[Atopic diseases in Brazilian children--etiologic multicentric study]. / Etiologia da doença atópica em crianças brasileiras--Estudo multicêntrico.

In order to determine the etiologic agents involved in atopic diseases in Brazilian children, we have performed this multicentric study in 8 areas in Brazil. We have done prick tests with inhalants and food antigens and analyzed skin tests results, considering positive the wheal mean diameter 3 mm. 22,2% of skin tests were negative and the majority were positive to inhalants: D.pteronyssinus(Dpt) (66.6%) and D. farinae(Df) (66.0%), house dust extract (29.0%), dogs epithelium (19.2%), cat's epithelium (8.8%), feather (5.5%), molds (4.2%), Penicillium sp (2.2%) and Lollium perene (0.6%). We have had 9,1% of food positive tests: cow milk (5.2%), peanut (3.5%), corn (3.2%), cocoa and soya (2.2%), eggs and wheat (1.9%). We have concluded that the domestic mites are the most important agents involved in the etiology of atopic diseases in Brazilian children, and the extracts involved, in line with the sensitization of each geographical area.

[Continuous positive airway pressure (CPAP) with face mask to treat acute respiratory failure]. / Uso do suporte ventilatório com pressão positiva contínua em vias aéreas (CPAP) por meio de máscara nasofacial no tratamento da insuficiência respiratória aguda.

OBJECTIVE: To evaluate the efficacy of continuous positive airway pressure (CPAP) administered by face mask in patients with acute respiratory failure with indication of mechanical ventilation. MATERIALS AND METHOD: Eleven patients (mean age 41.3 years) in acute respiratory failure were admitted in the Respiratory Unit--Hospital São Paulo--Escola Paulista de Medicina. At the admission pH, PaO2, PaCO2, respiratory rate (f), arterial pressure and heart rate were measured. The measurements were repeated with administration of oxygen with a high flow face mask at ambient airway pressure and then with 5 cm H2O of CPAP by face mask. RESULTS: The use of CPAP by face mask significantly improved the arterial blood oxygenation and decreased the respiratory rate (p < 0.05). CONCLUSION: These data allow the conclusion that CPAP administered by face mask improves gas exchange and decreases respiratory rate in patients with acute respiratory failure and may reduce the need for invasive mechanical ventilation.

Mycotic aneurysm caused by Burkholderia pseudomallei: report of a Brazilian strain genetically related to Thai strains.

Melioidosis, a severe infectious disease caused by Burkholderia pseudomallei that is prevalent in Southeast Asia and Northern Australia, has been sporadically reported in Brazil since 2003. We report a case of aortic aneurysm with blood culture positive for B. pseudomallei. The phylogenetic analysis of 16S ribosomal DNA showed this isolate to be evolutionarily grouped with the MSHR346 strains from Thailand.

Silicosis in Brazilian pit diggers: relationship between dust exposure and radiologic findings.

The incidental diagnosis of two cases of silicosis at Messejana Hospital, Fortaleza, capital of Ceará state, triggered a field research conducted with the objective of investigating the incidence of silicosis in pit diggers in four towns in the Ibiapaba Mountain Range, at the state's northwestern area, northeastern Brazil. Out of a universe of 1,050 pit diggers in the area, 366 participated in the study; they were all males ranging in age between 16 and 76 years old (average 39 years). The excavation and the sickening process were described and a dust exposure index in pit diggers (DEIPD) was defined. The study sample indicated a rate of 121 (33.06%) silicotics and possibly silicotics. The radiologic findings were related to the DEIPD and indicated significant prevalence of disease. Furthermore, during the research period, from 1986 to 1989, 30 (34.9%) silicotics died of respiratory failure and wasting of body tissues. The data suggested that these men were afflicted with a severe occupational health problem, possibly scattered throughout a large area in northeastern Brazil, where manual pit excavations occur during the whole year and increase during drought periods.

Uso do suporte ventilatório com pressäo positiva contínua em vias aéreas (CPAP) por meio de máscara nasofacial no tratamento da insuficiência respiratória aguda / Continuous positive airway pressure (CPAP) by face mask to treat acute respiratory failure

Objetivo. O objetivo dos autores foi avaliar o efeito da ventilaçäo com CPAP oferecida por meio de máscara nasofacial como método de suporte ventilatório em pacientes com insuficiência respiratória aguda com critérios de indicaçäo para intubaçäo traqueal. Casuística e Método. Foram estudados 11 pacientes com idade média de 41,3 anos em insuficiência respiratória aguda internados na Unidade Respiratória do Hospital Säo Paulo - Escola Paulista de Medicina. A admissäo, era colhida gasometria arterial em ar ambiente e monitorizava-se freqüência respiratória (f), freqüência cardíaca (FC) e pressäo arterial (PA). Os mesmos parâmetros eram avaliados após oxigenoterapia via máscara facial aberta e com máscara facial de CPAP usando PEEP de 5cm H2O. Resultados. Com o uso de CPAP através de máscara nasofacial, houve melhora significativa dos níveis de PaO2 e diminuiçäo da freqüência respiratória (<0,05), quando comparados aos valores em ar ambiemte e com máscara facial aberta. Conclusäo. Este trabalho permitiu concluir que a máscara facial de CPAP com 5cm H2O foi eficiente em melhorar a oxigenaçäo arterial e diminuir a freqüência respiratória dos pacientes com insuficiência respiratória aguda, proporcionando-lhes maior conforto, constituindo uma medida terapêutica capaz de evitar o suporte ventilatório invasivo.