In the March 2010 Issue of Clinics

In this issue of CLINICS we highlight a study by Lima et al. on the relation of delirium to post-discharge mortality and various other measured parameters, as observed prospectively in 199 hospitalized patients, aged 60 years or more. A highly significant correlation was found between the occurrence of delirium and mortality over a 2 year follow up period, as shown in Figure 1. However, according to a multivariate analysis, delirium was not an independent predictor of post-discharge mortality. Other predictors were age ≥ 80 years (p = 0.029), albumin concentration < 3.5 g/dl (p = 0.001), and immobility (p = 0.007). Apart from this study, CLINICS publishes six other clinical studies as well as four reports on basic research. Camanho et al. retrospectively analyzed the incidence, clinical significance, and clinical manifestations of pathological synovial plicae of the knee in 63 patients, of whom 21 had the diagnosis confirmation by previously performed MRI. Of these, 55 improved with conservative treatment, 6 of whom exhibited a recurrence of symptoms. The other eight patients underwent arthroscopic removal of the syno-vial plica. Authors conclude that a synovial plica of the knee is a clinical entity that should be borne in mind and should be considered as a potential diagnosis in patients with knee pain. Anger et al. evaluated the clinical, epidemiological and demographic aspects of primary cutaneous melanoma, and correlated them with patient prognosis for 84 patients treated between 1990 and 2007. They found that incidence was higher in areas of sun exposure, with trunk lesions in males, and lower limb lesions in females. Breslow's thickness and ulceration, the mitotic rate per mm 2 correlated with worse patient outcome. The sum of ulceration (0 or 1), Breslow index (1 to 3) and mitotic index (0 or 1) allowed the establishment of a prognostic score: if this sum was equal to or over three, nearly all (91.7%) patients had systemic disease. The overall 5-year survival rate was approximately seventy percent. Pesaro et al. investigated 1401 patients with acute myocardial infarction and evaluated the occurrence or the absence of atrial fibrillation, the use of oral β-blockers and mortality during the first 24 hours. They found that the use of β-blockers was inversely correlated with the presence of atrial fibrillation. The presence of atrial fibrillation was found to be independently correlated with mortality, whereas the use of β-blockers was inversely and independently correlated with mortality. Nery et …