São Paulo medical journal = Revista paulista de medicina
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Review Meta Analysis
Risk of persistent high-grade squamous intraepithelial lesion after electrosurgical excisional treatment with positive margins: a meta-analysis.
Even if precursor lesions of cervical cancer are properly treated, there is a risk of persistence or recurrence. The aim here was to quantify the risks of persistence of high-grade intraepithelial squamous lesions, one and two years after cervical electrosurgical excisional treatment with positive margins. ⋯ This meta-analysis confirms the importance of positive margins as an indicator of incomplete treatment after the first year of follow-up and highlights the need for appropriately chosen electrosurgical techniques based on disease location and extent, with close surveillance of these patients.
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Randomized Controlled Trial
Effectiveness of intra-articular lidocaine injection for reduction of anterior shoulder dislocation: randomized clinical trial.
Shoulder dislocation is the most common dislocation among the large joints. The aim here was to compare the effectiveness of reduction of acute anterior shoulder dislocation with or without articular anesthesia. ⋯ ISRCTN27127703.
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Review Case Reports
Stridor and respiratory failure due to tracheobronchomalacia: case report and review of the literature.
Tracheobronchomalacia (TBM) results from structural and functional abnormalities of the respiratory system. It is characterized by excessive collapse: at least 50% of the cross-sectional area of the trachea and main bronchi. In this paper, we present a rare case of a patient with TBM who first presented with stridor and respiratory failure due to exacerbation of chronic bronchitis. ⋯ TBM is fatal and often underdiagnosed. In COPD patients, stridor and respiratory failure may be helpful signs that should alert physicians to consider TBM as an early diagnosis. Thus, these signs may be important for optimizing the treatment and evolution of such patients.
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Pregnancies complicated by diabetes are associated with increased numbers of maternal and neonatal complications. Hospital costs increase according to the type of care provided. This study aimed to estimate the cost-benefit relationship and social profitability ratio of hospitalization, compared with outpatient care, for pregnant women with diabetes or mild hyperglycemia. ⋯ Decision-tree analysis confirmed that successful treatment avoided costs at the hospital. Cost-benefit analysis showed that outpatient management was economically more advantageous than hospitalization. The social profitability of both treatments was greater than one, thus demonstrating that both types of care for diabetic pregnant women had positive benefits.
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Head and neck cancer is the fifth most common type of cancer worldwide. The objective of this study was to evaluate the clinical and epidemiological parameters in a head and neck surgery service. ⋯ The cancer that affects patients assisted by the head and neck surgery service occurs mainly men, smokers and alcohol abusers, and the oral cavity and larynx are the sites with the highest incidence. The high rate of patients with stages III and IV indicates late diagnosis by the treatment centers, which reflects the need for prevention education campaigns for early diagnosis of the disease.