Vacuum-assisted venous drainage in cardiopulmonary bypass and need of blood transfusion: experience of service.

OBJECTIVE: To report the experience with the vacuum-assisted venous drainage (VAVD) technique in cardiopulmonary bypass (CPBP) and blood transfusion need. METHODS: A retrospective study was made about data from 111 patients who were operated, using VAVD between October 2006 and February 2008, at the Esperança Hospital, Recife, Pernambuco. The necessity of blood transfusion was verified on the single group of patients who underwent VAVD, comparing with sex, age and weigh, before the beginning of the CPBP and during the surgery, using Chi-square test and t-student test. RESULTS: Before the beginning of the CPBP only 10% of patients had need for blood transfusion and 12% during the surgery. It was observed that 17% of women received blood transfusion versus 4.7% of men before the beginning of CPBP (P=0.51), and 38% of women versus 9% of men during the surgery (P<0.001). The weight of patients who received blood transfusion were lower both before the beginning of the CPBP as during the surgery (P=0.049 e P=0.001, respectively). CONCLUSION: The VAVD technique has been used safely and satisfactorily, optimizing venous drainage during CPBP, in the hospital that conducted the study. However, prospective and comparative investigations between conventional drainage and VAVD are needed to better clarify this relation with blood transfusion.

Comparação da eficácia da aroeira oral (Schinus terebinthifolius Raddi) com omeprazol em pacientes com gastrite e sintomas dispepticos: estudo randomizado e duplo-cego / Comparision of the efficacy of oral mastic (Schinus terebinthifolius Raddi) with omeprazole in patients with gastritis and dyspeptic symptons: a randomized, double-blind

Objetivo: comparar a eficácia e segurança da aroeira oral (Schinus terebinthifolius Raddi) versus omeprazol no tratamento de pacientes com sintomas dispépticos associados à gastrite. Métodos: este estudo clínico foi prospectivo, randomizado e duplo-cego. Setenta e dois pacientes com gastrite confirmada pelo exame endoscópico e anatomopatológico foram aleatoriamente convidados a receber comprimidos de aroeira ou omeprazol, por quatro semanas. A eficácia foi avaliada pelo desaparecimento ou melhora dos sintomas e pela melhora dos achados endoscópicos e histopatológicos. A avaliação do relato de incidência de efeitos adversos do medicamento também foi feita por questionário padronizado. Exames de endoscopia digestiva alta e anatomopatológicos foram realizados antes do tratamento e após o término da terapia. Resultados: a melhora percentual dos sintomas foi maior no grupo da aroeira, mas a diferença não foi estatisticamente significativa. Também não houve diferença significativa nos resultados dos achados endoscópicos e histopatológicos entre os dois grupos. Conclusão: aroeira se mostrou tão eficiente quanto omeprazol no tratamento dos sintomas dispépticos em pacientes com gastrite.

Objective: to compare the efficacy and safety of aroeira oral (Schinus terebinthifolius Raddi) versus omeprazole in the treatment of patients with dyspeptic symptoms associated with gastritis. Methods: this was a randomized, doubleblind clinical study. Seventy two patients with gastritis were randomly assigned to receive aroeira or omeprazole daily. Efficacy was assessed by evaluating improvement on endoscopic and hystopathologics findings and by symptom disappearance rates. Safety was assessed by recording incidence of any adverse drug reactions. Upper gastro-intestinal endoscopy was conducted at baseline and after therapy. Results: there were no significant differences in the baseline characteristics between the two groups. Symptom disappearance rates were higher in the aroeiras group but the difference was not significant. There was also no significant difference in the result of endoscopic and hystopathologic data between the groups. Conclusion: aroeira appears to be as effective as omeprazole for gastritis-associated dyspeptics symptoms in gastritis patients.

Tromboembolismo pulmonar em pacientes com retocolite ulcerativa / Pulmonary thromboembolism in patient with ulcerative rectocolitis

Os autores apresentam o caso de uma paciente de 42 anos,portadora de Retocolite Ulcerativa Inespecífica (RCUI) assintomática há 6 anos, sem tratamento adequado. Foi internada após surgirem sintomas da doença em atividade (febre, astenia, diarreia sanguinolenta), realizou tratamento e recebeu alta. Posteriormente, retornou com queixa de edema em panturrilha esquerda, sendo diagnosticada Trombose Venosa Profunda (TVP) e utilizado heparina, que após 24h foi suspensa pelo fato da paciente ter apresentado hematoquezia intensa. Três dias após, a paciente apresentou quadro de desconforto respiratório e dor torácica, recebendo o diagnóstico de Tromboembolismo Pulmonar (TEP). Foi colocado filtro de veia cava inferior e iniciado heparinização com Marevan®, que foi suspenso seis meses depois. Atualmente, encontra-se em acompanhamento no ambulatório de Gastroenterologia do Hospital das Clínicas (HC) ­ UFPE, sem queixas, emuso de Sulfassalazina.

The authors present a case of a 42 year-old patient who developed Inespecifi c Ulcerative Rectocolitis, being asymptomatic for six years, without adequate treatment. She was interned after the appearance of symptoms of the disease in activity (fever, asthenia, bloody diarrhea). She underwent treatement and was discharged. Afterwards, she returned complaining about edema in the left calf, being diagnosed of a Deep Venous Thrombosis and using heparin that was suspended after 24 hours, because the patient developed intense hematochezia. After three days, the patient had respiratory discomfort and thoracic pain, and was diagnosed of a pulmonary thromboembolism, and was initialized a filter to the inferior vena cava and was used heparinezation with Marevan®, which was suspended six months later. Nowadays, the patient is accompanied by the Gastroenterology ambulatory of Hospital das Clinicas-Pernambuco, without complaints, using Sulfassalazin.