Revista paulista de medicina最新文献

Aiming to set out the occurrence of the Adult Respiratory Distress Syndrome (ARDS) in the neonatal period, and according to recent descriptions in literature, we prospectively analyzed 5 cases. The criterion adopted to characterize ARDS was the expanded definition of the syndrome suggested by Murray & Matthay, (10), conjointly with non-invasive cardiac monitoring, to exclude pulmonary edema resulting from myocardial dysfunction. For each case, evolution was briefly described, as well as the predisposing conditions associated to the clinical score punctuation for diagnosis, stressing the importance of adequate identification and fastest possible management of such source of systemic effects. Upon admission at the intensive care unit (Ped. ICU), the five cases were either related to sepsis or to the syndrome of multiple organ failure, or to both. Both syndromes were essentially triggered by severe anoxia neonatorum, respiratory distress of the newborn and/or previous hospitalization with hypoxemia and use of a higher inspired fraction of oxygen. The primary causes of death were related to uncontrolled infection or shock, and not directly related to pulmonary failure.

In order to evaluate the effects of iron therapy on weight and height, we studied 65 children with a mean age of 32 months who were assigned to oral iron therapy with 4-5 mg/kg/day of elemental iron as ferrous sulfate or ferric hydroxide polymaltose for 8 weeks. The medicine was distributed to the patients and its consumption was checked fortnightly. Statistically significant increases in hemoglobin, serum iron and transferrin levels and in transferrin saturation and ferritin levels were observed. The weight-for-age and weight-for-height Z-scores were determined using the ANTHRO computer software (CDC/WHO) which, based on birth and examination dates, permits age estimates with centesimal accuracy for the months using the National Center for Health Statistics (NCHS) standards. Mean Z-scores before and after iron therapy demonstrated a significant increase in weight-for-age (Z = -0.53 after, P < 0.01) and weight-for-height (Z = 0.19 before and -0.08 after, P < 0.01) indices, but not in the height-for-age index (Z = -0.46 before and Z = -0.46 after iron therapy). A significant decrease in the number of children with inadequate weight-for-age (< 90%)) and weight-for-height (< 90%) indices was observed after iron therapy in patients aged less than 60 months. In conclusion, oral iron therapy for a period of 8 weeks led to a significant weight gain.

The frequency of "pararama" occupational accidents between 1988 and 1990 as well as some associated clinical manifestations are herein reported. Data were collected at an industrial rubber tree plantation, in the northern part of Brazil and compared with data similarly collected from 1971 to 1974 on the same plantation, before starting protective measures. "Pararama" is the popular name of the larval form of a native insect of the Amazonian region, Premolis semirufa. During the study period, the annual average number of latex extractors was 337 and 60 accidents caused by "pararama" were registered. The annual average number of accidents per worker from 1971 to 1974 was 0.117 and in the period of this study, 0.063 (p = 0.061). Nineteen injured subjects were clinically evaluated and 13 of them were symptomatic. There was a statistically significant association between multiple accidents and the presence of symptoms (p = 0.001). "Pararamose", an occupational arthropathy, which may evolve with functional impairment of the affected joint, can be prevented with the latex extractors education and the institution of prophylactic measures, such as the use of gloves, boots and protective glasses.