Acta Medica Port
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The authors report a clinical case of warfarin hypersensitivity noticed when a patient, with thromboembolic risk, was submitted to warfarin. She was found to be heterozigotic to -1639G>A (gene VKORC1) and homozygotic to 1075A>C (genotype CYP2C9*3/*3). In this article the warfarin pharmacodinamics and its role over Vitamin K is revisited. It includes some suggested indications for investigating genetic polymorphisms, in order to avoid complications associated with warfarin.
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Pertussis is an acute bacterial disease involving the respiratory tract. The causal agent is Bordetella pertussis. Among all age groups, infants (aged < 12 months) have had the highest incidence of pertussis in the vaccine era. ⋯ This hospital-based study indicates that pertussis continues to be an important cause of morbidity and mortality in infants. Pertussis incidence remains high among infants, most of whom are under one year of age. Immunization strategies in the adult population must be reviewed and updated in order to attain higher protection of the more vulnerable paediatric population.
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The renin-angiotensin-aldosterone system (RAAS) is a neuroendocrine complex system that regulates the modulation of salt and water homeostasis, and regulation of blood pressure. Through its multiple interactions it protects the endothelium, heart, brain and kidney. ⋯ Consequently, the RAAS is an important therapeutic target in these situations. This article presents an overview of physiology, pathophysiology and pharmacologic modulation of the RAAS.
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Tuberculosis remains a global health problem, being the genitourinary tract the second most common site for tuberculosis infection after the lungs. Genital tuberculosis is now undergoing a worrying recrudescence. ⋯ Genital tuberculosis is rare in postmenopausal women and responsible for only approximately 1% of postmenopausal bleeding. However it is a curable disease and an early diagnosis is important and may prevent unnecessary invasive procedures for the patient.