Perfil de idosos admitidos em unidades de terapia intensiva gerais em Rio Grande, RS: resultados de um estudo de demanda

Este estudo teve por objetivo conhecer o perfil do paciente com 60 anos ou mais de idade internado nas duas unidades de terapia intensiva (UTI) do município de Rio Grande, RS. Utilizando-se de delineamento transversal, entre abril/2007 e março/2008, entrevistadores previamente treinados aplicaram questionário padrão investigando sobre suas características demográficas, socioeconômicas e ambientais, utilização prévia de serviços de saúde e condições clínicas, que em 90% dos casos foram respondidos por familiares. Os 213 idosos hospitalizados neste período provinham, em sua maioria, do próprio município, eram casados, tinham mais de 70 anos, cinco anos de escolaridade, dois ou mais salários mínimos de renda familiar mensal, viviam em casa própria com outras duas pessoas e não possuíam plano de saúde; 88% foram à consulta médica nos últimos seis meses e 56% foram hospitalizados nos últimos 12 meses; metade deles chegaram à UTI inconscientes, por problemas clínicos oriundos da enfermaria do próprio hospital, onde 147 foram submetidos a ventilação mecânica, e 45% do grupo total evoluiu para óbito, em média, no oitavo dia. Estes dados mostram que é possível identificar idosos com maior potencial de internação em UTI também a partir de suas condições socioeconômicas e ambientais.This study aimed at assessing the profile of patients aged ≥ 60 years admitted into intensive care units (ICU) in the city of Rio Grande, Southern Brazil. A cross-sectional survey was carried out between April/2007 and March/2008 in two hospitals. Family members answered a standardized questionnaire that collected data on demographic and socioeconomic characteristics, household conditions, use of healthcare services and current clinical conditions. Among the 213 elderly people included in the study, about 90% came from Rio Grande, were married, aged 70 years or more, had at least five years of schooling, earned two or more minimum wages, owned their house, and did not have health insurance; 88% had had a medical appointment in the previous six months and 56% a hospital admission in the previous 12 months; half of them were unconscious when they were admitted into the ICU; most of them came from the same hospital and were put on mechanical ventilation; for 45%, the mean duration of ICU stay was 8 days before death. This study shows that it is possible to identify elderly individuals with the highest potential to be admitted in intensive care units based on their socioeconomic and environmental conditions

Profile of elderly people hospitalized in general intensive care units in Rio Grande, southern Brazil: results of a cross-sectional survey

At the end of the first quarter of this century, Brazil will have the sixth largest population for people aged 60 years or more worldwide. This will increase the demands on health services for this sector. This study aimed at assessing the profile of patients in this age group who were admitted to intensive care units (ICU) in the city of Rio Grande, Southern Brazil. A cross-sectional survey was carried out between April/2007 and March/2008 in the two local hospitals. Family members answered a standardized questionnaire that collected data about demographic and socioeconomic characte- ristics, household conditions, use of health services and current clinical conditions. Among the 213 elderly people included in this study, 90% came from Rio Grande, were married, aged 70 years or more, had at least five years of schooling, earned two or more minimum wages, were owners of their hou- se and did not have private health insuran- ce; 88% had a medical appointment in the previous six months and 56% were admitted to a hospital in the previous 12 months; half of them were unconscious when they were admitted in the ICU; three quarters of them needed mechanical ventilation and 45% died within the first eight days after hospital admission. This study identified some socioeconomic and environmental characteristics and health care needed by elderly people admitted to the ICU. This information can be used to set up preventive programs and to promote adequate clinical management among this population

Anaplastic large T-cell lymphoma with involvement of the colon. Case report

Submitted by Ilno Conceição ([email protected]) on 2012-09-18T02:50:18Z No. of bitstreams: 1 Linfoma anaplásico de grandes células T com envolvimento do cólon. Relato de caso.pdf: 274958 bytes, checksum: b61c824918ac97d0b93818f266300a9e (MD5)Approved for entry into archive by Gabriela Silva da Rosa([email protected]) on 2012-09-18T18:38:21Z (GMT) No. of bitstreams: 1 Linfoma anaplásico de grandes células T com envolvimento do cólon. Relato de caso.pdf: 274958 bytes, checksum: b61c824918ac97d0b93818f266300a9e (MD5)Made available in DSpace on 2012-09-18T18:38:21Z (GMT). No. of bitstreams: 1 Linfoma anaplásico de grandes células T com envolvimento do cólon. Relato de caso.pdf: 274958 bytes, checksum: b61c824918ac97d0b93818f266300a9e (MD5) Previous issue date: 2012JUSTIFICATIVA E OBJETIVOS: Linfoma anaplásico de grandes células é um tipo raro de linfoma não-Hodgkin (LNH) originado de linfócitos T maduros. O diagnóstico é feito a partir de quadro morfológico típico e de um imunofenótipo de células T positivo para CD30. As lesões gastrintestinais são o tipo mais comum de linfomas extranodais primários, representando cerca de 5% a 10% de todos os LNH, sendo mais comum no fenótipo de células B. O objetivo deste relato foi descrever um caso com envolvimento primário do cólon, evoluindo rapidamente para a fase terminal, com falência múltipla de órgãos e sistemas. RELATO DO CASO: Paciente do sexo masculino 50 anos, admitido no serviço de Clínica Médica do Hospital Santa Casa do Rio Grande (ACSCRG) com história de dor abdominal inespecífica há dois meses. Havia realizado endoscopia digestiva alta e recebeu tratamento, ao final do qual desenvolveu lesões cutâneas eritematosas difusas, que motivaram sua admissão para investigação. Febril, com abdômen levemente distendido e fígado palpável. Na videocolonoscopia identificou-se placas arredondadas de mucosa escurecida com 4 a 6 mm em meio à mucosa normal, estendendo-se até o íleo terminal. CONCLUSÃO: O linfoma anaplásico de grandes células é raro e infrequente em descrições e revisões. Tipo raro de LNH apresenta- se com comportamento agressivo, em estágio avançado e frequentemente com localização extranodal. A localização gástrica é a mais encontrada, seguida pelo intestino delgado.BACKGROUND AND OBJECTIVES: Anaplastic large cell lymphoma is a rare type of non-Hodgkin lymphoma originated from mature T lymphocytes. The diagnosis is made from the recognition of typical morphological features and a CD30-positive T-cell immunophenotype. The gastrointestinal lesions are the most common type of primary extranodal lymphomas, accounting for about 5% to 10% of all NHLs, being more common in B-cell phenotype.The purpose of this report describes a case with primary involvement of the colon, rapidly progressing to the terminal phase, with the multiple organ dysfunction syndrome. CASE REPORT: A 50-year-old man admitted to the Internal Medicine ward at the, Hospital Santa Casa do Rio Grande (ACSCRG) with a history of nonspecific abdominal pain for two months. Endoscopy had been undertaken and he received treatment, at the end of which he developed diffuse erythematous skin lesions, which motivated admission for investigation. Investigation, feverish, with slightly distended abdomen and palpable liver. Through colonoscopy it was identified rounded plaques of darkened mucosal with 4 to 6 mm among the of normal mucosa, extending to the terminal ileum. CONCLUSION: Anaplastic large cell lymphoma is rare and infrequent in descriptions and reviews. Rare type of non Hodgkin lymphoma (NHL), this disease presents itself with an aggressive course, advanced stage, and often extranodal location. The gastric location is the most common, followed by the small intestine

Linfoma anaplásico de grandes células T com envolvimento do cólon. Relato de caso

JUSTIFICATIVA E OBJETIVOS: Linfoma anaplásico de grandes células é um tipo raro de linfoma não-Hodgkin (LNH) originado de linfócitos T maduros. O diagnóstico é feito a partir de quadro morfológico típico e de um imunofenótipo de células T positivo para CD30. As lesões gastrintestinais são o tipo mais comum de linfomas extranodais primários, representando cerca de 5% a 10% de todos os LNH, sendo mais comum no fenótipo de células B. O objetivo deste relato foi descrever um caso com envolvimento primário do cólon, evoluindo rapidamente para a fase terminal, com falência múltipla de órgãos e sistemas. RELATO DO CASO: Paciente do sexo masculino 50 anos, admitido no serviço de Clínica Médica do Hospital Santa Casa do Rio Grande (ACSCRG) com história de dor abdominal inespecífica há dois meses. Havia realizado endoscopia digestiva alta e recebeu tratamento, ao final do qual desenvolveu lesões cutâneas eritematosas difusas, que motivaram sua admissão para investigação. Febril, com abdômen levemente distendido e fígado palpável. Na videocolonoscopia identificou-se placas arredondadas de mucosa escurecida com 4 a 6 mm em meio à mucosa normal, estendendo-se até o íleo terminal. CONCLUSÃO: O linfoma anaplásico de grandes células é raro e infrequente em descrições e revisões. Tipo raro de LNH apresenta- se com comportamento agressivo, em estágio avançado e frequentemente com localização extranodal. A localização gástrica é a mais encontrada, seguida pelo intestino delgado.BACKGROUND AND OBJECTIVES: Anaplastic large cell lymphoma is a rare type of non-Hodgkin lymphoma originated from mature T lymphocytes. The diagnosis is made from the recognition of typical morphological features and a CD30-positive T-cell immunophenotype. The gastrointestinal lesions are the most common type of primary extranodal lymphomas, accounting for about 5% to 10% of all NHLs, being more common in B-cell phenotype.The purpose of this report describes a case with primary involvement of the colon, rapidly progressing to the terminal phase, with the multiple organ dysfunction syndrome. CASE REPORT: A 50-year-old man admitted to the Internal Medicine ward at the, Hospital Santa Casa do Rio Grande (ACSCRG) with a history of nonspecific abdominal pain for two months. Endoscopy had been undertaken and he received treatment, at the end of which he developed diffuse erythematous skin lesions, which motivated admission for investigation. Investigation, feverish, with slightly distended abdomen and palpable liver. Through colonoscopy it was identified rounded plaques of darkened mucosal with 4 to 6 mm among the of normal mucosa, extending to the terminal ileum. CONCLUSION: Anaplastic large cell lymphoma is rare and infrequent in descriptions and reviews. Rare type of non Hodgkin lymphoma (NHL), this disease presents itself with an aggressive course, advanced stage, and often extranodal location. The gastric location is the most common, followed by the small intestine