Departamento de Clínica Médica

Amniotic fluid embolism is a rare complication of pregnancy whose physiopathology is not completely known and still not frequently remembered by intensive care physicians and obstetricians. The main aim of this case report was to emphasize the need of better knowledge of this disease by physicians. A 15 years old, primigravida, 35th week of gestation was admitted in our intensive care unit (ICU) with a sudden respiratory distress. Soon after admission she was intubated and put on mechanical ventilation. After stabilization she was transferred to the operating room and a cesarean section was undertaken. During the operation, instead of fluid reposition with crystalloids in large amounts, her hemodynamic status deteriorated and it was necessary to use vasoactive drugs. After three days on mechanical ventilation she was successfully weaned and discharged from the intensive care unit (ICU) after 6 days. She and her baby were discharged from hospital on13th day of hospitalization. Amniot...

Percebe-se que muito se discute sobre políticas públicas eficazes que possibilitem o tratamento adequado da asma, oferecendo um atendimento integral e centrado no paciente asmático dentro do seu contexto social. Educar profissionais de saúde e a população de asmáticos possibilita um melhor reconhecimento dos sintomas, dos fatores desencadeantes de exacerbações e das formas para evitá-los, garantindo melhor tratamento e qualidade de vida do paciente. A asma impõe crescente carga à sociedade em termos de redução da qualidade de vida, custos com cuidados de saúde e morbidade. Por isso, torna-se de suma importância sua discussão no campo das políticas públicas.

SUMMARY OBJECTIVES The objective of this review was to evaluate high intensity post-discharge follow-up strategies to promote smoking cessation in hospitalized patients. METHODS A systematic review was performed, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA – P) protocol. The databases used for research were: PubMed, LILACS/BIREME, Scopus, Web of Science, Cochrane and Scielo. The included articles were randomized clinical trials, published from 1990 to 2018, which evaluated in-hospital and post-discharge intervention, and provided a minimum of 30-day care post discharge. The studies aimed to evaluate tobacco cessation. RESULTS Fourteen studies were selected for analysis. Across studies, pharmacotherapy was consistently effective for smoking cessation. Communication technologies likewise were consistently effective for cessation and post-discharge access. CONCLUSION Effective strategies exist. The challenge for future trials is to determine ...

Objective A clinical trial carried out in patients hospitalized for clinical and surgical conditions. This study evaluated the effectiveness of text messaging interventions (TM) versus telephone counseling (TC) to promote smoking cessation among hospitalized smokers in a middle-income country. Seven-day abstinence was measured during follow-up phone calls one month after discharge. The comparative cost of the two interventions considered the cost of calls, time spent on phone calls and sending SMS and cost of the professional involved in the approaches. Results Past 7-day tobacco abstinence was not statistically different between groups (30.5% in TM group and 26% in TC, p = 0.318). Costs were significantly lower in the TM group (U$9.28 × U$19.45- p < 0,001). Continuous abstinence was reported by 26% of TM participants and 24.5% of TC participants (p = 0.730). In the 3-month follow-up, 7-day abstinence was 23% in the TMI and 27% in the TC (p = 0.356) group. Continuous abstinence w...