Acute pulmonary edema as a complication of urinary infection in pregnant women: a case report

Introduction: Urinary infection (UI) is the third most common pathology during pregnancy, affecting 10-12% of pregnant women in the first trimester. Thus, the prenatal care is important to reduce indicators of maternal-fetal mortality, promoting quality of life during pregnancy and postpartum. Objective: The aim of this study is to report the case of a pregnant woman with pyelonephritis, who evolved with acute pulmonary edema. Case report: The present study was elaborated according to the rules of CARE case report. This study was analyzed and approved by the Research Ethics Committee (CEP) according to a substantiated opinion number 4,375,418 and obtaining the patient's consent. The present study therefore highlights pyelonephritis as the most severe form of UI in pregnant women, associated with septic shock, with evolution to respiratory failure, resulting from acute pulmonary edema, and may be related to worse maternal-fetal prognoses. This clinical study contributes to the literature, emphasizing that, currently, all forms of UI during pregnancy should be considered as great potential for complications, and should be treated even in its asymptomatic form. Conclusion: It is evident the need for early intervention to minimize maternal-fetal losses, unnecessary interventions and to reduce costs in relation to additional treatments. The importance of rapid diagnosis and early treatment is emphasized in order to minimize or extinguish the damage. As well as promoting actions to encourage pregnant women to perform prenatal care

Witnessing death does not necessarily relieve the dis-comfort of death: analysis of the relationship between religiosity and thanatophobia in medicine undergraduate students

Introduction: It is known that very few issues related to death and religiosity/spirituality are addressed during medical graduation. Understanding the process of death and dying is still a problem for medical students before the terminal condition of a patient. Probably the medical students of the fifth graders overestimate their abilities, probably because they have not yet had contact with terminally ill patients or because they have not graduated, they do not take responsibility for the death of a patient they are following. In Brazil, many students believe that the topic of spirituality influences health, but they do not feel prepared to address this issue with patients. Objective: It was to analyze whether there is a relationship between religiosity and thanatophobia in medical students. It also analyzed whether there was a correlation between fear of death and specific religions, sex and age, and the index of religiosity with sex and age. Methods: Followed a prospective observational cross-sectional model, following the STROBE clinical research rules. This study was analyzed and approved by the Research Ethics Committee (CEP) according to a substantiated opinion number 2,031,705, and obtaining the patient's consent. Results: A total of 542 students (61.2% of the total) answered the questionnaire. Most were female (65.7%) and with a mean age of 22.31 (ranging from 17 to 39 years). The majority of students have a religion (90.1%) and 90.4% considered it important to address the issue of death and religiousness during graduation. In this study, it was observed that most students, in addition to having some kind of religion, consider it important to address the themes highlighted during the course. This was similar to the findings in other studies. There was no statistically significant relationship between having a religion and being less afraid of death. However, students with higher levels of intrinsic religiosity showed greater discomfort when dealing with terminal patients. Furthermore, no studies comparing these two subjects were found. It was also found in this research that students with high levels of religiosity consider it more important to address the issues in question, with the majority being female students. Conclusion: It is necessary to include the topic in the medical academy, and it is essential to prepare a more humanistic and dedicated professional for patients, whether active or palliative treatment