Applicability of lung ultrasound in COVID-19 diagnosis and evaluation of the disease progression: A systematic review.

INTRODUCTION: The COVID-19 pandemic originated in China and within about 4 months affected individuals all over the world. One of the limitations to the management of the COVID-19 is the diagnostic imaging to evaluate lung impairment and the patients' clinical evolution, mainly, in more severe cases that require admission into the intensive care unit. Among image examinations, lung ultrasound (LU) might be a useful tool to employ in the treatment of such patients. METHODS: A survey was carried out on PubMed to locate studies using the descriptors: ((Lung ultrasound OR ultrasound OR lung ultrasonography OR lung US) AND (coronavirus disease-19 OR coronavirus disease OR corona virus OR COVID-19 OR COVID19 OR SARS-CoV-2)). The period covered by the search was November 2019 to October 2020 and the papers selected reported LU in COVID-19. RESULTS: Forty-three studies were selected to produce this systematic review. The main LU findings referred to the presence of focal, multifocal and/or confluent B lines and the presence of pleural irregularities. CONCLUSIONS: The use of LU in the evaluation of patients with COVID-19 should be encouraged due to its intrinsic characteristics; a low cost, radiation free, practical method, with easy to sanitize equipment, which facilitates structural evaluation of lung damage caused by SARS-CoV-2. With the increase in the number of studies and the use of ultrasound scans, LU has been shown as a useful tool to evaluate progression, therapeutic response and follow-up of pulmonary disease in the patients with COVID-19.

[Accidents with children in the region of Campinas, Brazil] / Acidentes com crianças e sua evolução na região de Campinas, SP.

OBJECTIVE: Evaluate prospectively the frequency and cause of accidents in children seen at the Pediatric Emergency Service of a University Hospital. The main aim is to subsidize the development of education and preventive programs.METHODS: Data of all children, less than 14 years old, from March 1997 to February 1998 were collected with a standard questionnaire.RESULTS: Accidents in 3,214 children were studied, 11.4% of the total. Males predominated (62.1%). Accidents were more common in the 9 to 13 year age group (33.4%), 2 to 5 year age group (27.2%) and 5 to 9 year group (25,5%). Traumatism, mainly due to falls, was the cause in 74%. Head trauma was important in the younger than 1 year, and trauma involving the extremities in the 9 to 13 age group. Bites and stings predominated in the 5 to 13 year age group, intoxication and foreign bodies in the 2 to 5 years age group. Burns predominated in the younger than 5 years. Most accidents (89.7%) were of low complexity but 20 patients had to be admitted to an ICU and 4 died in the Emergency Room.CONCLUSIONS: The child older than 9 years, male, with trauma of the extremities due to a fall was the most frequent case of accident. Prevention programs must be targeted to specific age ranges. Accidents are responsible for a great part of the overload of Emergency Services as 89.7% were of low complexity. Primary care health facilities personnel must be trained to manage accidents that do not involve complex procedures.

A double-blind comparison of the gastroduodenal safety and efficacy of diclofenac and a fixed dose combination of diclofenac and misoprostol in the treatment of rheumatoid arthritis.

This double-blind, parallel group study was conducted to evaluate the gastroduodenal safety and antiarthritic efficacy of a fixed combination of diclofenac sodium 50 mg and misoprostol 200 mcg, compared with a combination of diclofenac 50 mg and placebo. Three hundred and thirty-nine patients with rheumatoid arthritis and no significant gastric or duodenal mucosal damage were enrolled and received study medication (diclofenac/misoprostol, 164; diclofenac/placebo, 175) BID or TID for 12 weeks. Posttreatment gastroduodenal endoscopic examinations revealed ulcers in 11% of the diclofenac/placebo group, compared with only 4% of the diclofenac/misoprostol group (p = 0.034). Four-weekly assessments of arthritic condition revealed no clinically or statistically significant treatment differences. It was concluded that diclofenac/misoprostol caused significantly less gastroduodenal damage than diclofenac, but was as effective as diclofenac alone in the treatment of rheumatoid arthritis.

Kidney transplantation: the use of abnormal kidneys.

We transplanted 6 anatomically abnormal kidneys: a horseshoe kidney that after division was transplanted into 2 recipients; 1 kidney with ureteral stones and hydronephrosis; 1 ectopic and 1 hydronephrotic kidney; 2 kidneys with extensive ureteric lesions, donated as free organs. All these kidneys ultimately had normal function in the recipients, long-term in 4.2 patients died but in neither was the death caused by the renal abnormality.

Nutritional requirements of Corynebacterium pyogenes.

The nutritional requirements of Corynebacterium pyogenes (strains C100, 5, and 1909), a commonly encountered animal pathogen, were determined in this study. A semidefined medium (SDM) containing glucose, HCO3-, hemin, charcoal-treated Trypticase, and a defined mixture of purines and pyrimidines, amino acids, and minerals which supported optimal growth of C. pyogenes was employed in all nutritional studies. Adenine and uracil were required for optimal growth of strains 5 and C100 but were not required for strain 1909. Riboflavin and nicotinic acid were required for good growth of all three strains; biotin and thiamin were stimulatory but did not appear to be required for growth. Hemin and NaHCO3 were stimulatory for growth, whereas lipoic acid and Tween 80 were neither stimulatory nor required for growth. The replacement of Trypticase with a specific peptide fraction (obtained by fractionation of Trypticase on Sephadex G-25) rich in dipeptides gave growth comparable to that in SDM, indicating a peptide requirement for the growth of C. pyogenes. It was of considerable interest that growth comparable to that in SDM was obtained when Trypticase was replaced by inositol (1 microgram/ml of SDM).

Cisto parameatal: apresentacao de um caso. / Parameatalcyst: report of a case

Os autores apresentam um caso de cisto parameatal; e escassa a descricao de casos semelhantes na literatura. E feito uma revisao sobre sua etiologia e tratamento

Anestesia em pacientes com insuficiencia renal e uremia. / Anesthesia in patients with renal failure and uremia

Estudamos, retrospectivamente, 52 pacientes uremicos, por insufuciencia renal cronica, submetidos a 102 anestesias para cirurgias de grande porte (duracao media 195.5 +/- 76,3 minutos), analisando e comparado as alteracoes da potassemia durante diferentes tecnicas anestesicas. Hemodialise foi realizada 12 horas antes da cirurgia, exceto quando os pacientes eram admitidos para transplante de rim de cadaver, nos quais o objetivo era corrigir as alteracoes de azotemia e obter, com transfusao de hemacias, valores de hematocritos em torno de 25% (X = 27.0; DP 6,6); o potassio serico que antecedeu a cirurgia foi de 4.6 =/- 0,9 mEq/1. A associacao anestesica mais comumente empregada foi halotano, succinilcolina venosa continua (63% dos casos), seguindo-se a adicao de oxido nitroso e succinilcolina venosa continua.Nao houve obito anestesico apesar de duas paradas cardiacas e dos tres episodios de insuficiencia respiratoria imediata, que foram de curta duracao e de recuperacao espontanea. Ocasionalmente, a potassemia pos-operatoria imediata aumentou de 1.4 mEq/1, porem, em media, as alteracoes nao foram significativas e nao tiveram correlacao com as paradas cardiacas observadas

Chemically defined growth medium for Corynebacterium pyogenes.

A chemically defined medium and a relatively simple semidefined medium (SDM) which allow good growth of Corynebacterium pyogenes, a nutritionally fastidious animal pathogen, were described. The SDM contained glucose, trypticase, yeast extract, hemin, minerals, cysteine x HCl, and NaHCO3. To obtain a chemically defined medium, yeast extract in SDM was replaced with a defined mixture of nucleic acid bases, vitamins, amino acids, and trace minerals, and trypticase was replaced by myo-inositol (1 microgram/ml of medium).