Carlos Alberto Guimarães

Structured abstracts: narrative review

PURPOSE To summarize the main findings from research on structured abstracts. METHODS A narrative review of all the relevant papers known to the author was conducted. RESULTS Authors and readers judged the structured abstracts to be more useful than traditional ones. In 1987 the Ad Hoc Working Group for Critical Appraisal of the Medical Literature proposed guidelines for informative seven-headings abstracts. In 1990 Haynes et al. reconsidered the structured abstract of clinical research and review articles and proposed revised guidelines. Nowadays, most abstracts are informative, and the most commonly used structure is IMRAD (Introduction, Methods, Results And Discussion) format. CONCLUSIONS There are many variations in the structured-abstract formats prescribed by different journals. But even in recent years, not all abstracts of original articles are structured. More research is needed on a number of questions related to the quality and utility of structured abstracts.

Controle da hemoptise maciça com broncoscopia rígida e soro fisiológico gelado

BACKGROUND: Massive hemoptysis is a high morbidity and high mortality condition, independently of the treatment administered. A variety of methods are used to control the acute bleeding. The instillation of iced saline solution through a rigid bronchoscope was described in 1980. OBJECTIVE: To establish the efficacy of repeated instillations of iced saline solution (4oC) using a rigid bronchoscope for the acute control of massive hemoptysis. METHOD: A group of 94 patients with massive hemoptysis was treated with rigid bronchoscopy and lavage with iced saline solution of the actively bleeding lung. The absence of bleeding recurrence within the following 15 days was considered a therapeutic success. The causes of hemoptysis included: pulmonary tuberculosis: 78 (83%), among which 48 had active disease, and 30 had tuberculosis sequelae, bronchiectasis (6), lung cancer (5), intracavitary aspergilloma (3), and unknown (2). The bleeding site was found in 93 patients (99%). The mean saline volume used in the bronchoscopy was 528 mL, ranging from 160 mL to 2,500 mL. RESULTS: All patients stopped bleeding during the procedure. Fifteen patients were submitted to some kind of procedure (surgery, embolization, or radiation therapy) within 15 days, and the efficacy of lavage could not be assessed. Twenty of the 79 patients followed-up for more than 15 days had recurrence of hemoptysis. Cold saline lavage was repeated once in 13 patients, twice in 6 patients, and 3 times in one patient. CONCLUSION: The control of tracheobronchial hemorrhage through bronchoscopy and lavage with iced saline is an effective procedure and can be repeated in case of re-bleeding. It is a safe procedure, and allows the definitive treatment to occur in better clinical conditions.

Perfurações do esôfago

BACKGROUND: To correlate time period with death from esophageal perforation and tratment. METHODS: During the past 14 years (1987-2001), a series of 41 esophageal perforations, treated at Hospital do Andarai, have been reported, and were studied. RESULTS: In 19 patients (46%), perforation was located in cervical esophagus, in 20 (49%) at the thoracic portion and in two (5%) at the intraabdominal segment. Twenty seven sustained gunshot wounds and two suffered stab wounds, seven followed esophageal endoscopy, one was due to foreign body, two were spontaneous, one ocurred during fixation of spinal colummn and one was postpneumonectomy. In the first 24 hours, mortality rate was 4%. Among those seen later, mortality rate was 44%.The interval from perforation to operation was less than 24 hours in 23 (56%) patients, and more than 24 hours in 18 (44%). CONCLUSIONS: The most important prognostic item in the treatment of these patients was the time between perforation and surgery.

Práticas cirúrgicas baseadas em evidências: apendicectomia laparoscópica versus a céu aberto

Surgeons are told that they need not only read journal articles, but also understand them and make a critical appraisal of their validity. They offer better care if they are able to appraise critically the original literature and apply the results to their practice. This is a first article of a series - Evidence-Based Surgical Practices - which focus on issues of Evidence-Based Surgery.

Agenesis or pseudoagenesis of the dorsal pancreas

The authors present an evidence-based case report of a patient with agenesis or pseudoagenesis of the dorsal pancreas.

DESCRITORES EM CIÊNCIAS DA SAÚDE NAS TESES E DISSERTAÇÕES DE MESTRADO, NA ÁREA DE DOENÇAS RESPIRATÓRIAS

The process of indexing consisted of two phases: firstly, to identify and represent the intellectual contents of a document; and secondly, the translation of the subject analysis into a specified languague, with the aid of subject headings. At the Instituto de Doencas do Torax da UFRJ medical library, the indexing of biomedical journals and theses was performed through a controlled vocabulary - the DeCS (Subject Headings on Health Sciences). The purpose of this study was to identify if the authors of Master Degree thesis on respiratory diseases were using the DeCS for indexing. The subject headings of 29 Master theses from 1990 through 1996 were studied. The data collection showed that 29 authors employed 101 subject headings (3,48 headings/author). Four (14%) of authors utilized adequate subject headings from the DeCS. In conclusion: fourteen per cent of authors of Master theses on respiratory diseases employed correctly the subject headings.

Induced sputum in HIV- infected patients: diagnosis of acute pulmonary diseases

OBJECTIVE To make a narrative review of the accuracy of induced sputum for diagnosis of pulmonary disease in HIV-infected patients. DATA SOURCES The MEDLINE, LILACS, EMBASE and the Cochrane Library were searched. reference lists, abstracts of conference proceedings and scientific meetings were hand searched. METHODS STUDY SELECTION Fifteen articles that specifically addressed the stated purpose were selected. DATA EXTRACTION Yield of sputum induction and fiberoptic bronchoscopy with bronchoalveolar lavage were analyzed using explicit methodologic to evaluate the quality of clinical trials. RESULTS Sputum induction demonstrated 55.5% sensitivity and 98.6% specificity to Pneumocystis pneumonia. Sensitivity of sputum induction was significantly higher with immunofluorescence than with cytochemical staining (67.1 versus 43.1%). Sputum induction for diagnosis of bacterial pneumonia demonstrated 60% sensitivity, 40% specificity, 80% positive predictive value, 20% negative predictive value and 56% accuracy. In relation to tuberculosis, sputum induction demonstrated 36% sensitivity, 100% specificity, 100% positive predictive value and 54.2% negative predictive value. CONCLUSION Sputum induction seems to be effective and safe for diagnosis of pulmonary diseases in HIV-infected patients.

Práticas cirúrgicas baseadas em evidências: tomografia computadorizada helicoidal no diagnóstico da apendicite aguda

Os cirurgioes sao instados a nao somente ler os artigos dos periodicos, mas tambem a compreende-los e analisa-los criticamente quanto a validade. Eles cuidam melhor dos seus pacientes se sao capazes de analisar criticamente a literatura e aplicar os resultados a sua pratica. Este e o segundo artigo de uma serie - Praticas Cirurgicas Baseadas em Evidencia - que tem por objetivo apresentar a avaliacao critica de um teste diagnostico.

Brazilian Scientific Journals in Surgery: quality control in the abstract structure of non-experimental articles

PURPOSE To evaluate the quality of abstracts of original non-experimental research articles in Brazilian Journals in Surgery. METHODS Convenience sample of 471 abstracts of original research articles from six Brazilian surgical journals indexed in Thomson Reuters (ISI) Web of Knowledge. The quality of abstracts was measured against a checklist of eight evaluation criteria, which were divided into 32 categories. The total score for each abstract was obtained by summing the score of all criteria present. The overall mean score was also determined. RESULTS The overall mean score of abstract quality was that of a good abstract. Most of the abstracts contained some information from each of the eight basic categories of an abstract. All abstracts were structured ones. CONCLUSION The overall quality, for abstracts of original articles of six Brazilian non-experimental journals in surgery, was classified as good.

Uniform requirements for manuscripts submitted to biomedical journals: writing and editing for biomedical publication

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