RESUMO
Background: Cesarean section increases four times the risk of venous thromboembolism compared to vaginal delivery. The Royal College of Obstetricians and Gynecologists guidelines are used at our service. A written alert was designed to stratify patients at high, intermediate or low risk making a suggestion for thromboprophylaxis. Aim: To assess the compliance with the guidelines and to evaluate the impact of a written alert in the thromboprophylaxis compliance in women subjected to caesarean section. Patients and Methods: Review of medical records of 233 women aged 19 to 32 years, subjected to a caesarean section in a Gynecology Service, between 2016-2017. Results: Compliance with recommendations was observed in 29% of patients (68/233), 86% in the low-risk group, 26% in the intermediate risk group and 100% in the high risk group. In 41/233 (18%) of patients, a written alert was included in the medical record. Compliance with recommendations in the presence of the written alert was 61% (25/41 women) compared to 22% (43/192) in those lacking the alert (p < 0.01). In women whose emergency caesarean section was the only risk factor, the compliance with the recommendation was 8%, compared with 30% among those who had at least one thrombotic risk factor associated with caesarean section (p < 0.01). Conclusions: In this cross-sectional study, we observed a low compliance with thromboprophylaxis guidelines in cesarean women. We observed that the use of a written alert improved the compliance with thromboprophylaxis.
Assuntos
Humanos , Feminino , Gravidez , Cesárea/efeitos adversos , Tromboembolia Venosa/etiologia , Tromboembolia Venosa/prevenção & controle , Estudos Transversais , Cooperação do Paciente , AnticoagulantesRESUMO
One third of all cases of head and neck carcinoma (CA) concern the oral mucosa. The use of dental implants (DI) for dental rehabilitation is widely extended. However, a few studies have reported some cases with neoplasic alterations, among the tissue surrounding implants. Our aim was to analyze possible alterations at the bone-implant interface in patients with oral squamous cell carcinoma (SCC), providing new evidence that could relate or discard a possible link between these factors. We used, for the first time, different techniques, including electron microscopy and histology, to analyze the implant ´s surface and the surrounding tissue from four clinical cases with neoplasic alterations surrounding DI. Histologically, ample inflammatory tissue was found in direct contact with the implant surface. Surface analysis of this tissue, revealed titanium percentages. According to our study, no oncological relation with deterioration of the implant surface was found, although DI were constantly related with peri-implantitis, a chronic trauma of the oral mucosa that could involve a neoplastic factor. Key words:Dental implants, carcinoma, peri-implantitis.
RESUMO
La enfermedad de pie, mano boca es una patología frecuente de observar en niños menores de 5 años, generalmente producida por virus Coxsackies y Enterovirus. Existen presentaciones atípicas debido a serotipos recientemente descritos de estos virus, algunos de ellos se han reportado en pacientes adultos. Se presenta caso de paciente masculino de 19 años, con antecedentes de dermatitis seborreica facial en tratamiento, que desarrolla una presentación atípica del síndrome pie, mano boca en contexto de un brote de esta patología en su academia militar. Luego del análisis epidemiológico, clínico e histopatológico, se diagnostica eccema coxsackium, una patología infrecuente en este grupo etario que contiene algunas particularidades destacables en relación con su manejo y estudio.
The hand mouth foot syndrome is a common pathology observed in children under 5 years, usually caused by coxsackie virus and enterovirus. There are exuberant clinical presentations, due to infrequent and emerging serotypes of these viruses, some of them manifesting in adult patients. A case of a 19 year old patient is presented, with a history of seborrheic dermatitis of the face and scalp in treatment, who develops an atypical clinical presentation of the hand foot mouth syndrome, intensely affecting the areas of seborrheic dermatitis on the face, in the context of an outbreak of this pathology in his military academy. After the epidemiological, clinical and histopathological analysis, eczema coxsackium is diagnosed, an infrequent pathology in this age group that contains some remarkable peculiarities in relation to its management.