scholarly journals Revisão Narrativa sobre Choque na Sala de Emergência

2021 ◽  
Vol 34 (13) ◽  
Author(s):  
Jorge Dantas ◽  
Rita Vaz ◽  
Rui Morais ◽  
Irene Verdasca

The patient in shock represents a common clinical challenge in the emergency room, and potentially represents an immediate lifethreatening situation that requires the intervention of different medical specialties in order for hemodynamic stabilization to be achieved. This paper reports a non-systematic review of the initial approach to the patient in shock, highlighting the adaptation of the instituted measures to the particularities of the emergency room environment. This review is structured according to a proposed protocol of action based on the early diagnosis of shock, the identification of the type of shock and the most likely cause, and the institution of supportive therapy. The initial stabilization of the patient should be guided by the identification of failing physiological mechanisms, having in mind that strategies with little meaning in other contexts may be of interest in the emergency room - as they are practical and can be rapidly implemented - as is the case with the administration of vasoactive drugs in bolus or by peripheral access.

2016 ◽  
pp. 45-49
Author(s):  
P.N. Veropotvelyan ◽  
◽  
I.S. Tsehmistrenko ◽  
N.P. Veropotvelyan ◽  
N.S. Rusak ◽  
...  

Was to conduct a systematic review of data on the relationship between polymorphisms genes of detoxification system and development of preeclampsia (РЕ). Рresents the main genes of detoxification system (GSTPI, GSTМI, GSTТI, GРХI, ЕРНХI, SOD-2, SOD-3, CYPIAL, MTHЕR, MTR) and their functions. Of interest is the possibility of calculating the individual risk of PE based on the results about the presence of a combination of different polymorphisms in the genotype of the female. Question about early diagnosis of РЕ remains controversial and not fully understood. It is necessary to conduct further in-depth, extended study of this problem. Key words: preeclampsia, oxidative stress, genes of the detoxification system.


Author(s):  
Eva Hulstaert ◽  
Annelien Morlion ◽  
Keren Levanon ◽  
Jo Vandesompele ◽  
Pieter Mestdagh

2020 ◽  
Vol 105 (7) ◽  
pp. 2119-2131 ◽  
Author(s):  
Julie Harvengt ◽  
Caroline Gernay ◽  
Meriem Mastouri ◽  
Nesrine Farhat ◽  
Marie-Christine Lebrethon ◽  
...  

Abstract Context Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, autonomic dysregulation and neural crest tumor (ROHHHAD[NET]) is a rare and potentially fatal disease. No specific diagnostic biomarker is currently available, making prompt diagnosis challenging. Since its first definition in 2007, a complete clinical analysis leading to specific diagnosis and follow-up recommendations is still missing. Objective The purpose of this work is to describe the clinical timeline of symptoms of ROHHAD(NET) and propose recommendations for diagnosis and follow-up. Design We conducted a systematic review of all ROHHAD(NET) case studies and report a new ROHHAD patient with early diagnosis and multidisciplinary care. Methods All the articles that meet the definition of ROHHAD(NET) and provide chronological clinical data were reviewed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis individual patient data guidelines. The data were grouped into 7 categories: hypothalamic dysfunction, autonomic dysregulation, hypoventilation, NET, psychiatric symptoms, other clinical manifestations, and outcome. Results Forty-three individual patient data descriptions were analyzed. The timeline of the disease shows rapid-onset obesity followed shortly by hypothalamic dysfunction. Dysautonomia was reported at a median age of 4.95 years and hypoventilation at 5.33 years, or 2.2 years after the initial obesity. A NET was reported in 56% of the patients, and 70% of these tumors were diagnosed within 2 years after initial weight gain. Conclusion Because early diagnosis improves the clinical management and the prognosis in ROHHAD(NET), this diagnosis should be considered for any child with rapid and early obesity. We propose guidance for systematic follow-up and advise multidisciplinary management with the aim of improving prognosis and life expectancy.


2018 ◽  
Vol 42 (1) ◽  
pp. 36-43 ◽  
Author(s):  
Stefano Palma ◽  
Mohammad Keilani ◽  
Timothy Hasenoehrl ◽  
Richard Crevenna

2021 ◽  
Vol 14 (8) ◽  
pp. 793
Author(s):  
Gniewko Więckiewicz ◽  
Iga Stokłosa ◽  
Magdalena Piegza ◽  
Piotr Gorczyca ◽  
Robert Pudlo

Despite many different kinds of substances available for depression treatment, depression itself still appears to be a clinical challenge. Recently, formerly illicit substances came to scientists’ attention, including lysergic acid diethylamide (LSD), psilocybin and dimethyltryptamine (DMT). Some studies suggest that these substances might be effective in depression treatment. The aim of this study was to evaluate the efficiency of LSD, psilocybin and DMT in depression treatment in the light of current medical literature. The authors followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines for this systematic review. The authors searched the PubMed and Cochrane Library databases to identify relevant publications. Finally, 10 papers were included. Most of the selected studies showed significant correlation between psilocybin and DMT use and reduction in depression symptom intensity. By analyzing qualified studies, it can be concluded that psilocybin and DMT could be useful in depression treatment, but further observations are still required.


Author(s):  
Hassan Boskabadi ◽  
Ali Moradi ◽  
Maryam Zakerihamidi

Background: Biochemical markers including interleukins (ILs) has been proposed for early diagnosis of asphyxia. Objective: This study has aimed to systematically review the significance of IL measurements in the diagnosis of perinatal asphyxia. Materials and Methods: PubMed, Cochrane Library, Web of Science, Embase, and Scopus databases before 2017 were searched for the following keywords: asphyxia, neonatal, interleukin, and diagnosis. A total of 13 out of 300 searched papers were finally selected for evaluation. Interleukins under study were IL6 and interleukin 1


2017 ◽  
Vol 15 (1) ◽  
pp. 5-17 ◽  
Author(s):  
Toby Smith ◽  
Jane Cross ◽  
Fiona Poland ◽  
Felix Clay ◽  
Abbey Brookes ◽  
...  

Background: Primary care services frequently provide the initial contact between people with dementia and health service providers. Early diagnosis and screening programmes have been suggested as a possible strategy to improve the identification of such individuals and treatment and planning health and social care support. Objective: To determine what early diagnostic and screening programmes have been adopted in primary care practice, to explore who should deliver these and to determine the possible positive and negative effects of an early diagnostic and screening programme for people with dementia in primary care. Methods: A systematic review of the literature was undertaken using published and unpublished research databases. All papers answering our research objectives were included. A narrative analysis of the literature was undertaken, with the CASP tools used appropriately to assess study quality. Results: Thirty-three papers were identified of moderate to high quality. The limited therapeutic options for those diagnosed with dementia means that even if such a programme was instigated, the clinical value remains questionable. Furthermore, accuracy of the diagnosis remains difficult to assess due to poor evidence and this raises questions regarding whether people could be over- or under-diagnosed. Given the negative social and psychological consequences of such a diagnosis, this could be devastating for individuals. Conclusion: Early diagnostic and screening programmes have not been widely adopted into primary care. Until there is rigorous evidence assessing the clinical and cost-effectiveness of such programmes, there remains insufficient evidence to support the adoption of these programmes in practice.


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