Goal: Dissertation about the effective indications for massive transfusion in patients with severe trauma. Method: Literature review prepared between October and November 2022, through a search in the Scielo and Pubmed databases with the descriptors "massive transfusion", "blood Component transfusion", "protocol" and "indications". 5353 articles were found and, after the inclusion and exclusion criteria, 13 studies were selected. Review: Hemorrhage is a preeminent cause of possibly preventable mortality in cases of trauma and in many cases requires massive transfusions (MT). Thus, in clinical practice it is mainly based on guidelines that determine different TM protocols (MTP). After the appreciation of an abundance of clinical parameters of the patient, one can opt for the massive transfusion that must be performed in a period of 24 hours. Conclusion: The lack of research that standardizes parameters for massive transfusions leads teams to evaluate different clinical standards based on different emergency services.

Objetivo: Analisar os critérios clínicos e parâmetros complementares para realização do diagnóstico precoce em casos de síndrome HELLP que permitam garantir um tratamento oportuno visando a redução da morbimortalidade materno-fetal. Métodos: Estudo científico realizado através do levantamento bibliográfico de artigos publicados entre os anos de 2017 a 2022 indexados nas bases de dados da SciELO, LILACS e PubMed. Resultados: Critérios clínicos e parâmetros complementares diagnósticos, sobretudo os critérios de Tennessee e Mississipi, são úteis na identificação da patologia. Ademais, manifestações clínicas somadas a biomarcadores de hemólise celular, enzimas hepáticas elevadas e trombocitopenia possibilitam o reconhecimento da doença e, quando analisados de forma precoce, melhoram o desfecho materno-fetal, evitando complicações inerentes. O tratamento vai do conservador ao cirúrgico, não contando com terapia farmacológica específica, sendo que o parto com remoção placentária é o tratamento definitivo. Considerações finais: Uma abordagem diagnóstica e terapêutica precoce é indispensável para evitar repercussões deletérias à saúde da gestante e do bebê. A identificação dos parâmetros que preveem a evolução da doença é primordial para definição de condutas subsequentes, redução da morbimortalidade e melhoria na qualidade de vida deste grupo.

Goal: Discuss the prognosis of pituitary adenomas considering their clinical consequences and resulting systemic changes, in addition to possible therapeutic measures for management. Method: Literature review carried out from October to November 2022, through searches in the Scielo and Pubmed databases with the descriptors "pituitary adenoma", "symptoms", "treatment" and "diagnosis". 2925 articles were found and, after the inclusion criteria, 13 studies were selected. Review: Pituitary adenoma (HA) is the second most common intracranial tumor in the population. HAs can be asymptomatic, oligosymptomatic or cause clinical repercussions for the patient, ranging from visual disturbances to infertility. In this context, the diagnosis of HAs can be complex and must be performed by interdisciplinary professionals, with magnetic resonance imaging being the gold standard exam for imaging diagnosis. Final Considerations: There are variants regarding the tumorextension, pace of evolution and degree of impact on surrounding structures -that must be taken into account in order to shape an individualized and effective planning for each patient.