São Paulo medical journal = Revista paulista de medicina
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Polymorphisms in genes involved in folate metabolism may modulate the maternal risk of Down syndrome (DS). This study evaluated the influence of a 19-base pair (bp) deletion polymorphism in intron-1 of the dihydrofolate reductase (DHFR) gene on the maternal risk of DS, and investigated the association between this polymorphism and variations in the concentrations of serum folate and plasma homocysteine (Hcy) and plasma methylmalonic acid (MMA). ⋯ The 19-bp deletion polymorphism of DHFR gene was not a maternal risk factor for DS and was not related to variations in the concentrations of serum folate and plasma Hcy and MMA in the study population.
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The level of evidence and methodological quality of articles published in medical journals are important aids for clinicians in decision-making and also affect journals' impact factor. Although systematic reviews (SR) are considered to represent the highest level of evidence, their methodological quality is not homogeneous and they need to be as carefully assessed as other types of study. This study aimed to assess the design and level of evidence of articles published in 2007, in two recently indexed Brazilian journals (Clinics and Revista da Associação Médica Brasileira), and to evaluate the methodological quality of the SRs. ⋯ The main design types among the published papers were observational and experimental studies and narrative reviews. SRs accounted for a small proportion of the articles and had low methodological scores. Brazilian medical journals need to encourage publication of greater numbers of clinically relevant papers of high methodological quality.
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Review Case Reports
Histoplasmosis in the nasal septum without pulmonary involvement in a patient with acquired immunodeficiency syndrome: case report and literature review.
Histoplasmosis is a fungal disease caused by inhaling spores of the fungus Histoplasma capsulatum. The spores can be found in soil contaminated with bird, bat or chicken feces. Histoplasmosis occurs worldwide and is one of the most common pulmonary and systemic mycoses. ⋯ We report here the case of a 37-year-old man with acquired immune deficiency syndrome and histoplasmosis in the nasal septum, without pulmonary involvement, that evolved rapidly to disseminated infection, multiple organ failure and death.
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Kikuchi-Fujimoto disease (KFD) manifests in most cases as unilateral cervical lymphadenomegaly, with or without accompanying fever. The disease mainly affects young women and has a self-limited course. It is more common in oriental countries, with few reports of its occurrence in Brazil. KFD should be included in the differential diagnosis of suspected cases of viral infections, tuberculosis, reactive lymphadenitis, systemic lupus erythematosus and metastatic diseases. It can be histologically confused with lymphoma. The disease is benign and self-limiting and an excisional biopsy of an affected lymph node is necessary for diagnosis. There is no specific therapy. ⋯ This study reports on three cases of non-Asian female patients with KFD who were attended at our service between 2003 and 2006. A review of the literature was carried out, with a systematic search on this topic, with the aim of informing physicians about this entity that is manifested by cervical masses and fever.
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Stroke is a relevant issue within public health and requires epidemiological surveillance tools. The aim here was to validate a questionnaire for evaluating individuals with stroke symptoms in the Stroke Morbidity and Mortality Study (Estudo de Mortalidade e Morbidade do Acidente Vascular Cerebral, EMMA), São Paulo, Brazil. ⋯ The stroke symptom questionnaire is a useful tool and can be applied by trained interviewers with the aim of identifying community-dwelling stroke patients, through the structure of the Family Health Program.