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Säo Paulo med. j ; 140(3): 372-377, May-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1377393


ABSTRACT BACKGROUND: Favipiravir is generally used in treating coronavirus disease 2019 (COVID-19) pneumonia in Turkey. OBJECTIVE: To determine the side effects of favipiravir and whether it is a good treatment option. DESIGN AND SETTING: Retrospective study conducted in Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey. METHODS: 357 patients who completed favipiravir treatment at the recommended dose were included. 37 patients with drug side effects and 320 patients without drug side effects were examined in two groups. RESULTS: Side effects were observed in 37 (10.36%) out of 357 patients using favipiravir. The most common side effect was liver dysfunction, in 26 (7.28%) of the patients. The following other side effects were also observed: diarrhea (1.4%), nausea (0.84%), abdominal pain (0.28%) and thrombocytopenia (0.28%). One patient (0.28%) presented both increased transaminases and nausea. CONCLUSION: In this study, it was determined that favipiravir may constitute an alternative for treating COVID-19 pneumonia given that its side effects are generally well tolerated and not serious.

Drug-Related Side Effects and Adverse Reactions/drug therapy , COVID-19/drug therapy , Antiviral Agents/adverse effects , Pyrazines , Retrospective Studies , Treatment Outcome , Amides , SARS-CoV-2 , Nausea/chemically induced , Nausea/drug therapy
Article in Chinese | WPRIM | ID: wpr-927431


OBJECTIVE@#To systematically review the therapeutic effect of acupuncture and moxibustion on postoperative gastrointestinal dysfunction (GID) of gastric cancer with meta-analysis.@*METHODS@#The articles of randomized controlled trials (RCTs) of acupuncture and moxibustion treatment for postoperative GID of gastric cancer were retrieved from the following databases from the time of database establishment to December 31, 2020, including PubMed, EMbase, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Wanfang database, VIP database and China Biomedical Literature Database (SinoMed). RevMan5.3 software was used for meta-analysis. Using Stata16.0 software, sensitivity analysis and publication bias test were performed.@*RESULTS@#A total of 16 RCTs were included finally, including 1 360 patients, of which, there were 681 cases in the intervention group and 679 cases in the control group. Meta-analysis results showed that acupuncture and moxibustion shortened the time of first flatus (P<0.000 01, MD =-14.52, 95%CI = [-17.31, -11.74]), the time of first bowel sound (P<0.000 01, MD =-10.50, 95%CI =[-13.99, -7.01]) and the time of first defecation (P<0.000 1, MD =-13.79, 95%CI =[-20.09, -7.50]). Meanwhile, acupuncture and moxibustion shortened the time of the first food intake (P<0.000 1, MD =-3.23, 95%CI = [-3.45, -3.00]) and the hospital stay (P<0.000 01, MD =-1.94, 95%CI =[-2.20, -1.69]) after gastric cancer operation, and reduced the incidences of postoperative adverse reactions, i.e. nausea and vomiting (P =0.000 3, RR =0.43, 95%CI =[0.28, 0.68]) and abdominal distention (P =0.000 5, RR =0.41, 95%CI =[0.25, 0.68]).@*CONCLUSION@#Acupuncture and moxibustion can promote the recovery of postoperative gastrointestinal function in the patients with gastric cancer. But, for the comparison among different measures of acupuncture and moxibustion intervention, it needs more high-quality trials for a further verification.

Acupuncture Therapy/methods , Humans , Moxibustion/methods , Nausea , Stomach Neoplasms/surgery , Vomiting
Rev. Bras. Cancerol. (Online) ; 68(1)jan./fev./mar. 2022.
Article in Portuguese | LILACS | ID: biblio-1370558


Introdução: Náuseas e vômitos induzidos por quimioterapia acometem cerca de 70-80% dos pacientes com câncer. Assim, é importante a utilização de um instrumento para avaliar melhor esses sintomas, visando a um tratamento mais adequado. Objetivo: Traduzir e adaptar culturalmente a escala Morrow Assessment of Nausea and Emesis para o contexto brasileiro. Método: Estudo correlacional do tipo survey, com tradução e adaptação cultural da escala segundo o protocolo da European Organization for Research and Treatment of Cancer ­ Quality of Life Group (EORTC-QLG). A amostra foi constituída por 160 pacientes em tratamento quimioterápico em uma clínica de oncologia. No processo de validação, realizaram-se análises de correlação multimétodos entre os itens da escala Morrow Assessment of Nausea and Emesis e os escores das escalas visuais numéricas de náusea e vômito com nível de p<0,05. Resultados: O autor da escala autorizou a tradução. A escala Morrow Assessment of Nausea and Emesis e as escalas numéricas apresentaram correlações significativas (p<0,01; p<0,05), sendo que os itens que apresentaram correlação mais forte das escalas numéricas foram os que se referiram à avaliação de náusea e vômito pós-quimioterapia. Já os itens destinados à avaliação desses sintomas no momento pré-quimioterapia e ao uso da medicação antiemética e sua eficácia apresentaram associações fracas com as escalas numéricas. Conclusão: A escala Morrow Assessment of Nausea and Emesisapresentou-se adequada para a avaliação de náuseas e vômitos induzidos por quimioterapia no contexto brasileiro

Introduction: Chemotherapy-induced nausea and vomiting affects nearly 70-80% of patients with cancer. To achieve a better treatment it is important to utilize an adequate instrument to assess these symptoms. Objective:To translate and culturally adapt the Morrow Assessment of Nausea and Emesis Scale to the Brazilian context. Method: Survey and correlational study, with the translation and cultural adaptation of the scale according to the protocol of the European Organization for Research and Treatment of Cancer ­ Quality of Life Group (EORTC-QLG). The sample consisted of 160 patients undergoing chemotherapy treatment in an oncology clinic. In the validation process, multimethod correlation analyses were carried out among the items of the Morrow Assessment of Nausea and Emesis Scale items and the scores of the numerical visual scales of nausea and vomits at the level of p<0.05. Results: The author of the scale approved the translation process. The Morrow Assessment of Nausea and Emesis scale and the numerical scales presented significant correlations (p<0.01; p<0.05), considering that the items presenting stronger correlation with the numerical scales were those addressing post-chemotherapy assessment of nausea and vomit. On the other hand, the items for pre-chemotherapy assessment of these symptoms and use of the antiemetic drugs and their efficacy presented weak associations with the numerical scales. Conclusion: The Morrow Assessment of Nausea and Emesis scale was adequate for the assessment of chemotherapy-induced nausea and vomiting in the Brazilian context

Introducción: Las náuseas y vómitos inducidos por la quimioterapia afectan aproximadamente al 70-80% de los pacientes con cáncer. Por lo tanto, es importante utilizar un instrumento para evaluar mejor estos síntomas, con el objetivo de un tratamiento más adecuado. Objetivo: Traducir y adaptar culturalmente la escala de Morrow Assessment of Nausea and Emesisal contexto brasileño. Método: Estudio correlativo del tipo de encuesta, con la traducción y adaptación cultural de la escala según el protocolo de la European Organization for Research and Treatment of Cancer ­ Quality of Life Group (EORTC-QLG). La muestra consistió en 160 pacientes sometidos a quimioterapia en una clínica oncológica. En el proceso de validación, se realizaron análisis de correlación multimétodos entre los elementos de la escala de Morrow Assessment of Nausea and Emesis y las puntuaciones de las escalas visuales numéricas de náuseas y vómitos con nivel de p<0,05. Resultados: El autor de la escala autorizó la traducción. La Morrow Assessment of Nausea and Emesis y las escalas numéricas mostraron correlaciones significativas (p<0,01; p<0,05), y los elementos que presentaron una correlación más fuerte de las escalas numéricas fueron los que se refirieron a la evaluación de las náuseas y los vómitos después de la quimioterapia. Por otro lado, los elementos destinados a la evaluación de estos síntomas en el momento anterior a la quimioterapia y el uso de medicamentos antieméticos y su eficacia presentaron asociaciones débiles con escalas numéricas. Conclusión: La Morrow Assessment of Nausea and Emesis fue adecuada para la evaluación de náuseas y vómitos inducidos por quimioterapia en el contexto brasileño

Humans , Male , Female , Vomiting , Validation Study , Drug Therapy , Medical Oncology , Nausea
Article in Chinese | WPRIM | ID: wpr-936161


Pituitary immune-related adverse events induced by programmed cell death protein 1 inhibitors in advanced lung cancer patients: A report of 3 cases SUMMARY Programmed cell death protein 1 (PD-1) and its ligand 1 (PD-L1) have been widely used in lung cancer treatment, but their immune-related adverse events (irAEs) require intensive attention. Pituitary irAEs, including hypophysitis and hypopituitarism, are commonly induced by cytotoxic T lymphocyte antigen 4 inhibitors, but rarely by PD-1/PD-L1 inhibitors. Isolated adrenocorticotropic hormone(ACTH) deficiency (IAD) is a special subtype of pituitary irAEs, without any other pituitary hormone dysfunction, and with no enlargement of pituitary gland, either. Here, we described three patients with advanced lung cancer who developed IAD and other irAEs, after PD-1 inhibitor treatment. Case 1 was a 68-year-old male diagnosed with metastatic lung adenocarcinoma with high expression of PD-L1. He was treated with pembrolizumab monotherapy, and developed immune-related hepatitis, which was cured by high-dose methylprednisolone [0.5-1.0 mg/(kg·d)]. Eleven months later, the patient was diagnosed with primary gastric adenocarcinoma, and was treated with apatinib, in addition to pembrolizumab. After 17 doses of pembrolizumab, he developed severe nausea and asthenia, when methylprednisolone had been stopped for 10 months. His blood tests showed severe hyponatremia (121 mmol/L, reference 137-147 mmol/L, the same below), low levels of 8:00 a.m. cortisol (< 1 μg/dL, reference 5-25 μg/dL, the same below) and ACTH (2.2 ng/L, reference 7.2-63.3 ng/L, the same below), and normal thyroid function, sex hormone and prolactin. Meanwhile, both his lung cancer and gastric cancer remained under good control. Case 2 was a 66-year-old male with metastatic lung adenocarcinoma, who was treated with a new PD-1 inhibitor, HX008, combined with chemotherapy (clinical trial number: CTR20202387). After 5 months of treatment (7 doses in total), his cancer exhibited partial response, but his nausea and vomiting suddenly exacerbated, with mild dyspnea and weakness in his lower limbs. His blood tests showed mild hyponatremia (135 mmol/L), low levels of 8:00 a.m. cortisol (4.3 μg/dL) and ACTH (1.5 ng/L), and normal thyroid function. His thoracic computed tomography revealed moderate immune-related pneumonitis simultaneously. Case 3 was a 63-year-old male with locally advanced squamous cell carcinoma. He was treated with first-line sintilimab combined with chemotherapy, which resulted in partial response, with mild immune-related rash. His cancer progressed after 5 cycles of treatment, and sintilimab was discontinued. Six months later, he developed asymptomatic hypoadrenocorticism, with low level of cortisol (1.5 μg/dL) at 8:00 a.m. and unresponsive ACTH (8.0 ng/L). After being rechallenged with another PD-1 inhibitor, teslelizumab, combined with chemotherapy, he had pulmonary infection, persistent low-grade fever, moderate asthenia, and severe hyponatremia (116 mmol/L). Meanwhile, his blood levels of 8:00 a.m. cortisol and ACTH were 3.1 μg/dL and 7.2 ng/L, respectively, with normal thyroid function, sex hormone and prolactin. All of the three patients had no headache or visual disturbance. Their pituitary magnetic resonance image showed no pituitary enlargement or stalk thickening, and no dynamic changes. They were all on hormone replacement therapy (HRT) with prednisone (2.5-5.0 mg/d), and resumed the PD-1 inhibitor treatment when symptoms relieved. In particular, Case 2 started with high-dose prednisone [1 mg/(kg·d)] because of simultaneous immune-related pneumonitis, and then tapered it to the HRT dose. His cortisol and ACTH levels returned to and stayed normal. However, the other two patients' hypopituitarism did not recover. In summary, these cases demonstrated that the pituitary irAEs induced by PD-1 inhibitors could present as IAD, with a large time span of onset, non-specific clinical presentation, and different recovery patterns. Clinicians should monitor patients' pituitary hormone regularly, during and at least 6 months after PD-1 inhibitor treatment, especially in patients with good oncological response to the treatment.

Adenocarcinoma of Lung/drug therapy , Adrenocorticotropic Hormone/therapeutic use , Aged , B7-H1 Antigen/therapeutic use , Humans , Hydrocortisone/therapeutic use , Hyponatremia/drug therapy , Hypopituitarism/drug therapy , Immune Checkpoint Inhibitors , Lung Neoplasms/pathology , Male , Methylprednisolone/therapeutic use , Middle Aged , Nausea/drug therapy , Pituitary Gland/pathology , Pneumonia , Prednisone/therapeutic use , Programmed Cell Death 1 Receptor/therapeutic use , Prolactin/therapeutic use
Chinese Journal of Burns ; (6): 683-690, 2022.
Article in Chinese | WPRIM | ID: wpr-940975


Objective: To investigate the effects of compound analgesia on ultra-pulsed fractional carbon dioxide laser (UFCL) treatment of post-burn hypertrophic s in children. Methods: A prospective randomized controlled study was conducted. From April 2018 to March 2020, 169 pediatric patients with post-burn hypertrophic s admitted to the First Affiliated Hospital of Air Force Medical University were randomly divided into general anesthesia alone group (39 cases, 19 males and 20 females, aged 35 (21, 48) months), general anesthesia+lidocaine group (41 cases, 23 males and 18 females, aged 42 (22, 68) months), general anesthesia+ibuprofen suppository group (41 cases, 25 males and 16 females, aged 38 (26, 52) months), and three-drug combination group with general anesthesia + lidocaine+ibuprofen suppository (48 cases, 25 males and 23 females, aged 42 (25, 60) months), and the pediatric patients in each group were treated with corresponding analgesic regimens when UFCL was used to treat s, and the pediatric patients were given comprehensive care throughout the treatment process. The pain degree of pediatric patients scar was evaluated by facial expression,legs,activity,cry,and consolability (FLACC) of children's pain behavior scale at 0 (immediately), 1, 2, and 4 h after awakening from the first anesthesia, respectively. At 4 h after awakening from the first anesthesia of postoperative pain assessment, the self-made analgesia satisfaction questionnaire was used to evaluate the satisfaction for the analgesic effect of the pediatric patients or their families, and the satisfaction rate was calculated. Within 2 h after the first operation, the occurrences of adverse reactions of the pediatric patients, such as nausea and vomiting, headache, dizziness, drowsiness, etc, were observed and recorded. Before the first treatment and 1 month after the last treatment, the Vancouver scar scale (VSS) was used to evaluate the pediatric patients scar, and the difference value between the two was calculated. Data were statistically analyzed with least significant difference test, Kruskal-Wallis H test, chi-square test and Fisher's exact probability test. Results: At 0 h after awakening from the first anesthesia, the FLACC scores of pediatric patients in general anesthesia+lidocaine group, general anesthesia+ibuprofen suppository group and three-drug combination group were significantly lower than those in general anesthesia alone group (P<0.01). The FLACC scores of the pediatric patients in anesthesia+ibuprofen suppository group and three-drug combination group were significantly lower than that in general anesthesia+lidocaine group (P<0.01), and the FLACC score of the pediatric patients in three-drug combination group was significantly lower than that in general anesthesia+ibuprofen suppository group (P<0.01). At 1 and 2 h after awakening from the first anesthesia, the FLACC scores of pediatric patients in general anesthesia+ibuprofen suppository group and three-drug combination group were both significantly lower than those in general anesthesia alone group and general anesthesia+lidocaine group (P<0.01), and the FLACC score of the pediatric patients in three-drug combination group was significantly lower than that in general anesthesia+ibuprofen suppository group (P<0.01). At 4 h after awakening from the first anesthesia, the FLACC scores of the pediatric patients in general anesthesia+ibuprofen suppository group and three-drug combination group were significantly lower than those in general anesthesia alone group and general anesthesia+lidocaine group (P<0.01). At 4 h after awakening from the first anesthesia, the satisfactions rate with the analgesic effect in the four groups of pediatric patients or their families were 79.49% (31/39), 85.37% (35/41), 87.80% (36/41), and 97.92% (47/48), respectively. The satisfaction rate of the pediatric patients in three-drug combination group was significantly higher than those in general anesthesia alone group, general anesthesia+lidocaine group, general anesthesia+ibuprofen suppository group. Within 2 h after the first operation, there was no significant difference in the overall comparison of adverse reactions such as nausea and vomiting, headache, dizziness, and drowsiness of pediatric patients among the 4 groups (P>0.05). The VSS scores of pediatric patients before the first treatment, 1 month after the last treatment, and and the difference value between the two in the 4 groups were not significantly different (P>0.05). Conclusions: Three-drug combination for analgesia has a good effect in the treatment of hypertrophic scars after burn in pediatric patients with UFCL. Pediatric patients or their families are highly satisfied with the effect, and the treatment effect and incidence of adverse reactions are similar to other analgesic regimens, so it is recommended to be promoted in clinical practice.

Analgesia , Analgesics , Child , Cicatrix, Hypertrophic/pathology , Dizziness/drug therapy , Female , Headache/drug therapy , Humans , Ibuprofen/therapeutic use , Lasers, Gas/therapeutic use , Lidocaine , Male , Nausea/drug therapy , Pain/drug therapy , Prospective Studies , Treatment Outcome , Vomiting/drug therapy
Arq. Asma, Alerg. Imunol ; 5(2): 203-207, abr.jun.2021. ilus
Article in English | LILACS | ID: biblio-1398933


Allergy to persimmon (Diospyros kaki ) has been only rarely reported. The antigenic composition of the fruit is not entirely known. Thaumatin-like proteins (TLPs) have been described as allergens in pollens and various fruits, such as kiwi and banana, but not in persimmon. We report the case of a 22-year-old man, with persistent moderate-to-severe allergic rhinitis, sensitized to house dust mites. The patient describes an episode of oral mucosa and ear canal pruritus, followed by diffuse urticaria, which rapidly evolved to dysphonia, dyspnea, and dizziness, after eating raw persimmon. A few months later he developed similar cutaneous symptoms accompanied by nausea, vomiting, abdominal colic, and hypotension immediately after the intake of banana. The prick-prick test with raw persimmon and banana were positive, as well as the serum specific IgE to the extract of these fruits. The ImmunoCAP ISAC_112i test demonstrated a positive specific IgE against Act d 2 (kiwi thaumatin), which is homologous to banana TLP (Mus a 4). Serum IgE inhibition test with "sponge" of Diospyros kaki ImmunoCAP (f301) showed partial inhibition (40%) of IgE to Act d 2. This raises the suspicion that a TLP is at least partially responsible for the referred sensitization. This patient is sensitized to Diospyros kaki and Musa acuminata. An anaphylactic reaction to consumed persimmon, presumably as a result from cross-allergy with banana thaumatin was diagnosed in our patient. Thaumatin has not been previously described as an allergen of persimmon with cross-reactivity with banana, and in vitro with Act d 2 (kiwi TLP).

A alergia ao caqui (Diospyros kaki ) tem sido raramente documentada, não sendo a composição antigênica da fruta totalmente conhecida. Proteínas semelhantes à taumatina (TLPs) foram descritas como alergênicos em pólens e várias frutas, como no kiwi e banana, mas não no caqui. Apresenta-se o caso de um doente de 22 anos, com rinite alérgica persistente moderadagrave, sensibilizado a ácaros do pó doméstico. O doente refere episódio de prurido na mucosa oral e canal auditivo, seguido de urticária generalizada, que rapidamente evoluiu para disfonia, dispneia e tontura, após ingestão de caqui. Poucos meses depois, desenvolveu sintomas cutâneos semelhantes, acompanhados de náuseas, vómitos, cólica abdominal e hipotensão imediatamente após ingestão de uma banana. O teste cutâneo por picada com caqui e banana em natureza foram positivos, bem como o doseamento de IgE específica. O teste ImmunoCAP ISAC_112i identificou a presença de IgE específica para Act d 2 (taumatina do kiwi), homóloga da TLP da banana (Mus a 4). O estudo de inibição ImmunoCAP ISAC com "esponja" de Diospyros kaki (f301) produziu uma inibição parcial (40%) da ligação de IgE a Act d 2, permitindo presumir que uma proteína semelhante à taumatina é, pelo menos, parcialmente responsável pela referida sensibilização. Este doente encontra-se sensibilizado a Diospyros kaki e Musa acuminata. Uma anafilaxia ao caqui ingerido, presumivelmente resultante de reatividade cruzada com a taumatina da banana foi diagnosticada. Não estão descritas na literatura TLPs como alergênicos do caqui com reatividade cruzada com a banana e com Act d 2 in vitro (TLP do kiwi).

Humans , Male , Young Adult , Diospyros , Musa , Eating , Rhinitis, Allergic , Fruit , Hypersensitivity , Anaphylaxis , Mites , Pruritus , Signs and Symptoms , Urticaria , Vomiting , Immunoglobulin E , Intradermal Tests , Allergens , Colic , Ear Canal , Mouth Mucosa , Nausea
Säo Paulo med. j ; 139(2): 147-155, Mar.-Apr. 2021. tab
Article in English | LILACS | ID: biblio-1290231


ABSTRACT BACKGROUND: The Health-Related Quality of Life Questionnaire for Nausea and Vomiting of Pregnancy (NVPQOL) is a validated questionnaire assessing quality of life among pregnant women with nausea and vomiting. OBJECTIVE: To translate, cross-culturally adapt and evaluate the reliability of the NVPQOL. DESIGN AND SETTING: Observational cross-sectional study developed in a public university in Brazil. METHODS: The translation, synthesis of translations, back-translation, expert committee, pre-testing and validation were carried out, resulting in a Portuguese-language version. The internal consistency, intra-rater and test-retest reliability and correlation between the total score of the Portuguese-language version of the NVPQOL and the domains of the World Health Organization Quality of Life-bref questionnaire were considered in the data analysis. RESULTS: The instrument went through the process with testing on 104 pregnant women. Strong internal consistency (Cronbach's α: 0.95), strong intra-rater and test-retest reliability (P < 0.0; intraclass correlation coefficient: 0.89; confidence interval: 0.791-0.945) and strong correlation between the total score of the Portuguese-language version of the NVPQOL and the physical health domain of the World Health Organization Quality of Life-bref questionnaire (P < 0.01; R = −0.8) were observed. CONCLUSION: The NVPQOL was translated, cross-culturally adapted and validated for the Portuguese language with satisfactory psychometric properties for assessing quality of life, especially in relation to physical health, among pregnant women with symptoms of nausea and vomiting in the first trimester of pregnancy.

Humans , Female , Pregnancy , Quality of Life , Cross-Cultural Comparison , Psychometrics , Translations , Vomiting , Brazil , Cross-Sectional Studies , Surveys and Questionnaires , Reproducibility of Results , Nausea
Infectio ; 25(1): 67-70, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1154406


Resumen La infección por enterobacterias desencadena usualmente síntomas gastrointestinales caracterizados por vómito, diarrea y dolor abdominal, de severidad y curso variable. El compromiso extraintestinal esta descrito, inclusive sin las manifestaciones gastrointestinales clásicas lo que favorece diagnósticos y tratamientos tardíos pudiendo llegar a ser incapacitantes y letales. El síndrome de Ekiri, también denominado síndrome de encefalopatía letal tóxico, se caracteriza por una disfunción aguda del sistema nervioso central secundaria a infección por enterobacterias las cuales favorecen el desarrollo de microtrombos a nivel cerebral con inflamación mediada por el factor de necrosis tumoral α e IL- 1β y disfunción de la barrera hematoencefálica con una alta tasa de mortalidad. Dentro de nuestro conocimiento, presentamos el primer caso reportado en Colombia sobre el síndrome de Ekiri.

Abstract Gastrointestinal infection usually manifests with nausea, vomit and abdominal pain, all of them wit course and variable severity. Extrainstestinal compromise is described, even without gastrointestinal symptoms, what causes a delay on diagnosis and treatment, worsening the prognosis. Ekiri syndrome, also known as lethal toxic encephalopathy is characterized by an acute neurological dysfunction secondary to enterobacterial infection which favor thrombi development and local inflammation mediated by tumor necrosis factor alpha and IL-1β with blood brain barrier dysfunction and high mortality. As we know, we present the first Ekiri syndrome case reported in Colombia.

Humans , Female , Adult , Brain Diseases , Syndrome , Neurotoxicity Syndromes , Diarrhea , Enterobacteriaceae Infections , Escherichia coli , Nausea
Medicentro (Villa Clara) ; 25(1): 22-37, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1287180


RESUMEN Introducción: las náuseas y vómitos postoperatorios se sitúan como la peor experiencia del paciente junto al dolor y el despertar intraoperatorio. Objetivo: determinar la incidencia de náuseas y vómitos postoperatorios en pacientes que reciben anestesia general para cirugía electiva. Métodos: se realizó un estudio observacional, descriptivo, de corte transversal en 2 334 pacientes desde enero de 2013 a diciembre de 2018, en el Hospital Universitario Clínico-Quirúrgico Arnaldo Milián Castro y el Hospital Universitario Dr. Celestino Hernández Robau, de Santa Clara. Se estudiaron las variables: sexo, edad, tabaquismo, antecedentes de cinetosis, náuseas y vómitos postoperatorios, agentes anestésicos y halogenados empleados, uso de opiodes perioperatorios, tipo de intervención quirúrgica según estancia hospitalaria y tratamiento al sitio quirúrgico, tiempo quirúrgico y aparición de náuseas y vómitos en las primeras 24 horas del postoperatorio. Resultados: la incidencia de náuseas y vómitos postoperatorios fue de 15,9%, con predominio en el sexo femenino, en pacientes menores de 50 años de edad, los no fumadores, los que presentaban antecedentes de náuseas y vómitos postoperatorios o cinetosis, en los que se utilizó agentes halogenados y opiodes postoperatorios, en cirugía no ambulatoria y de enfoque convencional, y en los pacientes con tiempos quirúrgicos iguales o mayores a una hora. Conclusiones: la incidencia de náuseas y vómitos postoperatorios fue baja y se estableció una probabilidad de náuseas y vómitos postoperatorios desde ningún factor hasta 7 factores de riesgo de: 5,5 %, 6,9 %, 13,3 %, 29,7 %, 40 %, 50 %, 60 % y 71,4 %, respectivamente.

ABSTRACT Introduction: postoperative nausea and vomiting rank as the worst patient experience along with pain and intraoperative awakening. Objective: to determine the incidence of postoperative nausea and vomiting in patients who receive general anesthesia for elective surgery. Methods: an observational, descriptive, cross-sectional study was carried out in 2 334 patients belonging to "Arnaldo Milián Castro" Clinical and Surgical University Hospital and "Dr. Celestino Hernández Robau" University Hospital from Santa Clara between January 2013 and December 2018. Gender, age, smoking, history of motion sickness, postoperative nausea and vomiting, anesthetic and halogenated agents used, use of perioperative opioids, type of surgical intervention according to hospital stay and treatment at the surgical site, surgical time and appearance of nausea and vomiting in the first 24 hours after surgery were the variables studied. Results: the incidence of postoperative nausea and vomiting was 15.9%, with a predominance in female patients under 50 years of age, non-smokers, those with a history of postoperative nausea and vomiting or motion sickness, in which halogenated agents and postoperative opioids were used, in non-ambulatory surgery and conventional approach, and in patients with surgical times equal to or greater than one hour. Conclusions: the incidence of postoperative nausea and vomiting was low and a probability of postoperative nausea and vomiting was established from no factor to 7 risk factors with percentage values: 5.5%, 6.9%, 13.3%, 29.7%, 40%, 50%, 60% and 71.4%, respectively.

Postoperative Complications , Vomiting , Anesthesia, General , Nausea
Esc. Anna Nery Rev. Enferm ; 25(4): e20200520, 2021. tab, graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1279021


Resumo Objetivo identificar os principais sinais e sintomas manifestados por pacientes em cuidados paliativos oncológicos na assistência domiciliar. Método revisão integrativa nas bases LILACS, MEDLINE e CINAHL em janeiro de 2020. Perguntou-se: "Quais os principais sinais e sintomas manifestados por pacientes em cuidados paliativos oncológicos destacados nos estudos abrangendo o contexto do domicílio?". Foram descritores/termos: Sinais e Sintomas/Signs and Symptoms; Assistência Domiciliar/Home Care Services; Cuidados Paliativos/Palliative Care e Neoplasias/Neoplasms. Elencaram-se como critérios de elegibilidade: texto completo; entre 2015 e 2019; em inglês, português ou espanhol e idade adulta. Para o mapeamento dos dados, consideraram-se: título; país; ano; objetivo; método; sinais e sintomas. Os resultados foram categorizados em subgrupos, considerando a classificação conceitual predeterminada (sinal e sintoma). O elemento contagem facilitou a análise e a comparação de dados. Resultados foram selecionados 35 artigos, sendo identificados 25 sinais e 23 sintomas. Os mais frequentes foram: dor, náusea/vômito, dispneia, fadiga, depressão, ansiedade, constipação, perda de apetite, sonolência, bem-estar e insônia. A maioria (39) relacionou-se ao domínio físico. Conclusão a identificação dos principais sinais e sintomas, neste contexto, direciona a prática dos profissionais de saúde para as intervenções mais adequadas e o mais precocemente possível, contribuindo para viabilizar a assistência domiciliar, e alerta para a necessidade de educação permanente sobre este tema.

Resumen Objetivo identificar los principales signos y síntomas que manifiestan los pacientes en cuidados oncológicos paliativos en la atención domiciliaria. Método revisión integradora basada en LILACS, MEDLINE y CINAHL en enero de 2020. Se preguntó: "¿Cuáles son los principales signos y síntomas que manifiestan los pacientes en cuidados paliativos oncológicos destacados en estudios que abarcan el contexto del hogar?". Los descriptores / términos fueron: signos y síntomas / /Signs and Symptoms; Asistencia domiciliaria / Home Care Services; Cuidados paliativos / Palliative Care / y Neoplasias/ Neoplasms. Se enumeraron los siguientes criterios de elegibilidad: texto completo; entre 2015 y 2019; en inglés, portugués o español y edad adulta. Para el mapeo de datos, se consideraron los siguientes: título; padres; año; objetivo; método; signos y síntomas. Los resultados se categorizaron en subgrupos, considerando la clasificación conceptual predeterminada (signo y síntoma). El elemento de conteo facilitó el análisis y la comparación de datos. Resultados Se seleccionaron 35 artículos, se identificaron 25 signos y 23 síntomas. Los más frecuentes fueron: dolor, náuseas / vómitos, disnea, fatiga, depresión, ansiedad, estreñimiento, pérdida de apetito, somnolencia, bienestar e insomnio. La mayoría (39) estaban relacionados con el dominio físico. Conclusión la identificación de los principales signos y síntomas, en este contexto, orienta la práctica de los profesionales de la salud hacia las intervenciones más adecuadas y lo más temprano posible, contribuyendo a hacer factible la atención domiciliaria, y alerta sobre la necesidad de una educación permanente sobre este tema.

Abstract Objective to identify the main signs and symptoms manifested by palliative care oncology patients in home care. Method integrative review in LILACS, MEDLINE and CINAHL databases in January 2020. The question was asked: "What are the main signs and symptoms manifested by patients in palliative oncology care highlighted in studies covering the context of the home?" Descriptors/terms were: Signs and Symptoms/Signs and Symptoms; Home Care/Home Care Services; Palliative Care/Palliative Care and Neoplasms/Neoplasms. Eligibility criteria were listed as follows: full text; between 2015 and 2019; in English, Portuguese or Spanish and adult age. For data mapping, the following were considered: title; country; year; objective; method; signs and symptoms. The results were categorized into subgroups, considering the predetermined conceptual classification (sign and symptom). The counting element facilitated the analysis and comparison of data. Results a total of 35 articles were selected, and 25 signs and 23 symptoms were identified. The most frequent were: pain, nausea/vomiting, dyspnea, fatigue, depression, anxiety, constipation, loss of appetite, sleepiness, well-being, and insomnia. Most (39) were related to the physical domain. Conclusion the identification of the main signs and symptoms, in this context, directs the practice of health professionals to the most appropriate interventions as early as possible, contributing to the feasibility of home care, and alerts to the need for continuing education on this topic.

Humans , Adult , Palliative Care , Death , Home Nursing , Neoplasms , Anxiety , Quality of Life , Anorexia , Constipation , Depression , Dyspnea , Fatigue , Cancer Pain , Sleepiness , Sleep Initiation and Maintenance Disorders , Nausea
Ciênc. cuid. saúde ; 20: e55482, 2021. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1356116


RESUMO Objetivo: verificar os desconfortos apresentados por trabalhadores que necessitam utilizar a máscara N95 durante as suas atividades laborais. Método: pesquisa descritiva com delineamento transversal, desenvolvida no Centro Cirúrgico de um hospital de ensino localizado na região Sul do Brasil, no período de junho a agosto de 2019, durante o turno de trabalho diurno. Realizou-se o estudo com os profissionais de enfermagem que estavam expostos à fumaça cirúrgica no período de trabalho. Para a coleta dos dados, utilizou-se um instrumento com detalhamento sociodemográfico e ocupacional dos participantes e entregou-se uma máscara N95 aos profissionais para ser utilizada durante a cirurgia, a fim de verificar o tempo de uso da N95 e os motivos pelos quais os trabalhadores retiraram a máscara durante o ato anestésico-cirúrgico. Resultados: o maior número de trabalhadores (27,7%) utilizou a máscara até 3 horas durante o ato anestésico-cirúrgico, sendo que esse tempo foi relacionado com algumas queixas (p=0,037), tais como incômoda (27,8%), apertada (44,4%) eenjoo (5,6%). A retirada da máscara N95 (p=0,022) por esses profissionais antes do término da cirurgia foi relacionada a essas queixas. Conclusão: os trabalhadores apresentam queixas, como desconforto, máscara apertada e enjoo, sendo que estas estão relacionadas com o tempo de uso, o que precisa ser avaliado por gestores para a utilização da N95.

RESUMEN Objetivo: verificar las molestias presentadas por trabajadores que necesitan usar la mascarilla N95 durante sus actividades laborales. Método: investigación descriptiva con delineamiento transversal, desarrollada en el Centro Quirúrgico de un hospital de enseñanza ubicado en la región Sur de Brasil, en el período de junio a agosto de 2019, durante el turno de trabajo diurno. Se realizó el estudio con los profesionales de enfermería que estaban expuestos al humo quirúrgico en el período de trabajo. Para la recolección de los datos, se utilizó un instrumento con detalle sociodemográfico y ocupacional de los participantes y se entregó una mascarilla N95 a los profesionales para ser utilizada durante la cirugía, con el fin de verificar el tiempo de uso de la N95 y las razones por las que los trabajadores la quitaron durante el acto anestésico-quirúrgico. Resultados: el mayor número de trabajadores (27,7%) la utilizó hasta 3 horas durante el acto anestésico-quirúrgico, siendo que ese tiempo fue relacionado con algunas quejas (p=0,037), tales como: incómoda (27,8%), apretada (44,4%) y mareos (5,6%). El hecho de quitarse la mascarilla N95 (p=0,022), por estos profesionales, antes de la finalización de la cirugía se relacionó con estas quejas. Conclusión: los trabajadores presentan quejas, como incomodidad, mascarilla apretada y mareos, siendo que estas están relacionadas con el tiempo de uso, lo que necesita ser evaluado por gestores para la utilización de la N95.

ABSTRACT Objective: to check the discomfort presented by workers who need to use the N95 mask during their work activities. Method: descriptive and cross-sectional research, developed in the Surgical Center of a teaching hospital located in Southern Brazil, from June to August 2019, during the daytime work shift. The study was conducted with nursing professionals who were exposed to surgical smoke during their work period. In order to collect data, an instrument was used with sociodemographic and occupational details of the participants and a N95 mask was given to professionals to be used during surgery, in order to check the time of use of the N95 and the reasons why the workers removed the mask during the anesthetic-surgical procedure. Results: the largest number of workers (27.7%) used the mask for up to 3 hours during the anesthetic-surgical procedure, and this time was related to some complaints (p=0.037), such as discomfort (27.8%), tightness (44.4%) and nausea (5.6%). The removal of the N95 mask (p=0.022) by these professionals before the end of the surgery was related to these complaints. Conclusion: workers have complaints such as discomfort, tight mask and nausea, and these are related to the time of use, which needs to be assessed by managers for the use of N95.

Humans , Male , Female , Smoke , N95 Respirators , Masks , Nurses, Male , Respiratory Protective Devices , Surgical Procedures, Operative , Work , Health Personnel , Air Pollutants, Occupational , Personal Protective Equipment , Nausea , Nurse Practitioners
Article in English | WPRIM | ID: wpr-922123


BACKGROUND@#The side effects of chemotherapy-induced nausea and vomiting (CINV) and myelosuppression reduce the cancer patients' adherence to chemotherapy. Many Chinese patients choose Chinese medicine (CM) during chemotherapy to reduce side effects; however, the evidence is lacking. The efficacy of a CM herbal treatment protocol, Jianpi Bushen Sequential Formula (, JBSF) will be evaluated on chemotherapy completion rate among patients with colon cancer.@*METHODS@#A multi-center double-blind randomized controlled trial (RCT) will be conducted on 400 patients with colon cancer who will receive 8 cycles of adjuvant chemotherapy with oxaliplatin and capecitabine (CAPEOX). Patients will be randomized 1:1 to receive the JBSF or placebo formula. The primary outcome is the overall chemotherapy completion rate. The secondary outcomes include individual chemotherapy completion rate, 4-cycle completion rate of chemotherapy, time to treatment failure, relative dose intensity and treatment toxicity. Follow-up visits will be scheduled before every and after last chemotherapy.@*DISCUSSION@#This study will provide evidence on whether JBSF can improve the chemotherapy completion rate and reduce side effects among patients with colon cancer. (Trial registration:, No. NCT03716518).

Chemotherapy, Adjuvant , Colonic Neoplasms/drug therapy , Double-Blind Method , Humans , Multicenter Studies as Topic , Nausea , Quality of Life , Randomized Controlled Trials as Topic , Treatment Outcome , Vomiting
Arq. gastroenterol ; 57(4): 354-360, Oct.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1142334


ABSTRACT BACKGROUND: Cancer patients may have gastrointestinal changes that influence nutritional status. OBJECTIVE: To investigate the occurrence of gastrointestinal changes resulting from outpatient chemotherapy treatment in cancer patients. METHODS: In a retrospective longitudinal study, the nutritional status and chemotherapy gastrointestinal changes (nausea, vomit, diarrhea, constipation, mucositis, dysphagia, xerostomia, inappetence, dysgeusia and heartburn) in cancer patients (n=187) were investigated in an outpatient follow-up. For the study of the parameters over time, the generalized estimating equation (GEE) method was used. Kruskal-Wallis, Mann-Whitney tests and Spearman coefficient, at a significance level of 5% were also used. RESULTS: The majority of the patients were female (63.64%) and the mean age was 57.5±12.1 years. The most frequent symptoms were nausea (18.54%); inappetence (18.31%); intestinal constipation (11.58%); diarrhea (7.98%); xerostomia (7.59%) and vomiting (7.43%). The nutritional status did not exhibit any relevant changes (P=0.7594). However, a higher prevalence of eutrophy was observed, followed by overweight; vomiting exhibited a significant difference (P=0.0211). The nausea symptom exhibited a significant difference with a higher prevalence of colorectal neoplasia when compared to breast neoplasia (P=0.0062); as well as vomiting in lung and colorectal neoplasias (P=0.0022), and dysphagia, in head and neck neoplasia, when compared to other neoplasms (P<0.001). There was a statistically significant difference between the number of medical appointments and gender (P=0.0102) and between dysphagia and gender (P<0.0001). CONCLUSION: The study findings enhance the need for signs and symptoms follow up, as well as nutritional status follow up of patients undergoing outpatient chemotherapy.

RESUMO CONTEXTO: Pacientes oncológicos podem apresentar alterações gastrointestinais que influenciam o estado nutricional. OBJETIVO: Investigar a ocorrência de alterações gastrointestinais decorrentes do tratamento ambulatorial de quimioterapia, em pacientes oncológicos. MÉTODOS: Num estudo longitudinal retrospectivo, investigou-se o estado nutricional e as alterações gastrointestinais (náuseas, vômito, diarreia, constipação, mucosite, disfagia, xerostomia, inapetência, disgeusia e pirose) de pacientes oncológicos (n=187), em acompanhamento ambulatorial de quimioterapia. Para o estudo dos parâmetros ao longo do tempo, utilizou-se o método das equações de estimação generalizadas (EEG). Também foram utilizados os testes de Kruskal-Wallis, Mann-Whitney e o coeficiente de Spearman, com nível de significância de 5%. RESULTADOS: A maioria dos pacientes era do sexo feminino (63,64%) e a média de idade foi 57,5±12,1 anos. Os sintomas mais frequentes foram náuseas (18,54%); inapetência (18,31%); constipação intestinal (11,58%); diarreia (7,98%); xerostomia (7,59%) e vômito (7,43%). O estado nutricional não apresentou alterações relevantes (P=0,7594). No entanto, observou-se maior prevalência de eutrofia, seguido do sobrepeso e o vômito apresentou diferença significativa (P=0,0211). O sintoma de náusea apresentou diferença significativa com maior prevalência na neoplasia colorretal, quando comparado à neoplasia de mama (P=0,0062); assim como o vômito nas neoplasias de pulmão e colorretal (P=0,0022). E a disfagia, na neoplasia de cabeça e pescoço, quando comparada às demais neoplasias (P<0,001). Houve diferença estatisticamente significante entre o número de consultas médicas e sexo (P=0,0102) e entre disfagia e sexo (P<0,0001). CONCLUSÃO: Os achados encontrados no estudo permitem reforçar a necessidade do acompanhamento de sinais e sintomas, bem como do estado nutricional, de pacientes em acompanhamento ambulatorial de quimioterapia.

Humans , Female , Adult , Aged , Outpatients , Gastrointestinal Diseases/etiology , Neoplasms/complications , Neoplasms/drug therapy , Antineoplastic Agents/therapeutic use , Vomiting/etiology , Weight Loss , Nutritional Status , Retrospective Studies , Follow-Up Studies , Longitudinal Studies , Constipation/etiology , Diarrhea/etiology , Dyspepsia/etiology , Middle Aged , Nausea
Cienc. tecnol. salud ; 7(3): 381-395, 26 de noviembre 2020. ^c27 cmilus
Article in Spanish | LILACS, LIGCSA, DIGIUSAC | ID: biblio-1130181


La Enfermedad por Coronavirus 2019 (COVID-19) supone un reto sin precedentes para la salud pública. Los médicos deben fortalecer sus habilidades clínicas para combatir esta nueva enfermedad. El objetivo de esta revisión fue describir los signos, síntomas y complicaciones de pacientes con COVID-19. Se realizó una búsqueda en la literatura en la base de datos PubMed incluyendo publicaciones entre 1 de diciembre 2019 y 15 de agosto 2020, sin restricciones de lenguaje, utilizando las palabras clave 'COVID-19' cruzada con 'manifestaciones clínicas', 'signos y síntomas' y 'complicaciones'. Se incluyeron revisiones sistemáticas y meta-análisis, estudios epidemiológicos y series de casos. Se identificaron 1,066 artículos, de los cuales se seleccionaron 71 de acuerdo a los contenidos previamente definidos por los autores. La COVID-19 presenta un curso de leve a moderado y severo-crítico, específicamente en mayores de 65 años con o sin comorbilidades. Los signos y síntomas no son específicos y usualmente se superponen de acuerdo a la edad y a la fase de la enfermedad. Los síntomas más comunes son fiebre, tos y fatiga. Síntomas menos comunes incluyen escalofríos, dolor de garganta, cefalea, mialgias/artralgias, pérdida del gusto y del olfato, diarrea, nausea, vómitos, congestión nasal, palpitaciones, opresión precordial y dolor pleurítico. La sintomatología en niños difiere de la de los adultos y el curso es usualmente benigno y de baja mortalidad. La evaluación clínica de COVID-19 supone un reto hoy en día. Sin embargo, el conocimiento de la historia natural de la enfermedad permite situar los síntomas comunes e inespecíficos en el contexto clínico correcto.

Coronavirus disease 2019 (COVID-19) presents an unprecedented challenge to public health. Physicians must strengthen clinical skills for this new disease. This review aimed to describe the signs, symptoms and complications of patients with COVID-19. A literature search was conducted in the PubMed database, including publications between December 1, 2019, to August 15, 2020, without language restrictions, using the keywords 'COVID-19' crossed with 'clinical manifestations', 'signs and symptoms', and 'complications'. Systematic reviews, meta-analysis, epidemiological studies, and case report series were included. A total of 1,066 articles were identi¬fied, among 71 were selected according to the contents previously defined by the authors. COVID-19 has a mild to moderate or severe-critical course, specifically in over 65 years of age, with or without comorbidities. Signs and symptoms are not specific and usually overlap according to the age and stage of the disease. The most common symptoms are fever, cough, and fatigue. Less common symptoms include chills, sore throat, headache, myalgia/ arthralgia, loss of taste and smell, diarrhea, nausea, vomiting, nasal congestion, palpitations, chest tightness, and pleuritic pain. The symptomatology in children differs from that of adults, and the course is usually benign and low mortality. Clinical evaluation of COVID-19 is challenging today. However, knowledge of the disease's natural history allows placing common and nonspecific symptoms in the correct clinical context.

Humans , Male , Female , Child , Adult , Middle Aged , Aged , Signs and Symptoms , Betacoronavirus , COVID-19 , Pharyngitis , Cough , Ageusia , Diarrhea , Fever , Myalgia , Headache , Literature , Olfaction Disorders , Nausea
Arq. Asma, Alerg. Imunol ; 4(3): 360-362, jul.set.2020. ilus
Article in English | LILACS | ID: biblio-1382011


Ecallantide is a specific treatment currently indicated for acute crisis of hereditary angioedema (HAE) due to C1-inhibitor deficiency. Our objective is to report the first administration of ecallantide (Kalbitor®) in Peru, where the treatment was used in an HAE patient with normal C1-inhibitor and no F12 gene alteration. We report the case of a 32-year-old postpartum patient with HAE with normal C1-inhibitor who belongs to the Peruvian Association of Patients with Hereditary Angioedema. During pregnancy, she had increased frequency and intensity of abdominal pain and facial edema crisis and received maintenance treatment with tranexamic acid and spasmolytics, with moderate response. One month postpartum, the patient showed respiratory symptoms and tested positive for coronavirus disease (COVID-19) in a polymerase chain reaction (PCR) test, without any HAE crisis during the infectious process. Three months postpartum, she had an acute laryngeal edema crisis with difficulty breathing and speaking, nausea, and vomiting, triggered by nonsteroidal anti-inflammatory drugs (NSAIDs). The patient then received treatment with antihistamines, corticosteroids, and adrenaline, without improvement; for that reason, the allergist administered ecallantide (Kalbitor®) with good response within the first 15 minutes of administration. Some Peruvian HAE patients have developed mild-to-moderate facial and peripheral edema crisis after NSAID intake, without improvement after administration of allergy treatment. In our patient, HAE crisis was not triggered by COVID-19. The patient showed worsening HAE crisis during pregnancy. The first administration of ecallantide (Kalbitor®) in Peru had good response and tolerance to the treatment as shown in this report.

Ecallantide é um tratamento específico totalmente indicado na crise aguda de deficiência de inibidor de C1 HAE. Nosso objetivo é relatar a primeira administração de Ecallantide (Kalbitor®) no Peru, um caso de paciente peruano com EH com inibidor C1 normal sem alteração genética F12. Relatamos o caso de uma paciente de 32 anos, pós-parto, com HAE inibidor de C1 normal, pertencente à Associação Peruana de Angioedema Hereditário de Pacientes. Durante a gravidez, a paciente apresentou aumento na frequência e intensidade das crises de edema abdominal e facial e recebeu tratamento de manutenção com ácido tranexâmico e espasmolítico, com resposta moderada. Um mês após o parto, a paciente apresentou quadro respiratório e teste de PCR molecular positivo para Doença do Coronavírus (COVID-19), sem crise de AEH durante o processo infeccioso. Três meses após o parto, a paciente apresentou crise de edema agudo de laringe com dificuldade para respirar e falar, náuseas e vômitos, desencadeado por AINH. A paciente recebeu tratamento com anti-histamínicos, corticosteroides e adrenalina sem melhora, por isso o alergista administrou Ecallantide (Kalbitor®) com boa resposta nos primeiros 15 minutos após o início da administração. Alguns pacientes peruanos com AEH desenvolveram crises de edema facial e periférico leve a moderado após a ingestão de AINEs, sem melhora após a administração de tratamento para alergia. Em nossa paciente, a crise de AEH não foi desencadeada por infecção aguda por COVID-19. A paciente apresentou agravamento da crise de AEH durante a gravidez. Apresentamos a primeira administração de Ecallantide (Kalbitor®) no Peru, com boa resposta e tolerância ao tratamento.

Humans , Female , Adult , Tranexamic Acid , Abdominal Pain , Laryngeal Edema , Postpartum Period , Angioedemas, Hereditary , COVID-19 , Histamine Antagonists , Patients , Peru , Therapeutics , Vomiting , Anti-Inflammatory Agents, Non-Steroidal , Adrenal Cortex Hormones , Edema , Hypersensitivity , Nausea
Arq. ciências saúde UNIPAR ; 24(1): 35-39, jan-abr. 2020.
Article in Portuguese | LILACS | ID: biblio-1095986


O câncer infanto-juvenil corresponde a um grupo de várias doenças que têm em comum a proliferação descontrolada de células anormais e que pode ocorrer em qualquer órgão em fase de desenvolvimento. Assim, o objetivo deste estudo foi descrever o perfil clínico e epidemiológico de crianças e adolescentes atendidos na UNACON durante o ano de 2017. Trata-se de um estudo descritivo, de corte transversal, desenvolvido a partir da análise de 20 prontuários de crianças e adolescentes com câncer. Foram coletados dados sobre as características sociodemográficas e clínicas-epidemiológicas dos pacientes. Os dados foram digitados, revisados e analisados no programa estatístico SPSS, na versão 21.0. Foram calculadas as frequências e a média das variáveis de interesse. Observou-se que a maioria dos pacientes tinha de um a três anos (45,0%), era do sexo masculino (60,0%), pardos (70,0%), com renda familiar de até um salário mínimo (60,0%) e metade procedia do interior do estado (50,0%), sendo o tipo de câncer mais diagnosticado a leucemia linfoide aguda (45,0%) e o principal tratamento utilizado a quimioterapia (95,0%), causando principalmente alopecia (100%), algia (100%), náuseas (65,0%), palidez (40,0%) e febre (25,0%) nos pacientes. Foi possível concluir que conhecer o perfil pode contribuir para a tomada de decisões da equipe gestora e profissionais de saúde da unidade no estabelecimento de medidas assistenciais aos pacientes, visando um atendimento mais humanizado, voltado para as necessidades sociodemográficas e levando em consideração as características clínicas-epidemiológicas desse grupo populacional.

Child and youth cancer corresponds to a group of several diseases that have in common the uncontrolled proliferation of abnormal cells and that can occur in any organ during the development phase. Thus, the purpose of this study was to describe the clinical and epidemiological profile of children and adolescents cared at UNACON during 2017. It is a descriptive, cross-sectional study developed from the analysis of 20 records of children and adolescents with cancer. Data on the sociodemographic and clinical-epidemiological characteristics of the patients were collected. The data were entered, reviewed and analyzed using the SPSS statistical program, version 21.0. The frequencies and the average of the variables of interest were calculated. It could be observed that the majority of patients were aged between one and three years (45.0%), male (60.0%), brown (70.0%), with a family income of up to one minimum wage (60.0%) and half (50.0%) came from the interior of the state, with acute lymphoid leukemia (45.0%) being the most frequent diagnosis, and chemotherapy (95.0%) the most frequent treatment used, causing mainly alopecia (100%), pain (100%), nausea (65.0%), pallor (40.0%) and fever (25.0%) in patients. It was possible to conclude that knowing the profile can contribute to the decision-making of the management team and health professionals at the health facility in the establishment of care measures for patients, aiming at a more humanized care, focused on sociodemographic needs and taking into account the clinical-epidemiological characteristics of this population group.

Humans , Male , Female , Infant , Child, Preschool , Child , Health Profile , Neoplasms , Therapeutics , Leukemia/prevention & control , Medical Records , Diagnosis , Drug Therapy , Alopecia/drug therapy , Health Services Needs and Demand , Medical Oncology , Nausea/drug therapy
Rev. Soc. Bras. Clín. Méd ; 18(2): 112-115, abril/jun 2020.
Article in Portuguese | LILACS | ID: biblio-1361466


Esta revisão narrativa da literatura tratou da cefaleia sentinela. A cefaleia é um acometimento de alta prevalência mundial, sobretudo em mulheres. São várias as condições que podem levar à sua ocorrência, destacando-se, entre elas, a hemorragia subaracnóidea, que é sabidamente a terceira maior causa de acidente vascular encefálico. No âmbito da hemorragia subaracnóidea, existe um sintoma que, por vezes, é ignorado na investigação clÍnica do acidente vascular encefálico: é a cefaleia sentinela. Ela é conceituada como sendo cefaleia súbita, não usual, do tipo explosiva, persistente e de menor intensidade que a dor de cabeça da hemorragia subaracnóidea. Geralmente precede a hemorragia subaracnóidea por dias ou semanas. Este manuscrito traz uma revisão narrativa da literatura sobre cefaleia sentinela, usando as bases de dados PubMed® e Literatura Latino-Americana e do Caribe em Ciências da Saúde. A prevalência dessa condição é de 10% a 43% na hemorragia subaracnóidea, podendo ser fator preditor na identificação precoce do paciente com risco para sangramento aneurismático. Torna-se, então, necessária tanto a educação médica como a atuação precisa acerca do tema, a fim de mudar os desfechos da hemorragia subaracnóidea.

This narrative review of the literature addressed the sentinel headache. headaches are of high prevalence worldwide, especially in women. Several conditions can lead to its occurrence, such as the subarachnoid hemorrhage (known to be the third main cause of stroke). In the context of subarachnoid hemorrhage, there is a symptom that is sometimes overlooked in the clinical investigation of stroke: the sentinel headache. It is conceptualized as sudden, unusual, of explosive nature, persistent and of lesser intensity than the subarachnoid hemorrhage headache. It usually precedes the subarachnoid hemorrhage by days or weeks. This study provides a narrative review of the literature on sentinel headache, using the PubMed® and Latin American and Caribbean Health Sciences Literature databases. The prevalence of this condition in subarachnoid hemorrhage is 10 - 43%, and may be a predictive factor in the early identification of the patient with risk for aneurysmal bleeding. Both medical education and accurate action on this issue are necessary to change the outcomes of subarachnoid hemorrhage.

Humans , Subarachnoid Hemorrhage/complications , Headache/etiology , Subarachnoid Hemorrhage/diagnosis , Vomiting/etiology , Intracranial Aneurysm/diagnosis , Papilledema/etiology , Headache/diagnosis , Nausea/etiology
Med. UIS ; 33(1): 31-38, ene.-abr. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1124983


Resumen Introducción: el modafinilo es un fármaco neuroestimulante utilizado principalmente para promover estados de vigilia atención y disminuir la fatiga ante ciertos comportamientos que propician la somnolencia diurna excesiva. Objetivo: identificar en la literatura científica los efectos adversos neurológicos y cardiovasculares causados por el consumo del modafinilo. Materiales y Métodos: revisión bibliográfica de los artículos encontrados entre los meses de abril y julio de 2019 en las bases de datos PUBMED, SCOPUS, DIALNET. 51 artículos superaron la evaluación de calidad metodológica y se incluyeron en la revisión. Resultados: se identificaron que los principales efectos adversos a nivel cardiovascular son la cardiomiopatía Tako-Tsubo y la taquicardia ventricular polimórfica, mientras que a nivel neurológico puede generar insomnio y distonías. Conclusiones: El consumo del modafinilo genera repercusiones en las funciones cognitivas y cardiovasculares por lo cual no es aconsejable su uso a largo plazo en personas sanas. MÉD. UIS.2020;33(1):31-8.

Abstract Introduction: modafinil is a neurostimulant drug used mainly to promote wakefulness, attention and decrease fatigue in certain behaviors that cause excessive daytime sleepiness. Objective: identify in the scientific literature the neurological and cardiovascular adverse effects caused by the consumption of modafinil. Materials and Methods: bibliographic review of the articles found between the months of April and July of 2019 in the PUBMED, SCOPUS, DIALNET databases. 51 articles passed the methodological quality assessment and were included in the review. Results: the main adverse effects at the cardiovascular level were identified as Tako-Tsubo cardiomyopathy and polymorphic ventricular tachycardia, while at the neurological level it can generate insomnia and dystonia. Conclusions: the consumption of modafinil generates repercussions on cognitive and cardiovascular functions, so its long-term use in healthy people is not advisable. MÉD.UIS.2020;33(1):31-8.

Humans , Male , Female , Child , Adolescent , Adult , Sleep Wake Disorders , Tachycardia, Ventricular , Modafinil , Tachycardia , Blood Pressure , Dystonia , Takotsubo Cardiomyopathy , Headache , Central Nervous System Stimulants , Sleep Initiation and Maintenance Disorders , Narcolepsy , Nausea
Arq. Asma, Alerg. Imunol ; 4(1): 99-102, jan.mar.2020. ilus
Article in Portuguese | LILACS | ID: biblio-1381792


Introdução: A dermatite atópica (DA) é uma doença inflamatória da pele, multifatorial, crônica e recorrente, caracterizada por lesões eczematosas e prurido intenso. Nos casos graves refratários aos tratamentos tópicos, tem se utilizado imunossupressão sistêmica para o controle da doença, sendo a ciclosporina considerada por muitos como terapia de escolha. Este estudo visa avaliar a incidência e gravidade dos eventos adversos relacionados ao uso de ciclosporina em pacientes com DA grave. Métodos: Estudo retrospectivo observacional com análise de prontuários de pacientes com dermatite atópica grave em uso de ciclosporina atendidos em hospital terciário no período de 3 anos. Resultados: Avaliados 80 pacientes com dermatite atópica grave usando ciclosporina, com média de idade de 25,5 anos e 41 do sexo feminino (51,3%). Foram relatados eventos adversos em 25 pacientes. O tempo médio de uso de ciclosporina no grupo com eventos adversos foi de 29,3 meses. Os eventos de maior gravidade foram alteração da função renal e hipertensão, sendo mais observados nos casos de doença mais refratária, quando o uso de ciclosporina foi muito prolongado, superior a 60 meses. As reações evidenciadas foram: hipertensão arterial 40%, alteração renal 20%, náuseas/vômitos 16%, cefaleia 12%, herpes de repetição 12% e outros 4%. Os eventos adversos normalizaram após suspensão da ciclosporina. Conclusão: Pacientes com dermatite atópica grave que usaram ciclosporina por tempo prolongado tiveram maior frequência de eventos adversos potencialmente graves. Todos os efeitos adversos normalizaram após a suspensão de medicação.

Rationale: Atopic dermatitis (AD) is an inflammatory, multifactorial, chronic, recurrent skin disease characterized by eczematous lesions and intense itching. In severe cases refractory to topical treatments, systemic immunosuppression has been used to control the disease, and cyclosporine is largely considered firstline therapy. This study aims to assess the incidence and severity of adverse events related to the use of cyclosporine in patients with severe AD. Methods: This retrospective observational study analyzed medical records of patients with severe atopic dermatitis using cyclosporine treated at a tertiary hospital over a 3-year period. Results: Eighty patients with severe atopic dermatitis using cyclosporine were evaluated. Their mean age was 25.5 years, and 41 (51.3%) were female. Adverse events were reported in 25 patients. The mean duration of cyclosporine treatment in the group with adverse events was 29.3 months. The most serious events were changes in renal function and hypertension, which were most often observed in cases of more refractory disease, when the use of cyclosporine was very prolonged (over 60 months). The adverse reactions were hypertension (40%), renal changes (20%), nausea/vomiting (16%), headache (12%), recurrent herpes (12%) and others (4%). Adverse events were under control after cyclosporine was discontinued. Conclusion: Patients with severe atopic dermatitis who used cyclosporine for a long time had a higher frequency of potentially serious adverse events. All adverse effects were under control after discontinuation of medication.

Humans , Cyclosporine , Cyclosporins/adverse effects , Dermatitis, Atopic , Headache , Hypertension , Nausea , Patients , Therapeutics , Retrospective Studies , Immunosuppression Therapy , Drug-Related Side Effects and Adverse Reactions