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ABSTRACT OBJECTIVE To evaluate the prevalence of reported symptoms of flu-like syndrome (FS) among HCW and compare HCW and non-HCW on the chance of reporting these symptoms, this study analyzed data of a population-based survey conducted in Brazil. METHODS A cross-sectional analysis was performed with self-reported data from the Brazilian National Household Sample Survey (PNAD Covid-19) from May 2020. The authors analyzed a probability sample of 125,179 workers, aged 18 to 65, with monthly income lower than US$ 3 500. The variable HCW or non-HCW was the covariate of interest and having reported FS symptoms or not was the outcome variable. Authors tested interactions of HCW with other covariates. A logit model - when controlling for sociodemographic, employment, and geographic characteristics - investigated the chance of HCW reporting FS compared to non-HCW. RESULTS HCW have a significant effect (odds ratio of 1.369) on reporting FS symptoms when compared to non-HCW. HCW account for 4.17% of the sample, with a higher frequency of FS (3.38%) than observed for non-HCW (2.43%). Female, non-white and older individuals had higher chance to report FS. CONCLUSIONS The HCW had a higher chance of reporting symptoms than non-HCW aged over 18 years in the labor force. These results emphasize guidelines for preventive measures to reduce workplace exposures in the healthcare facilities. The prevalence is disproportionately affecting HCW women and HCW non-whites. In the regions North and Northeast the steeper progression is consistent with the hypothesis of socioeconomic factors, and it explains the greater prevalence in HCW and non-HCW living in those territories.
Subject(s)
Male , Female , Patient Care Team , Signs and Symptoms, Respiratory , Socioeconomic Factors , Health SurveysABSTRACT
Resumo Objetivo Identificar os indicadores clínicos mais relevantes para o Diagnóstico de Enfermagem Desobstrução ineficaz de vias aéreas. Método Estudo metodológico de análise de conteúdo organizado em três fases: definição conceitual do fenômeno de interesse, construção da estrutura do fenômeno de interesse e análise dos juízes sobre a estrutura construída. Resultados Foram identificados 21 indicadores clínicos. Apenas Sons respiratórios aumentados e Retração subcostal não foram indicadores significativamente relevantes para o diagnóstico. Conclusão Os indicadores de maior relevância para o diagnóstico Desobstrução ineficaz de vias aéreas foram: Dispneia, Mudanças no ritmo respiratório, Ruídos adventícios respiratórios, Taquipneia, Acúmulo excessivo de muco, Tosse ineficaz, Sons respiratórios diminuídos, Ortopneia, Cianose, Inquietação, Dificuldade para verbalizar e Uso da musculatura acessória para respirar.
Resumen Objetivo Identificar a los indicadores clínicos más relevantes para el Diagnóstico de Enfermería Desobstrucción ineficaz de las vías aéreas. Métodos Estudio metodológico de análisis de contenido organizado em tres fases: definición conceptual del fenómeno de interés, construcción de la estructura del fenómeno de interés y análisis de los jueces sobre la estructura construida. Resultados Se identificaron 21 indicadores clínicos. Únicamente Sonidos respiratorios aumentados y Retracción subcostal no fueron indicadores significantemente relevantes para el diagnóstico. Conclusión Los indicadores de mayor relevancia para el diagnóstico Desobstrucción ineficaz de las vías aéreas fueron: Disnea, Cambios en el ritmo respiratorio, Ruidos adventicios respiratorios, Taquipnea, Acúmulo excesivo de mucosidad, Tos ineficaz, Sonidos respiratorios disminuidos, Ortopnea, Cianosis, Inquietud, Dificultad para verbalizar y Uso de la musculatura accesoria para respirar.
Abstract Objective To identify the most relevant clinical indicators for the Ineffective airway clearance Nursing Diagnosis. Method This is a methodological study of content analysis organized into a conceptual definition of the phenomenon of interest, construction of the phenomenon of interest structure and analysis by judges on the constructed structure. Results Twenty-one clinical indicators were identified. Only Increased breath sounds and Subcostal retraction were not significantly relevant for the diagnosis. Conclusion The most relevant indicators for the Ineffective airway clearance diagnosis were: Dyspnea, Alteration in respiratory rate, Adventitious respiratory noises, Tachypnea, Excessive sputum, Ineffective cough, Decreased breathing sounds, Orthopnea, Cyanosis, Restlessness, Difficulty verbalizing and Use of accessory muscles to breathe.
Subject(s)
Humans , Signs and Symptoms, Respiratory , Nursing Diagnosis , Nursing Diagnosis/standards , Telemedicine , Airway Obstruction , Permeability , Indicators (Statistics) , Validation Studies as TopicABSTRACT
ABSTRACT Objective: To analyze symptoms at different times of day in patients with COPD. Methods: This was a multicenter, cross-sectional observational study conducted at eight centers in Brazil. We evaluated morning, daytime, and nighttime symptoms in patients with stable COPD. Results: We included 593 patients under regular treatment, of whom 309 (52.1%) were male and 92 (15.5%) were active smokers. The mean age was 67.7 years, and the mean FEV1 was 49.4% of the predicted value. In comparison with the patients who had mild or moderate symptoms, the 183 (30.8%) with severe symptoms were less physically active (p = 0.002), had greater airflow limitation (p < 0.001), had more outpatient exacerbations (p = 0.002) and more inpatient exacerbations (p = 0.043), as well as scoring worse on specific instruments. The most common morning and nighttime symptoms were dyspnea (in 45.2% and 33.1%, respectively), cough (in 37.5% and 33.3%, respectively), and wheezing (in 24.4% and 27.0%, respectively). The intensity of daytime symptoms correlated strongly with that of morning symptoms (r = 0.65, p < 0.001) and that of nighttime symptoms (r = 0.60, p < 0.001), as well as with the COPD Assessment Test score (r = 0.62; p < 0.001), although it showed only a weak correlation with FEV1 (r = −0.205; p < 0.001). Conclusions: Dyspnea was more common in the morning than at night. Having morning or nighttime symptoms was associated with greater daytime symptom severity. Symptom intensity was strongly associated with poor quality of life and with the frequency of exacerbations, although it was weakly associated with airflow limitation.
RESUMO Objetivo: Analisar os sintomas em diferentes momentos do dia em pacientes com DPOC. Métodos: Estudo observacional multicêntrico de corte transversal em oito centros brasileiros. Foram avaliados os sintomas matinais, diurnos e noturnos em pacientes com DPOC estável. Resultados: Foram incluídos 593 pacientes em tratamento regular, sendo 309 (52,1%) do sexo masculino e 92 (15,5%) fumantes ativos. A média de idade foi de 67,7 anos, e a média de VEF1 foi de 49,4% do valor previsto. Os pacientes com sintomas mais graves (n = 183; 30,8%), em comparação com aqueles com sintomas leves e moderados, apresentaram pior nível de atividade física (p = 0,002), maior limitação ao fluxo aéreo (p < 0,001), exacerbações ambulatoriais (p = 0,002) e hospitalares (p = 0,043) mais frequentemente e piores resultados em instrumentos específicos. Os sintomas matinais e noturnos mais frequentes foram dispneia (em 45,2% e 33,1%, respectivamente), tosse (em 37,5% e 33,3%, respectivamente) e chiado (em 24,4% e 27,0%, respectivamente). Houve forte correlação da intensidade dos sintomas diurnos com sintomas matinais (r = 0,65, p < 0,001), sintomas noturnos (r = 0,60, p < 0,001), bem como com o escore do COPD Assessment Test (r = 0,62; p < 0,001); porém, houve uma correlação fraca com VEF1 (r = −0,205; p < 0,001). Conclusões: A dispneia foi mais frequente no período matinal do que no período noturno. Ter sintomas matinais e/ou noturnos foi associado à pior gravidade dos sintomas diurnos. A intensidade dos sintomas foi fortemente associada a pior qualidade de vida e frequência de exacerbações, mas fracamente associada à limitação ao fluxo aéreo.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Pulmonary Disease, Chronic Obstructive/epidemiology , Periodicity , Quality of Life , Time Factors , Severity of Illness Index , Brazil/epidemiology , Smoking/epidemiology , Comorbidity , Cross-Sectional Studies , Pulmonary Disease, Chronic Obstructive/diagnosis , Symptom Flare Up , Lung/physiopathologyABSTRACT
We report a 64 years old female admitted with fever, cough, dyspnea and lung opacities in the chest X ray. A chest tomography scan (CTS) showed multiple-bilateral ring-shaped opacities and the reversed halo sign (RHS). The patient did not improve with antimicrobial therapy (AT). Infection and rheumatologic causes were excluded, therefore Cryptogenic organizing pneumonia (COP) was suspected with compatible percutaneous biopsy. Systemic steroids were started with a good clinical response. The patient was discharged four weeks after admission in good general conditions and practically no lungs opacities.
Subject(s)
Humans , Female , Middle Aged , Cryptogenic Organizing Pneumonia/pathology , Cryptogenic Organizing Pneumonia/diagnostic imaging , Biopsy , Prednisone/therapeutic use , Radiography, Thoracic , Tomography, X-Ray Computed , Cryptogenic Organizing Pneumonia/drug therapy , Glucocorticoids/therapeutic use , Lung/pathology , Lung/diagnostic imagingABSTRACT
Objective@#To investigate the health effects of air pollution on elementary school students with the indicator of absenteeism caused by respiratory symptoms and diseases, and to provide a reference for improving their physical health.@*Methods@#Absenteeism, air pollutants, and meteorological data during Sep. 2015 to Jun. 2017 in Pudong, Shanghai were collected. Generalized additive model was used to estimate the effects of air pollution on students’ absenteeism caused by respiratory symptom and diseases, time trends, day of week and meteorological factors were controlled.@*Results@#Totally 47 723 person-days of elementary school students’ absenteeism caused by respiratory symptoms and diseases were recorded during Sep.2015 to Jun. 2016 in Pudong, Shanghai, and the absenteeism rate was 0.07%. The PM2.5 concentration on lag0 and SO2 concentration on lag2 showed the most significant effects, the elementary school students’ absenteeism raised for 1.43% (95%CI=0.25%~2.62%)and 6.79% (95%CI=0.25%~13.32%) respectively with every 10 μg/m3 increment of PM2.5 and SO2.@*Conclusion@#Air pollution in Pudong new area have made a influence on the elementary school student’s respiratory symptoms and absenteeism, and the prevention work of air pollution should be strenghthened.
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RESUMEN Antecedentes y Objetivo: La prevalência de los principales síntomas respiratorios en Ginebra (Valle del Cauca) es desconocida. Este estudio busca investigar la prevalencia de disnea, tos, sibilancias y expectoración en Ginebra, un municipio rural de Colombia. Métodos: Se realizó un estudio de corte transversal, con una estrategia de muestreo por conglomerados para tener una muestra representativa de adultos mayores de 40 años. Cada paciente fue entrevistado con dos cuestionarios, el cuestionario de síntomas respiratorios Ferris validado para el español y el cuestionario de función pulmonar (LFQ), de este último, un puntaje menor o igual a 18 puntos fue considerado como riesgo de obstrucción al flujo aéreo. El análisis de datos fue realizado con software estadístico, el tamaño de muestra fue de 115 sujetos (prevalencia 50%, precisión 10% y porcentaje de pérdida del 20%), las variables cuantitativas se resumieron en frecuencias y porcentajes y las variables cuantitativas en medianas y rangos intercuartílicos, la prevalencia de síntomas respiratorios se calculó con un intervalo de confianza del 95% y se realizaron cruces exploratorios entre las variables de síntomas respiratorios y antecedentes exposicionales. Resultados: 146 sujetos, 2 pérdidas, mediana de edad 60,5 años (RIQ:22), 52,1% hombres, prevalencia de tos 18,1% (IC95%:11,8-24,3), expectoración 20,1% (IC95%:13,9-27,1), sibilancias 28,2% (IC95%:21,1-35,9), disnea 33,3% (IC95%:25-41), personas a riesgo de limitación flujo aéreo 19,4% (IC95%:14,2-28,4). En la realización de cruces exploratorios se obtuvo una relación entre el número de paquetes año y la presencia de tos (p=0,008), antecedente de exposición a leña y tos (p=0,008), número de paquetes año y expectoración (p=0,018), sibilancias y consumo de cigarrillo (p=0,047), disnea y antecedente de enfermedad coronaria (p=0,028), disnea y antecede de hipertensión arterial (p=0,037). Conclusión: La disnea es el síntoma respiratorio más frecuente en pacientes mayores de 40 años en Ginebra (Valle del Cauca), el antecedente de tabaquismo se relacionó con tos y sibilancias. La utilización de un cuestionario de síntomas respiratorios puede ser útil para identificar pacientes con riesgo de obstrucción al flujo aéreo cuando se compara con el auto-reporte de enfermedad respiratoria.
ABSTRACT Background and objective: The prevalence of main respiratory symptoms in Ginebra (Valle del Cauca) is unknown. This study aimed to investigate dyspnea, cough, wheezes and expectoration in Ginebra a Town of Colombia. Methods: A cross-sectional design and a random, conglomerates-sampling strategy were used to provide representative samples of adults aged > 40 years. Each participant was interviewed with two questionnaires, validated Spanish version of the Ferris Respiratory Questionnaire and Lung Function Questionnaire (LFQ), of the latter, and a score less or equal 18 points was considered with risk of obstructive airflow. Analysis was performed using statistical software, sample size of 115 subjects (prevalence 50%, precision 10% and lost percentage 20%), the variables quantitative were summarized with frequencies and percentages, and the variables qualitative in Median and range interquartile, the prevalence of respiratory symptoms was calculated with CI95%, exploratory analysis were made with respiratory symptoms variables and exposure antecedents. Results: 146 participants, with 2 missing, Median of age 60,5 years (IQR: 22), 52,1% men, prevalence of cough 18,1% (CI95%: 11,8-24,3), expectoration 20,1% (IC95%:13,9-27,1), wheezes 28,2% (IC95%:21,1-35,9), dyspnea 33,3% (CI95%:25-41), subjects with risk of airflow obstruction 19,4% (CI95%:14,2-28,4). Exploratory analysis showed relationship between package-year index and cough (p=0,008), wood smoke exposure and cough (p=0,008), package-year index and expectoration (p=0,018), wheezes and smoking exposure (p=0,047), dyspnea and coronary disease (p=0,028), and dyspnea and arterial hypertension (p=0,037). Conclusion: Dyspnea is the respiratory symptom more frequent in Ginebra (Valle del Cauca), the antecedent of smoking was relationship with cough and wheezes. Using a questionnaire of respiratory symptoms can be useful to identify patients with risk of airflow obstruction, when is compared with the auto-report of respiratory disease.
RESUMO Antecedentes e objetivo: A prevalência de sintomas respiratórios principais em Ginebra (Valle del Cauca) é desconhecida. Este estudo teve como objetivo investigar a dispneia, tosse, sibilos e expectoração em Ginebra, uma cidade da Colômbia. Métodos: Um desenho transversal e uma estratégia aleatória de amostragem de conglomerados foram utilizados para fornecer amostras representativas de adultos com idade> 40 anos. Cada participante foi entrevistado com dois questionários, versão validada em espanhol do Questionário Respiratório Ferris e Questionário de Função Pulmonar (LFQ), sendo este último considerado menor ou igual a 18 pontos com risco de fluxo obstrutivo de ar. A análise foi realizada utilizando software estatístico, tamanho de amostra de 115 indivíduos (prevalência 50%, precisão 10% e porcentagem perdida de 20%), as variáveis quantitativas foram resumidas com freqüências e porcentagens, e as variáveis qualitativas na mediana e intervalo interquartil, a prevalência de Os sintomas respiratórios foram calculados com IC95%, foram realizadas análises exploratórias com variáveis de sintomas respiratórios e antecedentes de exposição. Resultados: 146 participantes, com 2 perdidos, médios de idade 60,5 anos (IQR: 22), 52,1% homens, prevalência de tosse 18,1% (CI95%: 11,8-24,3), expectoração 20, 1% (IC95%: 13,9-27,1), sibilos 28,2% (IC95%: 21,1-35,9), dispnéia 33,3% (CI95%: 25-41), indivíduos com risco de obstrução do fluxo aéreo 19,4% (CI95%: 14,2-28,4). A análise exploratória mostrou relação entre índice do ano da embalagem e tosse (p = 0,008), exposição à fumaça da madeira e tosse (p = 0,008), índice do ano da embalagem e expectoração (p = 0,018), sibilos e exposição ao tabagismo (p = 0,047) dispnéia e doença coronária (p = 0,028) e dispnéia e hipertensão arterial (p = 0,037). Conclusão: A disnea é o sintoma respiratório mais freqüente em Ginebra (Valle del Cauca), o antecedente do tabagismo foi relação com tosse e sibilância. O uso de um questionário de sintomas respiratórios pode ser útil para identificar pacientes com risco de obstrução do fluxo aéreo, quando comparados com o auto-relato de doenças respiratórias.
Subject(s)
Humans , Middle Aged , Signs and Symptoms, Respiratory , Colombia , Cough , DyspneaABSTRACT
to analyze the accuracy of the defining characteristics of the Impaired gas exchange nursing diagnosis in children with acute respiratory infection. open prospective cohort study conducted with 136 children monitored for a consecutive period of at least six days and not more than ten days. An instrument based on the defining characteristics of the Impaired gas exchange diagnosis and on literature addressing pulmonary assessment was used to collect data. The accuracy means of all the defining characteristics under study were computed. the Impaired gas exchange diagnosis was present in 42.6% of the children in the first assessment. Hypoxemia was the characteristic that presented the best measures of accuracy. Abnormal breathing presented high sensitivity, while restlessness, cyanosis, and abnormal skin color showed high specificity. All the characteristics presented negative predictive values of 70% and cyanosis stood out by its high positive predictive value. hypoxemia was the defining characteristic that presented the best predictive ability to determine Impaired gas exchange. Studies of this nature enable nurses to minimize variability in clinical situations presented by the patient and to identify more precisely the nursing diagnosis that represents the patient's true clinical condition.
analisar a acurácia das características definidoras do diagnóstico de enfermagem troca de gases prejudicada, em crianças com infecção respiratória aguda. estudo de coorte prospectiva aberta, realizado com 136 crianças, acompanhadas por um período consecutivo de, no mínimo, seis dias e, no máximo, dez dias. Para coleta dos dados utilizou-se um instrumento baseado nas características definidoras do diagnóstico troca de gases prejudicada e na literatura pertinente acerca da avaliação pulmonar. Foram calculadas as medidas de acurácia de todas as características definidoras estudadas. o diagnóstico Troca de gases prejudicada esteve presente em 42,6% das crianças, na primeira avaliação. Hipoxemia foi a característica que apresentou as melhores medidas de acurácia. Respiração anormal apresentou elevado valor de sensibilidade e agitação, cianose e cor da pele anormal evidenciaram alta especificidade. Todas estas características apresentaram valor preditivo negativo acima de 70%, e cianose também se destacou pelo elevado valor preditivo positivo. hipoxemia foi a característica definidora que apresentou melhor capacidade preditiva para determinação de Troca de gases prejudicada. Estudos desta natureza permitem que o enfermeiro minimize a variabilidade existente nas situações clínicas apresentadas pelo paciente e identifique, de forma acurada, o diagnóstico de enfermagem que representa a sua verdadeira condição clínica.
analizar la precisión de las características definitorias del diagnóstico de enfermería Deterioro del intercambio gaseoso, en niños con infección respiratoria aguda. estudio de cohorte prospectivo abierto, realizado con 136 niños, acompañados por un período consecutivo de por lo menos seis días y como máximo de diez días. Para recolección de los datos se utilizó un instrumento basado en las características definitorias del diagnóstico Deterioro del intercambio gaseoso y en la literatura pertinente acerca de la evaluación pulmonar. Fueron calculadas las medidas de precisión de todas las características definitorias estudiadas. el diagnóstico Deterioro del intercambio gaseoso estuvo presente en 42,6% de los niños, en la primera evaluación. La hipoxemia fue la característica que presentó las mejores medidas de precisión. La respiración anormal presentó elevado valor de sensibilidad, agitación, cianosis y el color de la piel anormal evidenciaron alta especificidad. Todas estas características presentaron valor de predicción negativo arriba de 70%, y la cianosis también se destacó por el elevado valor de predicción positivo. la hipoxemia fue la característica definitoria que presentó mejor capacidad de predicción para determinación del Deterioro del intercambio gaseoso. Estudios de esta naturaleza permiten que el enfermero minimice la variabilidad existente en las situaciones clínicas presentadas por el paciente e identifique, de forma precisa, el diagnóstico de enfermería que representa su verdadera condición clínica.
Subject(s)
Humans , Male , Female , Infant , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/physiopathology , Nursing Diagnosis , Pulmonary Gas Exchange , Acute Disease , Prospective StudiesABSTRACT
Objective:To compare the differences of children’ s health in different area, and to confirm if the prevalence of respiratory diseases and symptoms among children are closely associated with the air pollution. Methods:A cross-sectional study was conducted in an urban area A and a suburban area B with different levels of air pollution in Beijing. Using a cluster sampling method, we recruited 4 564 chil-dren from 3 primary schools in urban A and 4 primary schools in suburban B. Respiratory symptoms were investigated using an international standardized questionnaire including characteristics of children, living conditions, respiratory diseases and symptoms and situation of parents. The concentrations of air pollu-tants for recent five years were obtained from Reports on the Quality of the Beijing Environment. SPSS 16. 0 was used to analyze data. Results: The prevalence of cough, persistent cough, phlegm, persistent phlegm, wheeze and asthma in A area were higher than those in B area[(62. 2% vs. 59. 9%), (6. 3%vs. 3. 1%), (42. 4% vs. 37. 4%),(3. 6% vs. 2. 4%),(13. 3% vs. 9. 9%) and(9. 5% vs. 5. 4%)]. Except for cough, cough with cold, cough without cold, the prevalence of respiratory diseases and symp-toms in A area were significantly higher than those in B area ( P <0 . 05 ) . Logistic regression analysis showed the prevalence of persistent cough, phlegm without cold, asthma in A area were significantly higher than those in B area ( P<0 . 05 ) . Conclusion:Respiratory diseases and symptoms among school-age children were closely associated with the level of air pollution.
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OBJECTIVE: To develop and validate conceptual and operational definitions for the defining characteristics of the respiratory nursing diagnoses, ineffective breathing pattern, impaired gas exchange and impaired spontaneous ventilation, in newborns. METHODS: This was a methodological study of conceptual validation of the defining characteristics of three respiratory nursing diagnoses, by consensus analysis of a committee of five specialist nurses, and then a group of five non-nursing professionals, using the Delphi technique. RESULTS: After two rounds of evaluation, consensus was obtained that was equal to or greater than 80% on all of the definitions, which were then considered validated. CONCLUSION: The definitions developed for the defining characteristics of three nursing diagnoses were validated with a high level of consensus. .
OBJETIVO: Elaborar e validar definições conceituais e operacionais para as características definidoras dos diagnósticos de enfermagem respiratórios, Padrão Respiratório Ineficaz, Troca de Gases Prejudicada e Ventilação Espontânea Prejudicada em recém-nascidos. MÉTODOS: Estudo metodológico, de validação conceitual das características definidoras dos três diagnósticos de enfermagem respiratórios por meio da análise de consenso de um comitê de cinco enfermeiras especialistas e de cinco profissionais não enfermeiros, utilizando a técnica Delphi. RESULTADOS: Após duas rodadas de avaliação, obteve-se consenso igual ou superior a 80% na totalidade das definições, sendo consideradas validadas. CONCLUSÃO: As definições elaboradas para as características definidoras dos três diagnósticos de enfermagem foram validadas com elevado grau de consenso. .
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OBJETIVO: Verificar a influência da idade sobre as dimensões nasofaríngeas e os sintomas respiratórios em pacientes submetidos à cirurgia para a correção da insuficiência velofaríngea pela técnica de retalho faríngeo. MÉTODOS: Amostra formada por 103 indivíduos distribuídos em três grupos: crianças (6 a 12 anos), adultos jovens (18 a 30 anos) e adultos de meia-idade (≥40 anos). Trata-se de estudo retrospectivo que analisou os valores da área nasofaríngea (técnica fluxo-pressão, valor de referência 0,570 cm²) e os sintomas de respiração oral, ronco e dificuldade respiratória durante sono, obtidos, em média, 12 meses após a cirurgia. A área nasofaríngea foi comparada entre os grupos por análise de variância e os sintomas respiratórios pelo teste Qui-quadrado (p<0,05). RESULTADOS: Os valores médios da área nasofaríngea após a cirurgia foram 0,527±0,215 cm², 0,599±0,213 cm² e 0,488±0,276 cm², respectivamente para crianças, adultos jovens e adultos de meia-idade, não havendo diferença entre os grupos. As proporções de respiração oral, ronco e dificuldade respiratória durante o sono foram, respectivamente, 66%, 69% e 9% nas crianças, 51%, 49% e 7% nos adultos jovens e 75%, 75% e 19% nos adultos de meia-idade, com maior frequência de ronco nos adultos de meia-idade. CONCLUSÃO: A idade não interferiu nas dimensões nasofaríngeas na presença de retalho faríngeo, mas foi um fator agravante de sintomas respiratórios, principalmente nos indivíduos mais velhos.
PURPOSE: To investigate the influence of age on nasopharyngeal dimensions and respiratory symptoms in patients undergoing surgery to correct velopharyngeal insufficiency using the pharyngeal flap technique. METHODS: A sample comprising 103 individuals divided into three groups: children (6-12 years old), young adults (18-30 years old) and middle-aged adults (≥ 40 years old). This was a retrospective study that analyzed the values for the nasopharyngeal area (pressure-flow technique, reference value: 0.570 cm²) and the symptoms of oral respiration, snoring and respiratory difficulties during sleep. The values were obtained, on average, 12 months after surgery. The nasopharyngeal area was compared between the groups using analysis of variance, and respiratory symptoms were compared using the chi-squared test (p<0.05). RESULTS: The mean nasopharyngeal area values after surgery were 0.527±0.215 cm², 0.599±0.213 cm² and 0.488±0.276 cm² for children, young adults and middle-aged adults, respectively, with no differences between groups. The proportions of oral respiration, snoring and breathing difficulty during sleep were, respectively, 66%, 69% and 9% in children; 51%, 49% and 7% in young adults; and 75%, 75% and 19% in middle-aged adults, with a higher frequency of snoring in middle-aged adults. CONCLUSION: Age did not affect nasopharyngeal dimensions in the presence of a pharyngeal flap, but it was an aggravating factor for respiratory symptoms, especially in older individuals.
Subject(s)
Humans , Child , Adult , Signs and Symptoms, Respiratory , Surgical Flaps , Velopharyngeal Insufficiency/surgery , Age Distribution , Airway Obstruction , Cleft Palate , Mouth Breathing , Retrospective Studies , Rhinomanometry , SnoringABSTRACT
OBJETIVO: Avaliar a prevalência de sintomas respiratórios como motivo para procura de atendimento de emergência por pacientes adultos e pediátricos, descrevendo as principais síndromes clínicas diagnosticadas e o desfecho dos pacientes. MÉTODOS: Estudo transversal, realizado na emergência de um hospital universitário terciário. Entre novembro de 2008 e novembro de 2009, o número total de atendimentos foi revisado diariamente. Foram incluídos no estudo crianças e adultos com pelo menos um sintoma respiratório. Os prontuários eletrônicos foram revisados e foram registradas as principais características dos pacientes. RESULTADOS: Durante o período do estudo, houve 37.059 admissões na emergência, das quais 11.953 (32,3%) foram motivadas por sintomas respiratórios. A prevalência de atendimentos por sintomas respiratórios foi 28,7% e 38,9% nos adultos e crianças, respectivamente. As taxas de internação hospitalar e de mortalidade nos adultos foram 21,2% e 2,7%, respectivamente, comparadas com 11,9% e 0,3%, respectivamente, nas crianças. Nos adultos, quanto maior o tempo entre o início dos sintomas e a visita à emergência, maiores foram a necessidade de hospitalização (p< 0,0001), o tempo de hospitalização (p < 0,0001) e a mortalidade (p = 0,028). CONCLUSÕES: Encontramos uma prevalência elevada de atendimentos por sintomas respiratórios entre os pacientes adultos e pediátricos. Nossos resultados podem contribuir para o planejamento de medidas de prevenção. Futuros estudos epidemiológicos poderão colaborar para a melhor elucidação dos fatores de risco para a presença de sintomas respiratórios nesses pacientes.
OBJECTIVE: To evaluate the prevalence of respiratory symptoms as the motive for emergency room visits by adult and pediatric patients, describing the major clinical syndromes diagnosed and the outcomes of the patients. METHODS: A cross-sectional study conducted in the emergency room of a tertiary care university hospital. Between November of 2008 and November of 2009, we reviewed the total number of emergency room visits per day. Children and adults who presented with at least one respiratory symptom were included in the study. The electronic medical records were reviewed, and the major characteristics of the patients were recorded. RESULTS: During the study period, there were 37,059 emergency room visits, of which 11,953 (32.3%) were motivated by respiratory symptoms. The prevalence of emergency room visits due to respiratory symptoms was 28.7% and 38.9% among adults and children, respectively. In adults, the rates of hospitalization and mortality were 21.2% and 2.7%, respectively, compared with 11.9% and 0.3%, respectively, in children. Among the adults, the time from symptom onset to emergency room visit correlated positively with the need for hospitalization (p < 0.0001), the length of the hospital stay (p < 0.0001), and the mortality rate (p = 0.028). CONCLUSION: We found a high prevalence of respiratory symptoms as the motive for emergency room visits by adult and pediatric patients. Our results could inform decisions regarding the planning of prevention measures. Further epidemiological studies are needed in order to clarify the risk factors for severe respiratory symptoms.
Subject(s)
Adult , Child , Female , Humans , Male , Middle Aged , Emergency Service, Hospital/statistics & numerical data , Hospitalization/statistics & numerical data , Respiratory Tract Infections/mortality , Cross-Sectional Studies , Length of Stay/statistics & numerical data , Prevalence , Tertiary Care Centers , Time FactorsABSTRACT
Fundamento: el programa para la detección de tuberculosis pulmonar se basa en la detección de casos mediante la pesquisa activa y pasiva. Esta última se centra en los pacientes con síntomas respiratorios que visitan espontáneamente la consulta médica, en la que es de suma importancia saber seleccionar los pacientes con riesgo de padecer tuberculosis. Objetivo: evaluar la calidad de la selección de pacientes con síntomas respiratorios según riesgo de padecer tuberculosis pulmonar. Métodos: estudio descriptivo retrospectivo realizado entre septiembre de 2004 y septiembre de 2005, sobre pacientes con síntomas respiratorios de 14 días y más de evolución, pertenecientes al área de salud del policlínico Antonio Guiteras, municipio La Habana Vieja. Se analizaron: edad, factores de riesgo, calidad de las muestras, de los cultivos y del desempeño del equipo de salud en el seguimiento de los pacientes con síntomas respiratorios. Resultados: el promedio de edad fue de 61,0 años ± 20,0. De los pacientes con síntomas respiratorios encuestados, los jubilados representaron el 45,8 %. Todos los esputos fueron muestras útiles, el 12,5 % de los cultivos no fueron realizados por estar contaminados o con muestras escasas. El 12,5 % de los pacientes necesitó de seguimiento por más tiempo; después del diagnóstico y el tratamiento impuesto el 18,8 % no mejoró. El 81 % de los pacientes tenía al menos un factor de riesgo. Conclusiones: es evidente la importancia de las encuestas para monitorear pacientes con síntomas respiratorios bajo el enfoque de riesgo para tuberculosis.
Background: the program for the detection of pulmonary tuberculosis is based on cases detection by passive and active searching. The latter focuses on patients with respiratory symptoms spontaneously visiting medical consultation, which is very important to know to select patients at risk for tuberculosis.Objective: To assess the quality of the selection of patients with respiratory symptoms according to the risk of pulmonary tuberculosis.Methods: A retrospective and descriptive study was conducted between September 2004 and September 2005 including patients with respiratory symptoms of 14 days and more of evolution, belonging to the health area of the Antonio Guiteras polyclinic in the municipality of Old Havana. The following variables were analyzed: age, risk factors, sample quality, culture quality and performance of the health team in monitoring patients with respiratory symptoms.Results: The average age was 20.0 ± 61.0 years old. Out of the surveyed patients with respiratory symptoms, retirees accounted for 45.8%. All sputum samples were helpful samples, 12.5% of the cultures were not performed because of contamination or inadequate samples. 12.5% of patients needed more follow-up after diagnosis and 18.8% did not improve. 81% of the patients presented at least one risk factor.Conclusions: the importance of surveys in order to monitor patients with respiratory symptoms according to the risks of tuberculosis becomes paramount with this study.
ABSTRACT
Con el objetivo de determinar la frecuencia de síntomas respiratorios entre los residentes de especialidades quirúrgicas expuestos al humo del electrocauterio, se realizó un estudio transversal durante el mes de febrero de 2012. Se incluyeron 50 médicos residentes del tercer año, de diferentes especialidades quirúrgicas, de un hospital de tercer nivel perteneciente al Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado ubicado en Jalisco, México. La selección de sujetos fue no probabilística. Para la recolección de datos, se empleó el cuestionario de síntomas respiratorios desarrollado en Cuba. Los síntomas más comunes fueron sensación de cuerpo extraño (58%) y ardor faríngeo (22%). La especialidad con mayor índice de exposición fue la de neurocirugía (24,1 min/acto quirúrgico). La totalidad de los médicos de esta especialidad tuvieron algún síntoma respiratorio. Se concluye que la inhalación del humo del cauterio puede constituir un riesgo para desarrollar síntomas respiratorios entre los médicos de especialidades quirúrgicas.
In order to determine the frequency of respiratory symptoms among residents from surgical specialties dures exposed to the electrocautery smoke, a cross-sectional study was conducted in February 2012. 50 third-year residents from different surgical specialties coming from a third-level hospital belonging to the Institute of Security and Social Services of the State Workers in Jalisco, Mexico, were included. The subject selection was non-probabilistic. A questionnaire on respiratory symptoms developed in Cuba was used for data collection. The most common symptoms were sensation of a lump in the throat (58%), and a sore throat (22%). The specialty with the highest rate of exposure was neurosurgery (24.1 min/surgical procedure). All, the physicians from this specialty had respiratory symptoms. We conclude that the cauterization smoke may be considered a risk for developing respiratory symptoms among physicians with surgical specialties.
Subject(s)
Adult , Female , Humans , Male , Electrocoagulation/adverse effects , Internship and Residency , Occupational Diseases/etiology , Respiration Disorders/etiology , Specialties, Surgical/education , Cross-Sectional Studies , Hospitals , MexicoABSTRACT
Introdução: Este estudo foi realizado com o intuito de avaliar efeitos da acupuntura sobre os pacientes com asma leve e moderada persistentes com o uso de beta-2 agonista ou corticoide inalatório. Métodos e casuística: Trata-se de um estudo prospectivo, duplo-cego, randomizado e cruzado com dois braços. Os 74 pacientes com diagnóstico de asma leve/moderada, de acordo com a classificação de GINA 2002/2003, foram divididos em dois grupos, sendo 31 do Grupo I, e 43 do Grupo II inicialmente. Foram realizadas consultas médicas e exames que incluíram espirometria, citologia de escarro induzido, NO expirado, preenchimento de escala de sintoma, questionários de qualidade de vida de asma e de SF 36, e realização de peak-flow, dependendo da Fase do protocolo. A Fase I constituiu-se dos exames pré-intervenção. Na Fase II, foram realizadas 10 sessões de Acupuntura Real no Grupo I e 10 sessões de Acupuntura Sham no Grupo II, na Fase III, houve 4 semana de washout, na Fase IV, houve a troca de técnicas de acupuntura, sendo uma sessão por semana e, na Fase V, realização dos exames. Resultados: Não há diferença nos critérios de avaliação no pré-tratamento entre dois grupos, com exceção de maior celularidade inflamatória no Grupo II. No entanto, houve uma redução significativa de eosinófilos (p = 0,035) e neutrófilos (p = 0,047), e aumento de macrófagos (p = 0,001), melhora da medida de volume do peak-flow (p = 0,01) na fase IV do Grupo II. No Grupo I, na avaliação de escala de sintomas diária, havia menor uso de medicação de resgate (p = 0,043) na Fase II, e, depois de receber a Acupuntura Sham na Fase IV, havia menos tosse (p = 0,007), menos chiado (p = 0,037), menos dispneia (p < 0,001) e menor uso de medicação de resgate (p < 0,001). No Grupo II, após receber o tratamento com a Acupuntura Sham na Fase II, houve diminuição de tosse (p = 0,037), de chiado (p = 0,013) e de dispneia (p = 0,014), e, na...
Introduction: This survey has been conducted in order to evaluate the effects of acupuncture in patients with persistent mild and moderate asthma (according to GINA criteria 2003), using beta agonist and/or inhaled glucocorticoid. Methods and patients: This is a prospective, double blinded, randomized and cross-over study with two branches: 74 patients diagnosed with mild and moderate asthma were divided into two groups: Group I with 31, initiating with real acupuncture and Group II, starting with sham acupuncture. Medical interview and laboratory tests including spirometry, induced sputum citology, exhaled NO measurement, quality of life questionnaire (SF-36 and QQL), besides, daily symptom scores and measurement of peak-flow were performed, in the beginning of the study, and in the end of each phase of treatment. Phase I: laboratory tests and other qualitative measurements. There were 10 real acupuncture weekly sessions to Group I and 10 sham acupuncture sessions to Group II in Phase II. On the other hand, in the Phase IV, there was an exchange between Group I and Group II, which was receiving real acupuncture started to receive sham, and vice-versa, the number of sessions remained the same (10 weekly sessions). Phase III, during the interval between Phase II and Phase IV, there was an interval of 4 weeks of washout. Phase V: laboratory tests and other qualitative measurements. Results: There was no difference beween both the groups in all criteria of evaluation pré treatment, with only na exception: in the Group II there was large inflammatory cell counts. However, there was a significant reduction in eosinophils (p = 0.035) and neutrophils (p = 0.047), and increase of macrophages (p = 0.001), improved peak-flow measurement in the morning (p = 0.01) in Group II (started with sham) in Phase IV. In Daily Symptons Score, there was a significant reduction in use of rescue medication (p = 0.043) in Group I (real acupuncture) in Phase II and after received...
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Acupuncture , Acupuncture Therapy , Asthma , Asthma/immunology , Dyspnea/prevention & control , Eosinophils , Macrophages, Alveolar , Medicine, Chinese Traditional/psychology , Neutrophils , Sickness Impact Profile , Controlled Clinical Trial , Signs and Symptoms, Respiratory , Affective Symptoms/immunologyABSTRACT
Objetivo: el presente estudio tuvo como objetivo principal determinar el Cumplimiento de la Norma Técnica de Salud para el Control de la Tuberculosis en relación a la evaluación de Sintomáticos Respiratorios y control de contactos de pacientes BK positivos en el Hospital Provincial Docente Belén de Lambayeque, Enero - Diciembre del 2011. Material y métodos: Se realizó el presente estudio con diseño epidemiológico de tipo descriptivo, observacional, retrospectivo y transversal con. La muestra de estudio estuvo constituida por 267 Sintomáticos Respiratorios. Resultados: Los principales resultados fueron: En los pacientes BK positivos predominó el sexo femenino, las edades entre 25 y 29 años y el grado de instrucción nivel secundario; el porcentaje de Sintomáticos Respiratorios examinados con dos muestras de esputo fue 52.1%; el porcentaje de visitas domiciliarias a los pacientes con diagnóstico de BK positivo fue 39.1%, el número de contactos examinados en relación a los contactos censados fue 12.8% del total. Conclusión: un 61% de incumplimiento de la Norma Técnica de Salud para el control de la Tuberculosis en relación a la evaluación de Sintomáticos Respiratorios y control de contactos de pacientes BK positivos en el HPDBL del año 2011-(AU)
Objetive: The present study had as main objective to determine the level of fulfillment of the Technical Norm of Health for the Tuberculosis control in the evaluation of respiratory symptomatic patients and contacts surveillance in positive Ziehl Neelsen stain patients from the Hospital Provincial Docente Belén in Lambayeque, in the year 2011. Material and Methods: This study had a descriptive, observational, retrospective and cros s - sectional epidemiological design. The study sample consisted of 267 patients with respiratory symptoms. Results: The main results were: most positive BK patients were females, ages between 25 and 29 and with high school education, the percentage of respiratory symptomatic patients with two sputum samples was 52.1%, the percentage of home visits patients with positive diagnosis of BK was 39.1%, the number of contacts examined in relation to contacts census was 12.8% of the total. Conclusions: 61% of non-fulfillment with health standards for TB control in relation to the evaluation of respiratory symptomatic patients and contact control of BK positive patients in the HPDBL of 2011.(AU)
ABSTRACT
Aims: To describe a case of choroid plexus carcinoma which initial signs and symptoms were related to the upper respiratory tract, contrary to the classic symptomatology of this disease reported in the literature. Case description: A two years and eight months old boy was admitted due to acute respiratory failure. He was treated with antibiotics for suspected croup without success. After two weeks he presented neurological manifestations that led to investigation and diagnosis of choroid plexus carcinoma. Resection was contraindicated due to extension of the tumor and involvement of vital areas.Conclusions: The rapid evolution of choroid plexus carcinoma in this case points to the need for early suspicion of central nervous system disorders. This case may alert pediatricians to the need to consider the presence of a brain tumor causinginjury to the vagus nerve in cases of respiratory distress resistant to treatment.
Objetivos: Descrever um caso de carcinoma do plexo coroide no qual os sinais e sintomas iniciais foram relacionadas ao trato respiratório superior, ao contrário da sintomatologia clássica da doença reportada na literatura.Descrição do caso: Um menino de dois anos e oito meses de idade foi internado por insuficiência respiratória aguda.O paciente foi tratado com antibióticos para suspeita de crupe, sem sucesso, e após oito dias mostrou sintomatologia neurológica, que levou a uma investigação e ao diagnóstico de carcinoma do plexo coroide. A ressecção foi contra-indicadadevido à extensão do tumor e envolvimento de áreas vitais.Conclusões: A evolução rápida do carcinoma do plexo coroide neste caso mostra a necessidade da suspeita precoce de distúrbios do sistema nervoso central. Este caso pode alertar os pediatras para a necessidade de considerar a presença de um tumor cerebral levando a lesão do nervo vago em casos de dificuldade respiratória resistente ao tratamento.
Subject(s)
Humans , Male , Female , Child , Neurobehavioral Manifestations , Brain Neoplasms , Choroid Plexus Neoplasms , Vagus NerveABSTRACT
OBJETIVO: Avaliar o efeito da sazonalidade climática na ocorrência de sintomas respiratórios em uma cidade de clima tropical no Brasil. MÉTODOS: Estudo de corte transversal relacionando dados de indivíduos que procuraram assistência médica em uma Unidade Básica de Saúde na cidade de Goiânia (GO) com dados meteorológicos coletados diariamente. No intervalo de um ano, todos os pacientes que preenchiam os critérios de inclusão foram entrevistados em 44 dias distintos (11 em cada estação) escolhidos aleatoriamente. ANOVA foi usada para a comparação das médias das variáveis dependentes por estação. Correlação foi conduzida entre as variáveis dependentes e cada variável meteorológica. Os efeitos das variáveis meteorológicas foram analisados com um modelo de AutoRegressive Moving Average with eXogenous input (ARMAX, média móvel autorregressiva com entrada exógena). RESULTADOS: Dos 3.354 participantes, 494 (14,6 por cento) apresentavam sintomas respiratórios. A variação de temperatura não foi suficiente para provocar mudanças no número de indivíduos com sintomas respiratórios; porém, houve aumento desse número com baixos níveis de umidade no inverno, com diferença estatisticamente significativa entre as estações (p < 0,01). Foi observado que a média da umidade relativa mínima dos três dias que antecederam as observações correlacionou-se negativamente com o número de indivíduos com sintomas respiratórios (p = 0,04), e um modelo ARMAX incluindo a mesma variável apresentou um coeficiente estatisticamente significativo (p < 0,0001). CONCLUSÕES: Nesta amostra, o número de indivíduos com sintomas respiratórios aumentou significativamente com a redução da umidade relativa do ar, e esse aumento pôde ser previsto a partir de dados meteorológicos.
OBJECTIVE: To evaluate the effect that seasonality has on the occurrence of respiratory symptoms in a Brazilian city with a tropical climate. METHODS: This was a cross-sectional study, in which data related to subjects who sought outpatient treatment at a primary health care clinic in the city of Goiânia, Brazil, were correlated with daily meteorological data. Over a one-year period, all the patients who met the inclusion criteria were interviewed on 44 distinct, randomly selected days (11 days per season). We used ANOVA in order to compare the means of the dependent variables by season. Correlations were drawn between each dependent variable and each meteorological variable. The effects of the meteorological variables were analyzed with an AutoRegressive Moving Average with eXogenous input (ARMAX) model. RESULTS: Of the 3,354 participants, 494 (14.6 percent) had respiratory symptoms. Although temperature variation alone had no effect on the number of individuals with respiratory symptoms, the low levels of humidity during winter resulted in a statistically significant difference among the seasons (p < 0.01). The mean minimum relative humidity on the three days prior to the interviews correlated negatively with the number of subjects with respiratory symptoms (p = 0.04). An ARMAX model including the same variable showed a statistically significant coefficient (p < 0.0001). CONCLUSIONS: In this sample, the number of subjects with respiratory symptoms increased significantly when the relative humidity dropped, and this increase could be predicted using meteorological data.
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Humidity , Respiratory Tract Diseases/epidemiology , Seasons , Tropical Climate , Brazil/epidemiology , Epidemiologic Methods , Models, TheoreticalABSTRACT
OBJETIVO: Determinar a associação de sintomas respiratórios e bronquite crônica com o uso de biocombustíveis entre mulheres habitantes de áreas rurais do estado de Ekiti, sudoeste da Nigéria. MÉTODOS: De janeiro a junho de 2009, realizou-se um estudo transversal com uma amostra de 269 mulheres adultas. Um questionário adaptado do European Community Respiratory Health Survey foi aplicado para a obtenção de dados sobre características sociodemográficas, tipo de combustível utilizado para a preparação de alimentos, sintomas respiratórios e história de tabagismo. Todas as participantes foram convidadas a realizar espirometria. RESULTADOS: Das 269 mulheres no estudo, 161 (59,9 por cento) utilizavam biocombustíveis para a preparação de alimentos. As mulheres que utilizavam biocombustíveis relataram mais sintomas respiratórios que aquelas que não os utilizavam - tosse (13,7 por cento vs. 3,7 por cento); sibilância (8,7 por cento vs. 2,8 por cento); dor no peito (7,5 por cento vs. 1,9 por cento); falta de ar (11,8 por cento vs. 6,5 por cento); sintomas nasais (9,3 por cento vs. 4,6 por cento); e bronquite crônica (10,6 por cento vs. 2,8 por cento). A análise multivariada por regressão logística confirmou que o uso de biocombustíveis está associado às seguintes variáveis: tosse (OR = 4,82; p = 0,01); bronquite crônica (OR = 3,75; p = 0,04); sibilância (OR = 2,22; p = 0,23); dor no peito (OR = 3,82; p = 0,09); falta de ar (OR = 1,54; p = 0,35); e sintomas nasais (OR = 2,32; p = 0,20). Todos os parâmetros espirométricos avaliados (VEF1, CVF, VEF1/CVF e PFE) foram menores nas mulheres que utilizavam biocombustíveis do que naquelas que não os utilizavam. CONCLUSÕES: Nossos resultados enfatizam a necessidade de se substituir o uso de biocombustíveis nos domicílios pelo de um tipo de combustível atóxico, como eletricidade ou gás.
OBJECTIVE: To determine whether respiratory symptoms and chronic bronchitis are associated with the use of biomass fuels (BMFs) among women residing in rural areas of the Ekiti State, in southwestern Nigeria. METHODS: From January to June of 2009, we carried out a cross-sectional study including 269 adult women. To collect data on sociodemographic status, type of fuel used for cooking in the household, respiratory symptoms, and smoking history, we used a questionnaire adapted from the European Community Respiratory Health Survey. All of the participants were invited to undergo spirometry. RESULTS: Of the 269 women in the study, 161 (59.9 percent) used BMFs for cooking. The proportion of women who reported respiratory symptoms was greater among those using BMFs than among those using a non-BMF-cough (13.7 percent vs. 3.7 percent); wheezing (8.7 percent vs. 2.8 percent); chest pain (7.5 percent vs. 1.9 percent); breathlessness (11.8 percent vs. 6.5 percent); nasal symptoms (9.3 percent vs. 4.6 percent); and chronic bronchitis (10.6 percent vs. 2.8 percent). Multivariate logistic regression analysis revealed that the use of BMFs was associated with the following variables: cough (OR = 4.82; p = 0.01); chronic bronchitis (OR = 3.75; p = 0.04); wheezing (OR = 2.22; p = 0.23); chest pain (OR = 3.82; p = 0.09); breathlessness (OR = 1.54; p = 0.35); and nasal symptoms (OR = 2.32; p = 0.20). All of the spirometric parameters evaluated (FEV1, FVC, FEV1/FVC ratio, and PEF) were lower in the women using BMFs than in those using a non-BMF. CONCLUSIONS: Our results underscore the need for women using BMFs in their households to replace them with a nontoxic type of fuel, such as electricity or gas.
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Biofuels/toxicity , Bronchitis, Chronic/etiology , Respiratory Tract Diseases/etiology , Air Pollution, Indoor/adverse effects , Biofuels/statistics & numerical data , Cross-Sectional Studies , Cooking/instrumentation , Logistic Models , Nigeria , Risk Factors , SpirometryABSTRACT
Realizou-se estudo transversal de base populacional em Lages, Santa Catarina, Brasil, para estimar a prevalência de sintomas de bronquite crônica, falta de ar e chiado no peito e os fatores associados em adultos de 20-59 anos de idade (n = 2.051). Processo de amostragem através de conglomerados e análise de regressão de Poisson foram realizados. As prevalências de bronquite crônica, falta de ar e chiado no peito foram de 5 por cento, 35,7 por cento e 20,2 por cento, respectivamente. Análises ajustadas mostraram presença de bronquite crônica associada à baixa escolaridade, fumar dez ou mais pacotes de cigarros ao ano e internação por problemas de pulmão na infância. Falta de ar associou-se ao sexo feminino, baixa escolaridade e renda familiar, pardos e amarelos, história de internação por problemas de pulmão na infância, ser fumante e trabalhar com poeira ou pó. Presença de chiado no peito associou-se ao sexo feminino, baixa escolaridade e renda familiar, pardos e pretos, história de internação por problemas de pulmão na infância, ser fumante e trabalhar com poeira ou pó. Particularidades do clima e das atividades laborais devem ser consideradas no planejamento das ações em saúde.
A cross-sectional population-based study was conducted in Lages, Santa Catarina State, Brazil, in order to estimate the prevalence of symptoms of chronic bronchitis, breathlessness, and wheezing and associated factors in a sample of adults 20 to 59 years of age (n = 2,051). The study employed a cluster sample design and Poisson regression analyses. Prevalence rates for chronic bronchitis, breathlessness, and wheezing were 5 percent, 35.7 percent, and 20.2 percent, respectively. The adjusted analysis showed chronic bronchitis associated with low schooling, smoking, and hospital admissions due to respiratory illness during childhood. Breathlessness was associated with female gender, low schooling and family income, non-white race, hospital admissions due to respiratory illness during childhood, smoking, and occupational exposure to dust. Wheezing was associated with female gender, low schooling and family income, non-white race, hospital admissions due to respiratory illness during childhood, smoking, and occupational exposure to dust. Public health planners should consider climatic factors and work activities when developing activities to prevent respiratory diseases.
Subject(s)
Adult , Female , Humans , Middle Aged , Young Adult , Respiratory Tract Diseases/epidemiology , Air Pollutants, Occupational/toxicity , Brazil/epidemiology , Bronchitis, Chronic/epidemiology , Bronchitis, Chronic/etiology , Educational Status , Epidemiologic Methods , Income , Respiratory Function Tests , Respiratory Sounds , Respiratory Tract Diseases/etiology , Sex Factors , Smoking/adverse effects , Young AdultABSTRACT
Este trabalho aborda aspectos éticos da temática transplantes de órgãos relacionados ao doador e à doação; à distribuição dos órgãos; à atenção médica; às relações entre familiares de doadores e receptores; à nacionalidade e cobertura previdenciária; e aos princípios que devem reger a postura dos envolvidos no processo de transplante.
It approaches the ethical issue of organs transplants related to aspects of the donor and the donation, the distribution of organs, medical care, the relationships between family members of donors and recipients, nationality and social security coverage and the principles which should govern the approach those involved in the transplant process.