Introdução: Os pacientes internados constituem o grupo mais suscetível a sofrerem interações medicamentosas (IM) devido à adição de novos medicamentos, prescrição de regimes terapêuticos complexos e presença de comorbidades. As IM são um problema de saúde pública por necessitarem em sua maioria de cuidados médicos, podendo causar risco de vida aos pacientes, o que eleva os custos hospitalares por conta do aumento do tempo de internação. Objetivo: Avaliar as IM potenciais em prescrições de pacientes admitidos na unidade de infectologia de um hospital universitário de Sergipe. Métodos: Foi realizado um estudo observacional exploratório, com delineamento longitudinal prospectivo, em pacientes admitidos no serviço de infectologia do hospital. Foram incluídos os pacientes com 18 anos ou mais, com 2 ou mais medicamentos prescritos e que permaneceram internados por, no mínimo, 7 dias. As reinternações foram excluídas. As IM foram identificadas pelo Drugdex System -Thomson Micromedex® -Interactions. Resultados: Dos 131 pacientes internados na enfermaria de infectologia, 78% apresentaram IM. Destas, 43,7% foram consideradas de gravidade moderada e 50,8% com documentação boa. Os pacientes foram analisados em três momentos, no 1º dia (D1), no 7º dia (D7) e no 15º dia (D15), e percebeu-se uma tendência temporal de aumento da utilização de medicamentos na amostra total de pacientes (D1: 6,3; D7: 8,1 e D15: 8,7), bem como do aumento proporcional das IM (D1: 2,1; D7: 3,2 e D15: 3,9). Conclusão: O conhecimento do perfil da unidade de infectologia vai permitir aos provedores de saúde a escolha de esquemas terapêuticos, vias de administrações e cuidados com os pacientes mais seguros, proporcionado um atendimento de qualidade com prevenção de danos.
Highly active antiretroviral therapy (HAART) allows chronicity of AIDS evolution, leading to association of other pathologies such as coronary artery disease (CAD). Myocardial ischemia (MI) and left ventricular diastolic dysfunction (LVDD) evaluation in HIV-infected patients may favor primary prevention of CAD. The study aimed to evaluate frequencies of MI and LVDD in the population living with the human immunodeficiency virus (PLHIV) and asymptomatic for CAD. We analyzed data from 110 HIV-infected patients who underwent clinical and laboratory evaluation, treadmill exercise stress test, and transthoracic echocardiogram, and compared it with 2,619 healthy individuals from the control group (non-HIV and non-CAD), selected from the database. HIV-infected patients presented lower average age (51.5 ± 7.7), systemic arterial hypertension (28.0%) and dyslipidemia frequencies (32.0%). On the other hand, their MI frequency was twice as high (14.7%); and diastolic dysfunction (DD) percentage was higher in ischemic patients (45.5%). In the HIV-infected group, MI frequency was 10.0%, while that of DD was 18.2%. MI was twice as frequent among HIV infected patients compared to uninfected, despite lower frequency of risk factors for CAD. Non-ischemic patients living with HIV had a frequency of DD more than twice compared to the control individuals.
Hyperreactio luteinalis (HL) is a very rare and benign condition related to pregnancy, in which there is a massive and functional increase in ovaries, occupied by multiple benign theca lutein cysts. It generally does not affect pregnancy course and can be observed and diagnosed incidentally in third trimester. The cysts and, consequently, the ovaries regress spontaneously after delivery due to decrease in hCG. This report describes a case of HL in a 29-year-old primiparous woman with dyspnea, pelvic pain and clinical signs of hyperandrogenism, with the ovaries enlarged on transvaginal ultrasound. The conduct was expectant and, during delivery, a biopsy was performed, which confirmed the diagnosis. The knowledge of benign and self-limited disease defends a conservative treatment and helps in differentiation between HL and other malignant diseases. It is, therefore, essential that obstetricians are familiar with HL to guide the correct management and avoid unnecessary iatrogenic procedures.
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