Clinics
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The protocols for glucocorticoid replacement in children with salt wasting 21-hydroxylase deficiency are well established; however, the current recommendation for mineralocorticoid replacement is general and suggests individualized dose adjustments. This study aims to retrospectively review the 9-α-fludrocortisone dose regimen in salt wasting 21-hydroxylase deficient children who have been adequately treated during infancy. ⋯ The mineralocorticoid needs of salt wasting 21-hydroxylase deficient patients are greater during early infancy and progressively decrease during the first two years of life, which confirms that a partial aldosterone resistance exists during this time. Our study proposes a safety regiment for mineralocorticoid replacement during this critical developmental period.
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To determine the prevalence of metabolic syndrome and related factors in bank employees in the city of Vitória/ES, Brazil. ⋯ A large number of bank employees have metabolic syndrome, which can be associated with an increased risk of developing cardiovascular disease. Individuals who had college degrees had a higher prevalence of metabolic syndrome; this finding can be explained by the high rates of overweight and obesity found in subjects with college and graduate school educations.
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To determine the relationship between enteral nutrition discontinuation and outcome in general critically ill patients. ⋯ The determination of the difference between prescribed and received enteral nutrition seemed to be a useful prognostic marker and is feasible to be incorporated into a gastrointestinal failure score.
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Observational Study
Infection as an independent risk factor for mortality in the surgical intensive care unit.
Medical and surgical intensive care unit patients represent two different populations and require different treatment approaches. The aim of this study was to investigate the parameters associated with mortality in medical and surgical intensive care units. ⋯ Although the presence of infection is associated with a high mortality in both the medical and surgical intensive care units, the results of this prospective study suggest that infection has a greater impact in patients admitted to the surgical intensive care unit. Measures and trials to prevent and treat sepsis may be most effective in the surgical intensive care unit population.