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1.
Acta neurol. colomb ; 37(4): 203-209, oct.-dic. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1349892

ABSTRACT

RESUMEN INTRODUCCIÓN: La leucoencefalopatia tóxica es una afección que compromete la sustancia blanca por exposición a sustancias tóxicas. La heroina es una de las implicadas en el desarrollo de la leucoencefalopatia con diferencias exclusivas que suceden con la inhalación según las diversas técnicas en comparación al uso intravenoso, bien sea de la heroína o de otras sustancias psicoactivas. En esta serie describimos cinco casos, de sexo masculino, que desarrollaron leucoencefalopatia espongiforme por heroína (LEH) posterior a la inhalación de vapores, en un hospital del sistema de salud público en la ciudad de Armenia, Colombia. OBJETIVO: El objetivo de este estudio es describir las características demográficas, clínicas, hallazgos de laboratorio e imágenes diagnósticas, así como la mortalidad asociada a LEH en la muestra estudiada. MÉTODOS: Recolección de datos de historias clinicas y búsqueda de imágenes registradas en el Hospital San Juan de Dios de Armenia durante el periodo 2017-2018. RESULTADOS: Se obtienen cinco casos clínicos de pacientes usuarios de vapores inhalados de heroina, quienes ingresan con signos neurológicos de predominio motores y extrapiramidales, con el signo radiológico clásico de "Chasing the Dragon" en estudios de TC cerebral simple en todos los casos. De los cinco casos se presenta un deceso, determinando una mortalidad de 20% comparado con un 25% de mortalidad reportado en la literatura. CONCLUSIONES: La LEH suele estar subdiagnosticada dado que suele confundirse con un trastorno neuropsiquiatríco o de la conducta asociada al consumo de sustancias psicoactivas (SPA), el diagnóstico se realizó con los hallazgos típicos en las imágenes de TC cerebral simple. Se debe tener en cuenta las estadísticas sobre consumo de heroína a la hora de realizar el abordaje de un paciente con historial de consumo de SPA y los signos neurológicos para relacionarlos con esta etiologia y dar un manejo integral a estos pacientes.


ABSTRACT IlNTRODUCTION: Toxic leukoencephalopathy is a condition that compromises the encephalic white matter due to exposure to toxic substances. Heroin is one of those involved in the development of leukoencephalopathy and there are certain differences that occur with its inhalation with the different techniques compared to intravenous use, either heroin or other psychoactive substances. In this serie, we describe five cases of male sex who developed heroin spongiform leukoencephalopathy (HSLE) after inhalation of vapors, in a Hospital of the public health system in the city of Armenia, Colombia. OBJECTIVES: The objective of this study is to describe the demographic and clinical characteristics, laboratory findings and diagnostic images, as well as the mortality associated with HSLE in the sample studied. METHODS: Collection of data from medical records and search of images registered at the San Juan de Dios Hospital in Armenia during the period 2017-2018. RESULTS: Five clinical cases were obtained of patients who were users of inhaled heroin vapors and were admitted to the hospital with predominantly motor and extrapyramidal neurological signs, with simple brain CT studies showing the classic radiological sign of "Chasing the Dragon" in all five cases. One death was presented, with a mortality of 20% compared to the 25% mortality that has been reported in the scientific literature. CONCLUSIONS: HSLE is usually underdiagnosed since it is often confused with a neuropsychiatric or behavioral disorder associated with the consumption of psychoactive substances (PAS). The diagnosis was made with the typical findings in simple brain CT images. Statistics on heroin use must be considered when approaching a patient with a history of PAS use and neurological signs, to relate them to this etiology and provide comprehensive management to these patients.


Subject(s)
Tomography, X-Ray Computed , Hypoxia, Brain , Inhalation , Heroin , Leukoencephalopathies
2.
Arch. argent. pediatr ; 119(4): e345-e348, agosto 2021. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1281782

ABSTRACT

El talco, un silicato de magnesio hidratado, formó parte durante décadas del cuidado tradicional de lactantes y niños pequeños. Si bien en los niños su inhalación aguda, que suele ser accidental durante el cambio de pañales, no es frecuente, es una condición potencialmente peligrosa, que puede provocar dificultad respiratoria grave e incluso cuadros mortales. Se describe el grave compromiso respiratorio por neumonitis química asociado con la inhalación accidental de talco en un lactante de 14 meses. El niño presentó un cuadro de dificultad respiratoria con requerimiento de asistencia respiratoria mecánica (ARM) durante una semana. En cuanto al tratamiento, no existe un estándar, se utilizaron antibióticos y corticoides sistémicos y aerosolterapia. No presentó complicaciones en otros órganos o sistemas. Su evolución fue favorable, se pudo externar al décimo día de internación y presentó posteriormente episodios aislados de hiperreactividad bronquial.


Talc is a hydrated magnesium silicate. It was part of traditional infant and young child care for decades. In children, its acute inhalation, generally accidental during diaper changes, although not frequent, is a potentially dangerous condition, and can cause severe respiratory distress and even death. We describe the case of a 14-month child who had an accidental inhalation of talc, chemical pneumonitis and severe respiratory compromise. The patient had acute respiratory distress syndrome requiring mechanical ventilation for one week. There is no standard treatment, we used systemic antibiotics and corticosteroids and aerosol therapy. He did not have complications in other organs or systems. He was hospitalized for ten days. In the follow up, he had isolated episodes of bronchial hyperresponsiveness.


Subject(s)
Humans , Male , Infant , Pneumonia/chemically induced , Respiratory Insufficiency/chemically induced , Talc/adverse effects , Pneumonia/therapy , Respiration, Artificial , Respiratory Insufficiency/therapy , Accidents, Home , Inhalation , Intubation, Intratracheal
3.
Int. j. morphol ; 39(4): 1042-1047, ago. 2021. ilus, tab
Article in English | LILACS | ID: biblio-1385449

ABSTRACT

SUMMARY: Formaldehyde (FA) is a toxic substance used frequently in the field of medicine as well as in many industrial areas. Especially people working in the field of anatomy, histology, and pathology are in high risk group because of the use of the FA. Studies showing the effects of FA on the cardiovascular system are few in number. The purpose of the present study was to investigate the effects of FA exposure, which we believe can cause oxidative stress, on the heart and aorta with various biochemical analyses. A total of 24 Wistar Albino rats were used in our study. We divided the rats into 3 groups as the Control Group (CG), the group exposed to low-dose FA (avg. 1 ppm) (DDG) Group, and the group exposed to high-dose FA (avg. 10 ppm) (YDG). At the end of the subchronic FA exposure, the blood samples, heart and aorta tissues of the rats were taken and subjected to biochemical analyses. As a result of the analyses, statistically significant differences were detected between CG (2.96?0.85 ng/mg), and HDG (2.08?0.77 ng/mg) in aortic tissues in TXNIP analysis (p<0.05). In heart tissues, significant differences were detected between CG (0.73?0.27 ng/mg) and LDG (1.13?0.22 ng/mg) (p<0.05). Statistically significant differences were also detected between CG (1.98?0.31 mM/ml) and YDG (2.43?0.31 mM/ml) in serum MDA analyses (p<0.05). It was shown that subchronic application of FA to LDG rats through inhalation had no effects on apoptosis markers in heart tissues. More studies are required to show FA toxicity and the mechanism of action of pathology on the cardiovascular system. We believe that our study will contribute to clarifying the roles of mild and subchronic exposure of FA in heart and aortic tissues in terms of oxidative stress risk.


RESUMEN: El formaldehído es una sustancia tóxica que se utiliza con frecuencia en el campo de la medicina, así como en muchas áreas industriales. Especialmente las personas que trabajan en el area de la anatomía, y patología se encuentran en el grupo de alto riesgo debido al uso de esta sustancia. Pocos son los estudios que muestran los efectos del formaldehído en el sistema cardiovascular. El propósito del presente estudio fue investigar a través de análisis bioquímicos, los efectos de la exposición a formaldehído, que podría causar estrés oxidativo, en el corazón y la aorta. Se utilizaron un total de 24 ratas Albinas Wistar. Dividimos a las ratas en 3 grupos: grupo control (GC), grupo expuesto a dosis bajas de AG (promedio 1 ppm) (DDG) y grupo expuesto a dosis altas de AG (promedio 10 ppm) (YDG). Al término de la exposición a FA subcrónica, se tomaron muestras de sangre, tejido cardíaco y aorta de las ratas y se sometieron a análisis bioquímicos. Como resultado de los análisis, se detec- taron diferencias estadísticamente significativas entre GC (2,96 ? 0,85 ng / mg) y HDG (2,08 ? 0,77 ng / mg) en los tejidos aórticos en el análisis TXNIP (p <0,05). En los tejidos cardíacos se detectaron diferencias significativas entre GC (0,73 ? 0,27 ng / mg) y LDG (1,13 ? 0,22 ng / mg) (p <0,05). También se detectaron diferencias estadísticamente significativas entre CG (1,98 ? 0,31 mM / ml) y YDG (2,43 ? 0,31 mM / ml) en los análisis de MDA en suero (p <0,05). Se demostró que la aplicación subcrónica de formaldehído a ratas LDG a través de la inhalación no tuvo efectos sobre los marcadores de apoptosis en los tejidos del corazón. Se requieren más estudios para demostrar la toxicidad de los AG y el mecanismo de acción de la patología en el sistema cardiovascular. Creemos que nuestro estudio contribuirá a aclarar las funciones de la exposición leve y subcrónica de formaldehído en los tejidos cardíacos y aórticos en términos de riesgo al estrés oxidativo.


Subject(s)
Animals , Rats , Aorta/drug effects , Oxidative Stress/drug effects , Formaldehyde/pharmacology , Heart/drug effects , Aorta/chemistry , Thioredoxins/analysis , Biochemical Phenomena , Inhalation , Rats, Wistar , Peroxidase/analysis , Formaldehyde/administration & dosage , Hydroxyproline/analysis , Myocardium/chemistry
4.
Autops. Case Rep ; 11: e2021266, 2021. graf
Article in English | LILACS | ID: biblio-1249032

ABSTRACT

Hydrogen chloride is available commercially as an anhydrous gas or an aqueous solution, hydrochloric acid. Exposure to this gas has been associated with the development of reactive airways dysfunction syndrome. However, there are few published reports. A 37-year-old woman developed progressive bronchospasm and acute respiratory failure after cleaning an enclosed space with an unknown concentration of hydrochloric acid gas from a cleaning substance. She had no prior history of asthma or atopy. Severe bronchospasm developed, leading to hypoxemia and diffuse interstitial infiltrates, necessitating orotracheal intubation and admission to the intensive care unit. Asthma-like symptoms such as cough, wheezing, and dyspnea; requiring bronchodilators, and repeated hospitalizations are persistent a year after the accident. Pulmonary function testing showed mild airflow obstruction.


Subject(s)
Humans , Female , Adult , Respiratory Distress Syndrome, Newborn/complications , Respiratory Insufficiency/etiology , Hydrochloric Acid/adverse effects , Inhalation , Bronchial Hyperreactivity/complications
5.
São Paulo; s.n; s.n; 2021. 110 p. tab, graf.
Thesis in Portuguese | LILACS | ID: biblio-1379145

ABSTRACT

Introdução: O Meropenem é um carbapenêmico de amplo espectro, prescrito na terapia do choque séptico nos pacientes graves adultos de UTI, com infecções graves causadas por patógenos Gram-negativos susceptíveis. Objetivo: Avaliar a efetividade do Meropenem em pacientes sépticos queimados, investigar a farmacocinética na fase precoce e na fase tardia durante o curso do choque séptico e o impacto no desfecho clínico. Ética, Casuística e Procedimentos: Aprovação ética, registro CAAE07525118.3.0000.0068; nenhum conflito de interesse declarado foi obtido dos autores. Após assinatura do TCLE pelo responsável legal, o paciente foi incluído no protocolo. Investigou-se a população de 15 pacientes sépticos grandes queimados, adultos de ambos os gêneros (10 M/ 5F) com função renal preservada (Clcr> 50 ml/min). As características demográficas da população de pacientes incluídos foram idade de 37(33 -41) anos, 71(59,5 - 80,0) kg e índice de massa corpórea de 24,3(20,6-24,7) kg/m2, medianas (interquartil). Registrou-se o escore SAPS*3 54(47-59) de admissão dos pacientes na UTI; a superfície corpórea total queimada foi de 33% (18,3-34,4), SCTQ medianas (interquartil). A lesão inalatória e o uso de vasopressores foram registrados em 12/15 pacientes após trauma térmico/ elétrico (10/5). Após intubação orotraqueal, a ventilação mecânica foi registrada em 13/15 pacientes. A terapia empírica do choque séptico com Meropenem no regime de 1g q8h, por infusão estendida de 3 horas, foi iniciada após a coleta das culturas. Realizou-se coleta seriada de amostras sanguíneas para dosagem sérica do antimicrobiano por cromatografia líquida. Aplicou-se o modelo aberto monocompartimental para estudo da farmacocinética e estimativa dos parâmetros, meia vida biológica, depuração total corporal e volume de distribuição. A abordagem farmacocinética-farmacodinâmica (PK-PD) foi baseada na dosagem sérica do Meropenem e na taxa de eliminação, para estimativa do índice de predição de efetividade (% ƒ Δ?T> CIM), considerando o novo alvo terapêutico de 100% ƒ Δ?T> CIM. Utilizou-se estatística não paramétrica pela aplicação do teste de Wilcoxon para dados pareados e testes de correlação linear. Resultados e Discussão: Registrou-se alteração dos parâmetros farmacocinéticos nos pacientes sépticos investigados frente aos dados reportados para voluntários sadios. Evidenciou-se redução na taxa de eliminação e da depuração total corporal; o prolongamento da meia vida biológica ocorreu pelo aumento do volume de distribuição. Estas alterações impactaram estendendo a cobertura do Meropenem, na fase precoce do choque séptico, contra os patógenos de susceptibilidade intermediária com CIM 4 mg/L. Conclusão: A cobertura do Meropenem foi garantida contra os patógenos isolados até CIM 2 mg/L para todos os pacientes. Adicionalmente, ocorreu a erradicação de patógenos de susceptibilidade intermediária CIM 4 mg/L, pela cobertura que foi atingida apenas na fase precoce do choque séptico. Então, a abordagem PK / PD contribui para a obtenção do resultado


Background: Meropenem is a carbapenêmic, agent largely prescribed to septic patients in the Intensive Care Units with severe infections caused by Gram-negative susceptible strains. Objective: To evaluate Meropenem effectiveness in ICU septic burn patients and to investigate pharmacokinetic changes that could impact the desired outcome by eradication of Gram-negative strains of intermediate susceptibility. Ethics, Casuistry and Methods: Ethical approval register CAEE 07525118.3.0000.0068was obtained; no conflicts of interest to declare were obtained from all authors. Fifteen burn adult patients of both genders (10 M/ 5F) with preserved renal function (Clcr> 50 ml/min) were investigated after TCLE signed. Demographic characteristics of patients included were: 37(33 -41) years, 71(59.5- 80.0) kg, 24.3 (20.6-24.7) kg/m2 body mass index, medians (quartiles). ICU patients admission was based on SAPS*3 score of 54(47-59), 33% (18.3-34.4) TBSA medians (quartiles). Inhalation injury and vasopressors requirements were in 12/15 patients after fire/electricity (10/5, proportion). Mechanical ventilation was necessary in 13/15 patients. Antimicrobial therapy of septic shock with meropenem 1g q8h 3 hours infusion started, after cultures collection. A serial of blood samples was collected from the central catheter after a minimum of 48 hours of Meropenem therapy for drug serum measurements by liquid chromatography. One compartment open model was applied to estimate PK data related to the elimination rate constant, biological half-life, total body clearance and volume of distribution PK/PD approach was based on serum trough levels and elimination rate constant to estimate the predictive index of drug effectiveness (% fΔT>CIM), based on the new PK/PD target 100% fΔT>CIM. Non parametric statistics was applied, Wilcoxon test for paired data and linear correlations. Results: Pharmacokinetic changes occurred in septic burn patients investigated by comparison with results reported in healthy volunteers as follows by the reduction on elimination rate constant and also on total body clearance, in spite of preserved renal function for all patients included. In addition, a prolongation of biological half-life occurred as a consequence of increases on volume of distribution. Pharmacodynamics was impacted by PK changes only at the earlier period of septic shock, once pathogens isolated of intermediate susceptibility up to MIC 4 mg/L were eradicated. Conclusion: Meropenem effectiveness was guaranteed against Gram-negative up to MIC 2 mg/L strains isolated for all patients. In addition, eradication of pathogens of intermediate susceptibility MIC 4 mg/L strains occurred only at the earlier period of septic shock. Then, PK/PD approach contributes to desired outcome achievement


Subject(s)
Humans , Male , Female , Adult , Patients , Wounds and Injuries/drug therapy , Burns/pathology , Pharmacokinetics , Meropenem/analysis , Shock, Septic/complications , Pharmaceutical Preparations/administration & dosage , Inhalation , Chromatography, Liquid/methods , Pharmacologic Actions , Intensive Care Units/classification
6.
Arq. Asma, Alerg. Imunol ; 4(3): 277-288, jul.set.2020. ilus
Article in Portuguese | LILACS | ID: biblio-1381995

ABSTRACT

A via inalatória é a mais adequada para o tratamento das doenças respiratórias. Muitos fatores influenciam na deposição pulmonar do fármaco inalado, e, consequentemente, no sucesso terapêutico, desde fatores relacionados ao indivíduo, como questões anatômicas das vias aéreas, dinâmica respiratória, doença de base e técnica correta, até situações relacionadas às questões aerodinâmicas das partículas que compõem o aerossol, como o tamanho (diâmetro aerodinâmico mediano de massa) e a homogeneidade das partículas (desvio padrão geométrico). Nos últimos anos os dispositivos inalatórios se aperfeiçoaram, buscando atender às características necessárias que garantam uma deposição pulmonar satisfatória dos fármacos. A escolha do dispositivo inalatório deve ser individualizada, e o conhecimento das particularidades de cada dispositivo e das vantagens e desvantagens instrumentaliza o profissional na decisão, e impacta diretamente no sucesso terapêutico da medicação utilizada.


The inhalation route is the most adequate for the treatment of respiratory diseases. Many factors influence pulmonary deposition of the inhaled drug and, consequently, therapeutic success. They include individual factors such as airway anatomy, respiratory dynamics, underlying disease, and correct technique, as well as factors related to the aerodynamics of aerosol particles such as size (mass median aerodynamic diameter) and homogeneity of the particles (geometric standard deviation). In recent years, inhalation devices have improved to comply with the necessary characteristics that guarantee a satisfactory pulmonary deposition of drugs. The choice of the inhalation device must be individualized, and the knowledge about the features of each device and their advantages and disadvantages instrumentalizes health professionals in the decision and impacts directly the therapeutic success of the medication used.


Subject(s)
Humans , Male , Female , Child , Adolescent , Societies, Medical , Nebulizers and Vaporizers , Aerosols , Pediatrics , Respiratory Tract Diseases , Therapeutics , Pharmaceutical Preparations , Inhalation , Allergy and Immunology , Equipment and Supplies , Particulate Matter
7.
Rev. bras. ter. intensiva ; 32(2): 284-294, Apr.-June 2020. tab, graf
Article in English, Spanish | LILACS | ID: biblio-1138496

ABSTRACT

RESUMO Objetivo: Identificar la relación de la asincronía paciente-ventilador con el nivel de sedación y evaluar la asociación con los resultados hemogasométricos y clínicos. Métodos: Estudio prospectivo de 122 pacientes admitidos en la unidad de cuidados intensivos con > 24 horas de ventilación mecánica invasiva y esfuerzo inspiratorio. En los primeros 7 días de ventilación, diariamente se evaluó la asincronía paciente-ventilador durante 30 minutos. La asincronía paciente-ventilador severa se definió con un índice de asincronía > 10%. Resultados: Se evaluaron 339.652 ciclos respiratorios en 504 observaciones. La media del índice de asincronía fue 37,8% (desviación estándar 14,1% - 61,5%). La prevalencia de asincronía paciente-ventilador severa fue 46,6%. Las asincronías paciente-ventilador más frecuentes fueron: trigger ineficaz (13,3%), auto-trigger (15,3%), flujo insuficiente (13,5%) y ciclado demorado (13,7%). La asincronía paciente-ventilador severa se relacionó con el nivel de sedación (trigger ineficaz: p = 0,020; flujo insuficiente: p = 0,016; ciclado precoz: p = 0,023) y el uso de midazolam (p = 0,020). La asincronía paciente-ventilador severa se asoció con las alteraciones hemogasométricas. La persistencia de la asincronía paciente-ventilador severa fue un factor de riesgo independiente para fracaso en la prueba de ventilación espontánea, tiempo de ventilación, neumonía asociada al ventilador, disfunción de órganos, mortalidad en la unidad de cuidados intensivos y estadía en la unidad de cuidados intensivos. Conclusión: La asincronía paciente-ventilador es un trastorno frecuente en los pacientes críticos con esfuerzo inspiratorio. La interacción del paciente con el ventilador debe optimizarse para mejorar los parámetros hemogasométricos y los resultados clínicos. Se requieren otros estudios que confirmen estos resultados.


Abstract Objective: To identify the relationship of patient-ventilator asynchrony with the level of sedation and hemogasometric and clinical results. Methods: This was a prospective study of 122 patients admitted to the intensive care unit who underwent > 24 hours of invasive mechanical ventilation with inspiratory effort. In the first 7 days of ventilation, patient-ventilator asynchrony was evaluated daily for 30 minutes. Severe patient-ventilator asynchrony was defined as an asynchrony index > 10%. Results: A total of 339,652 respiratory cycles were evaluated in 504 observations. The mean asynchrony index was 37.8% (standard deviation 14.1 - 61.5%). The prevalence of severe patient-ventilator asynchrony was 46.6%. The most frequent patient-ventilator asynchronies were ineffective trigger (13.3%), autotrigger (15.3%), insufficient flow (13.5%), and delayed cycling (13.7%). Severe patient-ventilator asynchrony was related to the level of sedation (ineffective trigger: p = 0.020; insufficient flow: p = 0.016; premature cycling: p = 0.023) and the use of midazolam (p = 0.020). Severe patient-ventilator asynchrony was also associated with hemogasometric changes. The persistence of severe patient-ventilator asynchrony was an independent risk factor for failure of the spontaneous breathing test, ventilation time, ventilator-associated pneumonia, organ dysfunction, mortality in the intensive care unit, and length of stay in the intensive care unit. Conclusion: Patient-ventilator asynchrony is a frequent disorder in critically ill patients with inspiratory effort. The patient's interaction with the ventilator should be optimized to improve hemogasometric parameters and clinical results. Further studies are required to confirm these results.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Respiration, Artificial/methods , Interactive Ventilatory Support/methods , Intensive Care Units , Time Factors , Inhalation/physiology , Prospective Studies , Risk Factors , Critical Illness , Pneumonia, Ventilator-Associated/epidemiology , Length of Stay
8.
Allergy, Asthma & Immunology Research ; : 164-170, 2020.
Article in English | WPRIM | ID: wpr-762175

ABSTRACT

PURPOSE: Occupational asthma may be induced by high- or low-molecular weight allergens (HMWA or LMWA, respectively). The study was conducted to compare the pattern of bronchial response in 200 HMWA-induced asthmatics (n = 130) and LMWA-induced asthmatics (n = 70). METHODS: The study participants underwent a single-blind, placebo-controlled specific inhalation challenge (SIC) with workplace allergens, accompanied by evaluation of non-specific bronchial hyperresponsiveness (NSBHR) with methacholine before and after the SIC. RESULTS: A single early bronchial response more frequently occurred in HMWA-induced asthmatics than in LMWA-induced asthmatics (86.2% vs. 20%). An isolated late bronchial response or atypical patterns were more frequently observed in LMWA-induced asthmatics than in LMWA-induced asthmatics (45.7% vs. 3.8% or 34.3% vs. 10%, respectively). Baseline NSBHR before SIC was more often detected in LMWA-induced asthmatics than in HMWA-induced asthmatics (81.4% vs. 54.6%), and the median value of the provocation concentration of methacholine was relevantly lower in these patients before and after SIC. A significant 3-fold increase in NSBHR after SIC was observed more often in LMWA-induced asthmatics than in HMWA-induced asthmatics (82.8% vs. 66.1%). In addition, compared to LMWA-induced asthmatics, HMWA-induced asthmatics were older, were more frequently active smokers, showed lower level of NSBHR, and more frequently continued their work in harmful occupational exposure. CONCLUSIONS: The results of this study suggest that HMWA-induced asthmatics may have milder clinical courses and that there is a possibility of job continuation despite asthma exacerbation requiring medical surveillance.


Subject(s)
Humans , Allergens , Asthma , Asthma, Occupational , Bronchial Hyperreactivity , Immunoglobulin E , Inhalation , Methacholine Chloride , Molecular Weight , Occupational Exposure , Prognosis
9.
Allergy, Asthma & Immunology Research ; : 454-466, 2020.
Article in English | WPRIM | ID: wpr-811066

ABSTRACT

PURPOSE: Asthma control in older asthmatics is often less effective, which may be attributed to small airway dysfunction and poor inhalation technique. We compared the efficacy of 2 inhalers (fluticasone propionate/formoterol treatment using a pressurized metered-dose inhaler [p-MDI group] vs. fluticasone propionate/salmeterol treatment using a dry powder inhaler [DPI group]) in older asthmatics.METHODS: We conducted a 12-week, randomized, open-label, parallel-designed trial in older patients (over 55 years old) with moderate-to-severe asthma, and compared the efficacy and safety for asthma control between the 2 groups. Subgroup analyses on disease duration and air trapping were performed. Clinical parameters, including changes in lung function parameters, inhaler technique and adherence, were compared with monitoring adverse reactions between the 2 groups.RESULTS: A total of 68 patients underwent randomization, and 63 (30 in the p-MDI group and 33 in the DPI group) completed this study. The p-MDI group was non-inferior to the DPI group with regard to the rate of well-controlled asthma (53.3% vs. 45.5%, P < 0.001; a predefined non-inferiority limit of 17%). In subgroup analyses, the proportion of patients who did not reach well-controlled asthma in the p-MDI group was non-inferior to that in the DPI group; the difference was 12.7% among those with a longer disease duration (≥ 15 years) and 17.5% among those with higher air-trapping (RV/TLC ≥ 45%), respectively (a predefined non-inferiority limit of 17%, P < 0.001). No significant differences were observed in lung function parameters, inhalation techniques, adherence and adverse reactions between the 2 groups.CONCLUSION: These results suggest that the p-MDI group may be comparable to the DPI group in the management of older asthmatics in aspects of efficacy and safety.


Subject(s)
Humans , Airway Management , Asthma , Dry Powder Inhalers , Fluticasone , Inhalation , Lung , Medication Adherence , Metered Dose Inhalers , Nebulizers and Vaporizers , Random Allocation
10.
Rev. Esc. Enferm. USP ; 54: e003538, 2020. tab, graf
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1091965

ABSTRACT

Abstract Objective: To evaluate the effectiveness of home visits in a group of children and adolescents with severe asthma by using the inhalation technique score and adherence rates to drug treatment. Method: A 12-month randomized controlled trial involving patients aged between three and 17 years under regular follow-up treatment at a pediatric pulmonology outpatient clinic of a university hospital in southeastern Brazil. A group of patients received only outpatient consultations and the other group received home visits from nurses in addition to outpatient consultations. The differences between groups were analyzed through the outcomes of inhalation technique scores and treatment adherence rate. Results: Participation of 29 patients. In the intervention group, there was a statistically significant increase in inhalation technique scores (p<0.05) and elimination of critical errors between the first and the second evaluation, and results were maintained in the third evaluation. In the control group, there were no significant changes in inhalation technique scores. Rates of adherence to drug treatment in both groups did not rise. Conclusion: Home visits were effective for improving inhalation technique scores in patients with severe asthma. Brazilian Registry of Clinical Trials: RBR-8GZWZP.


Resumen Objetivo: Evaluar la efectividad de la visita domiciliaria en un grupo de niños y adolescentes con asma severa, utilizando el score de la técnica inhalatoria y las tasas de adhesión al tratamiento medicamentoso. Método: Estudio experimental randomizado controlado, con duración de 12 meses, que incluyó a pacientes con edades entre tres y 17 años, acompañados regularmente en un ambulatorio de neumología pediátrica de un hospital universitario de la región Sureste de Brasil. Un grupo de pacientes recibió solo consultas ambulatorias y el otro grupo, además de las consultas ambulatorias, recibió visitas de la enfermera en el hogar. Fueron analizadas las diferencias entre los grupos en los resultados: scores de la técnica inhalatoria y tasa de adhesión al tratamiento. Resultados: Participaron 29 pacientes. En el grupo intervención, hubo aumento estadísticamente significativo de los scores de la técnica inhalatoria (p<0,05) y eliminación de errores críticos de la primera a la segunda evaluación, resultados que se mantuvieron en la tercera. No hubo modificaciones significativas en la técnica inhalatoria del grupo de control. Las tasas de adhesión al tratamiento medicamentoso en ambos grupos no se elevaron. Conclusión: La visita domiciliaria fue eficaz en mejorar los scores de técnica inhalatoria en pacientes con asma severa. Registro Brasileño de Ensayos Clínicos: RBR-8GZWZP


Resumo Objetivo: Avaliar a eficácia da visita domiciliar, em um grupo de crianças e adolescentes com asma grave, utilizando o escore da técnica inalatória e as taxas de adesão ao tratamento medicamentoso. Método: Estudo experimental randomizado controlado, com duração de 12 meses, envolvendo pacientes, com idades entre três e 17 anos, acompanhados regularmente em um ambulatório de pneumologia pediátrica de um hospital universitário da região Sudeste do Brasil. Um grupo de pacientes recebeu apenas consultas ambulatoriais e o outro grupo, além das consultas ambulatoriais, recebeu visitas da enfermeira no domicílio. Foram analisadas as diferenças entre os grupos nos desfechos: escores da técnica inalatória e taxa de adesão ao tratamento. Resultados: Participaram 29 pacientes. No grupo-intervenção, houve aumento estatisticamente significante dos escores da técnica inalatória (p<0,05) e eliminação de erros críticos da primeira para a segunda avaliação, resultados que foram mantidos na terceira. Não houve alterações significativas na técnica inalatória do grupo-controle. As taxas de adesão ao tratamento medicamentoso em ambos os grupos não se elevaram. Conclusão: A visita domiciliar foi eficaz em melhorar os escores de técnica inalatória em pacientes com asma grave. Registro Brasileiro de Ensaios Clínicos: RBR-8GZWZP.


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Asthma/drug therapy , Asthma/therapy , Inhalation , Medication Adherence , House Calls
11.
Rev. Esc. Enferm. USP ; 54: e03546, 2020. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1091959

ABSTRACT

Abstract OBJECTIVE To evaluate an educational program based on the principles of self-management with a conventional educational program through quality of life, anxiety and depression instruments within 12 months of starting cancer treatment. METHOD An experimental, randomized, controlled study conducted with head and neck cancer patients treated at a university hospital in the city of São Paulo, Brazil. Patients were randomly divided into two groups: the control group submitted to the conventional educational plan, and the experimental group submitted to the educational plan for self-management. Descriptive and analytical statistics were used for the analyzes using the t-test, Fischer's exact test and Repeated Measures ANOVA. RESULTS Twenty (20) patients were selected. Most participants were male, in advanced stages of disease and undergoing three therapeutic modalities. The control group showed a gradual decrease in quality of life scores during treatment, while the experimental group progressively increased. The correlation was significant between the presence of anxiety and depression symptoms and poor quality of life. Patients in the control group had a significant worsening in social/family well-being (P = 0.02) and the prevalence of additional head and neck cancer-related additional concerns (P = 0.01), while the experimental group had reduced anxiety symptoms (P = 0.001) and improved emotional well-being (P = 0.01). CONCLUSION The educational intervention based on building self-management skills favored quality of life and reduced anxiety and depression. Brazilian Registry of Clinical Trials (RBR 2q53ct).


Resumen OBJETIVO Evaluar un programa educativo basado en los principios de la autogestión con programa educativo convencional, mediante instrumentos de calidad de vida, ansiedad y depresión en período de 12 meses transcurridos desde el inicio del tratamiento. MÉTODO Estudio experimental, randomizado controlado, llevado a cabo con pacientes con cáncer de cabeza y cuello, tratados en hospital universitario del municipio de São Paulo. Los pacientes fueron divididos aleatoriamente en dos grupos: grupo control, sometido al plan educativo convencional, y grupo experimento, sometido al plan educativo para la autogestión. Para los análisis se empleó estadística descriptiva y analítica, utilizándose la prueba t, la prueba exacta de Fischer y ANOVA de Medidas Repetidas. RESULTADOS Fueron seleccionados 20 pacientes. La mayoría de los participantes fue del sexo masculino, en estadíos avanzados de enfermedad y sometidos a tres modalidades terapéuticas. El grupo control presentó caída gradual de los scores de calidad de vida en el trascurso del tratamiento, mientras que el grupo experimento incrementó progresivamente. La correlación fue significativa entre la presencia de síntomas de ansiedad y depresión y la baja calidad de vida. Pacientes del grupo control presentaron empeoramiento significativo del bienestar social/familiar (P = 0,02) y de la prevalencia de preocupaciones adicionales relacionadas con el cáncer de cabeza y cuello (P = 0,01), mientras que el grupo experimento presentó reducción de los síntomas de ansiedad (P = 0,001) y mejora del bienestar emotivo (P = 0,01). CONCLUSIÓN La intervención educativa basada en la construcción de habilidades para la autogestión favoreció la calidad de vida y redujo la ansiedad y la depresión. Registro Brasileño de Ensayos Clínicos (RBR 2q53ct).


Resumo OBJETIVO Avaliar um programa educativo baseado nos princípios do autogerenciamento com programa educativo convencional, por meio de instrumentos de qualidade de vida, ansiedade e depressão em período de 12 meses transcorridos do início do tratamento. MÉTODO Estudo experimental, randomizado, controlado, realizado com pacientes com câncer de cabeça e pescoço, tratados em hospital universitário do município de São Paulo. Os pacientes foram divididos aleatoriamente em dois grupos: grupo controle, submetido ao plano educativo convencional, e grupo experimento, submetido ao plano educativo para o autogerenciamento. Para as análises empregaram-se estatísticas descritiva e analítica, utilizando-se o teste t, o teste exato de Fischer e ANOVA de Medidas Repetidas. RESULTADOS Foram selecionados 20 pacientes. A maioria dos participantes foi do sexo masculino, em estádios avançados de doença e submetidos a três modalidades terapêuticas. O grupo controle apresentou queda gradual dos escores de qualidade de vida no transcorrer do tratamento, enquanto o grupo experimento aumentou progressivamente. A correlação foi significativa entre a presença de sintomas de ansiedade e depressão e baixa qualidade de vida. Pacientes do grupo controle apresentaram piora significativa do bem-estar social/familiar (P = 0,02) e da prevalência de preocupações adicionais relacionadas ao câncer de cabeça e pescoço (P = 0,01), enquanto o grupo experimento apresentou redução dos sintomas de ansiedade (P = 0,001) e melhora do bem-estar emocional (P = 0,01). CONCLUSÃO A intervenção educativa pautada na construção de habilidades para o autogerenciamento favoreceu a qualidade de vida e reduziu a ansiedade e a depressão. Registro Brasileiro de Ensaios Clínicos (RBR 2q53ct).


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Quality of Life , Self Care , Health Education , Head and Neck Neoplasms , Oncology Nursing , Anxiety , Inhalation
12.
Int. j. odontostomatol. (Print) ; 14(3): 380-386, 2020. tab
Article in Spanish | LILACS | ID: biblio-1114911

ABSTRACT

El objetivo de nuestro estudio de tipo longitudinal prospectivo simple de medidas repetidas fue determinar la variación del flujo aéreo nasal medido con un flujómetro nasal portátil, en niños entre 6 y 14 años de edad con compresión maxilar, después de la expansión rápida del maxilar (ERM). El trabajo constó de 16 niños diagnosticados con compresión maxilar y a quienes se les indicó una disyunción maxilar rápida. Los valores de la cantidad de expansión fueron registrados y la medición del flujo inspiratorio nasal máximo (FINM) se realizó antes de la ERM (T1), inmediatamente después (T2) y al cabo de 3 meses del período de retención (T3), manteniendo las mismas condiciones iniciales. El valor máximo y el promedio de las mediciones del FINM en T2 fueron significativamente mayores que en T1 (p-valor, 0,0056) y (p-valor 0,0062) respectivamente, mientras que entre T2 y T3 no existieron tales diferencias (p-valor: 0,3021) y (p-valor: 0,3315) respectivamente. Existe un aumento significativo en los valores del FINM inmediatamente después de la expansión rápida del maxilar que se mantienen en un período de tiempo de 3 meses.


The objective of our simple prospective longitudinal type study of repeated measures, was to determine the variation of nasal airflow measured with a portable nasal flow meter, in children between 6 and 14 years of age with maxillary compression, after rapid maxillary expansion (RME). The study consisted of 16 children diagnosed with maxillary compression and those who were identified with a rapid maxillary disjunction. The values of the amount of expansion were recorded and the measurement of the peak nasal inspiratory flow (PNIF) was performed before the ERM (T1), immediately after (T2) and after 3 months of retention period (T3), maintaining the same initial conditions. Results: the value maximum and average measurements of FINM in T2 were greater than in T1 (p-value, 0.0056) and (p-value 0.0062) respectively, while between T2 and T3 there were no differences (p value: 0.3021) and (p value: 0.3315) respectively. There is a significant increase in PNIF values immediately after rapid maxillary expansion that is in a period of 3 months.


Subject(s)
Humans , Male , Female , Child , Adolescent , Inhalation/physiology , Nose/physiology , Malocclusion/therapy , Maxillary Sinus/surgery , Nasal Obstruction/physiopathology , Prospective Studies , Longitudinal Studies , Palatal Expansion Technique , Flowmeters
13.
Braz. J. Pharm. Sci. (Online) ; 56: e18500, 2020. tab, graf
Article in English | LILACS | ID: biblio-1142493

ABSTRACT

Ethephon (Ethrel®) is an ethylene-based plant growth regulator that used in agriculture and it has direct and indirect effects on human health, direct effect via its inhalation during usage in agriculture and indirect effect through the diet (Fruits and vegetables) that is sprayed with it. The current study aimed to examine the possible modifying effects of costus (Saussurea lappa) root aqueous extract against Ethephon induced liver toxicity, injury, DNA fragmentation and PCNA alterations in male rats. Fifty adult male rats were divided into 5 groups (1st, control; 2nd, Costus; 3rd, Ethephon; 4th, Post treated Ethephon with costus; 5th, self-healing Ethephon). Current results revealed that; a significant increase in aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), liver injury, DNA damage and PCNA expressions in Ethephon group when compared with control group. In contrast; a significant decrease in albumin and total proteins in Ethephon group when compared with control group. Treatment of rats with costus after Ethephon improved these alterations as compared with Ethephon self-healing. So, it could be concluded that costus root extract worth to be considered as a natural substance for ameliorating the hepatic toxicity induced by plant growth regulator Ethephon.


Subject(s)
Animals , Male , Rats , Plant Growth Regulators/agonists , Plant Extracts/analysis , Costus/adverse effects , Chemical and Drug Induced Liver Injury , DNA Damage , Inhalation , Proliferating Cell Nuclear Antigen , Agriculture/classification , Liver/abnormalities
14.
Rev. bras. ter. intensiva ; 31(3): 289-295, jul.-set. 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1042581

ABSTRACT

RESUMO Objetivo: Avaliar os efeitos da hiperinsuflação com o ventilador sobre a mecânica respiratória. Métodos: Foi realizado ensaio clínico cruzado randomizado com 38 pacientes ventilados mecanicamente com infecção pulmonar. A ordem da hiperinsuflação ou controle (sem alterações nos parâmetros) foi randomizada. A hiperinsuflação foi realizada por 5 minutos no modo ventilação com pressão controlada, com aumentos progressivos de 5cmH2O até atingir pressão máxima de 35cmH2O, mantendo-se a pressão positiva expiratória final. Após atingir 35cmH2O, o tempo inspiratório e a frequência respiratória foram ajustados para que os fluxos inspiratório e expiratório atingissem a linha de base, respectivamente. As medidas de complacência estática, resistências total e de vias aéreas e pico de fluxo expiratório foram avaliadas antes, imediatamente após a manobra e após aspiração. Foi utilizada a análise de variância two-way para medidas repetidas com pós-teste de Tukey, considerando significativo p < 0,05. Resultados: A hiperinsuflação com o ventilador aumentou a complacência estática, mantendo-se após aspiração (46,2 ± 14,8 versus 52,0 ± 14,9 versus 52,3 ± 16,0mL/cmH2O; p < 0,001). Houve aumento transitório da resistência de vias aéreas (6,6 ± 3,6 versus 8,0 ± 5,5 versus 6,6 ± 3,5cmH2O/L.s-1; p < 0,001) e redução transitória do pico de fluxo expiratório (32,0 ± 16,0 versus 29,8 ± 14,8 versus 32,1 ± 15,3Lpm; p < 0,05) imediatamente após a manobra, com redução após aspiração traqueal. Não foram observadas modificações no controle e nem alterações hemodinâmicas. Conclusão: A hiperinsuflação com o ventilador promoveu aumento da complacência associado ao aumento transitório da resistência de vias aéreas e do pico de fluxo expiratório, com redução após aspiração.


ABSTRACT Objective: To evaluate the effects of ventilator hyperinflation on respiratory mechanics. Methods: A randomized crossover clinical trial was conducted with 38 mechanically ventilated patients with pulmonary infection. The order of the hyperinflation and control (without changes in the parameters) conditions was randomized. Hyperinflation was performed for 5 minutes in pressure-controlled ventilation mode, with progressive increases of 5cmH2O until a maximum pressure of 35cmH2O was reached, maintaining positive end expiratory pressure. After 35cmH2O was reached, the inspiratory time and respiratory rate were adjusted so that the inspiratory and expiratory flows reached baseline levels. Measurements of static compliance, total resistance and airway resistance, and peak expiratory flow were evaluated before the technique, immediately after the technique and after aspiration. Two-way analysis of variance for repeated measures was used with Tukey's post hoc test, and p < 0.05 was considered significant. Results: Ventilator hyperinflation increased static compliance, which remained at the same level after aspiration (46.2 ± 14.8 versus 52.0 ± 14.9 versus 52.3 ± 16.0mL/cmH2O; p < 0.001). There was a transient increase in airway resistance (6.6 ± 3.6 versus 8.0 ± 5.5 versus 6.6 ± 3.5cmH2O/Ls-1; p < 0.001) and a transient reduction in peak expiratory flow (32.0 ± 16.0 versus 29.8 ± 14.8 versus 32.1 ± 15.3Lpm; p <0.05) immediately after the technique; these values returned to pretechnique levels after tracheal aspiration. There were no changes in the control condition, nor were hemodynamic alterations observed. Conclusion: Ventilator hyperinflation promoted increased compliance associated with a transient increase in airway resistance and peak expiratory flow, with reduction after aspiration.


Subject(s)
Humans , Male , Female , Adult , Aged , Respiration, Artificial/methods , Ventilators, Mechanical , Respiratory Mechanics , Inhalation , Time Factors , Airway Resistance , Cross-Over Studies , Middle Aged
15.
Rev. chil. enferm. respir ; 35(2): 111-115, jun. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1020626

ABSTRACT

INTRODUCCIÓN: El uso prolongado de traqueostomía (TQT) conlleva a complicaciones que pueden minimizarse con una decanulación segura y temprana. La presión inspiratoria mantenida (PiMant) evalúa el comportamiento dinámico de la vía aérea en inspiración, la que puede relacionarse con la tolerancia a la oclusión de la TQT en pacientes en vía de decanulación. El OBJETIVO es el de describir la medición de PiMant y relacionar su valor con la tolerancia al uso de cánula tapada. METODOLOGÍA: Se evaluó la PiMant a 16 pacientes traqueostomizados, con vacuómetro anaeroide, registrando la moda de las presiones obtenidas, saturación de oxígeno, frecuencias respiratoria y cardíaca, uso de musculatura accesoria y estridor, a los minutos 1, 5, 10 y 15 de la oclusión de la TQT. RESULTADOS: mediana edad 60 meses, rango de presiones −2 a −40 cmH2O. Valores de PiMant > −7 cmH2O se asocian a mejor tolerancia al uso de cánula tapada. El estridor severo, asociado a aumento en frecuencia respiratoria, frecuencia cardiaca y uso de musculatura accesoria fueron los principales indicadores de fin de la prueba. CONCLUSIONES: PiMant es una prueba segura. PiMant> −7cmH2O, presentan mejor tolerancia a uso de cánula tapada.


INTRODUCTION: The prolonged use of tracheostomy leads to several complications, being necessary a prompt and safe decannulation. Maintained Inspiratory Airway Pressure (PiMant) is a functional evaluation of the dynamic changes of upper airway in inspiration which could indicate the tolerance to capped tracheostomy and adapting to this new airflow resistance, prior to decannulate. METHODS: Sixteen tracheostomized patients were evaluated with PiMant using a vacuum gauge, recording pressure value, oxygen saturation, respiratory rate, heart rate, accesory muscles use and presence of stridor during 15 minutes. RESULTS: Median age 60 months-old, pressure range −2 to −40 cmH2O. PiMant values > −7 cmH2O were associated with better tolerance to capped tracheostomy. Stridor was associated to increase of respiratory effort being the best criteria to bring to a halt the test. CONCLUSIONS: PiMant is a safe assessment, and indicates tolerance to capped tracheostomy when values > −7 cmH2O are found.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Tracheostomy , Airway Resistance , Inhalation/physiology , Catheter Obstruction , Oxygen , Device Removal , Respiratory Rate/physiology , Heart Rate/physiology
16.
Int. j. cardiovasc. sci. (Impr.) ; 32(3): 247-252, May-June 2019. graf
Article in English | LILACS | ID: biblio-1002222

ABSTRACT

Brazil is the worldwide leader in the long-term use of pesticides and herbicides. This compromises the health of handlers by causing harmful neurological, respiratory, and cardiovascular changes. The herbicide 2.4D has been shown to cause cardiac overload with subsequent pathological remodeling. Objective: To analyze the cardiac morphological repercussions on the left ventricle (LV) of mice submitted to nebulization by the herbicide 2.4D. Methods: Fifteen mice were divided into three groups: control group (CG; n = 5) exposed to nebulization with sodium chloride solution; low concentration group (LCG; n = 5) exposed to nebulization of the herbicide 2.4D with 3.71 x 10-3 grams; and high concentration group (HCG; n = 5) exposed to nebulization of the herbicide 2.4D with 9.28 x 10-3 grams for 15 minutes. The fractal dimension analysis was performed through the box-counting method. Later, the ImageJ program was used to calculate the fractal dimension of each group. To evaluate cardiac remodeling, histological slides were prepared and stained with Hematoxylin-Eosin (HE). Fifty areas of cardiomyocytes were analyzed per animal. The comparisons between groups were performed by ANOVA One-Way with Tukey's posttest (p < 0.05). Results: There was no change in fractal dimension values between the CG = 1.37 ± 0.02, LCG = 1.33 ± 0.04 and the HCG = 1.33 ± 0.07 groups. However, cardiac hypertrophy occurred in the HCG = 303.9 ± 38.80 µm(2) when compared to the CG group = 236.9 ± 61.71 µm(2) (p = 0.034). Conclusion: The herbicide 2.4D used for 72 hours did not promote cardiotoxicity when evaluated by fractal dimension. However, cardiomyocyte hypertrophy was observed in the LV


Subject(s)
Animals , Rats , Pesticides/adverse effects , Inhalation , Ventricular Function, Left , Ventricular Remodeling , Herbicides/adverse effects , Respiratory Tract Diseases , Brazil , Cross-Sectional Studies/methods , Analysis of Variance , Agrochemicals/adverse effects , Hypertrophy, Left Ventricular , Models, Animal , Mice , Neurologic Manifestations
17.
Nigerian Hospital Practice ; 23(4-5): 49-55, 2019.
Article in English | AIM | ID: biblio-1267717

ABSTRACT

Occupational exposure to wood dust may bring about some changes in blood indices of humans, especially in developing countries where use of protective gadgets like face masks are not in use. This study is aimed at evaluating changes in blood cell indices, haemostasis and CD 4 count on occupationally exposed workers to wood dust. This randomized study consisted of one hundred (100) male sawmill workers who have been exposed to wood dust by working in these environments without any form of protective masks, for over two years as test subjects and fifty male individuals randomly selected who were not exposed to wood dust as controls. Blood samples were obtained from these workers and analysed for complete blood count using PCE ­ 210N haematology analyser, prothnumbin time test (PTT) and activated partial thromboplastin (APTT) were manually done using commercially purchased kit and CD4 count was performed using the flow cytometry method. Haemoglobin, haemcitrocrit and granutocyte levels increased significantly in test subjects when compared with control subjects (P= 0.037, P=0.026, p=0.0005. Mean lymphocyte levels decreased significantly in test when compared to control subjects (P=0.028). while there were no changes in the other CBC parameters, PT, APTT and CD4 counts in test when compared with control subjects. This suggest that inhalation of wood dust increases haemotocrit, haemoglobin and granulocyte levels, decreased lymphocyte count and a longer exposure time to wood dust significantly affects these parameters. This may imply there is an increased rate of blood flow in the circulation of these individuals


Subject(s)
Blood , Inhalation , Lakes , Nigeria , Prothrombin Time , Rheology
18.
São Paulo; HSPM; 2019.
Non-conventional in Portuguese | SMS-SP, ColecionaSUS, LILACS, HSPM-Producao, SMS-SP | ID: biblio-1248306

ABSTRACT

A bronquiolite é a primeira causa de hospitalização entre crianças menores de um ano. Muitas modalidades de tratamento para bronquiolite já foram defendidas, mas ainda não há evidências para apoiar o uso de medicamentos como broncodilatadores, corticosteroides, fisioterapia respiratória, antibióticos ou antivirais. Um dos tratamentos mais recentes tem sido o uso de solução salina hipertônica (HS) a 3%. O tratamento com inalação HS tem sido proposto para bronquiolite no intuito de reduzir o tempo de internação hospitalar, bem como a maioria dos eventos adversos leves relatados. Há pesquisadores que defenderem que ela permite reduzir o edema das vias aéreas, diminuir o entupimento da mucosa e melhorar a eliminação do muco. No entanto, análises de estudos mais recentes lançam dúvidas sobre a verdadeira eficácia desse tratamento para lactentes internados e em sua capacidade de reduzir o tempo de internação hospitalar. Assim a escolha do tema se justifica devido a essa discussão sobre a eficácia desse tratamento. O objetivo do estudo foi de investigar na literatura recente se há algum benefício na inalação hipertônica no tratamento da bronquiolite em lactentes. Esse estudo foi desenvolvido por meio de uma revisão bibliográfica, através de 23 artigos publicados. Os resultados permitiram concluir que apesar de alguns resultados positivos, as evidências atuais não suportam o uso de inalação HS em lactentes com bronquiolite aguda como uma terapia eficaz. Palavras-chave: Bronquiolite. Inalação. Pediatria.


Subject(s)
Humans , Male , Female , Pediatrics , Bronchiolitis , Inhalation
19.
Journal of the Korean Medical Association ; : 376-382, 2019.
Article in Korean | WPRIM | ID: wpr-766601

ABSTRACT

Radon is a naturally occurring radioactive material classified as a carcinogen by the World Health Organization, and is known to be the factor with the second-greatest impact on lung cancer after smoking. An association between radon and lung cancer has consistently been reported in epidemiological studies on mine workers and residents of homes with indoor radon exposure. However, associations between radon and other diseases, such as leukemia and thyroid cancer, have yet to be confirmed due to a lack of consistent research findings and biological relevance. Such associations are unlikely because there is a very low likelihood that organs other than the lungs are exposed to radon upon inhalation due to the short half-life of radon and its progeny and the low permeability of alpha rays. In spring 2018, the radon bed mattress incident occurred, leading to a spike of concern and interest among the public regarding the health effects of radiation exposure. This paper presents a description of radon exposure and its health effects based on the current literature and provides practical information based on health consultations experienced following the 2018 radon mattress incident.


Subject(s)
Alpha Particles , Epidemiologic Studies , Half-Life , Inhalation , Leukemia , Lung , Lung Neoplasms , Miners , Permeability , Radiation Exposure , Radon , Referral and Consultation , Smoke , Smoking , Thyroid Neoplasms , World Health Organization
20.
Allergy, Asthma & Respiratory Disease ; : 57-60, 2019.
Article in Korean | WPRIM | ID: wpr-719519

ABSTRACT

Exogenous lipoid pneumonia is an uncommon medical condition resulting from aspiration or inhalation of oily material. Generally, lipoid pneumonia has nonspecific clinical and radiological presentations, and may be misdiagnosed as bacterial pneumonia or lung cancer. We describe an unusual case of exogenous lipoid pneumonia accompanied by peripheral blood and pulmonary eosinophilia. A 63-year-old man was admitted with progressively worsening exertional dyspnea and productive cough for 5 days. A chest radiograph showed abnormalities in the lower lobe of the right lung, and a diagnosis of community-acquired pneumonia was made; intravenous antibiotics were administered. However, dyspnea and hypoxia gradually worsened and peripheral blood eosinophilia developed. A bronchoscopy was performed and bronchoalveolar lavage fluid analysis showed markedly increased numbers of eosinophils (40%). Subsequently, a comprehensive review of history revealed that he fell asleep with camellia oil in his mouth for 2 weeks to relieve foreign body sensation of the throat. Sputum and bronchoalveolar lavage fluid cytology showed the presence of lipid-laden macrophages. He was diagnosed with lipoid pneumonia and acute eosinophilic pneumonia. Chest radiograph and symptom were rapidly improved after treatment with intravenous methylprednisolone.


Subject(s)
Humans , Middle Aged , Hypoxia , Anti-Bacterial Agents , Bronchoalveolar Lavage Fluid , Bronchoscopy , Camellia , Cough , Diagnosis , Dyspnea , Eosinophilia , Eosinophils , Foreign Bodies , Inhalation , Lung , Lung Neoplasms , Macrophages , Methylprednisolone , Mouth , Pharynx , Pneumonia , Pneumonia, Bacterial , Pneumonia, Lipid , Pulmonary Eosinophilia , Radiography, Thoracic , Respiratory Aspiration , Sensation , Sputum
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