ABSTRACT
Abstract Background Metastatic tumours sometimes present with neuropsychiatric symptoms, however psychiatric symptoms as rarely the first clinical manifestation. Cutaneous melanoma is the third most common cause of brain metastasis, with known risk factors increasing the chance of such central nervous system metastization. Objectives We present a clinical report of delirium as the first clinical manifestation of melanoma brain metastases, illustrating the relevance of an adequate and early differential diagnosis. Methods In addition to describing the clinical case, searches were undertaken in PubMed and other databases using keywords such as “brain metastasis”, “melanoma”, “agitation”, “psychiatric” and “delirium”. Results We here report the case of a 52-year-old female patient evaluated by Liaison Psychiatry after sudden onset of delirium while admitted at the Gastroenterology Department to study a hypothesis of pancreatitis. A head CT scan identified brain metastases, and after further examination, including brain biopsy, melanoma brain metastization was confirmed. Discussion Some of the diagnostic challenges of psychiatric symptoms associated with secondary brain tumours are discussed, underlining the importance of an adequate differential diagnosis when working in Psychiatry Liaison.
ABSTRACT
Este trabalho tem como finalidade sistematizar as rotinas de enfermagem na limpeza e desinfecção dos aparelhos endoscópios flexíveis no serviço de enfermagem de um hospital publico no Rio de Janeiro, especializado em oncologia. Serão descritas todas as etapas desde a limpeza manual imediatamente apos 0 termino do exame ate a desinfecção de alto nível através de processo automatizado. O objetivo principal e treinar, capacitar e assegurar ao trabalhador responsável par esta atividade e função, segurança no processo desenvolvido e garantir um reprocessamento com qualidade dos artigos médicos permitindo sua reutilização segura e livre de biofilmes. A metodologia aplicada foi a revisão bibliográfica baseada em indexadores como LILACS; BVS. Espera-se que ao final deste trabalho, possamos garantir condutas eficazes, buscando sempre 0 padrão ouro na qualidade total das funções desempenhadas.
This study aimed at systematizing nuursing routines for cleaning and disinfection of flexible endoscopes appliances nursing service of a public hospital in Rio de Janeiro, specializing in Oncology. Will describe all steps from the manual cleaning immediately after the examination to the high-level disinfection by automated process. The main goal is to train and ensure that employees responsible for this activity and function, safety in the developed process and ensure a quality of reprocessing medical papers allowing their re safe and free from biofilms. The methodology was applied to the review based on indices such as Lille, VHL. It is expected that by the end of this work, we can ensure effective conduits, always seeking the gold standard in total quality work done.