São Paulo medical journal = Revista paulista de medicina
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Case Reports
Case report of scrub typhus complicated by hypokalemia and multiple organ dysfunction syndrome.
Scrub typhus, caused by Orientia tsutsugamushi, has a wide range of clinical manifestations, including meningoencephalitis, acute renal failure, pneumonitis, myocarditis, and septic shock. However, there are no documented cases of scrub typhus with hypokalemia. In this report, we present a case of scrub typhus with hypokalemia and multiple organ failure syndrome, highlighting the importance of electrolyte imbalance in patients with scrub typhus. ⋯ This report highlights the potential for atypical presentations of scrub typhus, including a previously undocumented association with hypokalemia. Although the contribution of hypokalemia to the patient's clinical course remains uncertain, this case underscores the importance of considering electrolyte imbalance in the management of patients with scrub typhus. Further research is warranted to better understand the relationship between scrub typhus and electrolyte imbalance.
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Advance Directive documents allow citizens to choose the treatments they want for end-of-life care without considering therapeutic futility. ⋯ The authors suggest that all citizens should be clarified regarding the futility concept before filling out the Advance Directives and propose a grammatical change in the document, replacing the phrase "Health Care to Receive / Not to Receive" with the sentence "Health Care to Accept / Refuse" so that patients cannot demand treatments, but instead accept or refuse the proposed therapeutic plans.
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Meta Analysis
Emicizumab prophylaxis in people with hemophilia A and inhibitors: a systematic review and meta-analysis.
Until recently, the treatment of people with hemophilia A and inhibitors (PwHAi) was based on the use of bypassing agents (BPA). However, the advent of emicizumab as prophylaxis has demonstrated promising results. ⋯ CRD42021278726, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=278726.
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Meta Analysis
Suicide ideation and psychotropic recreational drug use by adolescents: a systematic review and meta-analysis.
Adolescence is characterized by complex and dynamic changes, often involving experimentation, including the use of psychotropic substances. Although it is well-established that recreational psychotropic drugs are associated with suicide ideation in adults, evidence of this association in adolescents remains limited. ⋯ Registered in the PROSPERO database under the identification number CRD42021232360. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021232360.
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Randomized Controlled Trial Comparative Study
Comparison between use of a pleural drainage system with flutter valve and a conventional water-seal drainage system after lung resection: a randomized prospective study.
There is still a debate regarding the most appropriate pleural collector model to ensure a short hospital stay and minimum complications. ⋯ RBR-85qq6jc (https://ensaiosclinicos.gov.br/rg/RBR-85qq6jc).