ. The theory of seasonal testicular torsion occurrence is based on studies from institutions located in cold and temperate regions. The objective here was to determine whether cold weather is associated with higher incidence of testicular torsion in a tropical country, such as Brazil. ⋯ Testicular torsion follows a seasonal association even in a tropical country, and is more frequent in the colder months of the year, namely fall and winter, when almost three-quarters of the cases occurred. These observations add further evidence that cold weather has an etiologic role in testicular torsion occurrence.
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Sunitinib is an antiangiogenic drug that has been approved for treating metastatic renal cancer. Its action as a tyrosine kinase inhibitor of vascular endothelial growth factor receptors (VEGFRs) and other angiogenesis receptors may lead to adverse effects such as hypertension and heart failure. However, reports in the literature on an association between sunitinib therapy and acute aortic dissection are rare. ⋯ Hypertension is a common event when antiangiogenic drugs are used in oncology. However, knowledge of other severe cardiovascular events that may occur in these patients, such as acute aortic dissection, is important. Adequate control over arterial pressure and frequent monitoring of patients during the first days of antiangiogenic therapy is essential for early diagnosis of possible adverse events.