3 research outputs found

    Analysis of the impact of pronation maneuver in patients on mechanical ventilation with diagnosis of pneumonia by Covid-19 and acute respiratory distress syndrome: Análise do impacto da manobra de pronação em pacientes em ventilação mecânica com diagnóstico de pneumonia por Covid-19 e síndrome do desconforto respiratório agudo

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    Objective: To analyze the profile of patients on invasive mechanical ventilation with SARS-CoV-2 pneumonia who were pronated and who developed acute respiratory distress syndrome. Methods: Historical cohort study through the analysis of a database containing 282 patients hospitalized in a large university hospital in the city of Porto Alegre, Brazil. The population studied included individuals infected with SARS-CoV-2 and with a clinical course marked by severe pneumonia and, mainly, by acute respiratory distress syndrome, submitted to mechanical ventilation and invasive pronation maneuver. Results: Database analysis showed a high mortality rate for all patient groups and a high case fatality rate, especially in elderly patients and in individuals with active oncologic disease or with chronic kidney disease. Conclusions: The high overall mortality rate, as well as the high lethality, especially in elderly patients and in individuals with active oncologic disease or with chronic kidney disease, suggests that, for certain specific population groups, the prone maneuver is not effective in reducing high. mortality caused by acute respiratory distress syndrome associated with COVID-19

    Nonagenarians in Hyperpolypharmacy: relationship between the level of drug interactions and sociodemographic, clinical, and functional characteristics

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    Aim: This research aimed to study the association of drug interactions and sociodemographic, clinical, and functional characteristics in nonagenarians in hyperpolypharmacy. Methods: This was a secondary analysis of an evaluation performed by the Multiprofessional Care for the Oldest-old Project in 2016, with participants identified in hyperpolypharmacy. Results: Results revealed that 69% of 29 participants had at least one major drug interaction, 41% had 10 or more moderate interactions, and 59% had minor interactions. The study revealed significant relationships for major drug interactions with the characteristics of recurrent urinary tract infections, anxiety, and palpitations. The study found near significance for white colour, not good general health and appetite, depression, and impaired cognition. For moderate drug interaction, findings showed a relationship near significance for females, perception of not good general health and appetite, hypertension, diabetes, urinary infection, depression scale change, agitation, pain, fatigue, and a fear of falling.  For minor drug interactions, the study revealed significant findings for an association with depression, and apathy or sleepiness.  There were findings near significance for an association with white colour, diabetes, agitation, pain, fatigue, and cough.  Conclusion: Drug interactions are highly prevalent among nonagenarians in hyperpolypharmacy, with clinical and quality of life impact. Thus, they must be constantly evaluated for the presence of drug interactions at all levels of care, whether in primary care or in specialized care. A study with larger sample size and longitudinal contour is proposed to prove the importance of our observations

    Tumor Recurrence of Breast Cancer Associated with Pulmonary Thromboembolism and Septic Shock: Case Report

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    Aims: Breast cancer is a malignant neoplasm caused by disordered clonal proliferation of breast  cells, resulting from the influence of hormonal exposure or inherited susceptible genes. Case Presentation: The present report is about a female patient with comorbidities, such as systemic arterial hypertension and depression, and with a previous history of breast cancer in 2008 and 2009 and underwent a mastectomy in 2015. She was admitted for investigation of tumor recurrence, and was diagnosed with a primary breast tumor, estrogen and progesterone receptor, which gave rise to a series of complications, culminating in septic shock and fatal outcome. Discussion: According to the Global Cancer Observatory, breast cancer is the most common malignant neoplasm in the world. Conclusion: The importance of cancer patients, especially those with breast tumors, is emphasized to maintain follow-up after undergoing surgical treatment for removal of the tumor and subsequent remission of the disease, since the early intervention of any complication is related to greater survival and better quality of life
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