Thoracic sympathectomy has been effective in relieving hyperhidrosis in several patients, with quality of life improvement. The knowledge of the clinical picture of each patient, as well as the possible postoperative complications, are fundamental to obtain good results. Thus, we performed a review of articles from the PubMed database published between 2005 and 2019 that presented, as the main topic, thoracoscopy sympathectomy for the treatment of hyperhidrosis, with the objective of evaluating the current state of art referring to postoperative quality of life, surgical time and its complications. From this analysis, we verified the importance of the level of sympathetic ganglion chain section in relation to results. The complication, although occurring, did not reduced the postoperative level of satisfaction or patients' quality of life. NicoliniVideo-assisted thoracic sympathectomy: literature review.
A reanimação cardiopulmonar (RCP) precoce e eficaz realizada por espectadores é um preditor importante da sobrevida em vítimas de parada cardiorrespiratória fora de hospitais. Nesse sentido, a OMS preconiza o treinamento em RCP em escolas desde 12 anos. Este estudo objetiva avaliar a efetividade do treinamento de crianças em suporte básico de vida. Para isso, foi realizada uma revisão sistemática da literatura na base indexadora MedLine, com frase de pesquisa construída com as palavras “Cardiopulmonary Resuscitation” “Education” e “Child” e suas variações obtidas no MeSH. Foram critérios de inclusão estudos publicados em até cinco anos com abordagem do treinamento de RCP para crianças em ambiente escolar. Foram excluídos estudos de revisão sem descrição dos métodos de treinamento e com resultados incompletos. Foram selecionados 13 adequados aos métodos deste estudo. Em todos houve um treinamento teórico e prático seguidos da aplicação de um questionário avaliativo. Os resultados demonstram a inefetividade das compressões de crianças menores atribuída ao baixo peso, altura e IMC, e um maior interesse de crianças menores em relação às maiores e adultos. Treinamentos de RCP para crianças antes mesmo dos 12 anos são efetivos. Apesar da RCP ineficaz, o conhecimento adquirido propicia a solidificação das técnicas no futuro.
Introduction The effects, severity, and prognosis of COVID-19 infections do not follow a linear pattern in different locations, but change according to the epidemiological data and social issues in each region. Aims The purpose of the current study is to provide the clinical and epidemiological standard of the population affected by COVID-19 in the city of Juiz de Fora, MG to better understand the disease and its risk factors, in order to enable more appropriate conduct for patients. Methods A retrospective observational study was carried out from March to August of 2020, with 266 participants admitted to the emergency department of the Instituto de Clínicas e Cirurgia de Juiz de Fora—Hospital Monte Sinai. Data were tabulated, analyzed, and classified according to the outcome using an ordinal regression model. Results Among the 266 admitted patients, the most common findings were ground-glass opacifications on chest CT (78.8%), cough (75.6%), fever (58.4%), and rhinorrhea (34.5%). There were greater severity and greater need for hospitalization and admission to the ICU in patients who were male, tachypneic at the time of admission, with older age, and with underlying diseases. Conclusion Collected data allowed for a better understanding of the disease, its severity criteria, and its pattern of affection in Juiz de Fora, MG. More studies based on the analysis of the behavior of COVID-19 in different regions must be carried out, to improve treatment and support to local populations.
This study aims to assess the risk of severe forms of COVID-19, based on clinical, laboratory, and imaging markers in patients initially admitted to the ward. This is a retrospective observational study, with data from electronic medical records of inpatients, with laboratory confirmation of COVID-19, between March and September 2020, in a hospital from Juiz de Fora-MG, Brazil. Participants (n = 74) were separated into two groups by clinical evolution: those who remained in the ward and those who progressed to the ICU. Mann–Whitney U test was taken for continuous variables and the chi-square test or Fisher’s exact test for categorical variables. Comparing the proposed groups, lower values of lymphocytes ( p = <0.001) and increases in serum creatinine ( p = 0.009), LDH ( p = 0.057), troponin ( p = 0.018), IL-6 ( p = 0.053), complement C4 ( p = 0.040), and CRP ( p = 0.053) showed significant differences or statistical tendency for clinical deterioration. The average age of the groups was 47.9 ± 16.5 and 66.5 ± 7.3 years ( p = 0.001). Hypertension ( p = 0.064), heart disease ( p = 0.048), and COPD ( p = 0.039) were more linked to ICU admission, as well as the presence of tachypnea on admission ( p = 0.051). Ground-glass involvement >25% of the lung parenchyma or pleural effusion on chest CT showed association with evolution to ICU ( p = 0.027), as well as bilateral opacifications ( p = 0.030) when compared to unilateral ones. Laboratory, clinical, and imaging markers may have significant relation with worse outcomes and the need for intensive treatment, being helpful as predictive factors.
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