Calcificaçöes pancreáticas em criança associada a ingestäo crônica de álcool: relato de caso / Pancreatic calcifications in child with association of chronic ingestiion of alcohol: a case report

Calcificaçöes pancreáticas em crianças tem sido descritas com pouca frequência, sendo a associaçäo com ingestäo crônica de álcool ainda mais rara. Os autores apresentaram o caso de uma criança de nove anos de idade com calcificaçöes pancreáticas e dores abdominais recorrentes, causadas pela pancreatite crônica alcoólica. Essa etiologia foi determinada por anamnese, dados epidemiológicos, exames laboratoriais e diagnóstico por imagem

The epidemiology of asthma.

Significant strides have been made in recent years in the epidemiologic study of obstructive lung diseases including asthma. Community population samples are being evaluated prospectively and followed up longitudinally to document the appearance of morbidity and clinical diagnoses. Also, a variety of environmental, physiologic, and immunologic variables are being collected on a serial basis to correlate changes with the appearance (or disappearance) of recognizable disease. Unfortunately, until the semantics and diagnostic labeling of airway abnormalities becomes more precise, especially in the older population, the incidence and prevalence of disease will lack the precision it should have.

Hypoalbuminemia associated with diffuse hypergammaglobulinemia in chronic diseases: lack of diagnostic specificity.

Although elevated gamma globulin is known to produce hypoalbuminemia both experimentally and in disease, a low albumin concentration in chronic liver disease often is assumed to reflect impaired liver synthetic function. Albumin and gamma globulin measurements in a series of 200 patients with a variety of chronic diseases (including cirrhosis, connective tissue disease, chronic inflammation, and malignancy) associated with diffuse hypergammaglobulinemia were combined with similar measurements from a previous study (Am J Med 1959; 29:596-616). The mean serum albumin concentration correlated inversely with mean gamma globulin, irrespective of disease category. Double reciprocal plot analysis showed that the relationship fits a rectangular hyperbola (r = -0.915, P less than 0.001), with the mean albumin concentration approaching 2.31 g/dL at infinite gamma globulin. This suggests that serum albumin decreases to a similar extent in various chronic diseases and that hypoalbuminemia has no diagnostic implications, except to the extent that it reflects the severity of hypergammaglobulinemia.

Functional Status Index: reliability of a chronic disease evaluation instrument.

The reliability of 3 methods of assessing respondents' perceptions of their functional ability was tested. The Functional Status Index defines function as including 3 distinct but related dimensions: the degree of dependence, the degree of difficulty and the amount of pain experienced in performing specific activities of daily living. A total of 149 adults with rheumatoid arthritis were studied. Exploratory factor analyses of scores on 18 specific daily activities across the 3 hypothesized dimensions yielded the following functional categories: gross mobility, hand activities, personal care, home chores and interpersonal activities. The resultant indexes achieve internal consistency reliability levels ranging from 0.66 to 0.91 across all but 1 functional category. Average test-retest and interobserver reliability values range from 0.65 to 0.81. Levels of interobserver reliability generally equal or surpass levels of test-retest reliability. The findings suggest that it is feasible to quantify level of function using self-report methods. The Functional Status Index is recommended for use in investigations where changes in functional ability are of interest.