Perfil dos pacientes notificados com suspeita de coronavírus em um hospital público do Distrito Federal / Perfil de pacientes notificados con sospecha de coronavirus en un hospital público del Distrito Federal / Profile of patients notified with suspected coronavirus in a public hospital in the Federal District

Objetivo: Analisar o perfil clínico epidemiológico dos pacientes notificados com suspeita de Covid-19 em um hospital público do Distrito Federal, Brasil. Método: Estudo epidemiológico descritivo, quantitativo, com delineamento transversal, pautado em dados da ficha de registro individual de casos de Síndrome Respiratória Aguda Grave do Núcleo de Vigilância Epidemiológica (NUVEI) do Hospital Regional da Asa Norte (HRAN). A coleta de dados ocorreu em etapa única no período compreendido entre 01 e 10 de março de 2021, e a análise estatística descritiva realizada por meio de frequência absoluta e frequência relativa. Resultados: Observou-se maior prevalência de hospitalizações em indivíduos do sexo masculino (53,47%), com média de idade de 52,25 anos, portadores de doença cardiovascular crônica, e presença de dispneia, tosse e febre. Conclusão: Concluímos que ainda existe muitas lacunas incompreendidas acerca do novo coronavírus, e ressaltamos a importância do preenchimento correto das notificações dos casos suspeitos(AU)

Objective: To analyze the clinical epidemiological profile of patients notified with suspected Covid-19 in a public hospital in the Federal District, Brazil. Method: Descriptive, quantitative, cross-sectional epidemiological study, based on data from the individual record form of cases of Severe Acute Respiratory Syndrome of the Epidemiological Surveillance Center (NUVEI) of Hospital Regional da Asa Norte (HRAN). Data collection took place in a single step in the period between March 1 and 10, 2021, and descriptive statistical analysis was performed using absolute frequency and relative frequency. Results: There was a higher prevalence of hospitalizations in male individuals (53.47%), with a mean age of 52.25 years, with chronic cardiovascular disease, and presence of dyspnea, cough and fever. Conclusion: We conclude that there are still many ununderstood gaps about the new coronavirus, and we emphasize the importance of correctly filling out the notifications of suspected cases(AU)

Objetivo: Analizar el perfil clínico-epidemiológico de los pacientes notificados con sospecha de Covid-19 en un hospital público del Distrito Federal, Brasil. Método: Estudio epidemiológico descriptivo, cuantitativo, transversal, basado en datos del formulario de registro individual de casos de Síndrome Respiratorio Agudo Severo del Centro de Vigilancia Epidemiológica (NUVEI) del Hospital Regional da Asa Norte (HRAN). La recolección de datos se realizó en un solo paso en el período comprendido entre el 1 y el 10 de marzo de 2021, y se realizó un análisis estadístico descriptivo utilizando frecuencia absoluta y frecuencia relativa. Resultados: Hubo mayor prevalencia de hospitalizaciones en varones (53,47%), con una edad média de 52,25 años, con enfermedad cardiovascular crónica, presencia de disnea, tos y fiebre. Conclusión: Concluimos que aún existen muchas lagunas incomprendidas sobre el nuevo coronavirus, y destacamos la importancia de completar correctamente las notificaciones de casos sospechosos(AU)

Condutas do enfermeiro em cuidados paliativos: uma revisão integrativa / Nurses conduct in palliative care: an integrative review

Objetivo: Reconhecer as principais condutas do profissional enfermeiro na assistência de enfermagem ao paciente em cuidados paliativos. Método: Revisão integrativa de literatura realizada entre março a junho de 2021, desenvolvida obedecendo as seguintes etapas: 1ª etapa (elaboração da pergunta norteadora); 2ª etapa (definição das fontes de informações, e critérios de inclusão e exclusão; 3ª etapa (coleta de dados, leitura e seleção dos artigos); 4ª etapa (interpretação dos resultados e elaboração das reflexões do estudo). Resultados: A coleta de dados utilizando os descritores cuidados paliativos; cuidados paliativos na terminalidade da vida; enfermagem de cuidados paliativos na terminalidade da vida resultou na seleção de 81 artigos, dos quais 08 artigos atenderam os critérios de inclusão e foram utilizados para elaboração deste estudo. Considerações finais: As condutas do profissional enfermeiro resultam na prestação de cuidados alicerçados na humanização e bioética, garantindo o respeito à dignidade humana do paciente e incluem a intervenção em sintomas de natureza física, social e emocional.(AU)

Objective: To recognize the main behaviors of professional nurses in nursing care for patients in palliative care. Method: Integrative literature review carried out between March and June 2021, developed following the following steps: 1st step (preparation of the guiding question); 2nd stage (definition of information sources, and inclusion and exclusion criteria; 3rd stage (data collection, reading and selection of articles); 4th stage (interpretation of results and elaboration of study reflections). Results: Data collection using the descriptors palliative care; palliative care in the end of life; palliative care nursing in the end of life resulted in the selection of 81 articles, of which 08 articles met the inclusion criteria and were used to prepare this study. Final considerations: The behavior of the professional nurse results in the provision of care based on humanization and bioethics, ensuring respect for the human dignity of the patient and including intervention in physical, social and emotional symptoms.(AU)

Objetivo: Reconocer las principales conductas del enfermero profesional en el cuidado de enfermería al paciente en cuidados paliativos. Método: Revisión integrativa de la literatura, desarrollada siguiendo los siguientes pasos: 1er paso (preparación de la pregunta orientadora); 2a etapa (definición de fuentes de información y criterios de inclusión y exclusión; 3ra etapa (recolección de datos, lectura y selección de artículos); 4ta etapa (interpretación de resultados y elaboración de reflexiones del estudio) Resultados: Recolección de datos mediante descriptores cuidados paliativos, paliativos cuidados al final de la vida, la guardería de cuidados paliativos al final de la vida resultó en la selección de 81 artículos, de los cuales 08 artículos cumplieron con la inclusión y fueron criterios utilizados para la elaboración de este estudio. Consideraciones finales: El comportamiento del profesional de enfermería resulta en la prestación de cuidados basados en la humanización y la bioética, asegurando el respeto a la dignidad humana del paciente e incluyendo la intervención en los síntomas físicos, sociales y emocionales.(AU)

Resolução de fístula bucossinusal decorrente de complicação após cirurgia de levantamento de seio maxilar / Oroantral fistula treatment due to complications after maxillary sinus lifting surgery

Dentre as complicações de levantamento de seio maxilar, a fístula bucossinusal é relatada em poucos casos, porém, trata-se de uma complicação importante e quando não tratada corretamente pode trazer graves problemas ao paciente. Contribuindo com os tratamentos apresentados na literatura, este trabalho relata um caso clínico de paciente submetido à cirurgia de levantamento de seio maxilar e enxerto ósseo para futura realização de implante dentário. O paciente apresentou acidentes e complicações no pós-operatório que evoluiu para formação de fístula bucossinusal com supuração ativa. O tratamento foi realizado em três etapas: 1) tratamento com antimicrobiano por sete dias; 2) curetagem, remoção do enxerto, debridamento e sutura da fístula e antibioticoterapia por 15 dias; 3) descolamento lateral de retalho para fechamento de fístula. Concluiu-se que o tratamento da fístula bucossinusal oriunda de enxerto no seio maxilar é complexa, envolvendo antibioticoterapia longa e específica, remoção do enxerto e técnica de manipulação de tecido mole para o fechamento da fístula.

Among complications of the maxillary sinus lifting procedure, the oroantral fistula is reported in a few cases. However, it is an important complication that, when not properly treated, can lead to serious problems. Contributing to the treatments proposed in the literature, the aim of this study was to describe a clinical case where maxillary sinus lift and bone grafting procedures were performed for further dental implant placement. The patient had shown a negative postoperative situation and complications that resulted in oroantral fistula with suppuration. The treatment proposed was performed in three steps: 1) antimicrobial therapy for seven days; 2) curettage, removal of the graft, debridement, and suture of the fistula and antibiotics for 15 days; 3) lateral flap detachment for closure. After this procedure, it could be concluded that treatment of oroantral fistula from sinus grafts involves a complex scenario, including a long and specific antibiotic therapy, graft removal, and delicate soft tissue manipulation to solve the case

Randomized controlled trial of DOTS versus conventional regime for treatment of ileocecal and colonic tuberculosis.

There is limited information regarding the efficacy of 'directly observed treatment short course' (DOTS) in the treatment of intestinal tuberculosis. We randomized patients with ileocecal or colonic tuberculosis to receive daily tuberculosis chemotherapy (Group A) or DOTS (Group B). Patients received isoniazid, rifampicin, pyrazinamide and ethambutol daily for two months in group A and thrice weekly for 2 months in group B, followed by isoniazid and rifampicin daily for 7 months in group A and thrice weekly for 4 months in group B. Patients were followed up at 2 and 4 weeks and monthly thereafter until the end of treatment. Follow up colonoscopy was done at 2 and 6 months after starting treatment. The improvement in clinical symptoms was not different between Groups A (24) and B (23) at 2 and 6 months. Mean increase in weight was 5.1 (0.5) Kg and 5.7 (0.6) Kg at 2 months and 7.1 (1.7) Kg and 6.9 (1.9) Kg at 6 months in Group A and B, respectively. Complete healing of ulceration was noted in 75% of Group A patients and 79% of Group B patients at 2 months and in all patients in both groups at 6 months. We conclude that DOTS and daily chemotherapy are equally effective for treating ileocecal and colonic tuberculosis.

External resection of a giant sigmoid lipoma causing colonic intussusception and prolapse through the anal canal.

We depict the case of an 80-year-old female patient who presented to us with a history of protruding mass per anum. Sigmoidoscopy revealed a large globular pedunculated polyp at 22 cm from the anal verge resulting in a sigmoidorectal intussusception. Endoscopic polypectomy was not technically possible due to the large size of the polyp. At the time of prolapse the polyp was tied at its pedicle with thread and resected surgically. The patient is asymptomatic on follow-up.

Non-familial juvenile polyposis in prolapsed rectum.

Juvenile polyposis located solely on prolapsed rectal mucosa is very unusual. We report the case of a 17-year old boy who presented to us with a history of passage of blood and mucus per rectum of a mass protruding through the anus during defecation. Per rectal and colonoscopic examinations revealed numerous polyps located solely on the prolapsed rectal mucosa. Histopathology was consistent with juvenile polyposis. He was managed with repeated sessions of endoscopic polypectomy. Family screening was negative for colonic polyps.

Time trends and pathological profile of carcinoma lower oesophagus and gastro-oesophageal junction over the last 20 years--an experience from South India.

There is an upward trend in the incidence of adenocarcinoma lower oesophagus in western countries. However there is only limited comparable data from Asian countries. We conducted a retrospective analysis of our data compiled over a twenty-year period (1985-2004). All lesions diagnosed as either squamous cell carcinoma or adenocarcinoma involving the oesophagus with or without involvement of the gastro-oesophageal junction were included in the study. 476 cases with biopsy proven malignancy (either adeno or squamous) of lower oesophagus were studied. The pattern of change in frequency and histology over twenty years was analysed using the chi square test for trend. There was a consistent increase in the frequency of cancer involving the gastro-oesophageal junction though it did not reach statistical significance (p = 0.15). Out of 476 lower oesophageal cancers, 249 were adeno-carcinomas and 227 were squamous cell carcinomas. Adenocarcinoma involving the gastro-oesophageal junction showed consistent increase even though the p value was not significant (p = 0.09) and this therefore requires further longitudinal studies. There was no change in trend for pattern and frequency of squamous cell carcinoma oesophagus involving different sub-sites during the study period.

Profile of colonic polyps in a southern Indian population.

BACKGROUND: In Western countries, colonic polyps are usually adenomatous in nature, are evenly distributed along the entire colon in asymptomatic per-sons and show a left-sided predominance in symptomatic patients. There is dearth of such literature from India. METHODS: We retrospectively analyzed reports of colonoscopies done in our institution during the period 2001 to 2005. Clinical features, colonoscopic description and histologic findings of all patients with polyps were noted. Association of the degree of dysplasia with the size, site and type of polyps and the person's age was assessed. RESULTS: Polyps were seen in 124 (5.1%) of 2412 complete colonoscopies. Mean age of patients with polyps was 58.1 (SD 19.9) years; ninety were men. A majority of polyps (92%) were located in the left colon. They were adenomatous in 99 (79.8%), juvenile in 12 (9.8%), hyperplastic in 11 (8.8 %), inflammatory in 1 (0.8%) and Peutz-Jegher's polyp in 1 (0.8%). Dysplasia was severe in large (>2 cm) polyps compared to small (< 1 cm) ones (p< 0.001). Age of patient and location of polyp had no association with degree of dysplasia. CONCLUSIONS: In southern Indian adults, most colonic polyps are adenomatous and are in the left colon. Large polyps are associated with severe dysplasia.

Endoscopic abnormalities in the oesophagus after variceal sclerotherapy--a long-term follow up study.

Endoscopic sclerotherapy is a well-established treatment modality for oesophageal varices. Various local, regional and systemic complications occur after sclerotherapy. Altered endoscopic appearances of the oesophagus have been observed on follow-up of patients after sclerotherapy. 171 consecutive patients with extra-hepatic portal venous obstruction on follow up after achieving variceal eradication by sclerotherapy during the period from January 2004 to June 2005 were enrolled in this study. The oesophagus was closely observed for mucosal abnormalities and the endoscopic findings were recorded. Out of 171 patients, 95 (55.5%) patients had no specific endoscopic changes in the oesophagus. The most common finding was mucosal neovascularization which was seen in 56 (32.7%) patients. Oval or oblong depressed areas were seen in 41 (23.9%) patients. Mucosal tags and polypoidal lesions were seen in 37 (21.6%) patients. 25 (15.6%) patients had stenosis of the lower oesophagus and 3 (1.7%) patients had mucosal bridges. On multivariate analysis, these abnormal endoscopic findings in the oesophagus correlated with the total volume of sclerosant injected when compared with those patients without similar findings on endoscopy (p value < 0.001). Endoscopic sclerotherapy leads to various abnormalities at the injection sites like neovascularization, oval or oblong depressed areas, mucosal tags, polypoidal lesions, stenosis and mucosal bridges. Endoscopic abnormalities correlated with the total volume of sclerosant used. The long-term significance of these changes is not known at present and further follow-up studies will be required.

Prevalence of Hepatitis B and C in the normal population and high risk groups in north Kerala.

BACKGROUND: Our aim is to assess the prevalence of Hepatitis B and Hepatitis C infections among normal healthy persons and high risk groups in the northern part of Kerala state in South India as there is insufficient published literature related to this subject. METHODS: HBsAg and AntiHCV screening were done in normal persons and in high risk groups. Normal persons screened included voluntary blood donors, those attending mandatory medical check up for jobs in middle east Asia and pregnant women. High risk groups were health care workers, intravenous drug abusers, commercial sex workers and male homosexuals. RESULTS: HBsAg and anti HCV antibody test results in the various groups were as follows. Voluntary blood donors--HBsAg was positive in 0.71 % and anti HCV was positive in 0.33%; job seekers to middle east Asia had 0.89% and 0.12% prevalence of HBV and HCV respectively. Among the pregnant women, 0.21% were HBsAg positive. Among the high risk groups, none of the health care workers were HbsAg positive and 0.79% were antiHCV positive. Among the IV drug abusers 2.7% were HBsAg positive and 51.89% were positive for antiHCV. In commercial sex workers, 3.47 % were HBsAg positive and 2.6 % were antiHCV positive. In male homosexuals, 4.49% were HBsAg positive and 3.37% were antiHCV positive. CONCLUSIONS: The prevalence of Hepatitis B and C in the normal population of Calicut in the northern part of Kerela is 0.52% and 0.24%. Compared to other areas of India, the seroprevalence of Hepatitis B and C are low in the normal population of Calicut. Among the high-risk groups, IV drug users have a high prevalence of AntiHCV.