With this new issue of CLINICS we transform the editorial format of the journal. We are completing the building of a new internet site for the journal, www.clinics.org.br. The journal itself goes into a new format, with an active PDF available for each individual article at our site, at PUBMED CENTRAL and at SCIELO. Moreover an e-book of each issue of CLINICS will become available exclusively at our new site. In this manner we hope to enhance the visibility of the ever improving science that we have been publishing.
In this issue we publish nine articles on clinical science, one of basic research, a review on recent Brazilian publications in infectious diseases and metabolic pathologies, one technical note and three case reports.
Feferbaum et al. report on the growth of forty very low birth weight infants fed with milk from a human milk bank selected according to the caloric and protein value. Ten infants were fed milk from their own mothers (GI), and thirty were fed from a human milk bank > 700 cal/L and 2 g/dL of protein. Growth curves were adjusted using nonlinear regression to the measured growth parameters. They conclude that Human Bank milk allowed a satisfactory growth and good clinical evolution for very low birth weight infants
Gerhard et al. examined the expression of the N-myc downstream-regulated gene 1 protein in benign and malignant lesions of the thyroid gland by immunohistochemistry and found that thyroid carcinomas showed increased immunohistochemical N-myc downstream-regulated gene 1 expression compared to normal and benign thyroid lesions and that expression correlated with more advanced tumor stages.
Ornek et al. investigated The effects of volatile induction and maintenance of anesthesia and selective spinal anesthesia on QT interval, QT dispersion, and arrhythmia incidence through a prospective, randomized, double-blind study conducted forty patients undergoing noncardiac surgery and conclude that although Volatile Induction and Maintenance of anesthesia with sevoflurane might prolong the QTc interval it did not result in arrhythmia, whereas selective spinal anesthesia with bupivacaine was not associated with alterations in the QT interval or arrhythmia.
Azevedo et al. compared the impact of two strategies of glycemic control on the incidence of acute kidney injury in 228 randomly selected critically ill patients and found that intensive insulin therapy and a carbohydrate-restrictive strategy were comparable regarding the incidence of acute kidney injury evaluated using RIFLE criteria.
Carvalho et al. assessed the efficiency of a guidance manual for patients with osteoarthritis of the knee in relation to pain, range of movement, muscle strength and function, active goniometry, manual strength test and function. The manual was applied to thirty-eight adults with osteoarthritis of the knee (≥ 45 years old) who were referred to the physiotherapy service at a university hospital and the authors conclude that even when performed at home without constant supervision, the use of the printed manual for orientation of the exercises for osteoarthritis of the knee was found to be beneficial.
Freitas-Silva et al. compared quality of life, satisfaction with surgery and shoulder-arm morbidity in breast cancer survivors submitted to breast-conserving therapy or mastectomy followed by immediate breast reconstruction. Through a cross-sectional study of women who underwent breast-conserving therapy (n = 44) or modified radical mastectomy and immediate breast reconstruction (n = 26). Quality of life was evaluated with the SF-36 Health Survey Questionnaire. Data suggest that the type of surgery did not affect the occurrence of lymphedema, but that breast-conserving therapy increased the risk of shoulder movement limitation. No differences were found between the two surgical techniques with respect to quality of life or satisfaction with surgery.
Vanderlei et al. analyzed cardiac autonomic modulation in 121 obese and eutrophic children aged 8 to 12 years and found that obese children exhibited modifications in heart rate variability, characterized by a reduction in both sympathetic and parasympathetic activity. These findings stress the need for the early holistic care of obese children to avoid future complications.
Auler Junior et al. conducted a pilot study to evaluate the flotrac/vigileotm system for continuous cardiac output monitoring in patients undergoing regional anesthesia for elective cesarean section. They found no significant hemodynamic effects, except for heart rate and stroke volume changes, which were observed in pregnant women managed with preload and vasopressors when undergoing elective cesarean section and spinal anesthesia.
Kebapcilar et al. endeavored to determine the effect of helıcobacter pylorı eradıcatıon on macrophage mıgratıon ınhıbıtory factor, c-reactıve proteın and fetuın-a levels in 30 infested patiernts compared to 30 H. pylori free controls. Migration inhibitory factor and hs-CRP levels were higher, and fetuin-A levels were lower, in H. pylori-infected patients (p<0.05). Following eradication of H. pylori, migration inhibitory factor and hs-CRP levels were significantly decreased, whereas fetuin-A levels were increased. However, eradication of the organism did not change lipid levels (p>0.05).leading authors to suggest that H. pylori eradication reduces the levels of pro-inflammatory cytokines such as migration inhibitory factor and hs-CRP and also results in a significant increase in anti-inflammatory markers such as fetuin-A.
Hosseini et al. evaluated the effect of chronic administration of l-arginine on the learning and memory of estradiol-treated ovariectomized rats tested in the morris water maze and claim that the observed results allow them to propose that chronic treatment with estradiol enhances spatial learning and memory of ovariectomized rats, and that long term l-arginine treatment attenuates the improvement produced by estradiol.