Revista da Associacao Medica Brasileira (1992)
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Rev Assoc Med Bras (1992) · Mar 2017
ReviewAssociation between antipsychotics and cardiovascular adverse events: A systematic review.
Determine whether there is an association between the risk of cardiovascular adverse events and the use of antipsychotic agents. ⋯ Clinical heterogeneity among the studies led to a provisional response and made it impossible to perform the meta-analysis, although the articles demonstrate an association between cardiovascular adverse events and the use of antipsychotics. More quality clinical trials are needed to support this evidence.
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Rev Assoc Med Bras (1992) · Mar 2017
ReviewHyperferritinemia in patients with nonalcoholic fatty liver disease.
In liver diseases, hyperferritinemia (HYF) is related to injured cells in acquired and genetic conditions with or without iron overload. It is frequent in patients with nonalcoholic fatty liver disease (NAFLD), in which it is necessary to define the mean of HYF to establish the better approach for them. The present study evaluated the significance of elevated ferritin in patients with NAFLD and steatohepatitis (NASH). ⋯ Hyperferritinemia in patients with NAFLD/NASH is associated more frequently with hepatocellular injury than hemochromatosis. These data suggest the relevance to evaluate carefully HYF in patients with NAFLD/NASH to establish appropriate clinical approach.
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Rev Assoc Med Bras (1992) · Mar 2017
ReviewDialectics of a medical provision policy in priority areas in Brazil.
The people living in vulnerable areas that are difficult to access in Brazil represent a portion of the population that has proven very sensitive to lack of medical and health services. The government, seeking to solve the situation urgently, implemented the More Doctors Program [Programa Mais Médicos, in the Portuguese original] in 2013. ⋯ The regional inequalities of concentration and dispersion of physicians, showed by studies on medical demography in Brazil, stem from several factors, including the lack of a career path and working conditions. There is no point in having physicians if they do not have safe and ethical conditions to establish the diagnosis and a treatment plan, as well as to monitor the rehabilitation of the patient.
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Rev Assoc Med Bras (1992) · Mar 2017
Impact of coronary intensive care unit in treatment of myocardial infarction.
The mortality rate attributed to ST-segment elevation myocardial infarction (STEMI) has decreased in the world. However, this disease is still responsible for high costs for health systems. Several factors could decrease mortality in these patients, including implementation of cardiac intensive care units (CICU). The aim of this study was to evaluate the effect of CICU implementation on prescribed recommended treatments and mortality 30 days after STEMI. ⋯ CICU implementation did not reduce mortality after 30 days in patients with STEMI; however, it increased the prescription of standard treatment for these patients.
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The effectiveness of the treatment of chronic diseases depends on the participation of the patient, influenced by different sociocultural factors, which are not fully recognized by the treatment routine. ⋯ The improved adherence to chronic treatment of ischemic heart disease depends on the establishment of effective flows for referral and counter-referral from one care unit to another, relevant information and clarification of the questions for the patients and the attention of health professionals to the many social and cultural factors involved in treatment adherence. New research should be focused on educational groups by integrated multidisciplinary teams in order to share treatment decisions, thereby increasing the patient's commitment to his own health.