In the December 2009 Issue of Clinics
This issue concludes our 5th year of existence under the new name of CLINICS. Maybe it is worthwhile remembering that in 2005 the journal relinquished its sixty year old original name, Revista do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo mainly because this was an impossible name to live within the era of internet and abbreviations. The name change meant starting from scratch as a technically new periodical, but this has been worth the effort. Figure 1 shows a threefold increase of submissions, in the beginning mostly from other Brazilian sources, but finally in 2008–2009 from authors outside Brazil. This year of 2009 will also mark the posting of our first Impact Factor by the Journal of Citation Reports of ISI. 
 
In this issue we publish 9 original articles of Clinical Science and one of Basic Research. 
 
Guimaraes et al. endeavored to determine the influence of radiological and procedural characteristics in predicting the success rates of computed tomography-guided fine needle aspiration biopsy of lung lesions. The study involved 340 patients and found greater success rates in biopsies performed in patients with suspicion of primary lung malignancy, with lesions located in the superior lobes, and with diameters equal to or larger than 40 mm. 
 
Rocha et al. compared visual inspection by nuclear physicians with the automated statistical parametric mapping program using SPECT datasets from 14 patients with neurological disorders vs. 32 normal control images and found that statistical parametric mapping replicated the findings described by more experienced nuclear physicians, which suggests that automated methods for individually analyzing SPECT images may be a valuable resource to complement visual inspection in clinical practice. 
 
Pereira AC et al. analyzed impact of intravenous immunoglobulin on the physical properties the sputum and inflammatory alterations of the airways in seven patients with common variable immunodeficiency and bronchiectasis and found that it results in significant improvement in indexes of inflammation of the airways with improvement in the transportability of the respiratory mucus by cough. 
 
Silva et al. analyzed the use of mechanical ventilation through a cohort study of 241 consecutive patients admitted to a Brazilian high-complexity pediatric intensive care unit placed on mechanical ventilation for 24 hours or more. They found that 35.7% of the admitted children received mechanical ventilation for 24 h or more, and that 91% had chronic functional status. There was a high incidence of Acute Respiratory Distress Syndrome, but a lung-protective strategy was not fully implemented. Inspiratory pressure at the beginning of mechanical ventilation was a predictor of mortality. 
 
Maciel SC et al. describe the development and validation of a low back pain knowledge questionnaire consisting of five focus groups. distributed to 50 patients to assess their comprehension of the terms. To assess the reproducibility, 20 patients were surveyed by two different interviewers on the same day and twice by a single interviewer with a one-to-two week interval. They conclude that the questionnaire was validated and proved to be reproducible, valid and sensitive to changes in patient knowledge. 
 
Bispo Junior and Camargo endeavored to identify prognostic factors in the survival of 24 patients diagnosed with primary non-metastatic osteosarcoma with a poor response to neoadjuvant chemotherapy and found that tumor size greater than 15 cm is an adverse factor for local recurrence-free survival and for overall survival but did not influence metastasis-free survival. The osteosarcoma histological type is a significant independent predictor for local recurrence-free survival, metastasis-free survival and overall survival, but did not influence metastasis-free survival. The osteosarcoma histological type is a significant independent predictor for local recurrence-free survival, metastasis-free survival and overall survival. 
 
Santos MF et al. investigated the effectiveness of Samarium153-particulate hydroxyapatite radiation synovectomy in 58 rheumatoid arthritis patients with chronic knee synovitis and found that it is not superior to triamcinolone hexacetonide alone for the treatment of knee synovitis in patients with rheumatoid arthritis at 1 y of follow-up. 
 
Satomi et al. evaluated the profile of osteoporosis treatment among 123 patients aged 60 years and over hospitalized due to hip fractures at a tertiary-level university hospital in order to compare the impact of hospitalization on approaches toward treating bone mass losses. They found that investigations and treatments of osteoporosis and strategies for preventing new fractures were not implemented during the hospitalization of these elderly patients with hip fractures, even though this is the most feared complication of osteoporosis. They sugges that these data must be disseminated so that professionals dealing with these patients are attentive to the need for primary and secondary prevention of osteoporosis. 
 
Ykeda et al. investigated hypoxia and sleep disordered breathing in 14 infants with congenital heart disease and found that sleep-disordered breathing associated with oxygen desaturations is frequently present even though arousal is normally absent indicating that sleep may represent a significant burden to infants with congenital heart disease. 
 
Kumar et al. describe the protective acion of ascorbic acid against restraint stress-induced memory deficits in wistar rats and suggest the possibility of using ascorbic acid as a dietary supplement to prevent stress-induced memory impairments. 
 
We also publish a review on the chronic gastrointestinal manifestations of Chagas Disease, three case reports and a technical note.