RESUMO
INTRODUCTION: One of the most important strategies of PROA in the Emergency Department (ED) is the accurate diagnosis of infection to avoid inappropriate prescription. Our objective is to evaluate patients who receive antibiotics despite not having objective data of infection. METHODS: We carried out a cross-sectional study of patients admitted to the ED of the Hospital Universitario Fundación Alcorcón in which it was recommended to suspend the antibiotic through the PROA. Clinical and epidemiological characteristics and 30-day follow-up were analyzed to assess readmissions and mortality. RESULTS: 145 patients were analyzed. It was recommended to suspend the antibiotic in 25. 44% of them had a diagnosis of urinary infection. The suspension recommendation was accepted by 88%. No patient died and one was readmitted. CONCLUSIONS: An important percentage of patients are prescribed antibiotics despite not having infection criteria, the clinical evolution after suspension of antibiotics was favorable.
RESUMO
Tipifarnib is a novel targeted treatment for hematologic malignancies that is being recently studied for the treatment of advanced solid organ tumors with HRAS mutations. There have been scarce reports on kidney adverse events in initial phase I and II trials. We present a case of acute kidney injury in a patient that had started treatment with tipifarnib for advanced squamous cell carcinoma of the lung. Kidney biopsy revealed acute tubular necrosis together with acute interstitial nephritis. Tipifarnib was discontinued and the patient was started with high-dose corticosteroids with an early taper completing a five-week steroid course, with full recovery of kidney function.
Assuntos
Antineoplásicos/efeitos adversos , Carcinoma de Células Escamosas/tratamento farmacológico , Necrose do Córtex Renal/induzido quimicamente , Neoplasias Pulmonares/tratamento farmacológico , Nefrite Intersticial/induzido quimicamente , Quinolonas/efeitos adversos , Idoso , Carcinoma de Células Escamosas/diagnóstico , Humanos , Necrose do Córtex Renal/complicações , Necrose do Córtex Renal/diagnóstico , Neoplasias Pulmonares/diagnóstico , Masculino , Nefrite Intersticial/complicações , Nefrite Intersticial/diagnósticoRESUMO
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Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Pancreatite Crônica/diagnóstico por imagem , Pancreatite Crônica/complicações , Dilatação Gástrica/diagnóstico por imagem , Dilatação Gástrica/etiologia , Doenças Raras , Tomografia Computadorizada por Raios X , Pancreatite Crônica/patologia , Dilatação Gástrica/patologiaRESUMO
A 57-year-old male with a history of chronic pancreatitis related to heavy smoking and alcohol abuse was evaluated in the emergency department due to a 3-day history of epigastric pain and postprandial vomiting. Abdominal computed tomography (CT) was performed and revealed a severe gastric dilation that reached the pelvis. There was a marked concentric mural thickening at the duodenal level and an intramural cysts that caused a narrowing of the light and a retrograde gastric dilation. There were no findings suggestive of chronic pancreatitis. A diagnosis was made of duodenal obstruction due to groove pancreatitis with severe secondary gastric dilatation.
