Eventos adversos a meios de contraste iodados em angioplastias coronárias / Adverse events to iodine contrast mediums in coronary angioplasties

Objetivo: identificar a incidência de eventos adversos a meios de contraste iodados em pacientes submetidos à angioplastia coronária. Método: trata-se de um estudo quantitativo, descritivo, exploratório, prospectivo e observacional realizado com registros de um setor de Hemodinâmica. Entrevistaram-se 104 indivíduos, excluíram-se 36 após a análise de prontuários e incluíram-se 68. Compilaram-se os dados com Microsoft Excel e realizou-se a análise estatística descritiva, apresentando os resultados em tabelas. Resultados: identificaram-se três eventos adversos relacionados aos meios de contraste em três diferentes participantes, sendo dois do sexo masculino e um do sexo feminino, onde se utilizaram, respectivamente, 120, 130 e 450 mililitros de volume de contraste. Conclusão: constatou-se que a prevalência de 4,4% de eventos está em consonância com a literatura. Observou-se que não se relacionou fator causal principal e verificou-se que os eventos adversos constituem importantes indicadores da qualidade da assistência, sendo pertinente a sua prevenção.(AU)

Objective: to identify the incidence of adverse events to iodinated contrast media in patients submitted to Coronary Angioplasty. Method: this is a quantitative, descriptive, exploratory, prospective and observational study carried out with records from the Hemodynamics sector. A total of 104 subjects were interviewed, 36 were excluded after chart analysis, and 68 were included. Data were compiled with Microsoft Excel and descriptive statistical analysis was performed, presenting the results in tables. Results: three adverse events related to contrast media were identified in three different participants: two males and one female, where 120, 130 and 450 milliliters of contrast volume were used, respectively. Conclusion: it was observed that the prevalence of 4.4% of events is in line with the literature. It was observed that the main causal factor was not related and it was verified that the adverse events are important indicators of the quality of the assistance, being pertinent its prevention.(AU)

Objetivo: identificar la incidencia de eventos adversos a medios de contraste yodados en pacientes sometidos a la angioplastia coronaria. Método: se trata de un estudio cuantitativo, descriptivo, exploratorio, prospectivo y observacional realizado con registros de un sector de Hemodinámica. Se entrevistaron 104 individuos, excluidos 36 después del análisis de prontuario y se incluyeron 68. Los datos fueron seleccionados con Microsoft Excel y se realizó el análisis estadístico descriptivo presentando los resultados en tablas. Resultados: se identificaron tres eventos adversos relacionados con los medios de contraste en tres diferentes participantes, siendo dos del sexo masculino y un del sexo femenino donde se utilizó, respectivamente, 120, 130 y 450 mililitros de volumen de contraste. Conclusión: se constató que la prevalencia del 4,4% de eventos está en consonancia con la literatura. Se observó que no se relacionó factor causal principal y se verificó que los eventos adversos constituyen importantes indicadores de la calidad de la asistencia, siendo pertinente su prevención.(AU)

Thrombus aspiration in STEMI patients: an updated systematic review and meta-analysis.

INTRODUCTION: Clinical efficacy and safety of adjunctive thrombus aspiration (TA) in patients with ST-segment elevation myocardial infarction (STEMI) during percutaneous coronary intervention (PCI) remain controversial. EVIDENCE ACQUISITION: Twenty-five eligible randomized controlled trials were included to compare the use of TA with PCI and PCI-only for STEMI. The primary endpoint was major adverse cardiac events (MACE) according to study definitions. The secondary endpoints were all-cause mortality, recurrent myocardial infarction (MI), target vessel revascularization (TVR), stent thrombosis (ST) and stroke. EVIDENCE SYNTHESIS: In comparison with conventional PCI, TA followed by PCI was associated with a lower risk for MACE with statistical significance [relative risk (RR): 0.91; 95% confidence interval (CI): 0.83-0.99; P=0.04). Regarding secondary endpoints, there was a significant increase in the risk for stroke (RR: 1.56; 95% CI: 1.09-2.24; P=0.015); there were no differences in the risk of all-cause mortality (RR: 0.88; 95% CI: 0.78-1.01; P=0.06), myocardial infarction (RR: 0.94; 95% CI: 0.79-1.13; P=0.537), target vessel revascularization (RR: 0.92; 95% CI: 0.82-1.04; P=0.177), and definite or probable stent thrombosis (RR: 0.84; 95% CI: 0.66-1.07; P=0.151). CONCLUSIONS: Updated data about routine TA-assisted PCI in STEMI showed reduced risk of subsequent MACE in comparison with conventional primary PCI, but get limited benefits related to the clinical endpoints, and may be associated with an increase in the risk of stroke. As a routine strategy, TA in patients with STEMI cannot be supported.

Phenomenology of OCD: lessons from a large multicenter study and implications for ICD-11.

This study aimed to investigate the phenomenology of obsessive-compulsive disorder (OCD), addressing specific questions about the nature of obsessions and compulsions, and to contribute to the World Health Organization's (WHO) revision of OCD diagnostic guidelines. Data from 1001 patients from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders were used. Patients were evaluated by trained clinicians using validated instruments, including the Dimensional Yale-Brown Obsessive-Compulsive Scale, the University of Sao Paulo Sensory Phenomena Scale, and the Brown Assessment of Beliefs Scale. The aims were to compare the types of sensory phenomena (SP, subjective experiences that precede or accompany compulsions) in OCD patients with and without tic disorders and to determine the frequency of mental compulsions, the co-occurrence of obsessions and compulsions, and the range of insight. SP were common in the whole sample, but patients with tic disorders were more likely to have physical sensations and urges only. Mental compulsions occurred in the majority of OCD patients. It was extremely rare for OCD patients to have obsessions without compulsions. A wide range of insight into OCD beliefs was observed, with a small subset presenting no insight. The data generated from this large sample will help practicing clinicians appreciate the full range of OCD symptoms and confirm prior studies in smaller samples the degree to which insight varies. These findings also support specific revisions to the WHO's diagnostic guidelines for OCD, such as describing sensory phenomena, mental compulsions and level of insight, so that the world-wide recognition of this disabling disorder is increased.