The most common inadequacies in red blood cell requests at a reference center in Western Paraná state

Abstract Introduction In the current scenario, in which evidence-based medicine is almost obligatory, therapeutic approaches are increasingly being restricted to measures that are proven to bring benefits to the patient. Transfusion therapy follows the same concept. Even though it can be an essential support procedure in some situations, it must be carefully used, exclusively in situations in which the literature assures scientific support for its usage. Transfusion exposes patients to risks and complications, so it is necessary that we, as doctors, continue working to reduce possible mistakes involving the practice of this type of therapy. Objective To analyze if the red blood cell requests are properly made, analyzing the indication written on them (by the doctor, comparing them to the references in the actual literature. Method In this research, we have analyzed and reviewed the requests for red blood cell concentrates between August and September of 2018 received at the Hematology and Hemotherapy Center studied to find the most common mistakes made by requesters/doctors. Results A total of 397 of the 754 analyzed requests were evaluated as inadequate. Therefore, 1 out of every 2 transfusions performed did not have their requests properly completed in the city of Cascavel, Paraná. Conclusions The number of inappropriate requests was high during the studied period, especially when compared to studies available in the literature. The number of inadequacies suggests that the blood component requests and the subsequent evaluation by the transfusion agency needs to be better addressed in clinical practice.

Rabdomiossarcoma embrionário de colo uterino: relato de caso em adolescente / Embryonic rabdomyosarcoma of the cervix: case report in a teenager

O rabdomiossarcoma embrionário, variante botrioide, é uma neoplasia maligna dos tecidos moles que deriva de células musculares mesenquimais embrionárias. Alguns fatores de risco genéticos são conhecidos, mas a doença geralmente se apresenta de forma esporádica. É raro manifestar-se em adolescentes, assim como é raro ser primário do colo uterino. Cursa com a presença de pólipos e até massas que se sobressaem na vagina com casos de sangramento vaginal anormal. O diagnóstico é realizado essencialmente pela história e exame anatomopatológico. Quanto maior o tempo para confirmação do diagnóstico, pior o prognóstico. Há várias modalidades de tratamento ­ que deve ser individualizado e envolver uma equipe multidisciplinar ­, que, basicamente, incluem quimioterapia, radioterapia e cirurgia. Os resultados geralmente são menos favoráveis em adolescentes, quando comparados com os de crianças com a mesma neoplasia.(AU)

Embryonic rhabdomyosarcoma, a botryoid variant, is a malignant neoplasm of soft tissues that derives from embryonic mesenchymal muscle cells. Some genetic risk factors are known, but the disease usually presents itself sporadically. It's rarely manifested in adolescents, just as it is rare to be primary in the cervix. It occurs with the presence of polyps and even masses that protrude in the vagina with cases of abnormal vaginal bleeding. The diagnosis is made essentially by history and anatomopathological examination. The longer the time to confirm the diagnosis, the worse the prognosis. There are several treatment modalities ­ involving a multidisciplinary team ­ that must be individualized and basically include chemotherapy, radiotherapy and surgery. The results are generally less favorable in adolescents, when compared with those of children with the same neoplasia.(AU)