[thrombolysis In Massive Pulmonary Embolism Based On The Volumetric Capnography].

This is the first report of a patient submitted to chemical thrombolysis due to massive pulmonary embolism (PE) during the postoperative period of neurosurgery, in whom due to the lack of adequate clinical conditions, no imaging assessment was performed. Clinical, gasometric and capnographic data allowed the decision to perform the thrombolysis with safety. The P(a-et)CO2 gradient decreased from 46.4 mmHg to 11.8 mmHg (normal < 5 mmHg) and the end-tidal alveolar dead space fraction decreased from 0.85 to 0.37 (normal < 0.15) from the pre-thrombolysis period to the 7th day post-thrombolysis. We conclude that the volumetric capnography (VC) was useful in the patient's diagnosis and clinical follow-up.95e97-e9

Panorama das Intervenções Coronárias Percutâneas em Oclusões Totais Crônicas em Centros Participantes do LATAM CTO Registry no Brasil

Background: Major advances have been seen in techniques and devices for performing percutaneous coronary interventions (PCIs) for chronic total occlusions (CTOs), but there are limited real-world practice data from developing countries. Objectives: To report clinical and angiographic characteristics, procedural aspects, and clinical outcomes of CTO PCI performed at dedicated centers in Brazil. Methods: Included patients underwent CTO PCI at centers participating in the LATAM CTO Registry, a Latin American multicenter registry dedicated to prospective collection of these data. Inclusion criteria were procedures performed in Brazil, age 18 years or over, and presence of CTO with PCI attempt. CTO was defined as a 100% lesion in an epicardial coronary artery, known or estimated to have lasted at least 3 months. Results: Data on 1196 CTO PCIs were included. Procedures were performed primarily for angina control (85%) and/or treatment of moderate/severe ischemia (24%). Technical success rate was 84%, being achieved with antegrade wire approaches in 81% of procedures, antegrade dissection and re-entry in 9%, and retrograde approaches in 10%. In-hospital adverse cardiovascular events occurred in 2.3% of cases, with a mortality rate of 0.75%. Conclusions: CTOs can be treated effectively in Brazil by using PCI, with low complication rates. The scientific and technological development observed in this area in the past decade is reflected in the clinical practice of dedicated Brazilian centersinfo:eu-repo/semantics/publishedVersio

Vesical metastasis of gastric adenocarcinoma

Metastatic vesical tumors are rare, and constitute approximately 1% of all neoplasias affecting this organ. The authors report the case of a 63-year old woman with vesical metastasis of gastric adenocarcinoma. Patient presented signs of cachexia and complained of left lumbar pain and dysuria unresponsive to antibiotic therapy for approximately 5 months. She reported a previous partial gastrectomy due to ulcerative undifferentiated gastric adenocarcinoma 1 year and 9 months before. Cystoscopy revealed an extensive vegetative lesion in bladder, occupying its entire mucosal surface. The biopsy revealed metastatic signet-ring cell adenocarcinoma

PF encontra cofre de Lula; juíza determina sigilo de investigação

Maria Priscilla alertou que análise de denúncia demandará ‘tempo’

Efficacy of intrarectal lidocaine hydrochloride gel for pain control in patients undergoing transrectal prostate biopsy

OBJECTIVE: To determine the efficacy of intrarectal lidocaine hydrochloride gel in reducing pain in patients undergoing transrectal prostate biopsy. MATERIALS AND METHODS: During the period from June to Noviber 2002, 72 patients undergoing transrectal prostate biopsy at an outpatient service were prospectively randomized. Patients were divided into 2 groups. In group 1, 20 mL of 2% lidocaine gel were administered by intrarectal route 15 minutes before biopsy. In group 2 (placebo), 20 mL of ultrasound gel were administered under the same conditions. At the end of the procedure, patients were asked to classify the discomfort degree observed during the procedure through a verbal pain scale. Statistical analysis was performed through qui-square test. RESULTS: The majority of patients in both groups presented slight pain on the examination, and 26 patients (76.4%) from group 1, and 26 (68.3%) patients from group 2 reported slight pain or no pain at all (p > 0.05). Moderate or intense pain was felt by 23.4% of patients in group 1 and 31.5% of patients in group 2 (p > 0.05). CONCLUSIONS: We concluded that lidocaine probably exerts a minimal effect on patients&#8217; tolerance to pain on transrectal prostate biopsy

Ética e filosofia prática: Para uma análise das políticas sobre direitos dos idosos em sociabilidades capitalistas enquanto manifestação do conflito entre justiça formal e justiça concreta

O objetivo deste artigo é analisar a natureza do direito e da política social sob o capitalismo, a partir da crítica sobre um dos principais programas nacionais de saúde voltados a materializar o direito social à saúde dos idosos.  Esforço fundamental para apreender as determinações e mediações acerca do tratamento da população idosa na sociedade capitalista. O estudo é qualitativo e resultado de pesquisa de campo e bibliográfica. Verificou-se a imaterialidade do direito à saúde refletida numa visão liberal, isto é, formal dos direitos humanos a partir da crítica marxista a esse conceito, trabalhadas no método histórico dialético, apontando o embate entre a concepção dos direitos da pessoa idosa e a tensão no que diz respeito a sua efetivação, por uma política que minimiza a responsabilidade do Estado como parte de uma contrarreforma, tornando-se um espaço não de concretização dos direitos, mas de resposta à necessidade de reprodução capitalista.