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OBJECTIVE: to determine the incidence of deep vein thrombosis and prophylaxis quality in hospitalized patients undergoing vascular and orthopedic surgical procedures. METHODS: we evaluated 296 patients, whose incidence of deep venous thrombosis was studied by vascular ultrasonography. Risk factors for venous thrombosis were stratified according the Caprini model. To assess the quality of prophylaxis we compared the adopted measures with the prophylaxis guidelines of the American College of Chest Physicians. RESULTS: the overall incidence of deep venous thrombosis was 7.5%. As for the risk groups, 10.8% were considered low risk, 14.9%moderate risk, 24.3% high risk and 50.5% very high risk. Prophylaxis of deep venous thrombosis was correct in 57.7%. In groups of high and very high risk, adequate prophylaxis rates were 72.2% and 71.6%, respectively. Excessive use of chemoprophylaxis was seen in 68.7% and 61.4% in the low and moderate-risk groups, respectively. CONCLUSION: although most patients are deemed to be at high and very high risk for deep vein thrombosis, deficiency in the application of prophylaxis persists in medical practice.

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OBJECTIVE: to determine the incidence of deep vein thrombosis and prophylaxis quality in hospitalized patients undergoing vascular and orthopedic surgical procedures. METHODS: we evaluated 296 patients, whose incidence of deep venous thrombosis was studied by vascular ultrasonography. Risk factors for venous thrombosis were stratified according the Caprini model. To assess the quality of prophylaxis we compared the adopted measures with the prophylaxis guidelines of the American College of Chest Physicians. RESULTS: the overall incidence of deep venous thrombosis was 7.5%. As for the risk groups, 10.8% were considered low risk, 14.9%moderate risk, 24.3% high risk and 50.5% very high risk. Prophylaxis of deep venous thrombosis was correct in 57.7%. In groups of high and very high risk, adequate prophylaxis rates were 72.2% and 71.6%, respectively. Excessive use of chemoprophylaxis was seen in 68.7% and 61.4% in the low and moderate-risk groups, respectively. CONCLUSION: although most patients are deemed to be at high and very high risk for deep vein thrombosis, deficiency in the application of prophylaxis persists in medical practice. .

OBJETIVO: determinar incidência de trombose venosa profunda e qualidade de profilaxia em pacientes internados submetidos a procedimentos cirúrgicos vasculares e ortopédicos. MÉTODOS: avaliou-se 296 pacientes, cuja incidência de trombose venosa profunda foi estudada por meio de ultrassonografia vascular. Os fatores de risco para trombose venosa foram estratificados conforme modelo de Caprini. Para avaliação da qualidade de profilaxia comparou-se as medidas adotadas com as diretrizes de profilaxia do American College of Chest Physicians. RESULTADOS: a incidência global de trombose venosa profunda foi 7,5%. Quanto aos grupos de riscos, 10,8% foram considerados de baixo risco, 14,9% moderado risco, 24,3% alto risco e 50,5% altíssimo risco. A profilaxia para trombose venosa profunda foi correta em 57,7%. Nos grupos de alto e altíssimo risco, as taxas de profilaxia adequada foram de 72,2% e 71,6%, respectivamente. O uso excessivo de profilaxia medicamentosa foi evidenciado em 68,7% e 61,4% nos grupos de baixo e moderado risco, respectivamente. CONCLUSÃO: Embora a maior parte dos pacientes seja considerada de alto e altíssimo risco para trombose venosa profunda, na prática médica persiste a deficiência na aplicação desta profilaxia. .

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O diagnóstico de endometrite puerperal baseia-se na existência de febre na ausência de qualquer outra causa. As manifestações clínicas mais comuns são constituídas por: útero amolecido, lóquios purulentos ou de odor fétido e leucocitose. Sua patogenia decorre da contaminação da cavidade uterina por microrganismos vaginais durante o trabalho de parto e invasão do miométrio. São fatores de risco a ruptura prolongada de membranas, múltiplos exames vaginais e parto cesáreo. É geralmente uma infecção polimicrobiana. Suas complicações incluem a extensão da infecção para a cavidade peritoneal, abscesso intra-abdominal ou sepse. Antes do advento dos antibióticos a febre puerperal era causa importante de morte materna. A antibioticoterapia inicial tem na associação clindamicina e gentamicina seu padrão-ouro. (AU)

The diagnosis of postpartum endometritis is based on the presence of fever in the absence of any other cause. The most common clinical manifestations consist of: softened uterus, purulent or malodorous lochia and leukocytosis. Its pathogenesis results from the contamination of the uterine cavity by vaginal microorganisms during labor and myometrial invasion. Risk factors are: prolonged rupture of membranes, multiple vaginal examinations and cesarean. It is usually a polymicrobian infection. Complications include the extension of the infection into the peritoneal cavity, intra-abdominal abscess or sepsis. Before the advent of antibiotics, puerperal fever was an important cause of maternal death. The initial antibiotic therapy has the association of clindamycin and gentamicin as the gold standard. (AU)

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