ABSTRACT
Abstract Objective To describe the clinical, laboratory, and radiological characteristics, as well as the outcomes of children with MIS-C. Method Multicenter, prospective cohort study, conducted in 17 pediatric intensive care units in five states in Brazil, from March to July 2020. Patients from 1 month to 19 years who met the MIS-C diagnostic criteria were included consecutively. Results Fifty-six patients were included, with the following conditions: Kawasaki-like disease (n = 26), incomplete Kawasaki disease (n = 16), acute cardiac dysfunction (n = 10), toxic shock syndrome (n = 3), and macrophage activation syndrome (n = 1). Median age was 6.2 years (IQR 2.4−10.3), 70% were boys, 59% were non-whites, 20% had comorbidities, 48% reported a contact with COVID-19 cases, and 55% had a recent SARS-CoV-2 infection confirmed by RT-PCR and/or serology. Gastrointestinal symptoms were present in 71%, shock symptoms in 59%, and severe respiratory symptoms in less than 20%. -Dimer was increased in 80% and cardiac dysfunction markers in more than 75%. Treatment included immunoglobulin (89%); corticosteroids, antibiotics, and enoxaparin in about 50%; and oseltamivir and antifungal therapy in less than 10%. Only 11% needed invasive mechanical ventilation, with a median duration of five days (IQR 5-6.5). The median length of PICU stay was six days (IQR 5-11), and one death occurred (1.8%). Conclusions Most characteristics of the present MIS-C patients were similar to that of other cohorts. The present results may contribute to a broader understanding of SARS-CoV-2 infection in children and its short-term consequences. Long-term multidisciplinary follow-up is needed, since it is not known whether these patients will have chronic cardiac impairment or other sequelae.
Subject(s)
Humans , Male , Child , COVID-19 , Brazil/epidemiology , Prospective Studies , Systemic Inflammatory Response Syndrome , Pandemics , SARS-CoV-2ABSTRACT
Se analizaron las estrategias de poder en la relación profesionales de la salud-pacientes, como instancia condicionante del trabajo profesional y para nuestra construcción de un modelo de rol. El objetivo es describir las acciones que se dan en la relación equipo de salud-usuario en la Atención Primaria, que habilitan y/o condicionan el comportamiento de los individuos con respecto a su salud, para re"exionar sobre el modelo profesional de la carrera de Medicina durante el año 2010. Desarrollamos nuestro objetivo a partir de la observación del comportamiento del equipo de salud en el Hospital Menor de Ingeniero White de la ciudad de Bahía Blanca. Observamos una clara asimetría de poder entre el equipo de salud y el usuario, dejando en evidencia la actual y fuerte influencia del modelo médico hegemónico en esta relación. Los profesionales de la salud tienden a adjudicarse el poder y/o control en la relación con sus pacientes, justi&cando su accionar en su posesión del conocimiento de tipo académico, y de esta manera desestimando el conocimiento del paciente.
We analyze the strategies of power in the relation between patientsand health professionals, as a conditioning instance of professionalwork and to our construction of a role model. The objective is to describethe actions given in the relation between health care teams and users, whichenable or conditionate the behavior of individuals regarding their health, tore"ect on the professional model of the medical career in 2010. We developedour objective from the observation of the behavior of the health teamin the Hospital Menor de Ingeniero White in the city of Bahia Blanca. Weobserved a clear asymmetry of power between the health care team and theuser, which evidences the strong and current in"uence of the hegemonicmedical model in this relationship. Health professionals tend to attributethemselves the power and/or control in the relationship with their patients,justifying their actions in the possession of knowledge of an academic nature,and thus dismissing the patients knowledege.