São Paulo medical journal = Revista paulista de medicina
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Hepatotoxicity is a potential complication from the usage of various illicit drugs, possibly consequent to their liver metabolism, but information on this is scarce in the medical literature. ⋯ Chronic marijuana usage, on its own or in association with other drugs, was associated with hepatic morphologic and enzymatic alterations. This indicates that cannabinoids are possible hepatotoxic substances.
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Hypertension is one of the most important cardiovascular risk factors but its control is still a challenge for physicians all around the world. For blood pressure control to be improved, it is important to guarantee the quality of attendance provided for hypertensive patients, especially in teaching hospitals, where future physicians are being trained. ⋯ The patients with arterial hypertension under treatment at the university hospital had a profile of high cardiovascular risk and poor blood pressure control. Greater effort for improving hypertension control is needed, since this is the only way to reduce the morbidity and mortality rates of cardiovascular diseases.
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The reality of medical services in Brazil points towards expansion and diversification of medical knowledge. However, there are few Brazilian studies on choosing a medical specialty. ⋯ The results from this group of Brazilian resident doctors corroborated data on choosing a medical specialty from other countries with different social and educational characteristics. This congruence indicates that the choice involves very similar desires and needs in different settings and has little dependence on the students' educational context.
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Case Reports
Central retinal vein prethrombosis as an initial manifestation of protein S deficiency.
Retinal vein thrombosis is most common in old people, and is often associated with systemic vascular disease. One of its rare systemic causes is protein S deficiency. ⋯ A case of a 21-year-old woman with retinal vein prethrombosis associated only with protein S deficiency is described. She presented with acutely reduced visual acuity and a central scotoma in her left eye. Warfarin therapy was initiated, and complete improvement in ophthalmoscopic findings was subsequently observed. This case illustrates that protein S deficiency is a factor that should be considered in cases of retinal vein occlusion, particularly in young patients.