clinicaltrials.gov Identifier: NCT00265356.
We determined the prevalence of asthma, rhinitis, and eczema among Brazilian children using the standardized protocol of the International Study on Asthma and Allergies in Childhood (ISAAC) to facilitate the comparison of our results with other studies using the ISAAC methodology. We conducted a cross-sectional study from June to October 1994 to determine the prevalence of asthma, rhinitis, and eczema in 5182 school children aged 7-8 years and 13-14 years residing in the Brazilian towns of Santa Maria and Itabira (iron-mining cities located in Minas Gerais). Parents completed questionnaires at their child's school in the presence of trained interviewers. The cumulative prevalence of doctor-diagnosed asthma was 4.6% for all ages with no significant difference between the age groups. In general, there was a higher prevalence of symptoms in the younger age group than the older. The prevalence of wheezing in the previous 12 months was 14.3% (7-8 years old) and 9.3% (13-14 years old) (p < 0.01), of chronic cough in the previous 12 months was 25.6% (7-8 years old) and 22.1% (13-14 years old) (p < 0.01), and of nighttime cough in the previous 12 months was 22.3% (7-8 years old) and 19.4% (13-14 years old) (p < 0.05). Overall the prevalences of asthma and wheezing symptoms in the previous 12 months were higher for boys than girls (5.2% vs. 3.9% for asthma, p < 0.01, and 13.2% vs. 10.6% for wheezing, p < 0.01, respectively). These results suggest that asthma-related respiratory illnesses affect a substantial part of the childhood population in Itabira and Santa Maria, Minas Gerais. Some factors such as male gender and younger age may be associated with an increase risk for chronic respiratory symptoms. Prevalences of asthma and allergic diseases in these Brazilian cities on the basis of self-reporting of symptoms and of one's medical history may more accurately portray the true prevalence of asthma than the use of medical records.
Background: With modern advancements in preoperative imaging for liver surgery, intraoperative ultrasonography (IOUS) may be perceived as superfluous. Our aim was to determine if IOUS provides new information that changes surgical strategy in hepatic resection. Methods:We retrospectively analyzed 121 consecutive liver resections performed at a single institution. Preoperative computed tomography and/or magnetic resonance imaging determined the initial surgical strategy. The size, location and number of lesions were compared between IOUS and preoperative imaging. Reviewing the operative report helped determine if new IOUS findings led to changes in surgical strategy. Pathology reports were analyzed for margins. Results:Of 121 procedures analyzed, IOUS was used in 88. It changed the surgical plan in 15 (17%) cases. Additional tumours were detected in 10 (11%) patients. A change in tumour size and location were detected in 2 (2%) and 3 (4%) patients, respectively. Surgical plans were altered in 7 (8%) cases for reasons not related to IOUS. There was no significant difference (p = 0.74) in average margin length between the IOUS and non-IOUS groups (1.09 ± 1.18 cm v. 1.18 ± 1.05 cm). Conclusion:Surgical strategy was altered owing to IOUS results in a substantial number of cases, and IOUS-guided resection planes resulted in R0 resections in nearly all procedures. The best operative plan in hepatic resection includes IOUS. Contexte :Compte tenu des récentes avancées de l'imagerie préopératoire pour les chirurgies du foie, l'utilisation de l'échographie peropératoire pourrait paraître inutile. Notre objectif était de déterminer si cette pratique permet d'obtenir des images nouvelles motivant un changement de stratégie chirurgicale pendant une résection hépatique.Méthodes : Nous avons analysé rétrospectivement 121 résections hépatiques consé-cu tives réalisées dans un même établissement. La tomographie par ordinateur ou l'imagerie par résonance magnétique préopératoires ont été utilisées pour choisir la stratégie chirurgicale initiale. La taille et la position des tumeurs détectées ainsi que leur nombre ont été comparés selon la méthode utilisée : échographie peropératoire ou imagerie préopératoire. Nous avons étudié les rapports opératoires pour déter-miner si l'échographie peropératoire avait entraîné un changement de stratégie chirurgicale et avons examiné les rapports de pathologie pour connaître les résultats de l'analyse des contours.Résultats : L'échographie peropératoire a été utilisée dans 88 des 121 interventions étudiées. Elle a influé sur la stratégie chirurgicale dans 15 cas (17 %). De nouvelles tumeurs ont été détectées chez 10 patients (11 %), et un changement dans la taille ou la position de la tumeur a été détecté chez 2 (2 %) et 3 patients (4 %), respectivement. Dans 7 cas (8 %), la stratégie chirurgicale a été modifiée, mais pour des raisons indépendantes des résultats de l'échographie. Nous n'avons pas observé de différence significative (p = 0,74) entre la taille moyenne des contours pour les 2 group...
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