Moderately hypofractionated post-operative radiation therapy for breast cancer: preferences amongst radiation oncologists from countries in Latin America and the Caribbean.

Background: The safety and effectiveness of moderately hypofractionated post-operative radiation therapy for breast cancer were demonstrated by several trials. This study aimed to evaluate the current patterns of practice and prescription preference about moderately hypofractionated post-operative radiation therapy to assess possible aspects that affect the decision-making process regarding the use of fractionation in breast cancer patients in Latin America and the Caribbean (LAC). We also aimed to identify factors that can restrain the utilization of moderately hypofractionated post-operative radiation therapy for breast cancer. Materials an methods: Radiation oncologists from LAC were invited to contribute to this study. A 38-question survey was used to evaluate their opinions. Results: A total of 173 radiation oncologists from 13 countries answered the questionnaire. The majority of respondents (84.9%) preferred moderately hypofractionated post-operative radiation therapy as their first choice in cases of whole breast irradiation. Whole breast plus regional nodal irradiation, post-mastectomy (chest wall and regional nodal irradiation) without reconstruction, and post-mastectomy (chest wall and regional node irradiation) with reconstruction hypofractionated post-operative radiation therapy was preferred by 72.2% 71.1%, and 53.7% of respondents, respectively. Breast cancer stage, and flap-based breast reconstruction were the factors associated with absolute contraindications for the use of hypofractionated schedules. Conclusion: Even though moderately hypofractionated post-operative radiation therapy for breast cancer is considered a new standard to the vast majority of the patients, its unrestricted application in clinical practice across LAC still faces reluctance.

Effect of High Altitude on the Survival of COVID-19 Patients in Intensive Care Unit: A Cohort Study.

Purpose: The effect of high altitude ( ≥ 1500 m) and its potential association with mortality by COVID-19 remains controversial. We assessed the effect of high altitude on the survival/discharge of COVID-19 patients requiring intensive care unit (ICU) admission for mechanical ventilation compared to individuals treated at sea level. Methods: A retrospective cohort multi-center study of consecutive adults patients with a positive RT-PCR test for COVID-19 who were mechanically ventilated between March and November 2020. Data were collected from two sea-level hospitals and four high-altitude hospitals in Ecuador. The primary outcome was ICU and hospital survival/discharge. Survival analysis was conducted using semi-parametric Cox proportional hazards models. Results: Of the study population (n = 670), 35.2% were female with a mean age of 58.3 ± 12.6 years. On admission, high-altitude patients were more likely to be younger (57.2 vs. 60.5 years old), presented with less comorbidities such as hypertension (25.9% vs. 54.9% with p-value <.001) and diabetes mellitus (20.5% vs. 37.2% with p-value <.001), less probability of having a capillary refill time > 3 sec (13.7% vs. 30.1%, p-value <.001), and less severity-of-illness condition (APACHE II score, 17.5 ± 8.1 vs. 20 ± 8.2, p < .01). After adjusting for key confounders high altitude is associated with significant higher probabilities of ICU survival/discharge (HR: 1.74 [95% CI: 1.46-2.08]) and hospital survival/discharge (HR: 1.35 [95% CI: 1.18-1.55]) than patients treated at sea level. Conclusions: Patients treated at high altitude at any time point during the study period were 74% more likely to experience ICU survival/discharge and 35% more likely to experience hospital survival/discharge than to the sea-level group. Possible reasons for these findings are genetic and physiological adaptations due to exposure to chronic hypoxia.

Gestão autônoma da medicação na atenção à saúde das pessoas que usam drogas / Autonomic management of medication in health care for people who use drugs / Gestión autónoma de medicamentos em la atenciónsanitaria de personas que consumen drogas

Ante ao consumo excessivo e desinformado de psicotrópicos por usuários dos serviços de saúde mental, algumas abordagens têm emergido neste campo, como a Gestão Autônoma da Medicação (GAM) que propõe uma discussão sobre o papel da medicação na vida daqueles que a utilizam. Na atenção à saúde das pessoas que consomem drogas o uso da GAM é um movimento recente a ser mapeado. Assim, este estudo objetivou analisar a produção acadêmica sobre a utilização da GAM no contexto da atenção à saúde das pessoas que consomem drogas. Trata-se de uma revisão integrativa da literatura que buscou publicações dos últimos 5 anos nas plataformas BVS e SciELO. Selecionamos 7 artigos nos quais identificamos 3 eixos temáticos: contexto histórico da GAM no Brasil e aspectos metodológicos; GAM e especificidades AD e; crítica à medicalização. Os estudos analisados elucidam especificidades, desafios e potencialidades do trabalho com a GAM no âmbito do consumo de drogas. O reduzido número de publicações sobre essa temática, entretanto, sugere serem necessários mais estudos para explorar a interface aberta pela inserção da GAM nesse contexto. (AU)

In response to the problem of excessive and uninformed use of psychotropic drugs among users of mental health services, approaches have emerged in this field, such as the case of Autonomous Medication Management (MMA) which proposes a discussion about the place occupied by medication in the lives of those who use it. In the health care for people who abuse drugs, the use of MMA is a recent movement to be mapped. Thus, this study analyzes the academic production about the use of MMA in the context of health care for people who abuse drugs. It is an integrative literature review that searched for publications referring to the last 5 years in the BVS and SciELO databases. The search resulted in the selection of 7 articles from which we identified 3 relevant themes: historical context of MMA in Brazil and methodological aspects; GAM and specificities AD and; critical of medicalization. The analyzed articles elucidate the specifics, challenges and potential of working with MMA in the context of drug abuse. However, the small number of publications found on this theme suggests further studies are needed to explore the interface opened by the insertion of MMA practices in this context. (AU)

Ante el uso excesivo y desinformado de psicofármacos por parte de los usuarios de los servicios de salud mental, han surgido algunos enfoques en este campo, como el Manejo Autónomo de Medicamentos (GAM) que propone una discusión sobre el papel de la medicación en la vida de quien es úselo. Em el cuidado de la salud de las personas que abusan de las drogas, el uso de GAM es um movimiento reciente que debe ser mapeado. Así, este estudio tuvo como objetivo analizar la producción académica sobre el uso de GAM em el contexto de la atención a la salud de las personas que consumen drogas. Es una revisión integradora de la literatura que busco publicaciones de los últimos 5 años en las plataformas BVS y SciELO. Se seleccionaron 7 artículos de loscuales identificamos 3 ejes temáticos: el contexto histórico del GAM en Brasil y aspectos metodológicos; GAM y especificidades AD y; crítica de la medicalización. Los estudios analizados aclaran las especificidades, desafíos y potencialidades de trabajar con GAM em el contexto del abuso de drogas. Sin embargo, el pequeño número de publicaciones sobre este tema sugiere que se necesitan más estudios para explorar la interfaz abierta para la inserción de GAM en este contexto. (AU)

Acute respiratory distress syndrome (ARDS) caused by the novel coronavirus disease (COVID-19): a practical comprehensive literature review.

INTRODUCTION: The exponential growth of SARS-CoV-2 virus transmission during the first months of 2020 has placed substantial pressure on most health systems around the world. The complications derived from the novel coronavirus disease (COVID-19) vary due to comorbidities, sex and age, with more than 50% of the patients requiring some level of intensive care developing acute respiratory distress syndrome (ARDS). The authors carried out an extensive and comprehensive literature review on SARS-CoV-2 infection, the clinical, pathological, and radiological presentation as well as the current treatment strategies. AREAS COVERED: Various complications caused by SARS-CoV-2 infection have been identified, the most lethal being the acute respiratory distress syndrome, caused most likely by the presence of severe immune cell response and the concomitant alveolus inflammation. The new treatment strategies are updated, and the analysis of the physiopathology is included in this review. EXPERT OPINION: ARDS is one of the most frequent complications in patients with COVID-19. Information regarding the etiology and physiopathology are still unfolding and for the prevention and amelioration, good clinical management, adequate ventilatory support and the use of systemic corticoids seem to be the most efficient way to reduce mortality and to reduce hospital lengths.

Oficinas de alfabetização com usuários de um Caps-AD / Literacy workshops with users of a Caps-AD

O presente artigo objetiva relatar uma experiência de intervenção que consistiu na realização de Oficinas de Alfabetização com usuários de um Centro de Atenção Psicossocial para pessoas com necessidades decorrentes do uso de Álcool e outras Drogas (CAPS-AD), ocorridas ao longo do segundo semestre de 2019. Partindo da articulação teórica entre os referenciais da atenção psicossocial e da pedagogia crítica, o artigo apresenta um estudo de abordagem qualitativa, do tipo relato de experiência, no qual se descreve a referida intervenção a partir das informações coletadas através da observação participante. Entre os principais resultados da intervenção estão a formação de vínculos entre os participantes, a constituição de um espaço de aprendizagem coletiva e a significativa adesão dos participantes ao uso de metodologias ativas. Além disso, o estudo depreende a autonomia como ferramenta fundamental nesse processo. Por fim, o artigo argumenta a importância das Oficinas de Alfabetização como recursos estratégicos na clínica ampliada de saúde mental e sinaliza a necessidade de mais estudos sobre a alfabetização no âmbito da atenção psicossocial.

This article aims to report an intervention experience that consisted of Literacy Workshops with users of a Psychosocial Care Center for people with needs arising from the use of Alcohol and other Drugs (CAPS-AD). Starting from the theoretical articulation between the references of psychosocial care and critical pedagogy, the article presents an experience report type study in which the methodology of participant observation was used. The Literacy Workshops took place throughout the second semester of 2019. Among the main results of the intervention are the formation of bonds between the participants and the constitution of a space for sharing their perceptions about educational processes and exclusion in a literate society. The use of active methodologies in conducting the workshops resulted in satisfactory adherence by the participants. In addition, autonomy stands out as a methodological tool and an important result in the educational practices of young people and adults. Finally, the article argues the importance of Literacy Workshops as strategic resources in the expanded mental health clinic and signals the need for further studies on literacy within the scope of psychosocial care.

O dispositivo das drogas nas políticas públicas / The dispositive of drugs in public policies / El dispositivo de las drogas en las políticas públicas

Este artigo aborda a emergência do dispositivo das drogas nas políticas públicas em suas facetas mais contemporâneas no governo da vida e produção de subjetividade. No início desta década observa-se um significativo crescimento do papel do dispositivo das drogas nas políticas públicas. Postas como problema social, as drogas têm sido acionadas sob a forma de ameaça à vida e à sociedade, bem como operacionalizadas enquanto tecnologia de governo. Nesse sentido, depois de uma discussão sobre a produção de conhecimento, o artigo enseja uma problematização sobre o dispositivo das drogas em sua interface com as políticas públicas partindo da análise de documentos, notícias e registros do diário de campo de um estágio em psicologia no Centro de Atenção Psicossocial - Álcool e outras Drogas (CAPS-AD). Por fim, faz-se apontamentos sobre as formas de disputa e resistência a partir dos jogos de forças que atuam no interior do dispositivo das drogas. (AU)

This article discusses the emergence of the dispositive of drugs in public policies in its most contemporary aspects in the government of life and production of subjectivity. Earlier this decade there has been a significant growth of the dispositive of drugs role in public policies. Put as a social problem, the drugs have been triggered in the form of threat to life and society, as well as operationalized while government technology. This way, after a discussion about the production of knowledge, the article leads to a problematization of the dispositive of drugs in its interface with public policies, starting from the analysis of documents, news and records of the field diary of a psychology internship in the Centro de Atenção Psicossocial - Álcool e outras Drogas (CAPS-AD). Observations were also made about the forms of dispute and resistance from the mechanisms of power operating inside the dispositive of drugs. (AU)

Este artículo aborda la emergencia del dispositivo de las drogas en las políticas públicas en sus facetas más contemporáneas en el control de la vida y producción de subjetividad. En esta década se observa un crecimiento del papel del dispositivo de las drogas en las políticas públicas, las drogas han sido puestas como un problema social que amenaza la vida y la sociedad valiéndose como una tecnología de control. Después de una discusión sobre la producción de conocimiento, el presente artículo plantea una problematización sobre el dispositivo de las drogas en su interfaz con las políticas públicas partiendo del análisis de documentos, noticias y registros del diario de campo de una pasantía en psicología en el Centro de Atenção Psicossocial - Álcool e outras Drogas (CAPS-AD). Finalmente, se hace un registro sobre las disputas y resistencias a partir de las fuerzas que actúan en el interior del dispositivo de las drogas. (AU)

Molecular profile of mannan-binding lectin in hepatitis C patients with MBL gene polymorphisms by a modified mannan-coated nitrocellulose assay.

The aim of this study was to develop an assay to analyze the serum profile of Mannose-binding lectin (MBL) through a simple and "in-house" method (called "dot-N-man"). Furthermore, the study attempted to associate molecular masses of MBL to the profile of MBL gene polymorphisms in patients with hepatitis C. Heterogeneity in molecular masses of MBL is due to the impairment of oligomers formation, which is linked to genetic polymorphisms in the MBL gene. Individuals with AA genotype (wild-type) produce high-molecular-mass proteins, whereas AO and OO individuals produce intermediate and low-molecular-mass proteins, respectively. Sera of thirty patients carrying the hepatitis C virus (HCV) were investigated using MBL binding assay with mannan-coated nitrocellulose (dot-N-man). Purified MBL was evaluated by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting. Dot-N-Man assay yielded MBL with molecular masses ranging between 55 and 320 kDa, comparable to low and high molecular mass forms of MBL. Nonreducing SDS-PAGE showed high molecular mass bands in all AA individuals while bands of 270 and 205 kDa were observed in sera for a number of patients with AO and OO genotypes, respectively. Immunoblotting confirmed the MBL samples obtained from the dot-N-man. These results provide new insights to understand the MBL molecular forms profile in patients infected with HCV- which could be useful in future investigations on the influence of the MBL structure/genotype on both the progression of infection and the response to hepatitis C therapy.

Espécies fúngicas responsáveis por onicomicose em Recife, Pernambuco / Fungal species causing onychomycosis in Recife, Pernambuco

Onicomicose é a infecção fúngica ungueal causada por leveduras, dermatófitos ou fungos filamentosos não-dermatófitos. O presente trabalho tem como objetivo demonstrar fungos em unhas de pacientes encaminhados a exame micológico em Recife, PE. Foram avaliadas 181 amostras ungueais dos pés e 107 das mãos oriundas de 251 pacientes. O exame direto foi realizado com KOH a 20% e a cultura em Agar Sabourand e Mycosel®. Das amostras estudadas, 167 (58%) foram positivas, 97 (34%) de unhas dos pés e 70 (24%) de unhas das mãos. Leveduras foram isoladas em 86 casos, representando 51% das amostras positivas, principalmente espéciesde Candida; os fungos filamentosos não dermatófitos foram isolados em 32 (19%) casos, com ênfase para espécies de Fusarium e Scytalidium; dermatófitos foram identificados em 26 (16%) amostras, com predominância de Trichophyton rubrum. Entretanto, nãofoi possível isolar o agente etiológico em 23 (14%) amostras com exame direto positivo. Os resultados obtidos demonstraram a ampla gama de espécies fúngicas envolvidas em patologias ungueais com destaque para os fungos filamentosos não-dermatófitos que constituíram o segundo grupo mais isolado. O diagnóstico micológico com identificação das espécies envolvidas é essencial para o tratamento mais específico de doenças fúngicas ungueais.

Espécies fúngicas isoladas a partir de unhas de manipuladores de alimentos / Fungal species isolated from food manipulators' nails

Doenças veiculadas por alimentos representam um importante problema de saúde pública, acometendo principalmente crianças, idosos e imunocomprometidos. Embora a contaminação alimentar possa ter várias origens, a inadequada manipulação dosalimentos durante seu processamento e distribuição é uma das principais causas de disseminação destas enfermidades. Infecções fúngicas ungueais podem favorecer a instalação de bactérias responsáveis por intoxicações alimentares. Objetivamos demonstrarespécies fúngicas isoladas em unhas de 50 manipuladores de alimentos com idades entre 20-50 anos. Foram realizados exames diretos com KOH 30% e culturas em Sabouraud-cloranfenicol. Leveduras foram identificadas em CHROMagar® Candida, microcultivos em lâmina e provas bioquímicas. Houve isolamento de Candida sp. a partir de 30 amostras, sendo C. parapsilosis em 33.3%, C. albicans em 13.3%, C. tropicalis em 13.3%, C. glabrata em 13.3%, C. pulcherrima em 6.6%, C. famata em 3.3% e C. guilliermondii em 3.3% dos casos. Em 14% dos casos positivos ao exame direto, não houve crescimento de colônias de leveduras em cultura. Não foram observados fungos filamentosos. É importante a identificação de agentes causadores de onicomicoses em unhas de manipuladores, visando a diminuição de infecções propagadas por alimentos contaminados, contribuindo com ações de vigilância sanitária

Estudo comparativo da prevalência de Staphylococcus aureus importado para as unidades de terapia intensiva de hospital universitário, Pernambuco, Brasil / Comparative study on the prevalence of Staphylococcus aureus imported to intensive care units of a university hospital, Pernambuco, Brazil

O Staphylococcus aureus é um dos principais patógenos que coloniza indivíduos saudáveis na comunidade e responde por infecções em pacientes hospitalizados. Um estudo transversal foi realizado para determinar a prevalência de S. aureus meticilina-resistente e sensível entre 231 pacientes, internados entre janeiro e abril de 2003, nas unidades de terapia intensiva (UTIs) do Hospital Universitário Oswaldo Cruz, assim como os possíveis fatores associados à colonização. Foram coletadas secreções de narinas, axilas, região perineal e dermatoses com soluções de continuidade, de todos os pacientes, nas primeiras 48 horas de internamento nas UTIs. O material foi semeado em meios de cultura adequados. A prevalência de S. aureus igualou-se a 37,7 por cento (87/231), sendo 13 por cento (30/231) meticilina-resistente e 24,8 por cento (57/231) meticilina-sensível. Idade, sexo, uso de antibioticoterapia, corticoterapia, motivo e local do internamento não se associaram à presença do S. aureus ou do meticilina-resistente. Houve associação significante entre procedência hospitalar e colonização por S. aureus, independente da cepa, e entre internamento anterior e presença do S. aureus meticilina-resistente. As narinas foram o sítio de colonização mais significante, por S. aureus meticilina-resistente (47/57=82,4 por cento) e sensível (23/30=76,7 por cento). Foi alta a prevalência do S. aureus (meticilina resistente ou sensível), assim como do meticilina-resistente entre os pacientes das UTIs deste hospital. Estudos futuros poderão comprovar se os resultados aqui descritos e medidas de rastreamento para S. aureus poderiam ser adotadas, de forma prospectiva, para se avaliar o risco, assim como a magnitude do efeito, no controle de infecções hospitalares provocadas por estes patógenos.

Staphylococcus aureus is the most important pathogen that colonizes healthy individuals in the community and is responsible for infections in hospitalized patients. A cross-sectional study was carried out to determine the prevalence of methicillin-resistant and sensitive S. aureus, in 231 patients, hospitalized from January to April 2003, in the Intensive Care Units (ICU) of Hospital Universitário Oswaldo Cruz, as well as possible factors associated with colonization. Secretions, from the anterior nostrils, armpits, perineum and dermatosis with continuity solutions, were collected from all patients, within the first 48 h of admission at the ICU. These samples were spread on appropriate media. The prevalence of S. aureus was 37.7 percent (87/231), of which 13 percent (30/231) methicillin-resistant and 24.8 percent (57/231) methicillin-sensitive. Age, gender, antibiotic therapy, corticoid therapy and cause and place of hospitalization were not associated to colonization by S. aureus or methicillin-resistance. There was a significant association between hospital of origin and S. aureus colonization, regardless of strain, as well as between previous hospitalization and the presence of methicillin-resistant S. aureus. Regardless of strain, nostrils were the most significant colonization site for methicillin-resistant (47/57=82.4 percent) and methicillin-sensitive S. aureus (23/30=76.7 percent). There was a high prevalence of S aureus, (methicillin resistant or sensitive), as well as of methicillin resistance among ICU patients in this hospital. Future studies may prove the results reported here and screening routines for S. aureus should be adopted, prospectively, to evaluate risk, as well as the magnitude of the effect, on the control of hospital infections caused by these pathogens.

Prevalence of Staphylococcus aureus introduced into intensive care units of a University Hospital.

Staphylococcus aureus is one of the principal human pathogens that colonize healthy individuals in the community in general, and it is responsible for severe infections in hospitalized patients. Due to an increase in the prevalence of strains of methicillin-resistant S. aureus (MRSA), combating these microorganisms has become increasingly difficult. A descriptive study was carried out on 231 patients in intensive care at the Oswaldo Cruz University Hospital (HUOC) in Recife, Brazil between January and April 2003 to determine the prevalence of S. aureus and MRSA and to evaluate risk factors for colonization by these bacteria when introduced into Intensive Care Units (ICUs). Body secretions were collected from the nostrils, axillary and perineal regions, and from broken skin lesions, of all patients during the first 48 hours following admission to the ICU. Samples were inoculated into blood agar and mannitol-salt-agar culture medium and identified by Gram staining, and by coagulase, DNAse and agglutination (Slidex Staph Test) tests. Growth in Mueller-Hinton agar with 4% sodium chloride and 6 mg/L oxacillin was used to identify MRSA. In addition, the latex agglutination test was performed to identify penicillin-binding protein, PBP 2A. The prevalence of S. aureus and MRSA was 87/231 (37.7%) and 30/231 (12.98%), respectively. There was no association between any risk factor studied (age, sex, origin of the patient--whether hospital or community, previous hospitalization, use of current or previous antibiotic therapy, corticotherapy and/or immunotherapy, reason for hospitalization and place of hospitalization) and the presence of S. aureus. However, a significant association was established between previous hospitalization and the presence of MRSA (RR:1.85; CI:1.00-3.41; p=0.041). The nostrils were the principal site of colonization by both S. aureus (80.4%) and MRSA (26.4%), followed by the perineal area, with rates of 27.6% and 12.6%, respectively. If only the nostrils had been investigated, the study would have failed to diagnose 17 patients (19.5%) as carriers of the pathogen into the ICU, thus contributing towards cross-dissemination.

Prevalence of Staphylococcus aureus introduced into intensive care units of a University Hospital

Staphylococcus aureus is one of the principal human pathogens that colonize healthy individuals in the community in general, and it is responsible for severe infections in hospitalized patients. Due to an increase in the prevalence of strains of methicillin-resistant S. aureus (MRSA), combating these microorganisms has become increasingly difficult. A descriptive study was carried out on 231 patients in intensive care at the Oswaldo Cruz University Hospital (HUOC) in Recife, Brazil between January and April 2003 to determine the prevalence of S. aureus and MRSA and to evaluate risk factors for colonization by these bacteria when introduced into Intensive Care Units (ICUs). Body secretions were collected from the nostrils, axillary and perineal regions, and from broken skin lesions, of all patients during the first 48 hours following admission to the ICU. Samples were inoculated into blood agar and mannitol-salt-agar culture medium and identified by Gram staining, and by coagulase, DNAse and agglutination (Slidex Staph Test®) tests. Growth in Mueller-Hinton agar with 4 percent sodium chloride and 6mg/L oxacillin was used to identify MRSA. In addition, the latex agglutination test was performed to identify penicillin-binding protein, PBP 2A. The prevalence of S. aureus and MRSA was 87/231 (37.7 percent) and 30/231 (12.98 percent), respectively. There was no association between any risk factor studied (age, sex, origin of the patient - whether hospital or community, previous hospitalization, use of current or previous antibiotic therapy, corticotherapy and/or immunotherapy, reason for hospitalization and place of hospitalization) and the presence of S. aureus. However, a significant association was established between previous hospitalization and the presence of MRSA (RR:1.85; CI:1.00-3.41; p=0.041). The nostrils were the principal site of colonization by both S. aureus (80.4 percent) and MRSA (26.4 percent), followed by the perineal area, with rates of 27.6 percent and 12.6 percent, respectively. If only the nostrils had been investigated, the study would have failed to diagnose 17 patients (19.5 percent) as carriers of the pathogen into the ICU, thus contributing towards cross-dissemination.

Criptosporidiose em crianças com desnutriçäo grave / Cryptosporidiosis in children with severe malnutrition

Observou-se a freqüência de Crytosporidiose em 90 crianças desnutridas graves, com e sem diarréia. Em 15,5% da casuística estudada essa coccidose foi encontrada, sendo em 21,3% das crianças que apresentavam diarréia e em 3,4% naquelas que näo demonstravam esse sintoma

Intoxicaçäo digitálica: análise de 216 casos do HSE do Rio de Janeiro / Digitalis intoxication: review of 216 cases at the HSE of Rio de Janeiro

Foram revisados os prontuários de 216 pacientes do HSE do Rio de Janeiro que apresentavam intoxicaçäo digitálica e os resultados obtidos comparados com a literatura. Diversos parâmetros foram analisados, ressaltando-se que os mesmos foram correlacionados às drogas usadas. Houve maior incidência em pacientes do sexo masculino (81,93%), agrupados na faixa etária de 61 a 70 anos (34,72%). A insuficiência cardíaca estava presente em 67,12% dos pacientes. A droga mais utilizada foi digoxina (77,7%). As principais manifestaçöes clínicas foram: vômitos (53,24%), náuseas (52,77%) e descompensaçäo da insuficiência cardíaca (50%). A arritmia mais freqüêntemente encontrada foi extra-sístole ventricular multifocal (25,88%). Houve boa resposta à terapêutica conservadora em 86,11% dos pacientes, sendo que 2,78% evoluíram para o óbito