INTRODUÇÃO:A Sińdrome de Bouveret é uma condição clínica rara, compreendida na literatura como uma forma rara de íleo biliar em que ocorre a obstrução , caracterizada pela impactação de um cálculo biliar de grandes dimensões no duodeno devido af ormacaõ de uma fiśtula bilioenteŕica. Se relaciona mais frequentemente com indivíduos idosos com comorbidades e historia recente de cólica biliar, icterićia ou colecistite aguda, seu quadro clinico pode ser inespecífico com naúseas, vomitos e dor abdominal e podem ocorrer manifestações mais graves que necessitam de cuidados emergenciais, como hematemese, lesões esofágicas e até mesmo sepse. O diagnostico pode ser firmado por meio de exames endoscópicos e principalmente pelo uso da tomografia computadorizada, e se realizado tardiamente aumenta significativamente a mortalidade para o paciente. Mesmo sendo uma afecção com grande potencial negativo a literatura ainda é escassa a respeito desta condição, sendo a Sińdrome de Bouveret frequentemente subdiagnosticada. OBJETIVOS: Revisar na literatura artigos científicos que demonstrem os benefícios do reconhecimento da Sińdrome de Bouveret, trazendo um subsídio para outros pesquisadores como mais uma fonte bibliográfica sobre o tema. METODOLOGIA: Revisão integrativa da literatura que incluiu 10 artigos publicados no período de 2001 a 2015 , baseada na análise de dados referentes a Sińdrome de Bouveret, realizada por meio da consulta nas bases de dados online da PubMed, Scielo, e Periódicos Capes. RESULTADOS: Foi visto em cada um dos artigos que a Sińdrome de Bouveret é uma afecção com importantes manifestações clínicas que necessitam de diagnostico e tratamento corretos. CONCLUSÃO: O conhecimento antecipado dessa patologia é de grande importância, especialmente em atendimentos de urgência e emergência, pois o tratamento é de modo eminente cirúrgico e a incidência de diagnóstico pré-operatório é relativamente baixa.
Introduction: Non -opioid analgesics and non-steroidal antiinflammatory drugs (NSAIDs) are among the most used drugs in the world, and are often used without a medical prescription. Objective: To describe the epidemiological profile of hospitalizations due to adverse effects due to the use of analgesics, antipyretics and anti-inflammatories in Brazil between 2007 and 2021. Methodology: This is a descriptive observational study, whose data were collected through the DataSUS platform. Collection started from the Hospital Information System (SIH), through hospital morbidity data by place of residence between January 2007 and December 2021. Results and Discussion: There were 688 hospitalizations due to adverse effects from the use of analgesics, antipyretics and antiinflammatories. The most affected region was the southeast with 44.33% of all cases in the country. The national average age group most affected is represented by two peaks: from one to four years of age and from 20 to 29. Although there is no difference between the number of hospitalizations of men and women, the female rate was approximately 25 %. The general mortality rate was 2.47 among hospitalized patients, however, this rate varied between private and public services, the latter being 70% higher. Conclusion:Greater awareness policies on the proper and rational use of medicines must be implemented. In addition, further investigation by the hospital team must be encouraged, in order to promote lower rates of adverse reactions in those patients who have had episodes of suspected complications before.
Thyroid disorders are common in patients with Down syndrome, which can lead to significant impacts on the quality of life and cognitive development of these patients. Studies report a prevalence of 15-30% of thyroid disorders in patients with Down syndrome. Diagnosis of thyroid disorders in patients with Down syndrome is done using blood tests to measure levels of thyroid hormones and TSH. In addition, clinical evaluation is important to identify possible signs and symptoms of thyroid dysfunction, such as fatigue, weight gain or loss, intolerance to cold or heat, among others. To screen for thyroid disorders in patients with Down syndrome, the American Down Syndrome Society and the European Society recommend regular blood tests from birth and iodine prophylaxis to prevent thyroid dysfunction. The screening protocol must be individualized for each patient, taking into consideration, the factors such as age, family history and exposure to environmental risk factors. Treatment of hypothyroidism in patients with Down syndrome involves replacing thyroid hormones using medications such as levothyroxine. Furthermore, the adoption of non-pharmacological measures, such as diet and physical exercise, can help control the disease. The treatment of hyperthyroidism may involve the use of medications, such as propylthiouracil or methimazole, and, in more severe cases, treatment with radioactive iodine or surgery.
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