Cácio Ricardo Wietzycoski

Fatores de risco para sibilância recorrente em menores de 13 anos no Sul do Brasil

OBJECTIVE To study the prevalence of and major factors associated with recurrent wheezing in children younger than 13 years of age in the urban area of Rio Grande, in the state of Rio Grande do Sul, Brazil. METHODS The presence of recurrent wheezing was investigated in a cohort as part of a cross-sectional study that was begun in 1997 that focused on the morbidity from respiratory diseases in children then between 0 and 5 years of age. During home visits in 2004 a standardized questionnaire given by trained interviewers was used to obtain information concerning the familys socioeconomic and living conditions, maternal care during pregnancy and delivery, and childrens current and previous morbidity patterns. The statistical analysis included the calculation of the odds ratio (OR) and 95% confidence interval (95% CI), with nonconditional logistic regression adjustment for potential confounding factors, according to a predefined hierarchical model. RESULTS Of the 775 children studied in 1997, 685 were located in 2004 (loss of 11.6%). In this group, the prevalence of recurrent wheezing at the time of the interview was 27.9%. After adjustment, the risk factors were: current rhinitis (OR=45.7; 95% CI: 24.2 to 86.5), use of wood stove for cooking (OR=2.7; 95% CI: 1.4 to 4.9), childs history of acute respiratory infection (OR=2.1; 95% CI: 1.3 to 3.5), bottle feeding (OR=2.1; 95% CI: 1.1 to 3.8), history of asthma in siblings (OR=1.9; 95% CI: 1.2 to 3.2), maternal history of asthma (OR=1.8; 95% CI: 1.1 to 2.9), and fewer than six prenatal medical consultations (OR=1.6; 95% CI: 1.1 to 2.4). Paternal schooling<9 years was a protective factor against recurrent wheezing (OR=0.6; 95% CI: 0.4 to 0.9). CONCLUSIONS These results suggest that the management of recurrent wheezing and asthma must consider checking for and simultaneously treating rhinitis. The measures to minimize the effects of recurrent wheezing should include educational and treatment programs focusing on asthma.

Pólipo fibrovascular gigante do esôfago: desafio diagnóstico

Fibrovascular polyps of the esophagus are rare benign tumors, with just over 100 cases reported in the literature. Are pedunculated, intraluminal, covered by normal mucosa and composed of vascular, adipose and fibrous tissue3. It originates usually on the proximal third of the esophagus and can reach large dimensions. The symptoms only appear when the polyp becomes large. There are reports of sudden death from asphyxiation after regurgitation of the tumor11. The incidence is higher in men, 50 to 60 years3,10. In view of the debilitating symptoms and the risk, resection is indicated and usually performed by cervical esophagotomy3. Endoscopic surgery is reserved for cases of small polyps.

IMPROVEMENT IN OXIDATIVE STRESS AFTER DUODENOJEJUNOSTOMY IN AN EXPERIMENTAL MODEL OF TYPE 2 DIABETES MELLITUS

ABSTRACT Background: Type 2 Diabetes Mellitus is a multifactorial syndrome with severe complications. Oxidative stress is accepted as a causal factor of chronic complications Aim: To demonstrate alterations in oxidative stress after metabolic surgery. Methods: Twenty-four 2-day-old Wistar rats were used. In 16, Type 2 Diabetes Mellitus was induced by 100 mg/kg streptozotocin injection. The development of diabetes was confirmed after 10 weeks using an oral glucose tolerance test. Eight diabetic rats composed the diabetic surgical group; the remaining eight composed the diabetic group. Eight animals in which diabetes was not induced formed the clinical control group. The Marchesini technique was used in the diabetic surgical group. After 90 days, the rats were sacrificed, and the oxidative stress markers were measured. Results: Thiobarbituric acid reactive substances, superoxide dismutase and catalase were significantly reduced in the diabetic surgical group compared to the diabetic group. Conclusion: The duodenojejunostomy was effective in controlling the exacerbated oxidative stress present in diabetic rats.