São Paulo medical journal = Revista paulista de medicina
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Randomized Controlled Trial
Effects of single dose of dexamethasone on patients with systemic inflammatory response.
Systemic inflammatory response syndrome (SIRS) is a very common condition among critically ill patients. SIRS, sepsis, septic shock and multiple organ dysfunction syndrome (MODS) can lead to death. Our aim was to investigate the efficacy of a single dose of dexamethasone for blocking the progression of systemic inflammatory response syndrome. ⋯ Dexamethasone enhanced the effects of vasopressor drugs and evaluation of the respiratory system showed improvements (better PaO2/FiO2 ratio), one day after its administration. Despite these improvements, the single dose of dexamethasone did not block the evolution of SIRS.
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Randomized Controlled Trial Comparative Study
Contribution to the treatment of nausea and emesis induced by chemotherapy in children and adolescents with osteosarcoma.
Chemotherapy-induced emesis is a limiting factor in treating children with malignancies. Intensive chemotherapy regimens along with emetogenic drug administration have increased the frequency and severity of emesis and nausea. Our study was designed to consider the importance of this problem and the need for improvement in emesis treatment for patients receiving chemotherapy. Our objective was to compare the efficacy and safety of the antiemetic drug granisetron and a regimen of metoclopramide plus dimenhydrinate. ⋯ In children and adolescents with osteosarcoma, granisetron was safe and more efficient than metoclopramide plus dimenhydrinate for controlling chemotherapy-induced emesis and nausea.
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Controlled Clinical Trial
Effects of prone position on the oxygenation of patients with acute respiratory distress syndrome.
Acute respiratory distress syndrome (ARDS) is characterized by arterial hypoxemia, and prone position (PP) is one possible management strategy. The objective here was to evaluate the effects of PP on oxygenation. ⋯ For a significant number of ARDS patients, PP may rapidly enhance arterial oxygenation and its inclusion for management of severe ARDS is justified. However, it is not a cost-free maneuver and caution is needed in deciding on using PP.
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Patients are often admitted to intensive care units with delay in relation to when this service was indicated. The objective was to verify whether this delay influences hospital mortality, length of stay in the unit and hospital, and APACHE II prediction. DESIGN AND SETITNG: Prospective and accuracy study, in intensive care unit of Santa Casa de São Paulo, a tertiary university hospital. ⋯ APACHE II foresaw the mortality rate among patients that arrived faster to the intensive core unit, while the mortality rate was higher among those patients whose admission to the intensive care unit took longer.
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Although it is generally agreed that a medical history and physical examination should be obtained as part of preoperative evaluation, there is still substantial controversy about the additional benefits of preoperative screening tests. The objective of the present study was to determine the percentage of abnormalities on laboratory tests among a population that underwent non-cardiac surgery and to correlate these tests with changes in preoperative evaluation management. ⋯ Although there were substantial numbers of screening test abnormalities in preoperative evaluations, these results seldom interfered in patient management.