Background: Cerebral venous thrombosis (CVT) is still documented as a rare disease that affects less than 1% of the population, mainly young women. Symptoms are nonspecific, easily confused with less severe pathologies, with a primary focus on headache, which requires attention and knowledge from professionals. The diagnosis is made possible by the use of complementary exams, when the diagnosis is made early, it is of high recovery. In case of late diagnosis or incorrect treatment, the sequelae may be irreversible. Objectives and methodology: to analyze the use of new anticoagulants (NOACs) in relation to treatment with warfarin in cases of CVT, through narrative review. Studies from the years 2015-2020 were used in the following databases: Pubmed, Scielo and Medline. Results: Studies from the last 5 years, composed mainly of case reports and multicentric analyzes, report non-inferiority of the outcome when treatments are compared or better outcome with NOACs due to the lower risk of bleeding. However, the European Stroke Organization in its last guideline (2017) does not recommend the use, especially during the acute phase. Conclusions: CVT can affect patients of various ages, so knowledge of the best therapy is essential. Currently, the use of warfarin and heparin is still recommended for acute cases, assessing the risk of complications such as bleeding. In view of the possible safety of new anticoagulants in view of the risk of hemorrhagic complications, further studies of non-inferiority in relation to warfarin are necessary so that the best approach is employed for these patients.
Background: Cerebral venous thrombosis (CVT) is a rare condition (less than 1% of stroke). It occurs in the younger population (less than 50 years old), 3 times more common in women, especially those of reproductive age. Objectives and methodology: Narrative review to correlate CVT with the use of combined oral contraceptives (ACO). The following databases were used: Pubmed, Scielo and Medline. Results: A systematic review had 11 studies included showing that the use of OAC increases the chances of developing CVST (central venous sinus thrombosis). Among the 9 studies that reported odds ratios, the combined probability of developing CVST in women of reproductive age who use OAC was 7.59 times the probability of developing CVST compared to those who do not take oral contraceptives (OR = 7.59, 95 CI % 3.82-15.09). A retrospective study of 37 female adolescents was diagnosed with CVT, 22 (59%) of whom used OAC and the remaining 15 had other etiological factors. The data indicate that adolescents using OAC to treat hirsutism, menstrual dysfunction or polycystic ovary syndrome may also have some risk factors for thrombosis, such as hereditary coagulopathy. The coexistence of these diseases mentioned with the use of OCA can increase the risk of CVT. Conclusions: The two main studies analyzed concluded the association between the use of ACO and cases of CVT in women. It’s necessary to be attentive to suggestive signs and symptoms in this population, as they are common to other pathologies, making the diagnosis of CVT difficult.
Introduction: Obesity is one of the biggest world health issues in current days; it results in the increasing prevalence of bariatric surgery. The gastric bypass Roux-en-Y is one of the most performed surgeries for weight loss, however, it is associated with an elevated risk of cholelithiasis development. Objective: The study's objective is evaluating the benefits of ursodeoxycholic acid versus to prophylaxis cholecystectomy for cholelithiasis prevention. Methodology: This study is a narrative revision of literature. The key words cholelithiasis; gastric bypass ; gastrectomy; ursodeoxycholic acid, were searched in the databases PubMed / Medline. Results: 13 articles were selected for analysis, wich the most recent was published in 2019 and the oldest in 2015. The type of studies accepted were cohort study, systematic reviews and metanalysis. Discussion: The preventive cholecystectomy and the post-bariatric offers risks and complications. The preventive use of UDCA significantly reduces the incidence of cholelithiasis post-bypass, besides that, it is well tolerate and has a smaller cost than cholecystectomy. Conclusion: The use of UDCA seems to be efficient for prevention of cholelithiasis and cholecystectomy post-bypass , besides there are other advantages, as better cost-benefit in comparison to other interventions.
Objetivo: Discorrer acerca da pancreatite aguda de origem alcoólica através de uma revisão da literatura no que tange a sua fisiopatologia, quadro clínico, diagnóstico, abordagens terapêuticas, complicações e prognóstico. Revisão bibliográfica: A pancreatite aguda pode ser definida como um processo inflamatório agudo do pâncreas que pode envolver os tecidos peripancreáticos e/ou órgãos a distância, podendo variar de formas leves a graves. Nesse sentido, destaca-se a de origem alcoólica , responsável por 30% das pancreatites agudas, afetando predominantemente homens jovens com histórico de consumo alcoólico abusivo. O tratamento é orientado a partir da gravidade do quadro clínico. O prognóstico do paciente está intimamente relacionado a avaliação dos parâmetros clínicos e laboratoriais, bem como os escores Ranson e APACHE-II. Considerações finais: Nota-se uma incidência expressiva de PA alcoólica (30% das PAs) e, desta forma, ressalta-se os impactos de seus efeitos ao indivíduo e ao sistema de saúde, evidenciando a importância de realizar uma atualização dos pontos principais relativos a esse tema.
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