Revista da Associacao Medica Brasileira (1992)
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Rev Assoc Med Bras (1992) · Jul 2020
Case ReportsThe value of morphofunctional magnetic resonance imaging with hepatospecific contrast agent in the characterization of hepatocellular carcinoma in a non-cirrhotic patient with hepatitis C.
Hepatocellular carcinoma in patients with hepatitis C in the absence of cirrhosis is uncommon. We demonstrate the importance of morphofunctional magnetic resonance imaging (MRI) with a hepatospecific contrast agent by describing an asymptomatic female patient with HCV, who presented with a nodule detected on ultrasound. ⋯ MRI with hepatospecific contrast providing functional information combined with the superior tissue contrast inherent to this method stands out for its greater accuracy with the possibility of not resorting to invasive diagnostic methods. With increasing experience and the dissemination of this new diagnostic modality in the medical field, its use and other potential benefits of morphofunctional MRI with hepatospecific contrast agents may be established, benefiting patients with challenging focal liver lesions.
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Rev Assoc Med Bras (1992) · Jul 2020
ReviewHyperbilirubinemia impact on newborn hearing: a literature review.
The increase in bilirubin levels in newborns can cause toxic effects on the auditory system, which can lead to hearing loss. This review aimed to verify the impact of hyperbilirubinemia in the hearing of newborns, relating audiological findings to serum levels of bilirubin. A literature review was conducted during October 2017, using the terms "hyperbilirubinemia", "jaundice", "infant", "newborn" and "hearing loss", on databases CAPES journals, MEDLINE and BIREME (SciELO, BBO). 827 studies were identified and 59 were selected for full-text reading, resulting in the selection of seven articles that met the inclusion criteria and were considered relevant to the sample of this study. ⋯ Changes in the audiological findings of neonates with hyperbilirubinemia were observed in all studies. There was no consensus on the serum bilirubin levels that may cause auditory changes; however, the relationship between hearing disorders and blood levels of bilirubin was positive. We identify the need to establish reference values for bilirubin levels considered critical for the occurrence of hearing disorders as well as the audiological follow-up of neonates with hyperbilirubinemia.
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Rev Assoc Med Bras (1992) · Jul 2020
ReviewBenzodiazepinics and the treatment of delirium: a literature review.
OBJECTIVE To discuss the role of the benzodiazepine class in delirium patient management. METHODS Using the PubMed database, articles were reviewed after the year 2000 containing in their title the words 'delirium' and 'benzodiazepines'. ⋯ There is currently no definite consensus regarding its pathophysiology, nor regarding pharmacological measures, especially concerning the benzodiazepine class. CONCLUSION Evidence suggests that there may be a role for the use of pharmacological class in the treatment of this condition, indicating a change in the previously paradigmatic pattern of treatment.
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Rev Assoc Med Bras (1992) · Jul 2020
Primary Health Care in Brasil in the times of COVID-19: changes, challenges and perspectives.
The pandemic of Coronavirus Disease 2019 (COVID-19) has put pressure on countries' health systems. Although attention is mostly directed at the hospital sector, since many critically ill people will need intensive care, Primary Health Care (PHC) has also been disrupted. ⋯ However, like other countries, the Brazilian health system is being overloaded with the increase in the large number of COVID-19 cases. It is worth reflecting on the changes and challenges in PHC during the COVID-19 pandemic in Brasil.
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Rev Assoc Med Bras (1992) · Jul 2020
Role of a Neonatal Intensive Care Unit during the COVID-19 Pandemia: recommendations from the neonatology discipline.
On 11th March 2020, the World Health Organization (WHO) declared the COVID-19 a pandemic. The Obstetrics and Neonatology disciplines needed to be revised to suit the institutional need to expand intensive care beds to care for confirmed or suspected patients with COVID-19 in the state of São Paulo, following the recommendations of the Institutional Crisis Committee. ⋯ Some special considerations about breastfeeding and rooming-in were needed. The third action was the drafting of a protocol to admit infants from other hospitals with confirmed COVID-19 as the unit never admitted outpatients before.