São Paulo medical journal = Revista paulista de medicina
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Review Meta Analysis
Neuraxial anesthesia for orthopedic surgery: systematic review and meta-analysis of randomized clinical trials.
Taking the outcome of mortality into consideration, there is controversy about the beneficial effects of neuraxial anesthesia for orthopedic surgery. The aim of this study was to compare the effectiveness and safety of neuraxial anesthesia versus general anesthesia for orthopedic surgery. ⋯ So far, the evidence available from the studies included is insufficient to prove that neuraxial anesthesia is more effective and safer than general anesthesia for orthopedic surgery. However, this systematic review does not rule out clinically important differences with regard to mortality, stroke, myocardial infarction, length of hospitalization, postoperative cognitive dysfunction or pneumonia.
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Review Comparative Study
Neuraxial anesthesia versus general anesthesia for urological surgery: systematic review.
CONTEXT AND OBJECTIVE Choosing the best anesthetic technique for urological surgery with the aim of mortality reduction remains controversial. The objective here was to compare the effectiveness and safety of neuraxial anesthesia versus general anesthesia for urological surgery. DESIGN AND SETTING Systematic review, Universidade Federal de Alagoas. ⋯ Meta-analysis was not performed. CONCLUSION At the moment, the evidence available cannot prove that neuraxial anesthesia is more effective and safer than general anesthesia for urological surgery. There were insufficient data to pool the results relating to mortality, stroke, myocardial infarction, length of hospitalization, quality of life, degree of satisfaction, postoperative cognitive dysfunction and blood transfusion requirements.
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CONTEXT AND OBJECTIVE Falls from the roof slabs of houses are accidents of high potential severity that occur in large Brazilian cities and often affect children and adolescents. The aims of this study were to characterize the factors that predispose towards this type of fall involving children and adolescents, quantify the severity of associated lesions and suggest preventive measures. DESIGN AND SETTING Descriptive observational prospective longitudinal study in two hospitals in the metropolitan region of São Paulo. ⋯ In 72% of the cases, the children were unaccompanied by an adult responsible for them. Severe conditions such as multiple trauma and traumatic brain injuries resulted from 79% of the accidents. CONCLUSION Falls from roof slabs are accidents of high potential severity, and preventive measures aimed towards informing parents and guardians about the dangers and risk factors associated with this type of accident are needed, along with physical protective measures, such as low walls around the slab and gates with locks to restrict free access to these places.
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The Beliefs about Medicines Questionnaire (BMQ-Specific) has proven useful for measuring patients' beliefs and associating them with non-adherence to treatment in several illness groups. The aim was to cross-culturally adapt the BMQ-Specific into Portuguese for the general population of medicine users. ⋯ A cross-culturally adapted Portuguese version of the BMQ-Specific questionnaire for use among the general population of medicine users was obtained, presenting good internal consistency and component structure identical to the original English version.
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Calcium renal lithiasis is a frequent condition that affects the worldwide population and has a high recurrence rate. Different metabolic changes may trigger the onset of calcium stone disorders, such as hypercalciuria, hyperoxaluria, hyperuricosuria, hypocitraturia and others. There are also other very prevalent disorders that are associated with calcium calculi, such as arterial hypertension, obesity and loss of bone mineral density. ⋯ Once the metabolic diagnosis is known, it is possible to establish dietary and pharmacological treatment that may enable monitoring of the disease and prevent recurrence of stone formation. Some advances in treating this pathological condition have been made, and these include use of sodium alendronate in patients with calcium renal lithiasis and osteopenia/osteoporosis, or use of a combination of a thiazide with a bisphosphonate. In summary, calcium renal lithiasis often requires multidrug treatment with strict control and follow-up of patients.