Identified the inappropriate prescription of drugs in elderly assisted geriatric outpatient clinic in the region of Vale do Rio Pardo in Rio Grande do Sul according to the criteria of STOPP and START. Cross-sectional study of 221 elderly, based on retrospective analysis of medical records using comprehensive geriatric assessment data held in the first visit. Descriptive variables were age, sex, number of pathologies and number of medications in use. And the study variables were potentially inappropriate medications (MPI) and potentially omitted medications (MPO), according to the STOPP and START criteria. Descriptive statistics were performed with frequencies, means and standard deviations where appropriate. It was observed 157 (71%) female patients. The average age was 75 (±8.26) years, 49.8% in the range of 75-84 years. The average number of drugs was 3 (±2.27), with 22.63% using 5 or more medications. The average pathologies was 3.45 (±2.02). They identified 194 prescriptions of MPI and observed 93 MPO. The most identified were the MPI for the cardiovascular system, especially β noncardioselective blockers and acetylsalicylic acid. Also MPO were found most of the cardiovascular system, with emphasis on acetylsalicylic acid and inhibitors of angiotensin converting enzyme. This is sample of elderly with significant prevalence of inappropriate prescribing of drugs. Studies using the STOPP criteria and START in different health care settings can qualify the care provided to the elderly.
Coronary artery fistulas are uncommon and are consist in direct connections from both arteries or just from one of them with other structure. When they have low output, they usually tend to communicate with any of the cardiac chambers or other adjacent cardiac vessels. However, communications with the pulmonary trunk are rare and underdiagnosed, since most of patients are asymptomatic or have nonspecific symptoms related to the condition. In this report, we describe and discuss the case of a patient with a recurrent history of syncope, that started clinical follow-up in an ambulatory of geriatric and gerontology, whose investigation lead to the identification of an underlying cardiac cause as the etiology of the episodes.
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