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1.
Brasília; s.n; 8 jun. 2020.
Non-conventional in Portuguese | LILACS (Americas), BRISA, PIE | ID: biblio-1100298

ABSTRACT

O Informe Diário de Evidências é uma produção do Ministério da Saúde que tem como objetivo acompanhar diariamente as publicações científicas sobre tratamento farmacológico e vacinas para a COVID-19. Dessa forma, são realizadas buscas estruturadas em bases de dados biomédicas, referente ao dia anterior desse informe. Não são incluídos estudos pré-clínicos (in vitro, in vivo, in silico). A frequência dos estudos é demonstrada de acordo com a sua classificação metodológica (revisões sistemáticas, ensaios clínicos randomizados, coortes, entre outros). Para cada estudo é apresentado um resumo com avaliação da qualidade metodológica. Essa avaliação tem por finalidade identificar o grau de certeza/confiança ou o risco de viés de cada estudo. Para tal, são utilizadas ferramentas já validadas e consagradas na literatura científica, na área de saúde baseada em evidências. Cabe ressaltar que o documento tem caráter informativo e não representa uma recomendação oficial do Ministério da Saúde sobre a temática. Foram encontrados 13 artigos.


Subject(s)
Humans , Pneumonia, Viral/drug therapy , Coronavirus Infections/drug therapy , Betacoronavirus/drug effects , Acetylcysteine/therapeutic use , Technology Assessment, Biomedical , gamma-Globulins/therapeutic use , Immunoglobulins/therapeutic use , Methylprednisolone/therapeutic use , BCG Vaccine , Influenza Vaccines , Famotidine/therapeutic use , Autohemotherapy , Chloroquine/therapeutic use , Colchicine/therapeutic use , Interferon-alpha/therapeutic use , Ritonavir/therapeutic use , Pneumococcal Vaccines , Lopinavir/therapeutic use , Observational Study , Nitric Oxide/therapeutic use
2.
Rev. inf. cient ; 99(1): 3-11, ene.-feb. 2020. tab
Article in Spanish | LILACS (Americas) | ID: biblio-1093924

ABSTRACT

RESUMEN Introducción: En el Hospital General Docente "Dr. Agostinho Neto" de Guantánamo no se han caracterizado las adolescentes maternas ingresadas en la Unidad de Cuidados Intensivos (UCI). Objetivo: Caracterizar la morbilidad materna en adolescentes ingresadas en la UCI del Hospital General Docente "Dr. Agostinho Neto" de Guantánamo durante el año 2019. Método: Se realizó un estudio observacional, prospectivo y transversal, con todas las maternas adolescentes ingresadas en dicha unidad durante el 2019. En cada una se analizó la edad, antecedentes patológicos, estado al egreso, modo de terminar el embarazo, realización de tratamiento quirúrgico, enfermedades relacionadas o no con el embarazo, complicaciones y si se trataron con ventilación mecánica. Resultados: El 18,2 % de las maternas ingresadas fueron adolescentes (3,2 del total de ingresos en la unidad). El 9,7 % recibió ventilación artificial. El 64,7 % tenía entre 18 y 19 años de edad y todas egresaron vivas. El 23,5 % era asmática, el 70,7 % era puérpera e ingresó por enfermedad obstétrica, al 41,2 % se les realizó tratamiento quirúrgico, el más común fue la histerectomía (41,2 %). La preclampsia grave - eclampsia (23,4 %) y la atonía uterina (25,9 %) fueron las enfermedades más comunes. El choque hipovolémico por atonía uterina (23,4 %) determinó el criterio de morbilidad materna severa. El 52,9 % de las pacientes presentó complicaciones. Conclusiones: La morbilidad materna en adolescentes ingresadas en esta UCI reveló que en esta etapa de la vida fue elevada la morbilidad por complicaciones del embarazo, el parto y el puerperio, lo que es un problema de salud no resuelto en la provincia de Guantánamo.


ABSTRACT Introduction: In the General Teaching Hospital "Dr. Agostinho Neto" of Guantanamo have not characterized the maternal adolescents admitted to the Intensive Care Unit (ICU). Objective: To characterize maternal morbidity in adolescents admitted to the ICU of the General Teaching Hospital "Dr. Agostinho Neto"of Guantanamo during the year 2019. Method: An observational, prospective and cross-sectional study was carried out, with all adolescent mothers admitted to said unit during 2019. In each one, age, pathological history, state at discharge, were analyzed. way of terminating pregnancy, performing surgical treatment, diseases related or not to pregnancy, complications and whether they were treated with mechanical ventilation. Results: 18.2% of the mothers admitted were adolescents (3.2 of the total income in the unit). 9.7% received artificial ventilation. 64.7% were between 18 and 19 years old and all graduated alive. 23.5% were asthmatic, 70.7% were poor and admitted for obstetric disease, 41.2% underwent surgical treatment, the most common was hysterectomy (41.2%). Severe preclampsia-eclampsia (23.4%) and uterine atony (25.9%) were the most common diseases. Hypovolemic shock due to uterine atony (23.4%) determined the criterion of severe maternal morbidity. 52.9% of the patients presented complications. Conclusions: Maternal morbidity in adolescents admitted to this ICU revealed that morbidity due to complications of pregnancy, childbirth and the puerperium was elevated at this stage of life, which is an unresolved health problem in the province of Guantanamo.


RESUMO Introdução: No Hospital Geral de Ensino "Dr. Agostinho Neto" de Guantánamo não foram caracterizadas as adolescentes maternas internadas na Unidade de Terapia Intensiva (UTI). Objetivo: Caracterizar a morbidade materna em adolescentes internadas na UTI do Hospital Geral de Ensino "Dr. Agostinho Neto" de Guantánamo durante o ano de 2019. Método: Foi realizado um estudo observacional, prospectivo e transversal, com todas as mães adolescentes internadas nessa unidade durante o ano de 2019. Em cada uma, foram analisadas a idade, história patológica, estado de alta, maneira de interromper a gravidez, realizar tratamento cirúrgico, doenças relacionadas ou não à gravidez, complicações e se foram tratadas com ventilação mecânica. Resultados: 18,2% das mães admitidas eram adolescentes (3,2 da renda total da unidade). 9,7% receberam ventilação artificial. 64,7% tinham entre 18 e 19 anos e todos se formaram vivos. 23,5% eram asmáticos, 70,7% eram pobres e admitidos por doença obstétrica; 41,2% foram submetidos a tratamento cirúrgico; o mais comum foi a histerectomia (41,2%). Pré-eclâmpsia-eclâmpsia grave (23,4%) e atonia uterina (25,9%) foram as doenças mais comuns. O choque hipovolêmico por atonia uterina (23,4%) determinou o critério de morbidade materna grave. 52,9% dos pacientes apresentaram complicações. Conclusões: A morbidade materna em adolescentes internadas nesta UTI revelou que a morbidade por complicações na gravidez, parto e puerpério estava elevada nesta fase da vida, que é um problema de saúde não resolvido na província de Guantánamo.


Subject(s)
Humans , Pregnancy , Adolescent , Pregnancy Complications , Pregnancy in Adolescence , Maternal Mortality , Cross-Sectional Studies , Prospective Studies , Observational Study
3.
Rev. inf. cient ; 99(1): 12-19, ene.-feb. 2020. tab
Article in Spanish | LILACS (Americas) | ID: biblio-1093925

ABSTRACT

RESUMEN Introducción: La sepsis y el choque séptico representan una de las complicaciones más graves durante el puerperio. Objetivos: Identificar los factores asociados a la presentación de sepsis puerperal en las pacientes que ingresaron en el Servicio de Cuidados Intensivos del Hospital General Docente "Dr. Agostinho Neto" durante el período 2017-2018. Método: Se realizó un estudio explicativo-observacional, longitudinal, retrospectivo y tipo caso control. Resultados: La endomiometritis fue la principal causa de ingreso con el 79,5 %. Las variables que se comportaron como predictoras de sepsis puerperal fueron la paridad-multípara, la edad gestacional menor de 37 semanas, el parto por cesárea, el antecedente de preclampsia, de sepsis vaginal y sepsis urinaria, la rotura prematura de membranas y el trabajo de parto mayor a 12 horas. Las variables que constituyeron factores de riesgo independiente para la morbilidad por sepsis grave fueron el exceso de base <- 4 (OR=11,9; IC 95 %; 3,9-35,3; p<0,05) la proteína C reactiva >8 mg/L (OR=9,67; IC 95 %; 5,9-14,24), la SatO2< 75 (OR=6,35; IC 95 %; 1,72-23,4), el anión gap >16 mmol/L (OR=5,88; IC 95 %; 3,86-8,97), el APACHE II y la escala SOFA (Sequential Organ Failure Assessment) al ingreso con el (OR=2,57; IC 95 %; 0,97-6,80) y el (OR=2,67; IC 95 %; 1,95-3,66), respectivamente. Conclusiones: La sepsis puerperal significa una problemática en el Hospital General Docente "Dr. Agostinho Neto" de Guantánamo, por lo que su reconocimiento y tratamiento adecuados son las claves para disminuir la morbilidad por esta causa.


ABSTRACT Introduction: Sepsis and septic shock represent one of the most serious complications during the puerperium. Objective: To identify the factors associated with the presentation of puerperal sepsis in patients admitted to the Intensive Care Service of the General Teaching Hospital "Dr. Agostinho Neto" during the 2017-2018 period. Method: An explanatory, observational, longitudinal, retrospective and case-control study was conducted. Results: Endomyometritis was the main cause of admission with 79.5%. The variables that behaved as predictors of puerperal sepsis were multiparous parity, gestational age under 37 weeks, delivery by caesarean section, history of preclampsia, vaginal sepsis and urinary sepsis, premature rupture of membranes and work of delivery greater than 12 hours. The variables that constituted independent risk factors for severe sepsis morbidity were base excess <- 4 (OR=11.9; 95% CI; 3.9-35.3; p <0.05) protein C reactive> 8 mg/L (OR=9.67; 95% CI; 5.9-14.24), SatO2 <75 (OR=6.35; 95% CI; 1.72-23.4), the gap anion> 16 mmol/L (OR=5.88; 95% CI; 3.86-8.97), APACHE II and the SOFA (Sequential Organ Failure Assessment) scale upon admission with (OR=2, 57; 95% CI; 0.97-6.80) and (OR=2.67; 95% CI; 1.95-3.66), respectively. Conclusions: Puerperal sepsis means a problem at the "Dr. Agostinho Neto" General Teaching Hospital in Guantanamo, so that its recognition and adequate treatment are the keys to reducing morbidity from this cause.


RESUMO Introdução: Sepse e choque séptico representam uma das complicações mais graves durante o puerpério. Objetivo: Identificar os fatores associados à apresentação de sepse puerperal em pacientes internados no Serviço de Terapia Intensiva do Hospital Geral de Ensino "Dr. Agostinho Neto" no período 2017-2018. Método: Estudo explicativo, observacional, longitudinal, retrospectivo e caso-controle. Resultados: A endomiometrite foi a principal causa de admissão com 79,5%. As variáveis que se comportaram como preditores de sepse puerperal foram: paridade multípara, idade gestacional abaixo de 37 semanas, parto por cesariana, história de pré-eclâmpsia, sepse vaginal e sepse urinária, ruptura prematura de membranas e trabalho de parto. entrega superior a 12 horas. As variáveis que constituíram fatores de risco independentes para morbidade grave por sepse foram excesso de base <- 4 (OR=11,9; IC 95%; 3,9-35,3; p<0,05) proteína C reativo> 8 mg/L (OR=9,67; IC 95%; 5,9-14,24), SatO2 <75 (OR=6,35; IC 95%; 1,72-23,4), o ânion de gap> 16 mmol/L (OR=5,88; IC 95%; 3,86-8,97), APACHE II e SOFA (Sequential Organ Failure Assessment) na admissão com (OR=2, 57; IC95%; 0,97-6,80) e (OR=2,67; IC95%; 1,95-3,66), respectivamente. Conclusões: Sepse puerperal representa um problema no Hospital Geral Dr. Agostinho Neto, em Guantánamo, para que seu reconhecimento e tratamento adequado sejam as chaves para reduzir a morbidade por essa causa.


Subject(s)
Humans , Female , Puerperal Infection/etiology , Risk Factors , Case-Control Studies , Retrospective Studies , Longitudinal Studies , Observational Study
4.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-811310

ABSTRACT

PURPOSE: To compare the visual acuity and retinal thickness in patients with an idiopathic epiretinal membrane (ERM) after vitrectomy and membranectomy using two different methods.METHODS: This retrospective observational study included 77 eyes (32 eyes in the diamond-dusted membrane scraper [DDMS] group, and 45 eyes in the intraocular forceps [IOF] group) of 77 patients with idiopathic ERM who underwent pars plana vitrectomy and membranectomy. The main outcome measures were best-corrected visual acuity (BCVA, logMAR) and mean retinal thickness.RESULTS: In the IOF group, the BCVA at postoperative 1 week was significantly lower than at baseline and had improved at 12 weeks after surgery. In the DDMS group, the BCVA at postoperative 1 week showed no significant difference at baseline and had improved at 4 weeks after surgery. The central macular thickness at postoperative 6 months was significantly lower than at baseline (all, p < 0.001); there was no significant difference between the two groups (p = 0.400). The postoperative macular thickness of the DDMS group was significantly lower than that of the IOF group in the inner inferior and outer inferior areas at postoperative 12 weeks and 4 weeks (p = 0.046 and p = 0.039, respectively). Five eyes of the DDMS group and 15 eyes of the IOF group developed cystoid macular edema, 14 eyes of that improved without treatment.CONCLUSIONS: In patients with ERM, the use of DDMS or IOF for vitrectomy and membranectomy both resulted in improved visual acuity and decreased mean retinal thicknesses.


Subject(s)
Epiretinal Membrane , Humans , Macular Edema , Membranes , Observational Study , Outcome Assessment, Health Care , Retinaldehyde , Retrospective Studies , Surgical Instruments , Visual Acuity , Vitrectomy
5.
Article in English | WPRIM (Western Pacific) | ID: wprim-782517

ABSTRACT

This study reports the clinical use of two sevoflurane-based anesthetic techniques in dogs undergoing craniectomy. Twenty-one animals undergoing elective rostrotentorial or transfrontal craniectomy for brain tumor excision, anesthetized with sevoflurane, were enrolled in this retrospective, observational study. Anesthetic records were allocated to two groups: Sevo-Op (sevoflurane and short acting opioid infusion): 8 dogs and Sevo-Dex (sevoflurane and dexmedetomidine infusion): 13 dogs. Average mean arterial pressure (MAP), heart rate, end-tidal carbon dioxide, end-tidal sevoflurane and intraoperative infusion rates during surgery were calculated. Presence of intra-operative and post-operative bradycardia, tachycardia, hypotension, hypertension, hypothermia, hyperthermia was recorded. Time to endotracheal extubation, intraoperative occurrence of atrioventricular block, postoperative presence of agitation, seizures, use of labetalol and dexmedetomidine infusion were also recorded. Data from the two groups were compared with Fisher's exact test and unpaired t tests with Welch's correction. Odds ratio (OR) and 95% confidence interval (CI) were calculated for categorical variables. Intra-operatively, MAP was lower in Sevo-Op [85 (± 6.54) vs. 97.69 (± 7.8) mmHg, p = 0.0009]. Time to extubation was longer in Sevo-Dex [37.69 (10–70) vs. 19.63 (10–25), p = 0.0033]. No differences were found for the other intra-operative and post-operative variables investigated. Post-operative hypertension and agitation were the most common complications (11 and 12 out of 21 animals, respectively). These results suggest that the infusion of dexmedetomidine provides similar intra-operative conditions and post-operative course to a short acting opioid infusion during sevoflurane anesthesia in dogs undergoing elective rostrotentorial or transfrontal intracranial surgery.


Subject(s)
Airway Extubation , Anesthesia , Animals , Arterial Pressure , Atrioventricular Block , Bradycardia , Brain Neoplasms , Carbon Dioxide , Dexmedetomidine , Dihydroergotamine , Dogs , Fever , Heart Rate , Hypertension , Hypotension , Hypothermia , Labetalol , Neurosurgery , Observational Study , Odds Ratio , Retrospective Studies , Seizures , Tachycardia
6.
Article in English | WPRIM (Western Pacific) | ID: wprim-782495

ABSTRACT

BACKGROUND: Medical staff members are concentrated in the intensive care unit (ICU), and medical residents are essentially needed to operate the ICU. However, the recent trend has been to restrict resident working hours. This restriction may lead to a shortage of ICU staff, and there is a chance that regional academic hospitals will face running ICUs without residents in the near future.METHODS: We performed a retrospective observational study (intensivist crossover design) of medical patients who were transferred to two ICUs from general wards between September 2017 and February 2019 at one academic hospital. We compared the ICU outcomes according to the ICU type (ICU with resident management under high-intensity intensivist staffing vs. ICU with direct management by intensivists without residents).RESULTS: Of 314 enrolled patients, 70 were primarily managed by residents, and 244 were directly managed by intensivists. The latter patients showed better ICU mortality (29.9% vs. 42.9%, P = 0.042), lower cardiopulmonary resuscitation (CPR) (10.2% vs. 21.4%, P = 0.013), lower continuous renal replacement therapy (CRRT) (24.2% vs. 40.0%, P = 0.009), and more advanced care planning decisions before death (87.3% vs. 66.7%, P = 0.013) than the former patients. The better ICU mortality (hazard ratio, 1.641; P = 0.035), lower CPR (odds ratio [OR], 2.891; P = 0.009), lower CRRT (OR, 2.602; P = 0.005), and more advanced care planning decisions before death (OR, 4.978; P = 0.007) were also associated with intensivist direct management in the multivariate cox and logistic regression analysis.CONCLUSION: Intensivist direct management might be associated with better ICU outcomes than resident management under the supervision of an intensivist. Further large-scale prospective randomized trials are required to draw a definitive conclusion.


Subject(s)
Cardiopulmonary Resuscitation , Critical Care , Cross-Over Studies , Humans , Intensive Care Units , Internal Medicine , Internship and Residency , Logistic Models , Medical Staff , Mortality , Observational Study , Organization and Administration , Patients' Rooms , Prospective Studies , Renal Replacement Therapy , Retrospective Studies , Running , Survival Rate
7.
Article in English | WPRIM (Western Pacific) | ID: wprim-782487

ABSTRACT

BACKGROUND: An implantable loop recorder (ILR) is an effective tool for diagnosing unexplained syncope (US). We examined the diagnostic utility of an ILR in detecting arrhythmic causes of US and determining which clinical factors are associated with pacemaker (PM) implantation.METHODS: This retrospective, multicenter, observational study was conducted from February 2006 to April 2018 at 11 hospitals in Korea. Eligible patients with recurrent US received an ILR to diagnose recurrent syncope and document arrhythmia.RESULTS: A total of 173 US patients (mean age, 67.6 ± 16.5 years; 107 men [61.8%]) who received an ILR after a negative conventional workup were enrolled. During a mean follow-up of 9.4 ± 11.1 months, 52 patients (30.1%) had recurrent syncope, and syncope-correlated arrhythmia was confirmed in 34 patients (19.7%). The ILR analysis showed sinus node dysfunction in 24 patients (70.6%), supraventricular tachyarrhythmia in 4 (11.8%), ventricular arrhythmia in 4 (11.8%), and sudden atrioventricular block in 2 (5.9%). Overall, ILR detected significant arrhythmia in 99 patients (57.2%) irrespective of syncope. Among patients with clinically relevant arrhythmia detected by ILR, PM implantation was performed in 60 (34.7%), an intra-cardiac defibrillator in 5 (2.9%), and catheter ablation in 4 (2.3%). In a Cox regression analysis, history of paroxysmal atrial fibrillation (PAF) (hazard ratio [HR], 2.34; 95% confidence interval [CI], 1.33–4.12; P < 0.01) and any bundle branch block (BBB) (HR, 2.52; 95% CI, 1.09–5.85; P = 0.03) were significantly associated with PM implantation.CONCLUSION: ILR is useful for detecting syncope-correlated arrhythmia in patients with US. The risk of PM is high in US patients with a history of PAF and any BBB.


Subject(s)
Arrhythmias, Cardiac , Atrial Fibrillation , Atrioventricular Block , Bundle-Branch Block , Catheter Ablation , Defibrillators , Follow-Up Studies , Humans , Korea , Male , Observational Study , Retrospective Studies , Sick Sinus Syndrome , Syncope , Tachycardia
8.
Article in English | WPRIM (Western Pacific) | ID: wprim-782224

ABSTRACT

BACKGROUND: Chronic cough is defined as a cough lasting more than 8 weeks and socio-economic burden of chronic cough is enormous. The characteristics of chronic cough in Korea are not well understood. The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) published guidelines on cough management in 2014. The current study evaluated the clinical characteristics of chronic cough in Korea and the efficacy of the KATRD guidelines.METHODS: This was a multi-center, retrospective observational study conducted in Korea. The participants were over 18 years of age. They had coughs lasting more than 8 weeks. Subjects with current pulmonary diseases, smokers, ex-smokers with more than 10 pack-years or who quit within the past 1 year, pregnant women, and users of cough-inducing medications were excluded. Evaluation and management of cough followed the KATRD cough-management guidelines.RESULTS: Participants with chronic cough in Korea showed age in the late forties and cough duration of more than 1 year. Upper airway cough syndrome was the most common cause of cough, followed by cough-variant asthma (CVA). Gastro-esophageal reflux diseases and eosinophilic bronchitis were less frequently observed. Following the KATRD cough-management guidelines, 91.2% of the subjects improved after 4 weeks of treatment. Responders were younger, had a longer duration of cough, and an initial impression of CVA. In univariate and multivariate analyses, an initial impression of CVA was the only factor related to better treatment response.CONCLUSION: The causes of chronic cough in Korea differed from those reported in other countries. The current Korean guidelines proved efficient for treating Korean patients with chronic cough.


Subject(s)
Asthma , Bronchitis , Cohort Studies , Cough , Diagnosis , Disease Management , Eosinophils , Epidemiology , Female , Gastroesophageal Reflux , Humans , Korea , Lung Diseases , Multivariate Analysis , Observational Study , Pregnant Women , Retrospective Studies , Tuberculosis
9.
Annals of Dermatology ; : 47-52, 2020.
Article in English | WPRIM (Western Pacific) | ID: wprim-782141

ABSTRACT

BACKGROUND: Bowen's disease (BD) is treated by multiple treatment modalities.OBJECTIVE: To assess the effectiveness of photodynamic therapy (PDT) and ingenol mebutate (IMB) in treating BD and determine the factors affecting the treatment outcome.METHODS: Patients with histologically confirmed BD from January 1, 2006, to December 31, 2017, were identified from the database of CHA Bundang Medical Center. Those treated with PDT or IMB were included. Patient, tumor characteristics, and treatment response data were retrospectively collected from the database.RESULTS: Overall, 44 and 24 BD were treated with PDT and IMB, respectively. Mean time to the first follow-up visit was 1.2 (0.5~4) months. Mean follow-up duration was 7.6 (1~36) months. The mean number of treatment sessions for PDT is 2 sessions (1~5), while that of IMB was equally 1 session. The complete response rates at the first follow-up visit were 66.7% and 53.0% and recurrence rates were 10.3% and 15.3% for PDT and IMB, respectively. However, the treatment outcome and recurrence rate between both treatment modalities were not significantly different (p=0.349 and p=0.993, respectively). In factor analysis, the complete response rate significantly decreased with older patients in IMB (p=0.012). Adverse events, occurred in 20.5% and 45.8% of patients treated with PDT and IMB, respectively.CONCLUSION: PDT and IMB are effective noninvasive treatment modalities for BD. However, PDT is a safer treatment modality, considering its fewer adverse events. Particularly, with age being a factor that reduces IMB outcome, in older patients, PDT can be considered as preferred treatments over IMB.


Subject(s)
Bowen's Disease , Follow-Up Studies , Humans , Observational Study , Photochemotherapy , Recurrence , Retrospective Studies , Treatment Outcome
10.
Article in English | WPRIM (Western Pacific) | ID: wprim-782077

ABSTRACT

BACKGROUND AND PURPOSE: The US Food and Drug Administration approval for perampanel has only recently been expanded to patients as young as 4 years, and so there have been few real-life studies of the effects of perampanel in pediatric patients. The aim of this study was to determine the long-term efficacy, factors affecting treatment response, and tolerability of perampanel as an add-on therapy in pediatric patients aged 4 years or older with epilepsy.METHODS: This multicenter retrospective observational study collected data from pediatric epilepsy centers of four Korean national universities. Changes in the seizure frequency from baseline, adverse events, and retention rates were obtained at 3, 6, and 12 months. Adverse events and discontinuation profiles were obtained to assess tolerability.RESULTS: This study included 220 children and adolescents (117 males and 103 females) aged 4 to 20 years. The overall response rate was 43.6%, and the seizure-freedom rate was 17.7%. Factors affecting a good treatment response were the absence of intellectual disability, small number of concomitant antiepileptic drugs, and low baseline seizure frequency. Eighty-eight patients (40%) experienced adverse events, but they mostly were of mild severity and resolved after the dose reduction or discontinuation of perampanel. The retention rates at 3, 6, and 12 months were 85.0%, 71.8%, and 50.5%, respectively.CONCLUSIONS: Adjunctive treatment with perampanel was efficacious and tolerated in pediatric patients aged 4 years or older with epilepsy. Early perampanel treatment may help to reduce the burden of their seizures and improve their quality of life.


Subject(s)
Adolescent , Anticonvulsants , Child , Drug-Related Side Effects and Adverse Reactions , Epilepsy , Humans , Intellectual Disability , Male , Observational Study , Quality of Life , Retrospective Studies , Seizures , Treatment Outcome , United States Food and Drug Administration
11.
Article in English | WPRIM (Western Pacific) | ID: wprim-782044

ABSTRACT

BACKGROUND: The objective of this study was to investigate whether androgen deprivation therapy (ADT) with gonadotropin-releasing hormone agonist (GnRHa) in prostate cancer (Pca) patients is associated with cardiovascular disease in the cohort based from the entire Korean population.METHODS: Using the Korean National Health Insurance database, we conducted an observational study of 579,377 men who sought treatment for Pca between January 1, 2012 and December 31, 2016. After excluding patients with previously diagnosed cardiovascular disease or who had undergone chemotherapy, we extracted the data from 2,053 patients who started GnRHa (GnRHa users) and 2,654 men who were newly diagnosed with Pca (GnRHa nonusers) between July 1, 2012, and December 31, 2012, with follow-up through December 31, 2016. The primary outcomes were cerebrovascular attack (CVA) and ischemic heart disease (IHD).RESULTS: GnRHa users were older, were more likely to reside in rural areas, had lower socioeconomic status, and had more comorbidities than nonusers (all P < 0.050). Although GnRHa users had an increased incidence of CVA and IHD (P = 0.013 and 0.048, respectively) in univariate analysis, GnRHa use was not associated with the outcomes in multivariate analysis. Furthermore, the cumulative duration of ADT was not associated with the outcomes whereas the associations between age at diagnosis with all diseases were significant.CONCLUSION: Our complete enumeration of the Korean Pca population shows that ADT is not associated with increased risks of cardiovascular disease.


Subject(s)
Antineoplastic Agents , Cardiovascular Diseases , Cohort Studies , Comorbidity , Diagnosis , Drug Therapy , Follow-Up Studies , Gonadotropin-Releasing Hormone , Humans , Incidence , Male , Morinda , Multivariate Analysis , Myocardial Ischemia , National Health Programs , Observational Study , Passive Cutaneous Anaphylaxis , Prostate , Prostatic Neoplasms , Social Class
12.
Chonnam Medical Journal ; : 55-61, 2020.
Article in English | WPRIM (Western Pacific) | ID: wprim-787273

ABSTRACT

The optimal dose of beta blockers after acute myocardial infarction (MI) remains uncertain. We evaluated the effectiveness of low-dose nebivolol, a beta1 blocker and a vasodilator, in patients with acute MI. A total of 625 patients with acute MI from 14 teaching hospitals in Korea were divided into 2 groups according to the dose of nebivolol (nebistol®, Elyson Pharmaceutical Co., Ltd., Seoul, Korea): low-dose group (1.25 mg daily, n=219) and usual- to high-dose group (≥2.5 mg daily, n=406). The primary endpoints were major adverse cardiac and cerebrovascular events (MACCE, composite of death from any cause, non-fatal MI, stroke, repeat revascularization, rehospitalization for unstable angina or heart failure) at 12 months. After adjustment using inverse probability of treatment weighting, the rates of MACCE were not different between the low-dose and the usual- to high-dose groups (2.8% and 3.1%, respectively; hazard ratio: 0.92, 95% confidence interval: 0.38 to 2.24, p=0.860). The low-dose nebivolol group showed higher rates of MI than the usual- to high-dose group (1.2% and 0%, p=0.008). The 2 groups had similar rates of death from any cause (1.1% and 0.3%, p=0.273), stroke (0.4% and 1.1%, p=0.384), repeat PCI (1.2% and 0.8%, p=0.428), rehospitalization for unstable angina (1.2% and 1.0%, p=0.743) and for heart failure (0.6% and 0.7%, p=0.832). In patients with acute MI, the rates of MACCE for low-dose and usual- to high-dose nebivolol were not significantly different at 12-month follow-up.


Subject(s)
Angina, Unstable , Follow-Up Studies , Heart , Heart Failure , Hospitals, Teaching , Humans , Hypertension , Korea , Myocardial Infarction , Nebivolol , Observational Study , Receptors, Adrenergic, beta , Seoul , Stroke
13.
BEPA, Bol. epidemiol. paul. (Impr.) ; 196(17): 1-10, 2020. graf
Article in Portuguese | LILACS (Americas), SES-SP, SESSP-CTDPROD, SES-SP | ID: biblio-1096217

ABSTRACT

Introdução: Recentemente, o manejo de pacientes infectados cronicamente pelo vírus da Hepatite C tem progredido, incluindo os antivirais de ação direta (DAAs) de segunda geração, que têm potencial de clarear a infecção em muitos pacientes, especialmente naqueles infectados pelo genótipo 1. Objetivo: Avaliar a resposta virológica sustentada (RVS) ao tratamento para Hepatite C com as drogas de ação direta (DAA) de segunda geração, disponibilizados pelo Ministério da Saúde em pacientes acompanhados por um serviço de saúde da cidade de São Paulo. Métodos: Estudo retrospectivo observacional, baseado em dados secundários obtidos dos sistemas GAL e MEDEX. Foram analisadas 615 amostras de conveniência de pacientes que realizaram tratamento com os DAA de segunda geração no período de junho de 2016 a abril de 2018. Os dados demográficos e clínicos também foram analisados. Resultados: RVS foi observada em 600 pacientes (97,6%). Além disso, 98,4% e 94,7% dos pacientes genótipo 1 e 3, respectivamente, responderam ao tratamento (P = 0.02). Dentre os pacientes que não responderam ao tratamento, 93,3% eram do sexo masculino, virgens de tratamento, e foram tratados por 12 semanas, exceto 1 paciente genótipo 1 e coinfectado com HIV que tratou por 24 semanas. Conclusão: A alta taxa de RVS foi observada para tratamento da Hepatite C com os DAA de segunda geração. A RVS foi significativamente reduzida em pacientes do sexo masculino e infectados pelo genótipo 3, apesar de ainda ser superior a 90%. A coinfecção com o HIV não demonstrou associação com a redução das taxas de RVS (p=0,98). PALAVRAS-CHAVE: Hepatite C crônica


Subject(s)
Therapeutics , Hepatitis C , Observational Study
14.
Article in English | WPRIM (Western Pacific) | ID: wprim-811145

ABSTRACT

BACKGROUND: Diabetes mellitus (DM) is the most common chronic metabolic disorder with an increasing prevalence worldwide. According to a previous study, physicians' treatment patterns or patients' behaviors change when they become aware of the risk for cardiovascular (CV) disease in patients with DM. However, there exist controversial reports from previous studies in the impact of physicians' behaviors on the patients' quality of life (QoL) improvements. So we investigate the changes in QoL according to physicians and patients' behavioral changes after the awareness of CV risks in patients with type 2 DM.METHODS: Data were obtained from a prospective, observational study where 799 patients aged ≥40 years with type 2 DM were recruited at 24 tertiary hospitals in Korea. Changes in physicians' behaviors were defined as changes in the dose/type of antihypertensive, lipid-lowering, and anti-platelet therapies within 6-month after the awareness of CV risks in patients. Changes in patients' behaviors were based on lifestyle modifications. Audit of Diabetes Dependent Quality of Life comprising 19-life-domains was used.RESULTS: The weighted impact score change for local or long-distance journey (P=0.0049), holidays (P=0.0364), and physical health (P=0.0451) domains significantly differed between the two groups; patients whose physician's behaviors changed showed greater improvement than those whose physician's behaviors did not change.CONCLUSION: This study demonstrates that changes in physicians' behaviors, as a result of perceiving CV risks, improve QoL in some domains of life in DM patients. Physicians should recognize the importance of understanding CV risks and implement appropriate management.


Subject(s)
Cardiovascular Diseases , Diabetes Mellitus , Diabetes Mellitus, Type 2 , Holidays , Humans , Korea , Life Style , Observational Study , Prevalence , Prospective Studies , Quality of Life , Risk Management , Tertiary Care Centers
15.
Article in English | WPRIM (Western Pacific) | ID: wprim-811118

ABSTRACT

BACKGROUND: In drug therapy for patients with arthritis, a naproxen/esomeprazole combination drug may be a tolerable choice because it can minimize gastrointestinal and cardiovascular adverse effects. The aim of this study was to investigate the changes in quality of life (QOL), medication adherence, and satisfaction after switch from the existing drug to the combination drug. In addition, we analyzed the correlation between the above-mentioned variables and the stratified demographic and medical data of the patients.METHODS: A prospective, noninterventional, observational study was conducted in 30 hospitals between May 2014 and July 2016. In total, 2,308 patients with osteoarthritis, 99 patients with rheumatoid arthritis, and 76 patients with ankylosing spondylitis were enrolled. Demographic information (age, sex, body mass index [BMI], alcohol consumption, and smoking) and medical information (type of arthritis, duration of disease, and comorbidities) were collected via a self-administered questionnaire. Patients were observed for more than three months after switching to the combination drug. Data on the QOL (EuroQoL 5-Dimension questionnaire [EQ-5D questionnaire]), medication adherence (Morisky Medication Adherence Scale [MMAS]), and satisfaction were collected at the first and last visits.RESULTS: A total of 2,483 patients enrolled at 30 hospitals completed the questionnaire. After the switch to the combination drug, the mean EQ-5D score improved from 0.72 ± 0.17 to 0.79 ± 0.14 (p < 0.001), and significant improvement was associated with female sex (p = 0.016), shorter disease duration (p < 0.001), and absence of comorbidities (p < 0.001). The mean MMAS score was 6.38 ± 1.77, indicating medium adherence. Satisfaction was significantly higher in female patients (p < 0.001), in patients with a shorter disease duration (p < 0.001), osteoarthritis (p = 0.003), and no comorbidities (p < 0.001). Serious drug-related adverse effects did not occur.CONCLUSIONS: The overall QOL was improved with medium adherence after the switch to the combination drug. On the basis of the analysis of stratified data, sex, age, drinking, smoking, disease duration, comorbidities, and BMI might be associated with QOL, satisfaction, and adherence.


Subject(s)
Alcohol Drinking , Arthritis , Arthritis, Rheumatoid , Body Mass Index , Comorbidity , Drinking , Drug Therapy , Female , Humans , Medication Adherence , Naproxen , Observational Study , Osteoarthritis , Prospective Studies , Quality of Life , Smoke , Smoking , Spondylitis, Ankylosing
16.
São Paulo; s.n; 2020. 77 p. ilus.
Thesis in Portuguese | LILACS (Americas), Inca | ID: biblio-1116247

ABSTRACT

Introdução: O Câncer de Pênis configura-se como uma neoplasia maligna do sistema urogenital, diretamente associado ao desenvolvimento socioeconômico de uma população, refletindo dificuldades no acesso ao sistema de saúde e falta de medidas preventivas. Traz consigo sérias implicações de ordem física, emocional, social e familiar. Apresenta desproporcional distribuição geográfica mundial, nacional e regional, com maior magnitude em regiões economicamente desfavorecidas. Sua incidência é maior em homens com idade acima de 50 anos. No Brasil concentra 2% de todos os tipos de câncer masculino, sendo mais frequente nas regiões norte e nordeste. Desta forma, é uma questão de interesse para a saúde pública pelo seu potencial de prevenção por meio de medidas, comportamentais, assistenciais. Seu prognóstico favorável depende da precocidade do diagnóstico em função da estreita relação das características histopatológicas para o adequado tratamento. O conhecimento das características epidemiológicas nacionais, regionais deste câncer é primordial para a proposição de políticas de saúde pública para o seu controle. Objetivos: Conhecer o perfil epidemiológico do Câncer de Pênis no estado de Mato Grosso e os seus aspectos histopatológicos nos pacientes diagnosticados em Mato Grosso e no Hospital do Câncer de Mato Grosso na série histórica de 2010 a 2015 (janeiro a dezembro), estabelecendo associações entre as variáveis analisadas: variáveis demográficas; hábitos de vida e variáveis referentes ao tumor; tratamento, seguimento dos casos e mortalidade por Câncer de Pênis. Materiais e Métodos: Estudo observacional, longitudinal, analítico de caso-controle (série histórica de 2010 a 2015) com a utilização de dados do Registro Hospitalar de Câncer (RHC), prontuários, laudos histopatológicos. A amostra foi composta por homens com Câncer de Pênis diagnosticados em Mato Grosso e especificamente na Fundação Hospital do Câncer de Mato Grosso. A análise dos dados foi por meio do Teste χ2 com significância de 5% (p < 0,05). Resultados: Os resultados da análise dos dados do RHC, revelaram que no período em análise houve o registro de 61 casos de Câncer de Pênis em Mato Grosso sendo 0,68% do total das neoplasias entre os homens, estando aquém dos resultados divulgados pelo INCA que apresenta o Câncer de Pênis com 2,0% do total de câncer entre os homens. Os indígenas no Mato Grosso foram representados por 1,64% dos casos de Câncer de Pênis, resultado superior ao encontrado em vários outros estudos. Os resultados demostraram que 91,8% dos casos foram classificados como Câncer de Pênis SOE, portanto acima do recomendado (< 3,0%). Houve diagnóstico microscópico, em 100%, dos diagnósticos, sendo um indicador positivo (≥ 95,0) pautado nas padronizações nacionais e internacionais do INCA e da Candian Cancer Surveillance. Em relação à mortalidade por Câncer de Pênis em homens residentes em Mato Grosso, o ano de 2012 foi o que apresentou a maior taxa bruta de mortalidade 0,43/100.000 homens), estando acima da taxa bruta de mortalidade por Câncer de Pênis no Brasil no ano de 2018 com 0,33/100.000 homens, caracterizando-se como situação preocupante, por ser um tipo raro de câncer. Os resultados obtidos demonstram que a Fundação Hospital do Câncer de Mato Grosso foi a responsável por atender 71,44% dos casos de Câncer de Pênis ocorridos em Mato Grosso, sendo a localização primária SOE registrada em 92,50% dos casos. Quanto ao tipo histológico 70,0% dos casos era Carcinoma Epidermóide. Os indígenas representaram 2,5%. Quanto à procedência dos pacientes 77,50% era proveniente de regiões do interior do estado. Conclusão: O Câncer de Pênis relaciona-se ao autocuidado, por meio da higiene intima, busca rotineira pelos serviços de saúde, entre outros fatores. Seu prognóstico depende da precocidade do diagnóstico. É reconhecido que o homem utiliza menos os serviços disponíveis na Atenção Básica à Saúde, se comparado com o segmento feminino, o que determina, entre outros fatores o diagnóstico tardio do Câncer de Pênis. Os resultados apresentados, reforçam as razões para exploração dos aspectos epidemiológicos, e proposições políticas para efetivar a prevenção e diagnóstico precoce desta neoplasia na Atenção Básica.


Introduction: Penile Cancer is a malignant neoplasm of the urogenital system, directly associated with the socioeconomic development of a population, reflecting difficulties in accessing the health system and lack of preventive measures. It has serious physical, emotional, social and family implications. It presents a disproportionate geographical distribution worldwide, nationally and regionally, with greater magnitude in economically disadvantaged regions. Its incidence is higher in men over 50 years of age. In Brazil it concentrates 2% of all types of male cancer, being more frequent in the north and northeast regions. Thus, it is a matter of interest to public health because of its potential for prevention through measures, behavioral, assistance. Its favorable prognosis depends on the early diagnosis due to the close relationship of histopathological characteristics for adequate treatment. Knowledge of the national and regional epidemiological characteristics of this cancer is essential for proposing public health policies for its control. Objectives: To know the epidemiological profile of Penile Cancer in the state of Mato Grosso and its histopathological aspects in patients diagnosed in Mato Grosso and at the Cancer Hospital of Mato Grosso (HC) in the historical series from 2010 to 2015 (January to December), establishing associations between the variables analyzed: demographic variables; lifestyle and variables related to the tumor; treatment, follow-up of cases and mortality from Penile Cancer. Materials and Methods: Observational, longitudinal, analytical case-control study (historical series from 2010 to 2015) using data from the Hospital Cancer Registry (RHC), medical records, histopathological reports. The sample consisted of men with Penile Cancer diagnosed in Mato Grosso and specifically at the Cancer Hospital Foundation of Mato Grosso. Data analysis was performed using the χ2 test with a 5% significance level (p <0.05). Results: The results of the analysis of the RHC data revealed that in the period under analysis there was a record of 61 cases of Penile Cancer in Mato Grosso, being 0.68% of the total neoplasms among men, being below the results published by the INCA that presents Penile Cancer with 2.0% of the total cancer among men. The indigenous people in Mato Grosso were represented by 1.64% of the cases of Penile Cancer, a result superior to that found in several other studies. The results showed that 91.8% of the cases were classified as WOS Penile Cancer, therefore above the recommended (<3.0%). There was a microscopic diagnosis, in 100% of the diagnoses, being a positive indicator (≥ 95.0) based on the national and international standards of INCA and Candian Cancer Surveillance. Regarding mortality from Penile Cancer in men living in Mato Grosso, 2012 was the year with the highest gross mortality rate of 0.43 / 100,000 men), being above the crude mortality rate from Penile Cancer in Brazil in 2018 with 0.33 / 100,000 men, characterized as a worrying situation, as it is a rare type of cancer. The results obtained demonstrate that the Hospital do Câncer de Mato Grosso Foundation was responsible for attending 71.44% of the Penile Cancer cases that occurred in Mato Grosso, with the primary WOS location being registered in 92.50% of the cases. As for the histological type, 70.0% of the cases were squamous cell carcinoma. The indigenous represented 2.5%. Regarding the origin of the patients, 77.50% came from the interior of the state. Conclusion: Penile Cancer is related to self-care, through intimate hygiene, routine search for health services, among other factors. Its prognosis depends on the early diagnosis. It is recognized that men use less of the services available in Primary Health Care, when compared to the female segment, which determines, among other factors, the late diagnosis of Penile Cancer. The results presented, reinforce the reasons for exploring the epidemiological aspects, and political proposals to effectively prevent this neoplasia in Primary Care.


Subject(s)
Humans , Male , Penile Neoplasms , Health Profile , Surveys and Questionnaires , Men's Health , Observational Study
18.
Article in English | WPRIM (Western Pacific) | ID: wprim-786071

ABSTRACT

OBJECTIVE: This study investigated whether serum bilirubin levels can predict the progression of carotid atherosclerosis in individuals with type 2 diabetes mellitus (T2DM).METHODS: This observational study included 1,381 subjects with T2DM in whom serial measurements of carotid intima-media thickness (CIMT) were made at 1- to 2-year intervals for 6–8 years. The progression of carotid atherosclerosis was defined as newly detected plaque lesions on repeat ultrasonography. After dividing total serum bilirubin levels into tertiles, the association between total serum bilirubin at baseline and plaque progression status was analyzed.RESULTS: Among 1,381 T2DM patients, 599 (43.4%) were categorized as having plaque progression in their carotid arteries. Those with plaque progression were significantly older; showed a higher prevalence of hypertension, abdominal obesity, and chronic kidney disease; and had a longer duration of T2DM, higher levels of total cholesterol (TC), triglycerides, and insulin resistance, and lower total bilirubin concentrations than those with no plaque progression. When total serum bilirubin levels were divided into tertiles, the highest tertile group was younger than the lowest tertile group, with higher levels of TC and high-density lipoprotein cholesterol. Multiple logistic regression analysis demonstrated that higher serum bilirubin levels were associated with a significantly lower risk of CIMT progression (odds ratio, 0.584; 95% confidence interval, 0.392–0.870; p=0.008). Age (p<0.001), body mass index (p=0.023), and TC (p=0.019) were also associated with the progression of carotid atherosclerosis in T2DM patients.CONCLUSION: Total serum bilirubin is independently associated with progression of atherosclerosis in the carotid arteries in T2DM patients.


Subject(s)
Atherosclerosis , Bilirubin , Body Mass Index , Carotid Arteries , Carotid Artery Diseases , Carotid Intima-Media Thickness , Cholesterol , Diabetes Mellitus, Type 2 , Humans , Hypertension , Insulin Resistance , Lipoproteins , Logistic Models , Obesity, Abdominal , Observational Study , Prevalence , Renal Insufficiency, Chronic , Triglycerides , Ultrasonography
19.
Asia Pacific Allergy ; (4): 9-2020.
Article in English | WPRIM (Western Pacific) | ID: wprim-785456

ABSTRACT

BACKGROUND: Recently, the prevalence of food allergies during childhood is increasing, with fruits being common allergens. However, data on allergens that cause fruit and vegetable allergies and pollen-food allergy syndrome (PFAS) in childhood are relatively few. This study aimed to examine the allergens in fruit and vegetable allergies in pediatric patients and to determine the association between fruit and vegetable allergies and PFAS.OBJECTIVE: This study aimed to examine the current status of fruit and vegetable allergies in Japanese children.METHODS: This was a multicenter case series observational study. The participants included children aged <15 years who developed allergic symptoms after eating fruits and vegetables and subsequently received treatment in the Pediatric Department of 6 hospitals in the Osaka Prefecture in Japan during the study period from August 2016 to July 2017. Participants' information was obtained using a questionnaire, and data were obtained by performing several types of allergy tests using blood samples.RESULTS: A total of 97 children (median age, 9 years; 56 males) were included in the study. Apple was the most common allergen, followed by peach, kiwi, cantaloupe, and watermelon. A total of 74 participants (76%) exhibited allergic symptoms due to PFAS; moreover, pathogenesis-related protein-10 (PR-10) was the most common allergen superfamily. On the contrary, in the group where neither PR-10 nor profilin was sensitized, kiwi and banana were the most common allergens, and the age of onset was lower than that in the PFAS group. Specific antibody titer was significantly associated with Birch for Bet v1 and latex for Bet v2 (r = 0.99 and r = 0.89).CONCLUSION: When we examine patients with fruit and vegetable allergies, we should first consider PFAS even in childhood specifically for children greater than 4 years old.


Subject(s)
Age of Onset , Allergens , Asian Continental Ancestry Group , Betula , Child , Citrullus , Clinical Study , Cucumis melo , Eating , Food Hypersensitivity , Fruit , Humans , Hypersensitivity , Japan , Latex , Musa , Observational Study , Prevalence , Profilins , Prunus persica , Rhinitis , Rhinitis, Allergic, Seasonal , Vegetables
20.
Rev. cuba. angiol. cir. vasc ; 20(2): e385, jul.-dic. 2019. tab, graf
Article in Spanish | LILACS (Americas) | ID: biblio-1003858

ABSTRACT

Introducción: La coordinación entre niveles asistenciales centrada en las enfermedades frecuentes, graves y vulnerables, constituye un elemento esencial para incrementar la eficiencia del sistema sanitario con la ayuda del uso de instrumentos diagnósticos. Objetivo: Validar el Cuestionario de Edimburgo modificado para el diagnóstico de la claudicación arterial periférica en la atención primaria de salud. Métodos: Estudio de evaluación de instrumentos diagnósticos a través de un estudio explicativo observacional de corte transversal, en una muestra de 100 pacientes provenientes de la atención primaria de salud. El período de estudio fue el segundo semestre (julio-diciembre) de 2016. A todos los participantes se les realizó un examen físico vascular, se midieron los índices de presiones tobillo-brazo, se identificó la topografía de las lesiones arteriales de los miembros inferiores, se les aplicó el Cuestionario de Edimburgo modificado y se calculó su sensibilidad, especificidad, valores predictivos positivos y negativos y exactitud diagnóstica. Resultados: El examen físico vascular constató un predominio de la afección fémoro-poplítea (54,8 por ciento) seguido de la aorta-ilíaco (29,9 por ciento). Se obtuvo en la validación del Cuestionario una sensibilidad de 98 por ciento, una especificidad de 31,5 por ciento con alta probabilidad de tener falsos negativos. El valor predictivo positivo fue de 70 por ciento y el negativo de 92 por ciento. La exactitud de las pruebas diagnósticas fue de 73 por ciento, para cada prueba. Conclusiones: El uso del Cuestionario de Edimburgo modificado en la atención primaria de salud es de gran utilidad para establecer el diagnóstico clínico positivo de una claudicación intermitente por enfermedad arterial periférica(AU)


Introduction: Coordination between care levels centered in the severe, frequently and vulnerable diseases constitutes an essential element to increase the efficiency of the health system with the help of diagnostic means. Objective: To validate the modified Edinburgh Questionnaire for the diagnostic of arterial claudication in the primary health care. Methods: An assessment study of diagnostic instruments was done through of a cross-sectional, observational explicative study in a sample of 100 patients from primary health care. The study was conducted in the second semester (July-December) of 2016. A vascular physical exam was performed to all the participants where ankle- brachial pressure index was measured, the topography of the arterial occlusions of the lower limbs was identified, the modified Edinburgh Questionnaire was carried out; and the sensitivity, specificity, positive and negative predictive values and the diagnostic exactitude were calculated. Results: The vascular physical exam exhibited a predominant femoro-popliteal affectation (54,8 percent) followed of the aorta-iliac (29,9 percent). In the validation of the modified Edinburgh Questionnaire it was obtained a sensitivity of 98 percent and an specificity of 31,5 percent with high probabilities of false negative. The positive predictive value was 70 percent and the negative 92 percent. The exactitude of the diagnostic test was 73 percent for each test. Conclusions: The use of the modified Edinburgh Questionnaire in the primary health care is useful to establish the positive clinical diagnostic of an intermittent arterial claudication by Peripheral Arterial Disease(AU)


Subject(s)
Humans , Male , Female , Primary Health Care , Surveys and Questionnaires/standards , Cross-Sectional Studies , Peripheral Arterial Disease/diagnosis , Observational Study , Intermittent Claudication/diagnosis
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