São Paulo medical journal = Revista paulista de medicina
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Randomized Controlled Trial
Preoperative warming combined with intraoperative skin-surface warming does not avoid hypothermia caused by spinal anesthesia in patients with midazolam premedication.
Inadvertent perioperative hypothermia is common during spinal anesthesia and after midazolam administration. The aim of this study was to evaluate the effects of intraoperative skin-surface warming with and without 45 minutes of preoperative warming in preventing intraoperative and postoperative hypothermia caused by spinal anesthesia in patients with midazolam premedication. ⋯ Forty-five minutes of preoperative warming combined with intraoperative skin-surface warming does not avoid but minimizes hypothermia caused by spinal anesthesia in patients with midazolam premedication.
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Review Case Reports
Sudden sensorineural hearing loss and vertigo associated with arterial occlusive disease: three case reports and literature review.
Sudden sensorineural hearing loss and vertigo (SSNHLV) has multifactorial causes, of which viral, autoimmune and vascular insufficiency are the most common. The therapeutic management for SSNHLV includes antiviral drugs, corticosteroids, vasodilators, normovolemic hemodilution therapy and hyperbaric oxygen therapy. ⋯ Here, we present our experience with three cases managed with interventional treatment and conduct a review and discussion on the relevant literature. We conclude that investigation of vertebrobasilar and carotid occlusive diseases is necessary in patients over 50 years of age who present SSNHLV, mild neurological symptoms and a history of arteriosclerosis, high blood pressure or thrombosis.
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Comparative Study
Evaluation of early hospital discharge after allogeneic bone marrow transplantation for chronic myeloid leukemia.
The increasing number of patients waiting for bone marrow transplantation in our service led to the implement of an early hospital discharge program with the intention of reducing the interval between diagnosis and transplantation. In this study we analyzed the results from early discharge, with outpatient care for patients with chronic myeloid leukemia who underwent allogeneic bone marrow transplantation. ⋯ This partially outpatient-based hematopoietic stem cell transplantation program allowed an increased number of transplantations in our institution, in cases of CML and other diseases, since it reduced the median length of hospital stay without increasing morbidity and mortality.
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Quantification of clinical signs such as the presence or absence of pallor at clinical examination is a key step for making diagnoses. The aim was, firstly, to evaluate two methods for anemia diagnosis by physical examination: four-level evaluation (crosses method: +/++/+++/++++) and estimated hemoglobin values, both performed by medical students and staff physicians; and secondly, to investigate whether there was any improvement in assessment accuracy according to the number of years in clinical practice. ⋯ This study showed that estimated hemoglobin was more accurate than evaluation by the four-level method. The number of years in clinical practice did not improve the accuracy of clinical examination for anemia.