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1.
Goiânia; SES-GO; 12 ago 2020. 1-18 p. ilus, tab, graf, mapas.(Boletim Epidemiológico Covid-19, 19).
Monography in Portuguese | LILACS (Americas), ColecionaSUS, CONASS, SES-GO | ID: biblio-1117152

ABSTRACT

A Secretaria de Estado da Saúde de Goiás através da Superintendência de Vigilância em Saúde e Gerência de Vigilância Epidemiológica, apresentam neste boletim a distribuição de casos confirmados, óbitos e taxa de crescimento de COVID-19 no mundo, no Brasil, no período compreendido entre 31 de dezembro de 2019 a 08 de agosto de 2020. Quanto ao Estado de Goiás apresenta a distribuição dos casos notificados de COVID-19 segundo classificação e critério de confirmação, no período de 04 de fevereiro a 08 de agosto de 2020, a distribuição dos casos confirmados por data de início de sintomas, do acumulado de casos confirmados, dos casos confirmados e média móvel segundo a data de início de sintomas, do acumulado de óbitos, dos óbitos confirmados e média móvel segundo a data de ocorrência do óbito, da distribuição proporcional dos casos confirmados por municípios integrantes da Região metropolitana, do interior e capital, dos casos confirmados e taxa de incidência por município de residência, de casos confirmados por Semana Epidemiológica nas Macrorregiões, distribuição de casos confirmados de COVID-19 por Semana Epidemiológica segundo a região de saúde, número de casos confirmados segundo gênero, faixa etária e taxa de incidência, percentual de casos confirmados segundo raça/cor, casos confirmados segundo evolução, percentual de casos confirmados segundo ocupação, distribuição por município de residência dos óbitos confirmados segundo taxa de letalidade, percentual dos óbitos confirmados por sexo, óbitos confirmados e letalidade segundo faixa etária, casos confirmados que necessitaram de hospitalização segundo a evolução, perfil de gestantes com COVID-19, distribuição dos casos confirmados em gestantes segundo a necessidade de hospitalização, dos casos confirmados em gestantes segundo o local de internação, dos casos confirmados em gestantes segundo evolução, casos confirmados que necessitaram de hospitalização segundo o tempo médio de internação, percentual de casos confirmados por critério laboratorial segundo o método diagnóstico e positividade dos testes RT-PCR liberados pelo LACEN-GO segundo identificação de SARS-CoV-2


The Goiás State Department of Health, through the Health Surveillance Superintendence and Epidemiological Surveillance Management, presents in this bulletin the distribution of confirmed cases, deaths and growth rate of COVID-19 in the world, in Brazil, in the period between 31 from December 2019 to August 8, 2020. As for the State of Goiás, it presents the distribution of notified cases of COVID-19 according to classification and confirmation criteria, in the period from February 4 to August 8, 2020, the distribution of cases confirmed by date of onset of symptoms, cumulative number of confirmed cases, confirmed cases and moving average according to date of symptom onset, accumulated number of deaths, confirmed deaths and moving average according to date of occurrence of death, proportional distribution of confirmed cases by municipalities in the metropolitan region, inland and capital, confirmed cases and incidence rate by municipality of residence, d and confirmed cases by Epidemiological Week in Macroregions, distribution of confirmed cases of COVID-19 by Epidemiological Week according to health region, number of confirmed cases according to gender, age group and incidence rate, percentage of confirmed cases according to race / color, cases confirmed according to evolution, percentage of confirmed cases according to occupation, distribution by municipality of residence of deaths confirmed according to lethality rate, percentage of deaths confirmed by sex, confirmed deaths and lethality according to age group, confirmed cases that required hospitalization according to evolution, profile of pregnant women with COVID-19, distribution of confirmed cases in pregnant women according to the need for hospitalization, confirmed cases in pregnant women according to the place of hospitalization, confirmed cases in pregnant women according to the evolution, confirmed cases that required hospitalization according to the average length of hospitalization , percentage of trusted cases according to laboratory criteria according to the diagnostic method and positivity of the RT-PCR tests released by LACEN-GO according to the identification of SARS-CoV-2


Subject(s)
Humans , Male , Female , Pregnancy , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Brazil/epidemiology , Incidence , Coronavirus Infections/epidemiology , Public Health Surveillance , Epidemiological Monitoring , Health Surveillance , Mortality , Disease Notification , Clinical Laboratory Techniques , Pregnant Women , Continental Population Groups , Diagnosis , Hospitalization , Age Groups
2.
Caracas; Observatorio Nacional de Ciencia, Tecnología e Innovación; ago. 2020. 32-52 p. ilus, tab.(Observador del Conocimiento. Revista Especializada en Gestión Social del Conocimiento, 5, 2).
Monography in Spanish | LILACS (Americas), LIVECS | ID: biblio-1118413

ABSTRACT

Se describe el comportamiento de la COVID-19 en la República Bolivariana de Venezuela durante el período febrero-junio 2020, mediante la caracterización epidemiológica según tiempo, espacio, persona y tipo de transmisión de los casos confirmados y fallecidos por esta enfermedad. Se identifican condiciones relacionadas con la mortalidad. Es un estudio descriptivo, observacional, retrospectivo que utilizó la base de datos de COVID-19 del Sistema Único de Información en Salud (SUIS) del Ministerio del Poder Popular para la Salud (MPPS). Se evidencia que después de la confirmación de los primeros casos, la incidencia se mantuvo estable hasta mediados de mayo, cuando la curva de casos confirmados presentó una inflexión abrupta, lo que se relacionó en gran medida con casos importados. La enfermedad ha afectado en su mayoría a personas del sexo masculino, menores de 40 años, con un elevado porcentaje de forma clínica asintomáticas. La letalidad registrada en el período es menos de 1% y está relacionada a la edad avanzada, presencia de comorbilidades como hipertensión arterial y/o diabetes. Se concluye que la COVID-19 ha afectado mayormente a personas menores de 40 años, con casos relacionados en su mayoría con el regreso de connacionales provenientes de países vecinos, con una proporción importante de casos asintomáticos, lo cual a su vez se encuentra asociado a la baja tasa de complicaciones y de mortalidad por esta enfermedad en Venezuela(AU)


The behavior of COVID-19 in the Bolivarian Republic of Venezuela during the period February - June 2020, is described through the epidemiological characterization according to time, space, person and type of transmission of the confirmed and deceased cases of this disease. Conditions related to mortality are identified. A descriptive, observational, retrospective study used the COVID-19 database of the Unified Health Information System (SUIS) of the Ministerio del Poder Popular para la Salud (MPPS). It is evident that after the confirmation of the first cases, the incidence remained stable until mid-May, when the curve of confirmed cases presented an abrupt inflection, which was largely related to imported cases. The disease has affected mostly male people, under 40, with a high percentage of clinically asymptomatic. The case fatality rate recorded in the period is less than 1% and is related to old age, the presence of comorbidities such as high blood pressure and / or diabetes. It is concluded that COVID-19 has mainly affected people under 40, with cases mostly related to the return of compatriots from neighboring countries, with a significant proportion of asymptomatic cases, which in turn are associated with the low rate of complications and mortality from this disease in Venezuela(AU).


Subject(s)
Humans , Venezuela , Incidence , Mortality , Coronavirus Infections/epidemiology , Comorbidity
3.
Rev. salud pública ; 22(3): e184617, May-June 2020. tab, graf
Article in Spanish | LILACS (Americas) | ID: biblio-1115881

ABSTRACT

RESUMEN Latinoamérica, al igual que el resto del mundo, se está enfrentando actualmente a las consecuencias del envejecimiento poblacional, entre las que se incluye el aumento en la incidencia de neoplasias malignas en adultos mayores, con un subsecuente incremento en la uso de servicios de salud oncológicos. La oncología geriátrica es una disciplina de reciente creación que suma principios geriátricos a los avances oncológicos para ofrecer un tratamiento individualizado a los adultos mayores con cáncer. Este abordaje multidisciplinario actualmente es recomendado en el cuidado oncológico rutinario en adultos mayores. En Latinoamérica existen varias iniciativas asistenciales de enseñanza e investigación en oncología geriátrica; sin embargo, el número de centros especializados y la disponibilidad de personal capacitado en el área es limitada en comparación con los recursos disponibles en países de ingresos altos. En este trabajo se describen recomendaciones internacionales para la implementación de los principios de la oncología geriátrica en la práctica clínica habitual, los centros y recursos con los que se cuenta en Latinoamérica y los retos a futuro para mejorar la atención multidisciplinaria de los adultos mayores con cáncer en la región.(AU)


ABSTRACT Latin America, like the rest of the world, is currently facing the consequences of population aging. Among these consequences is a rise in incidence in malignant neoplasms among older adults, with an anticipated increase in oncologic health service requirements in this population. Geriatric oncology is a recently created discipline which integrates geriatric principles into oncology care to offer older adults with cancer individualized treatments. This multidisciplinary approach is now recommended as part of routine oncology care by international associations. Although several geriatric oncology clinical, educational and research initiatives exist in Latin America, the number and availability of specialized facilities and personnel is limited in comparison to those in high-income regions. In this manuscript, we review international recommendations for the implementation of geriatric oncology principles into routine clinical practice, describe resources available for geriatric oncology in Latin America, and provide recommendations to improve multidisciplinary care for older adults with cancer in the region.(AU)


Subject(s)
Humans , Middle Aged , Aged , Cancer Care Facilities/organization & administration , Aging , Health Services for the Aged/organization & administration , Neoplasms/epidemiology , Incidence , Latin America/epidemiology
4.
Rev. chil. enferm. respir ; 36(1): 51-61, mar. 2020. tab, graf
Article in Spanish | LILACS (Americas) | ID: biblio-1115463

ABSTRACT

La tuberculosis continúa siendo una de las principales causas de morbimortalidad a nivel mundial. En Chile, luego de un período de estancamiento, se ha observado un aumento de casos en los últimos dos años, llegando a una tasa de incidencia de 15,7 casos por 100.000 habitantes en 2018. El estudio busca dilucidar si este aumento es generalizado o si se produce en grupos específicos de la población, y en qué medida corresponde a cambios epidemiológicos u operacionales del programa. Se realizó un estudio descriptivo utilizando datos de fuentes secundarias oficiales para analizar los cambios en el número de casos de tuberculosis en los últimos dos años según áreas geográficas y grupos vulnerables. Además, se analizó el comportamiento de las actividades de pesquisa y diagnóstico de la enfermedad. Se observó aumento de casos en 6 regiones del país, siendo los extranjeros los que aumentan en mayor medida respecto a los otros grupos vulnerables, aunque la incidencia de tuberculosis en este grupo no afecta la incidencia entre los chilenos. La importancia de los extranjeros en el aumento de los casos se produce fundamentalmente en la Región Metropolitana, en cambio en las otras regiones son otros los grupos vulnerables prioritarios. En cuanto a la pesquisa y los métodos diagnósticos, éste puede ser un factor que colabora al aumento de casos en algunas regiones, pero en general no tiene un peso relevante. En conclusión, el aumento de casos de tuberculosis está focalizado a algunas áreas específicas lo que refuerza la importancia de los análisis locales y la definición de estrategias diferenciadas.


Tuberculosis (TB) continues to be one of the leading causes of morbidity and mortality worldwide. In Chile, after a period of stagnation, an increase in cases has been observed in the last two years, reaching an incidence rate of 15.7 per 100,000 inhabitants in 2018. The study seeks to elucidate whether this increase is widespread or if it occurs in specific groups, also if it corresponds to epidemiological or operational changes. A descriptive study was carry on using data from official secondary sources to analyze changes in the number of cases in the last two years according to geographic areas and risk groups. In addition, case finding and diagnosis activities of TB program was analyzed. Increase in cases was observed in 6 regions of the country and foreigner people had the largest increase compared to other risk groups, although the incidence among Chilean is not affected for this fact. The importance of foreigners in the increase of cases occurs mainly in metropolitan region, while in the other regions there are other priority risk groups. Case finding and diagnosis activities may be contribute to increase of cases in some regions, but it does not have a relevant weight in general. In conclusion, the increase of tuberculosis cases is focused on some specific areas, which reinforces the importance of local analysis and the definition of differentiated strategies.


Subject(s)
Humans , Tuberculosis/epidemiology , Tuberculosis/etiology , Risk Groups , Chile/epidemiology , Epidemiology, Descriptive , Incidence , Emigrants and Immigrants
5.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 31-37, Jan.-Mar. 2020. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1090554

ABSTRACT

Abstract Introduction Diseases of the salivary glands are rare in children and adolescents, with the exception of viral-induced infections. Objective To determine the clinical course of the disease, the diagnostic procedures, the treatment and the outcome of all children and adolescents affected with salivary gland diseases at our clinic over a period of 15 years. Methods A retrospective chart review including a long-term follow-up was conducted among 146 children and adolescents treated for salivary gland disorders from 2002 to 2016. Results Diagnosing acute sialadenitis was easily managed by all doctors regardless of their specialty. The diagnosis of sialolithiasis was rapidly made only by otorhinolar- yngologists, whereas diagnosing juvenile recurrent parotitis imposed difficulties to doctors of all specialties - resulting in a significant delay between the first occurrence of symptoms and the correct diagnosis. The severity-adjusted treatment yielded improve- ments in all cases, and a full recovery of 75% of the cases of sialolithiasis, 73% of the cases of juvenile recurrent parotitis, and 100% of the cases of acute sialadenitis. Conclusions Due to their low prevalence and the lack of pathognomonic symptoms, salivary gland diseases in children and adolescents are often misdiagnosed, resulting in an unneces- sarily long period of suffering despite a favorable outcome following the correct treatment.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Salivary Gland Diseases/diagnosis , Salivary Gland Diseases/pathology , Salivary Gland Diseases/therapy , Salivary Gland Diseases/epidemiology , Parotitis/epidemiology , Sialadenitis/epidemiology , Magnetic Resonance Spectroscopy , Salivary Gland Calculi/epidemiology , Tomography, X-Ray Computed , Medical Records , Incidence , Prevalence , Retrospective Studies , Longitudinal Studies , Ultrasonography , Biopsy, Fine-Needle , Germany
6.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 5-10, Jan.-Mar. 2020. tab
Article in English | LILACS (Americas) | ID: biblio-1090555

ABSTRACT

Abstract Introduction The cochlea and the vestibular receptors are closely related in terms of anatomy and phylogeny. Patients with moderate to profound sensorineural hearing loss (MPSHL) should have their vestibular organ functions tested. Objective To evaluate the incidence of vestibular abnormalities in patients with MPSHL and to study the correlation between the etiology of hearing loss (HL) and a possible damage to the labyrinth. Methods A case-control retrospective study was performed. In the case group, 20 adults with MPSHL of known etiology were included. The control group was composed of 15 adults with normal hearing. The case group was divided into 4 subgroups based on the etiology (bacterial meningitis, virus, vascular disease, congenital). Cervical vestibular-evoked myogenic potentials (cVEMPs) were used to rate the saccular function and lower vestibular nerve. Results The study was performed in 70 ears, and it highlighted the presence of early biphasic P1-N1 complex in 29 (71.5%) out of 40 ears in the study group, and in all of the 30 ears in the control group (p = 0.001). Regarding the presence or absence of cVEMPs among the four subgroups of patients with MPSHL, the data were statistically significant (p < 0.001). The comparison between the latencies and amplitude of P1-N1 in case and control groups from other studies and in the four subgroups of cases in the present study did not detect statistically significant differences. Conclusion The present study demonstrates that patients with MPSHL have a high incidence of damage to the labyrinthine organs, and it increases the current knowledge about the etiopathogenesis of sensorineural HL, which is often of unknown nature.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Vestibular Evoked Myogenic Potentials , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/etiology , Hearing Loss, Sensorineural/physiopathology , Audiometry, Pure-Tone , Vascular Diseases/complications , Virus Diseases/complications , Case-Control Studies , Vestibular Diseases/diagnosis , Vestibular Diseases/epidemiology , Incidence , Retrospective Studies , Meningitis, Bacterial/complications , Hearing Loss, Sensorineural/congenital , Labyrinth Diseases/diagnosis , Labyrinth Diseases/physiopathology , Labyrinth Diseases/epidemiology
7.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 72-76, Jan.-Feb. 2020. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1055367

ABSTRACT

Objective: Depression has been associated with hepatitis C, as well as with its treatment with proinflammatory cytokines (i.e., interferon). The new direct-acting antiviral agents (DAAs) have minimal adverse effects and high potency, with a direct inhibitory effect on non-structural viral proteins. We studied the incidence and associated factors of depression in a real-life prospective cohort of chronic hepatitis C patients treated with the new DAAs. Methods: The sample was recruited from a cohort of 91 patients with hepatitis C, of both sexes, with advanced level of fibrosis and no HIV coinfection, consecutively enrolled during a 6-month period for DAA treatment; those euthymic at baseline (n=54) were selected. All were evaluated through the depression module of the Patient Health Questionnaire (PHQ-9-DSM-IV), at three time points: baseline, 4 weeks, and end-of-treatment. Results: The cumulative incidence (95%CI) of major depression and any depressive disorder during DAA treatment was 13% (6.4-24.4) and 46.3% (33.7-59.4), respectively. No differences were observed between those patients with and without cirrhosis or ribavirin treatment (p > 0.05). Risk factors for incident major depression during DAA treatment included family depression (relative risk 9.1 [1.62-51.1]), substance use disorder (11.0 [1.7-73.5]), and baseline PHQ-9 score (2.1 [1.1-3.1]). Conclusions: The findings of this study highlight the importance of screening for new depression among patients receiving new DAAs, and identify potential associated risk factors.


Subject(s)
Humans , Male , Female , Adult , Aged , Antiviral Agents/therapeutic use , Hepatitis C/psychology , Hepatitis C/drug therapy , Depressive Disorder/epidemiology , Psychiatric Status Rating Scales , Ribavirin/therapeutic use , Spain/epidemiology , Time Factors , Logistic Models , Incidence , Prospective Studies , Risk Factors , Treatment Outcome , Hepatitis C/epidemiology , Middle Aged
8.
Article in Portuguese | LILACS (Americas) | ID: biblio-1097199

ABSTRACT

Objetivos: prever a tendência epidemiológica de casos e óbitos do COVID-19 no Brasil e, especificamente, em Mato Grosso, por meio do modelo estatístico duplo exponencial. Métodos: para a realização deste trabalho, foram utilizados dados de casos e óbitos do COVID-19 fornecidos pelo Ministério da Saúde do Brasil e Secretaria de Estado de Saúde de Mato Grosso, e, para realizar as previsões com esses dados, foi utilizada a técnica estatística de séries temporais, considerando o modelo exponencial duplo, e para o processamento dos dados, foi utilizado o programa MINITAB V 17. Resultados: os resultados mostram que os valores ajustados pelo modelo exponencial duplo transformado dos casos e óbitos estão muito próximos dos valores observados de COVID-19 no Brasil e, principalmente, em Mato Grosso, no período considerado, indicando que esse modelo é adequado para os dados em estudo, o qual foi verificado, prevendo alguns valores com seus respectivos intervalos de confiança de 95%. Conclusões: a possibilidade de se estimar, pautado em análises estatísticas, o número de casos e óbitos de COVID-19 que ocorrerá no Brasil e no estado de Mato Grosso poderá instrumentalizar os gestores para o planejamento de ações estratégicas de prevenção, monitoramento e controle da pandemia.(AU)


Objective: to predict the epidemiological trend of COVID-19 cases and deaths in Brazil and Mato Grosso state using the double exponential statistical model. Methods: in order to carry out this work, data on cases and deaths from COVID-19 provided by the Ministry of Health of Brazil and the State Secretariat of Health of Mato Grosso were used and to make the predictions with these data, the time series statistical technique was used, considering the double exponential model and the MINITAB V 17 program was used for data processing. Results: the results show that the values adjusted by the double exponential transformed model of cases and deaths are very close to the observed values of COVID-19 in Brazil and Mato Grosso, in the period considered, indicating that this model is suitable for the data under study, which was verified by predicting some values with their respective 95% confidence intervals. Conclusions: the possibility of estimating, based on statistical analysis, the number of cases and deaths of COVID-19 that will occur in Brazil and in the state of Mato Grosso, may instrumentalize the managers for the planning of strategic actions for prevention, monitoring and control of pandemic.(AU)


Subject(s)
Humans , Death Certificates , Coronavirus Infections/mortality , Coronavirus Infections/epidemiology , Brazil , Time Series Studies , Incidence
9.
J. Health Biol. Sci. (Online) ; 8(1): 1-7, 20200101. ilus
Article in Portuguese | LILACS (Americas) | ID: biblio-1118382

ABSTRACT

Objectve: To analyze the incidence and lethality of COVID-19 in Brazil, through a historical series. Methods: Retrospective ecological study carried out by analyzing biweekly time series with secondary data from Brazilian regions and states, was on the state and integral health sites of the State of Health and IntegraSUS, related to SARS-CoV disease, from March to May 2020. Results: All states showed an increasing incidence trend, except Ceará. The highest lethality found was from Piauí. However, in the last analyzed period, the states of Rio de Janeiro, Pernambuco, São Paulo and Ceará stood out. The North had an increased incidence in relation to the others and the Southeast had the highest lethality rate. Conclusion: There was an increasing trend in incidence in all states, except Ceará. Piauí had the highest lethality coefficient. Considering the regions, the North showed an increasing trend in incidence and lethality was higher in the Southeast.


Objetivo: Analisar a incidência e letalidade do COVID-19 no Brasil, por meio de uma série histórica. Métodos: Estudo ecológico, retrospectivo, realizado mediante a análise de séries temporais quinzenais com dados secundários de regiões e estados brasileiros. Os dados foram coletados nos sites das secretarias de saúde estaduais e no IntegraSUS, relacionados à doença SARS-CoV, de março a maio de 2020. Resultados: Todos os estados apresentaram uma tendência crescente de incidência, exceto o Ceará. A maior letalidade encontrada foi no Piauí. No entanto, no último período analisado, destacaram-se os estados do Rio de Janeiro, Pernambuco, São Paulo e Ceará. O Norte teve maior incidência em relação aos demais e o Sudeste, a maior taxa de letalidade. Conclusão: Houve uma tendência crescente de incidência em todos os estados, exceto no Ceará. O Piauí apresentou o maior coeficiente de letalidade. Considerando as regiões, o Norte mostrou uma tendência crescente de incidência e a letalidade foi maior no Sudeste.


Subject(s)
Coronavirus Infections , Coronavirus , Incidence , Mortality , SARS Virus
10.
Blood Research ; : 27-34, 2020.
Article in English | WPRIM (Western Pacific) | ID: wprim-820806

ABSTRACT

BACKGROUND: Although T-cell-replete hematopoietic cell transplantation (HCT) from haploidentical donors (HIDs) using anti-thymocyte globulin (ATG) has shown promising outcomes, previous studies often adopted heterogenous graft sources and conditioning.METHODS: We retrospectively compared HCT outcomes from 62 HIDs, 36 partially-matched unrelated donors (PUDs), and 55 matched unrelated donors (MUDs) in patients with acute leukemia or myelodysplastic syndrome using the same graft source of peripheral blood and a reduced intensity conditioning of busulfan, fludarabine, and ATG.RESULTS: The estimates of 3-yr disease-free survival (DFS) and overall survival (OS) rates were not significantly different among the MUD, HID, and PUD groups, at 46%, “41%, and 36%” for the DFS rate (P=0.844), and 55%, 45%, and 45% for the OS rate (P=0.802), respectively. Cumulative incidence of relapse and non-relapse mortality at 3 yr was similar among different donor types. Subsequent multivariable analyses showed that the sex of the patient (male) and a high/very high disease risk index were independently associated with poorer DFS and OS, while the donor type was not.CONCLUSION: T-cell replete HCT from HIDs using an ATG-containing reduced intensity conditioning regimen may be a reasonable option in the absence of matched related donors in patients with acute leukemia or myelodysplastic syndrome.


Subject(s)
Antilymphocyte Serum , Busulfan , Cell Transplantation , Disease-Free Survival , Humans , Incidence , Leukemia , Mortality , Myelodysplastic Syndromes , Recurrence , Retrospective Studies , T-Lymphocytes , Tissue Donors , Transplants , Unrelated Donors
11.
Blood Research ; : 44-48, 2020.
Article in English | WPRIM (Western Pacific) | ID: wprim-820804

ABSTRACT

BACKGROUND: Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is a known cause of morbidity and mortality after bariatric surgery. However, the data concerning appropriate thromboprophylaxis after bariatric surgery is uncertain. The objective of this study was to evaluate the efficacy and safety of extended duration thromboprophylaxis in post-bariatric surgery patients.METHODS: We conducted a retrospective study of consecutive patients who underwent bariatric surgery from November 2014 to October 2018 at King Fahad General Hospital in Jeddah, Saudi Arabia. All included patients were treated with extended duration thromboprophylaxis.RESULTS: We identified 374 patients who underwent bariatric surgery during the study period. Of these, 312 patients (83%) were followed for at least 3 months. The most common type of surgery was a laparoscopic sleeve gastrectomy (N=357) and the median weight was 110 kg. The cumulative incidence of symptomatic postoperative VTE at 3 months was 0.64% (95% confidence interval, 0.20–1.52). All events occurred after hospital discharge. The most commonly used pharmacological prophylaxis (91%) for VTE prevention after bariatric surgery was enoxaparin 40 mg subcutaneously twice daily for 10–14 days after hospital discharge. There were no reported cases of bleeding or VTE related mortality after 3 months.CONCLUSION: Extended thromboprophylaxis after bariatric surgery appears to be an effective and safe strategy for VTE prevention. Large prospective studies are needed to evaluate the optimal thromboprophylaxis regimen after bariatric surgery.


Subject(s)
Bariatric Surgery , Enoxaparin , Gastrectomy , Hemorrhage , Hospitals, General , Humans , Incidence , Mortality , Prospective Studies , Pulmonary Embolism , Retrospective Studies , Saudi Arabia , Venous Thromboembolism , Venous Thrombosis
12.
Article in English | WPRIM (Western Pacific) | ID: wprim-816633

ABSTRACT

The increased incidence of thyroid cancer is a worldwide phenomenon; however, the issue of overdiagnosis has been most prominent in South Korea. The age-standardized mortality rate of thyroid cancer in Korea steeply increased from 1985 to 2004 (from 0.17 per 100,000 to 0.85 per 100,000), and then decreased until 2015 to 0.42 per 100,000, suggesting that early detection reduced mortality. However, early detection of thyroid cancer may be cost-ineffective, considering its very high prevalence and indolent course. Therefore, risk stratification and tailored management are vitally important, but many prognostic markers can only be evaluated postoperatively. Discovery of preoperative marker(s), especially for small cancers, is the most important unmet clinical need for thyroid cancer. Herein, we discuss some such factors that we recently discovered. Another unmet clinical need is better treatment of radioiodine-refractory (RAIR) differentiated thyroid cancer (DTC) and undifferentiated cancers. Although sorafenib and lenvatinib are available, better drugs are needed. We found that phosphoglycerate dehydrogenase, a critical enzyme for serine biosynthesis, could be a novel therapeutic target, and that the lymphocyte-to-monocyte ratio is a prognostic marker of survival in patients with anaplastic thyroid carcinoma or RAIR DTC. Deeper insights are needed into tumor-host interactions in thyroid cancer to improve treatment.


Subject(s)
Humans , Incidence , Korea , Medical Overuse , Mortality , Phosphoglycerate Dehydrogenase , Prevalence , Prognosis , Serine , Thyroid Carcinoma, Anaplastic , Thyroid Gland , Thyroid Neoplasms
13.
Article in English | WPRIM (Western Pacific) | ID: wprim-816617

ABSTRACT

BACKGROUND: Pheochromocytomas and paragangliomas (PPGLs) are rare endocrine tumors originating from chromaffin cells. PPGLs are associated with a high mortality rate and several complications. To date, no epidemiological studies have been conducted on PPGLs in Asia. This study aimed to investigate the epidemiology and prognosis of PPGLs in Korea using nationwide data.METHODS: Using the National Health Insurance Service Database, subjects with a principal diagnosis of PPGLs on two or more occasions between 2003 and 2014 who satisfied the operational definition of PPGLs were included. Incidence, prevalence, complications, metastasis, and mortality were investigated.RESULTS: In total, 1048 subjects with a mean age of 47.6±16.1 years were included. There was no sex preponderance. The overall prevalence of PPGLs was 2.13 per 100,000 persons, and the overall age-standardized incidence rate was 0.18 per 100,000 person-years. Malignant PPGLs accounted for 17.7% (185 of 1,048) of cases, and 94 subjects exhibited metastasis at the time of diagnosis. Among initially non-metastatic PPGLs, 9.5% (nine of 954) eventually metastasized after a mean duration of 78.1±41.4 months. The 5-year survival rates for non-metastatic and metastatic PPGLs at diagnosis were 97% and 84%, respectively. Multivariable Cox regression models adjusted for covariates showed that metastatic PPGLs were associated with a 2.40-fold higher risk of mortality than non-metastatic PPGLs (95% confidence interval, 1.38 to 4.17; P=0.002).CONCLUSION: PPGLs are rare in Korea, and the prognosis of these endocrine tumors varies depending on whether they are benign or malignant. This epidemiological study paves the way for further research on PPGLs.


Subject(s)
Asia , Chromaffin Cells , Diagnosis , Epidemiologic Studies , Epidemiology , Humans , Incidence , Korea , Mortality , National Health Programs , Neoplasm Metastasis , Paraganglioma , Pheochromocytoma , Prevalence , Prognosis , Survival Rate
14.
Article in English | WPRIM (Western Pacific) | ID: wprim-816604

ABSTRACT

BACKGROUND: The weather has well-documented effects on infectious disease and reports suggest that summer peaks in the incidences of gram-negative bacterial infections among hospitalized patients. We evaluated how season and temperature changes affect bloodstream infection (BSI) incidences of major pathogens to understand BSI trends with an emphasis on acquisition sites.METHODS: Incidence rates of BSIs by Staphylococcus aureus, Enterococcus spp., Escherichia coli, Klebsiella pneumoniae, Acinetobacter spp., and Pseudomonas aeruginosa were retrospectively analyzed from blood cultures during 2008–2016 at a university hospital in Seoul, Korea according to the acquisition sites. Warm months (June–September) had an average temperature of ≥20℃ and cold months (December–February) had an average temperature of ≤5℃.RESULTS: We analyzed 18,047 cases, where 43% were with community-onset BSI. E. coli (N = 5,365) was the most common pathogen, followed by Enterococcus spp. (N = 3,980), S. aureus (N = 3,075), K. pneumoniae (N = 3,043), Acinetobacter spp. (N = 1,657), and P. aeruginosa (N = 927). The incidence of hospital-acquired BSI by Enterococcus spp. was weakly correlated with temperature, and the median incidence was higher during cold months. The incidence of community-onset BSI by E. coli was higher in warm months and was weakly correlated with temperature.CONCLUSION: We found seasonal or temperature-associated variation in some species-associated BSIs. This could be a useful information for enhancing infection control and public health policies by taking season or climate into consideration.


Subject(s)
Acinetobacter , Climate , Climate Change , Communicable Diseases , Enterococcus , Escherichia coli , Gram-Negative Bacterial Infections , Humans , Incidence , Infection Control , Klebsiella pneumoniae , Korea , Pneumonia , Pseudomonas aeruginosa , Public Health , Retrospective Studies , Seasons , Seoul , Staphylococcus aureus , Tertiary Care Centers , Weather
15.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-811448

ABSTRACT

PURPOSE: The first aim of this study was to retrospectively survey sports injuries among 608 athletes participating in 26 sport events. The second aim was to compare the characteristics of sports injuries depending on the occurrences during the high school and university periods.METHODS: The data were collected based on the daily injury report form proposed by the International Olympic Committee from March to June 2019.RESULTS: Four hundred and thirty-nine athletes (313 men) of 608 participated athletes experienced a total of 747 sports injuries, indicating 0.7 injuries per 1,000 athlete exposures (AEs). The incidence rate during the university period was 6.1 injuries/1,000 AEs, which was approximately two-fold higher than that during the high school period (2.8 injuries/1,000 AEs). The reported frequency of injuries was the highest among long distance athletics (n=60, 8.0%), and in each subgroup as well.CONCLUSION: Many more injuries were incurred during practice wherein injuries in long-distance athletics were the most common than in competition athletics; handball injuries and taekwondo injuries were the most common during high school and university, respectively. The most contact injuries occurred in taekwondo and most noncontact injuries occurred in gymnastics during high school and in badminton during university. The most commonly affected body parts were the knee, shoulder, and ankle. Severe injuries were the most frequent in long distance athletics, and emergent situations were the most common in taekwondo.


Subject(s)
Ankle , Athletes , Athletic Injuries , Gymnastics , Human Body , Humans , Incidence , Knee , Racquet Sports , Retrospective Studies , Shoulder , Sports
16.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-811446

ABSTRACT

Optimal bowel preparation is essential for a more accurate, comfortable, and safe colonoscopy. The majority of postcolonoscopy colorectal cancers can be explained by procedural factors, mainly missed polyps or inadequate examination. Therefore the most important goal of optimal bowel preparation is to reduce the incidence of colorectal cancer. Although adequate preparation should be achieved in 85–90% or more of all colonoscopy as a quality indicator, unfortunately 20–30% shows inadequate preparation. Laxatives for oral colonoscopy bowel preparation can be classified into polyethylene glycol (PEG)-electrolyte lavage solution, osmotic laxatives, stimulant laxatives, and divided into high-volume solution (≥3 L) and low-volume solution (<3 L). The updated 2019 European Society of Gastrointestinal Endoscopy (ESGE) guideline is broadly similar to the 2014 American Society for Gastrointestinal Endoscopy (ASGE) recommendations and reaffirms the importance of split-dosing. However, new ESGE guideline, unlike the 2014 ASGE recommendation, suggests the use of high volume or low volume PEG-based regimens as well as that of non-PEG based agents that have been clinically validated for most outpatient scenarios. For effective, safe, and highly adherent bowel preparation, physicians who prescribe and implement colonoscopy should properly know the advantages and limitations, the dosing, and the timing of regimens. Recently many studies have attempted to find the most ideal regimens, and more convenient, effective, and safe regimens have been developed by reducing the dosing volume and improving the taste. The high tolerability and acceptability of the new low-volume regimens suggest us how we should use it to increase the participation of the national colorectal cancer screening program.


Subject(s)
Colonoscopy , Colorectal Neoplasms , Endoscopy, Gastrointestinal , Humans , Incidence , Laxatives , Mass Screening , Outpatients , Polyethylene Glycols , Polyps , Therapeutic Irrigation
17.
Article in English | WPRIM (Western Pacific) | ID: wprim-811441

ABSTRACT

Hepatic hydrothorax is a transudative pleural effusion that complicates advanced liver cirrhosis. Patients refractory to medical treatment plus salt restriction and diuretics are considered to have refractory hepatic hydrothorax and may require transjugular intrahepatic portosystemic shunt (TIPS) or liver transplant. Successful antiviral therapy reduces the incidence of some complications of cirrhosis secondary to HCV infection. We report a case of hepatic hydrothorax in a 55-year-old female patient with HCV cirrhosis, which exhibited a spontaneous decrease in pleural effusion after direct antiviral agent (DAA) therapy. In cases of HCV cirrhosis, DAAs are worth administering before treatment by TIPS or liver transplantation.


Subject(s)
Antiviral Agents , Diuretics , Female , Fibrosis , Hepacivirus , Hepatitis C, Chronic , Hepatitis, Chronic , Humans , Hydrothorax , Incidence , Liver , Liver Cirrhosis , Liver Transplantation , Middle Aged , Pleural Effusion , Portasystemic Shunt, Surgical
18.
Article in English | WPRIM (Western Pacific) | ID: wprim-811430

ABSTRACT

OBJECTIVES: The purpose of this study was to determine the incidence of radix molaris (RM) (entomolaris and paramolaris) in the mandibular first permanent molars of a sample Saudi Arabian subpopulation using cone-beam computed tomography (CBCT).MATERIALS AND METHODS: A total of 884 CBCT images of 427 male and 457 female Saudi citizens (age 16 to 70 years) were collected from the radiology department archives of 4 dental centers. A total of 450 CBCT images of 741 mature mandibular first molars that met the inclusion criteria were reviewed. The images were viewed at high resolution by 3 examiners and were analyzed with Planmeca Romexis software (version 5.2).RESULTS: Thirty-three (4.5%) mandibular first permanent molars had RM, mostly on the distal side. The incidence of radix entomolaris (EM) was 4.3%, while that of radix paramolaris was 0.3%. The RM roots had one canal and occurred more unilaterally. No significant difference in root configuration was found between males and females (p > 0.05). Types I and III EM root canal configurations were most common, while type B was the only RP configuration observed.CONCLUSIONS: The incidence of RM in the mandibular first molars of this Saudi subpopulation was 4.5%. Identification of the supernumerary root can avoid missing the canal associated with the root during root canal treatment.


Subject(s)
Cone-Beam Computed Tomography , Dental Pulp Cavity , Female , Humans , Incidence , Male , Molar , Prevalence
19.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-811372

ABSTRACT

OBJECTIVES: This study examined the association of the total diet quality with the incidence risk of metabolic syndrome constituents and metabolic syndrome among Korean adults.METHODS: Based on a community-based cohort of the Korean Genome and Epidemiology Study (KoGES) from 2001 to 2014, data from a total of 5,549 subjects (2,805 men & 2,744 women) aged 40~69 years at the baseline with a total follow-up period of 38,166 person-years were analyzed. The criteria of the National Cholesterol Education Program Adult Treatment Panel was employed to define metabolic syndrome. The total diet quality was estimated using the Korean Healthy Eating Index (KHEI). Hazard ratios (HR) and 95% confidence intervals (CI) for risk of metabolic syndrome constituents and metabolic syndrome in relation to KHEI quintile groups was calculated by multivariate Cox proportional hazards regression model.RESULTS: After adjusting for age, energy intake, income, education, physical activity, smoking, and drinking, the incidence of abdominal obesity and high blood pressure was significantly lower, by approximately 29.7% (P < 0.01) and 25.2% (P < 0.01), respectively, in the fifth KHEI quintile compared to the first quintile in men. A significant decreasing trend of the metabolic syndrome incidence was observed across the improving levels of KHEI (HRq5vs.q1: 0.775, 95% CIq5vs.q1: 0.619~0.971, P for trend < 0.01). In women, the incidence of abdominal obesity and metabolic syndrome was significantly lower, by approximately 29.8% (P < 0.01) and 22.5% (P < 0.05), respectively, in the fifth KHEI quintile compared to the first quintile adjusting for multiple covariates. On the other hand, the linear trend of metabolic syndrome risk across the KHEI levels did not reach the significance level.CONCLUSIONS: A better diet quality can prevent future metabolic syndrome and its certain risk factors among Korean men and women.


Subject(s)
Adult , Cholesterol , Cohort Studies , Diet , Drinking , Eating , Education , Energy Intake , Epidemiology , Female , Follow-Up Studies , Genome , Hand , Humans , Hypertension , Incidence , Male , Obesity, Abdominal , Physical Education and Training , Prospective Studies , Risk Factors , Smoke , Smoking
20.
Korean Circulation Journal ; : 302-316, 2020.
Article in English | WPRIM (Western Pacific) | ID: wprim-811370

ABSTRACT

Percutaneous pulmonary valve implantation (PPVI) is recognized as a feasible and low risk alternative to surgery to treat dysfunctional right ventricular outflow tract (RVOT) in usually pluri-operated patients. Evolving technology allowed to develop different kind of prosthesis and to go from an initial treatment exclusively of stenotic conduit to an actual approach extended also to wide native RVOT. The Melody transcatheter pulmonary valve (TPV) and the Edwards Sapien valve are nowadays the most commonly implanted prostheses. However, other devices have been developed to treat large RVOT (i.e., the Venus p-valve, the Medtronic Harmony TPV, the Alterra Adaptive Prestent, and the Pulsta valve). Indications for PPVI are the same as for surgical interventions on pulmonary valve, with limits related to the maximum diameter of the available percutaneous prosthesis. Therefore, an accurate preoperative evaluation is of paramount importance to select patients who could benefit from this procedure. The overall periprocedural mortality incidence is around 1.4%, while freedom from RVOT reintervention ranges from 100% at 4 months to 70% at 70 months, according to the different published studies.


Subject(s)
Freedom , Heart Defects, Congenital , Humans , Incidence , Mortality , Prostheses and Implants , Pulmonary Valve , Venus
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