Einstein-Sao Paulo最新文献

Objective: To analyze cardiopulmonary resuscitation skill acquisition and retention at 3 and 6-month intervals and determine the optimal training frequency and associated costs.

Methods: Fifth and sixth-year medical students practiced cardiopulmonary resuscitation using a feedback-equipped simulator.

Results: The study included 43 students. Training with a feedback-equipped device significantly improved the performance compared to baseline: overall performance (median=95% [87-98%] versus 60% [18-89%]; p<0.001), compression depth (median=71% [24-92%] versus 13% [0-94%]; p<0.001), and compression rate (median=89% [71-98%] versus 69% [23-96%]; p=0.002. No significant differences were observed in the total recoil (median=93% [78-99%] versus 93% [58-100%]; p=0.991) or hand position (median=99% [100-100%] versus 99% [100-100%]; p=0.754). Over time, the overall performance increased by 12% at 3 months (mean ratio [MR]=1.12; p=0.001) and 10.1% at 6 months (MR=1.101; p<0.001). The compression depth improved by 38.9% at 3 months (MR=1.389; p<0.001) and 24.7% at 6 months (MR=1.247; p=0.010), whereas the compression rate increased only at 6 months (MR=1.086; p=0.026). No significant differences were found between the groups trained every 3 months and those trained every 6 months (p>0.05).

Conclusion: Short-term training with a cardiopulmonary resuscitation feedback-equipped simulator significantly improved cardiopulmonary resuscitation skill acquisition and retention. However, no differences were observed between the 3- and 6-month training intervals, suggesting that a 6-month interval may be sufficient for maintaining proficiency.

Platypnea-orthodeoxia syndrome, first described in 1949, is a rare clinical condition characterized by positional dyspnea and oxygen desaturation in the upright position that improves when lying down. Herein, we report the case of an 86-year-old patient who experienced episodes of dyspnea on assuming an upright position, which limited her daily activities. The patient's oxygen saturation was 82% in the standing position and 91% in the supine position. During diagnostic investigation, a patent foramen ovale was identified using transesophageal echocardiography. The patient underwent percutaneous patent foramen ovale closure with an Amplatzer device, which resulted in significant improvement in her symptoms and oxygen saturation. Diagnosis of this condition requires a high index of clinical suspicion and is confirmed when the syndrome's signs and symptoms correlate with the presence of a right-to-left interatrial shunt. It is predominantly diagnosed using echocardiography with agitated saline injection.

Background: Lymphatic leakage after pelvic lymphadenectomy is a rare complication. Furthermore, in some cases, drainage is not possible or proves insufficient to resolve this complication. Therefore, more effective and minimally invasive interventional treatments are necessary. Accordingly, this case report presents a case of transafferent nodal embolization in a 50-year-old woman who underwent videolaparoscopic total hysterectomy with pelvic lymphadenectomy. The patient developed high post-surgery vaginal flow due to a lymphatic fistula, which was identified after intranodal lymphangiography and treated successfully via transafferent nodal embolization. This case report shows the importance of considering lymphatic leakage as a possible pelvic surgery complication, particularly when accompanied by local lymphadenectomy. Moreover, the case report reveals that intranodal lymphangiography and transafferent nodal embolization are safe and highly effective methods to detect and treat this complication. This prevents the need for follow-up surgery, which may add morbidity to an otherwise uneventful postoperative period.

Level of evidence: Level 5, Case Report.