■ Canadiam Medical Association Journal
Série Five Things to Know About
■ Eosinophilic esophagitis: Five things to Know About
Thurarshen Jeyalingam, Samir C. Grover
CMAJ. 2018 Apr 30; 190(17): E542
1 – Eosinophilic esophagitis is becoming more common
2 – Eosinophilic esophagitis should be suspected in patients presenting with dysphagia or food bolus obstruction
3 – Endoscopic findings alone are not sufficient to make a diagnosis of eosinophilic esophagitis
4 – Proton pump inhibitors should be prescribed for a histologic finding of esophageal eosinophilia
5 – Topical steroids and elimination diets are the mainstays of therapy
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5929894/
■ Hepatopulmonary syndrome: Five Things to Know About
Samir Gupta, Michael J. Krowka
CMAJ. 2018 Feb 26; 190(8): E223.
1 – Hepatopulmonary syndrome is defined by lliver disease, intrapulmonary vascular dilatation and abnormal oxygenation
2 – Hepatopulmonary syndrome is not uncommon among patients with liver disease
3 – Hepatopulmonary syndrome should be considered in patients with liver disease and na unxplained oxygen saturation of less than 96%, or any of platypnea, orthodeoxia, clubbing or cyanosis
4 – Liver transplantation is the only known cure for the syndrome
5 – Hepatopulmonary syndrome and portopulmonary hypertension are not the same disease
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5826708/
■ Fecal microbiota transplantation for recurrent Clostridium difficile infection: Five Things to Know About
Susy S. Hota, Susan M. Poutanen
CMAJ. 2018 Jun 18; 190(24): E746
1 – Fecal microbiota transplantation is an effective treatment for recurrent Clostridium difficile
2 – Most fecal microbiota transplantation
are performed by gastroenterologists and infectious disease specialists
3 – Donors should be rigously screened
4 – There are four ways to administer fecal microbiota transplantation
5 – The long-term health effects are unknow
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6008194/
■ Inflammatory bowel disease in pregnancy: Five Things to Know About
Amelie I. Stritzke, Cynthia H. Seow
CMAJ. 2017 May 8; 189(18): E669
1 – In most women with inflammatory bowel disease (IBD), the condition is diagnosed during prime child-bearing years
2 – Active IBD (Crohn disease or ulcerative colitis) during conception and pregnancy increases the risk of adverse pregnancy outcomes
3 – Except for metrotrexate, IBD therapies should be continued throughout pregnancy and lactation to optimize and maintain disease control
4 – Vaginal delivery should be considered in women with IBD unless they have active perianal disease or have undergone an ieloanal anastomosis
5 – Transplacental transfer of biologic therapies, specifically anti-TNF-alpha therapy, menas that the live rotavirus vaccines scheduled at two and four months of age should be omitted
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422151/
■ Loperamide abuse: Five Things to Know About
Tony Antoniou, David N. Juurlink
CMAJ. 2017 Jun 12; 189(23): E803
1 – Loperamide is not just an innocuous antidiarrheal agent
2 – Abuse of loperamide is increasing
3 – Patientes may present with cardiac manifestations without overt opioid toxicity
4 – Diagnosis of loperamide abuse requires a high index of suspicion
5 – Treatment is mostly supportive
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5468105/
■ Acute mesenteric ischemia: Five Things to Know About
N D Dattani, R Horvath
CMAJ. 2016 Aug 9, 188 (11): 820
1 – Acute mesenteric ischemia is caused by arterial insufficiency or venous obstruction
2 – The diagnosis is made most reliabley with angiography or surgery
3 – In the absence of peritonitis, minimally invasive treatment options can be considered
4 – Mortality rates are high, even with appropriate management
5 – Long-term antiplatelet or anticoagulation treatment may be indicated, depending on the cause of the ischemia
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4978579/
■ Dr Paulo Fernando Leite
Cardiologia/Prevenção Cardiovascular
Estratificação de Risco Cardiovascular
Consultório: Rua Padre Rolim 815/sala 815
Tel: 33245518 (Consulta Particular/Unimed)
Belo Horizonte/MG/Brasil
CRMMG: 7026
Email: pfleite1873@gmail.com