ABSTRACT
BACKGROUND: The COVID-19 pandemic posed a great strain in health services. AIM: To describe the epidemiological and clinical features of patients with SARS-CoV-2 admitted to a regional hospital in southern Chile between April and August 2020. MATERIAL AND METHODS: Clinical records of all hospitalized patients with RT-PCR (+) for SARS-CoV-2 were retrospectively analyzed. RESULTS: During the study period 226 patients aged 55 ± 18 years (55% men) were admitted. The main comorbidities were high blood pressure in 45%, diabetes in 31% and obesity in 21%. The main symptoms were dyspnea in 70%, cough in 69%, fever in 62% and myalgia in 47%. Pneumonia was the main cause of admission in 66%. Images on admission were compatible with pneumonia in 81%, and with a typical COVID-19 pattern in 84%. In 76% there was five-lobe involvement. Eighty-seven cases (39%) were admitted to critical care, with an APACHE score of 10.9 ± 7.1. Invasive mechanical ventilation was used in 16%, 30% required prone position and 13%, a high-flow nasal cannula. The mean stay in critical care was 13.3 days. The mean duration of invasive mechanical ventilation was 14.1 days. Antimicrobials were used in 55% and dexamethasone in 36%. Twenty-two (9.7%) patients aged 71.7 ± 14 died. A Charlson comorbidity index > 3, heart failure and connection to invasive mechanical ventilation were independent risk factors for death. An age > 65 years alone and other comorbidities were not risk factors. CONCLUSIONS: Viral pneumonia is the main cause of hospitalization for COVID-19, usually extensive and bilateral. The greater severity and poor prognosis of these patients are mainly related to comorbidities.
Subject(s)
Humans , Male , Female , Pandemics , COVID-19/epidemiology , Respiration, Artificial , Dexamethasone , Chile/epidemiology , Retrospective Studies , SARS-CoV-2 , Hospitalization , HospitalsABSTRACT
Background: In a decade, we faced two pandemic viruses, influenza A H1N1pdm09 and SARS CoV-2, whose most serious manifestation is pneumonia. Aim: To compare the clinical, epidemiological and management aspects of pneumonias caused by each pandemic virus in adults requiring hospitalization. Material and Methods: Comparative, observational study carried out at a regional Chilean hospital, including 75 patients with influenza A H1N1pdm09 prospectively studied in 2009 and 142 patients with SARS-CoV-2 studied in 2020. Results: Patients with SARS-CoV-2 pneumonia were older (56 and 39.7 years respectively, p < 0.01) and had significantly more comorbidities. Cough, fever and myalgias were more frequent in influenza. Dyspnea was more frequent in COVID-19. Patients with COVID-19 had more extensive lung involvement and a longer hospitalization (13.6 and 8.6 days respectively, p = 0.01). There was no difference on ICU admission requirements and mortality attributable to pneumonia. Patients with influenza had greater APACHE scores and a higher frequency of a PaO2/FiO2 ratio ≤ 200. During COVID-19pandemic chest sean replaced x-ray examination. Also high-flow nasal cannulas and awake prone position ventilation were added as treatments. Conclusions: COVID-19 patients were older, had fewer classic flu symptoms but more dyspnea and longer hospitalization periods than patients with influenza.
ABSTRACT
El objetivo del estudio fue analizar la percepción de escolares de 8 a 12 años, de ambos sexos, distinto nivel socioeconómico (NSE) y estado nutricional, sobre la regulación de la publicidad de alimentos y bebidas azucaradas. En un estudio de corte transversal, se aplicó una encuesta previamente validada a 812 escolares (399 niños y 413 niñas) de NSE alto y bajo en 3 ciudades del país. Los datos se analizaron según NSE y estado nutricional. La obesidad fue más prevalente en los niños de NSE bajo, quienes veían más comerciales de alimentos y bebidas en televisión y los de NSE alto en Internet y celulares. Sobre el 65% de los escolares en ambos NSE llevaba dinero para comprar alimentos en el horario escolar. En los primeros meses de entrada en vigencia de la Ley 20.606, el 80% de los niños indicaron que les gustaba ser informados de lo que contenían los alimentos y los sellos Alto en Calorías, Alto en Grasas Saturadas y Alto en Sodio fueron significativamente más importantes para los de NSE alto. El sello Alto en Azúcares fue igualmente importante en ambos NSE. Estos resultados permitirán apoyar intervenciones de educación en nutrición y marketing social que motiven la alimentación saludable en niños, padres y profesores(AU)
The objective of this study was to analyze the perception of schoolchildren, 8 to 12 years, both sex, of different socioeconomic status (SES) and nutritional status, on food and sugary beverages advertising regulation. A cross-sectional study that used a previously validated survey to 812 schoolchildren (399 boys and 413 girls) of high and low SES in 3 Chilean cities was performed. The data was analyzed according to NSE and nutritional status. Obesity was more prevalent in low-SES children. These children watched significantly more food and beverages TV ads while high SES children do it more through Internet and cell phones. Over 65% of children of both SES brought money to school to buy food. In the first months after the 20.606 Law was implemented, 80% of the children indicated that they like to be informed on food content. On the other hand, the symbols "High in Calories", "High in Saturated Fats", and "High in Sodium", were significantly more relevant for children of high SES. The symbol "High in Sugars" was equally important for children of both SES. These results will support the design of nutrition education and social marketing interventions that promote healthy eating in children, parents and teachers(AU)
Subject(s)
Humans , Male , Female , Child , Food Composition , Food Publicity , Pediatric Obesity , Food Labeling , Feeding Behavior , Nutritive ValueABSTRACT
Bronchopulmonary dysplasia is one of the most common pediatric chronic lung diseases. In the recent decades the advances made in perinatal care and the increase survival of extreme preterm have shown an overall change in the characteristics of this disease giving rise to the concept of new dysplasia. In the development of the disease is essential the exposure of the immature lung to various factors such as nutritional deficiency, pre and post-natal infections, persistent ductus arteriosus, and genetic susceptibility. This article reviews the most important characteristics of this disease, treatment and follow-up.
La displasia broncopulmonar (DBP) es una de las enfermedades pulmonares crónicas frecuentes en pediatría. Los avances experimentados en las últimas décadas en cuidados perinatales y la sobrevida de prematuros cada vez más extremos han demostrado un cambio global en las características de esta enfermedad dando lugar al concepto de nueva displasia, en cuyo desarrollo son fundamentales la exposición del pulmón inmaduro a diversos factores como deficiencia nutricional, infecciones pre y post-natales, ductus arterioso persistente, y susceptibilidad genética. El presente articulo revisa las características más relevantes de esta patología, su enfrentamiento global, manejo y seguimiento ambulatorio.
Subject(s)
Humans , Infant, Newborn , Antibodies, Monoclonal, Humanized/therapeutic use , Bronchopulmonary Dysplasia/diagnosis , Bronchopulmonary Dysplasia/drug therapy , Infant, Premature , Bronchopulmonary Dysplasia/complications , PrognosisABSTRACT
En la Cumbre Mundial sobre la Alimentación (CMA) del año 1996, los jefes de estado de 186 países acordaron para el año 2015, reducir al 50 por ciento la cantidad de personas que padecen subnutrición en el mundo. Con el propósito de monitorear el avance hacia el cumplimiento de esta meta, la FAO publica desde 1999 El estado de la inseguridad alimentaria en el mundo, informe que estima año a año la cifra de personas subnutridas, en base a una metodología aplicada con propósitos comparativos a todos los países sin excepción. La cifra resultante es una estimación y no pretende reemplazar la medición directa del consumo de alimentos provenientes de encuestas poblacionales, o la medición del estado nutricional de los habitantes de un país a partir de medidas antropométricas. En el caso de Chile, al usar esta metodología, el informe SOFI 2004 indica que la proporción de personas subnutridas alcanza un 4 por ciento de la población total, es decir, 600.000 personas. Esta cifra amerita un análisis complementario en virtud de que en este país existe información actualizada y representativa de su población, basada en indicadores socioeconómicos, de salud y de estado nutricional. En consecuencia el análisis de esta información nacional, muestra que la cifra de personas subnutridas es comparable al número de personas indigentes, las que evidentemente se encuentran en riesgo de inseguridad alimentaria. Sin embargo, resultados del estado nutricional de la población demuestran elevados índices de sobrepeso y obesidad en los diferentes grupos etareos, estando la subnutrición más asociada a una dieta inadecuada desde el punto de vista de calidad (adecuación de micronutrientes) y no de cantidad (aporte energético). La primera Encuesta Nacional en Salud (ENS 2003) indica que Chile tiene como mayor manifestación, la carga de enfermedades crónicas relacionadas con la nutrición derivadas del sobrepeso y obesidad, en una población adulta que ha estado sometida a desnutrición tempra...
At the World Food Conference (WFC) in 1996, 186 chief of states made the compromise to reduce by 50 percent the amount of people that suffer undernourishment in the world by the year 2015. In order to monitor the accomplishment of this goal, FAO published since 1999 The State of Food Insecurity in the World, a Report that estimates yearly the amount of undernourished people, based on a methodology applied with comparative purposes to all countries without exception. The value obtained is an estimation and does not pretend to replace the direct measurement of food consumption obtained from population surveys or analysis of nutritional status of the country population based on anthropometrical measurements. In the case of Chile, using this methodology, SOFI 2004 Report states that the proportion of undernourished population amounts to 4 percent of the total population or 600.000 people. This figure requires complementary analysis since the country has current information representative from its population, based on socio-economical, health and nutritional status indicators. As a consequence the analysis of these national data indicates that de estimation of undernourished people is comparable with the number of indigent population, who evidently are at risk of food insecurity. However, nutritional status of the population indicates high prevalence of overweight and obesity in all age groups. Undernourishment in Chile is more related to an unhealthy diet from the stand point of quality (nutrient adequacy) and not quantity (energy intake). The first Chilean National Health Survey (NHS 2003) showed that Chile presents mainly a nutrition related burden of chronic diseases. The prevalence of overweight and obesity in the adult population is highest in the groups that experienced early undernutrition, as evidenced by their low height...
Subject(s)
Humans , Food Deprivation , Malnutrition , Nutritional Status , Risk Factors , Chile , Data Interpretation, Statistical , Nutrition Surveys , Poverty , Socioeconomic FactorsABSTRACT
In memoriam Jaime Talesnik. Born in Santiago, Chile, 18 May 1915; deceased Toronto, Canada, 7 April 1996. Medical studies at University of Chile, 1935-1940. MD, University of Chile, 1941. Assistant Professor of Physiology, Faculty of Biology and Medicine, University of Chile, 1940-45. Rockefeller Research Fellow, Banting-Best Institute, Department of Medical Research, University of Toronto, Canada, 1945-46. Associate Professor of Physiology, Faculty of Medicine, University of Chile, 1947-51. British Council Research Scholar in Pharmacology, National Institute for Medical Research, London, England, 1951-52. Associate Professor of Pathophysiology, Faculty of Medicine, University of Chile, 1952-63. Professor and Chairman, Department of Experimental Medicine, Faculty of Medicine, University of Chile, 1963-67. Visiting Professor, Department of Pharmacology, University of Toronto, Canada, 1967-69. Professor, Department of Pharmacology, University of Toronto, Canada, 1969-81. Professor Emeritus, University of Toronto, Canada, 1981. Member Emeritus, Medical Association of Chile, 1991. Honorary Member, Chilean Society of Physiological Sciences, 1995. Author of textbook of pathophysiology and many articles in scientific journals
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History, 20th Century , Pathology/history , Physiology/history , Canada , Chile , PortraitABSTRACT
Bleomycin may produce diffuse pulmonary damage. Our objective was to evaluate the effect of imidazole, a thromboxane-synthetase inhibitor, on pulmonary damage induced by endotracheal instillation of bleomycin in rats. Bleomycin 1 U/100 g body weight produced diffuse pulmonary damage and increased number of inflammatory cells after 3 days, hemorrhage and focal fibrosis after 7 days, and diffuse fibrosis and pneumocyte hyperplasia after 14 to 30 days. Imidazole 5 mg/100 g body weight, given intraperitoneally 30 min before bleomycin, decreased the 3rd day lesions without altering the histopathology in subsequent periods. Imidazole reduced (p < 0.05) the increases in cell number (3rd and 14th days) as well as in proteins in bronchoalveolar lavage (3rd day), without modifying the increase in phospholipids observed in rats treated with bleomycin. We conclude that imidazole decreases initial bleomycin-induced pulmonary damage, but it does not interfere with fibrosis and late development of epithelial hyperplasia