Venous thromboembolism events are important causes of maternal death during pregnancy and the postpartum period worldwide. A review of the literature with the objective of evaluating venous thromboembolism events in the puerperium according to the route of delivery was performed through a bibliographic survey in the Medline, LILACS and Scielo databases. We observed that patients submitted to cesarean sections present a significantly higher risk of developing venous thromboembolism when compared with those who undergo spontaneous vaginal delivery. The pathophysiological bases for this difference were explored and described in this review, as well as the indications of prophylaxis and treatment. Doctors and health professionals must be continuously vigilant regarding this condition, since it is associated with high morbidity and mortality.
Approximately 33% of patients with epilepsy do not respond to treatment with a single antiepileptic drug. Many of these patients can benefit from neurosurgical treatment. However, not all patients are candidates for surgery, and in these cases vagus nerve stimulation (VNS) presents as a good therapeutic option. Objectives: Evaluation of efficiency, tolerability and safety in the control of seizures after VNS implantation in patients from a reference hospital. Methods: cross-sectional study examined 20 patients who underwent implantation of the VNS in our facilities between 2007 and 2014. Proportions and chi-square test were applied (statistical significance level set to p ≤ 0.05). Results: Mean follow-up was 31.3 months. Seizure frequency decreased in 55% of the patients. Among them, 11 patients believed that VNS had improved their quality of life. The mean reduction reported by other patients was 78.3%. More than 30% reported no adverse effects. About 70% of patients no longer required hospitalizations and 95% reported reduction in the number of hospitalizations. Conclusion: In this population, VNS proved to be a good option in the treatment of refractory epilepsy and also in providing a significant improvement in quality of life, (reduction of seizures and hospitalizations), mood, attention and memory, which directly reflects on their social and cognitive.
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